PTSD as an Outcome of Childhood Abuse

Originally, Post Traumatic Stress Disorder was recognized and diagnosed in returning war veterans.  Now, it is recognized as an outcome from a traumatic situation. In fact, new research postulates that PTSD can result from events that may not seem too severe.

Diagnostic and Statistical Manual of the American Psychiatric Association V5, has refined the diagnostic criteria of PTSD, but it now lists two sets of criteria – one for anyone over six and another for children under 6. This confirms that PTSD can occur in very young children and results in symptoms strong enough to be observed and measured.  If you have time to spare, feel free to read about the new criteria here.

For all of us, a traumatic event has some natural repurcussions. When our sense of safety is shattered, it’s normal to feel numb, or disconnected, depressed or ‘out of control’. Bad dreams, obsessive thoughts about the experience and overwhelming fear are all normal reactions to events that are beyond our normal life.  For most people, these feelings are short-lived and gradually dissipate. With PTSD, the feelings don’t lift and get worse with time. And since you feel ‘crazy’ you are not likely to talk to anyone about the event or your emotional reactions.

Children who experience trauma may lack the vocabulary to express what happened, may not be believed if they speak out or may have been told it’s their fault.  Latest research shows that abuse and/or trauma affect brain development, causing structural abnormalities in the frontal lobe, home to our emotions. Over time, these changes in the brain may result in personality deficits if not recognized and treated. (See http://www.upliftprogram.com/article_ptsd.html)

To diagnose PTSD there must be the presence or threat of a traumatic event, experienced or observed. It can also occur from hearing about a friend’s experience or observation. It is common in those who are exposed to the details of such events (police officers, firemen and paramedics reading reports).

While everyone experiences PTSD differently (and the DSM – V has more detailed criteria), there are three main symptoms:

1.  Flashbacks (re-experiencing the traumatic event): The re-living of traumatic events in the moment.  They can be precipitated by an external event (the sound of footsteps in the hall) or a jogged memory.  They feel ‘crazy’ and disorienting because of ‘feeling’ back in that moment in time.  To work thru them, remind yourself that you are an adult and are safe now. Breathe slowly but naturally. Consciously slow down your alarm response. Sometimes wrapping yourself in a blanket or holding a pillow can help.  If you’re in public, grab hold of something, (a chair or a desk) plant your feet firmly on the ground and take a couple of deep breaths, and remind yourself that you are an adult, you are in a safe place and that all is well.

Bad memories can also occur as bad dreams.  If they occur regularly, remind yourself before you go to sleep, that should a bad dream occur, you will wake up immediately.  (This will take practice but can be learned.) Then follow the suggestions above to soothe and calm yourself.

 2.  Avoiding reminders of the trauma – At its simplest, PTSD is the ‘storing away’ of bad memories which are too difficult to assimilate, integrate and release.  Because we need to deal with them, they pop up, usually at inopportune times.  From the desire (Conscious or sub-conscious) to keep the memories at bay sufferers may try to avoid reminders of the trauma.  So they won’t go near a specific house, or will avoid certain types of people. Or will only sleep in locked rooms or high windows.  Making love in certain positions may cause panic attacks. Ditto for the shower hitting your face. 

 The list is endless and applies to the person’s need to feel safe and avoid the memories.  Ironically, often there is no knowledge of why I can only sleep in a room with a locked door, but that’s my truth and so I live that way. 

Most of us have seen TV programs where a car backfiring throws a veteran into a flashback.  But this is not necessarily the only type of trigger.  For abuse survivors, triggers are often more personal and less obvious.  I regularly hear from clients who can’t sleep in their parents’ home or at grandma’s house.  The smell of a barn or a new vehicle can be triggers.  As they try to avoid any stimulus that might trigger their memories, the risk is that their world becomes smaller and smaller.  And they get more and more stuck in the drive to keep the memories at bay. And worst of all, along with this symptom is the inability to remember the original trauma.

 3. Increased anxiety and emotional arousal: Over time, clients with PTSD often have trouble falling asleep, or once asleep, they can’t stay asleep.  Or if they do sleep, it is a light, shallow sleep that is not restorative. Sufferers are usually hyper vigilant – they know where everyone is around them, all the time.  I had a client who could empty a handful of change from his pocket, along with all the other paraphernalia men carry, and seemingly drop it on the nightstand.  He could always tell if any of it had been moved – even 24 hours later! This kind of vigilance consumes lots of energy and is exhausting.  It exacerbates the lack of sleep. 

Many people with PTSD have an exaggerated startle effect, so a slamming door will be much more jarring to them.  Usually they are more sensitive to noise (banging plates as the table is set) and loud voices.  And because of their heightened state of awareness, they may have trouble concentrating.  Often misdiagnosed as ADHD, PTSD clients do not find relief with the drugs or therapies for that syndrome because the cause is different.

If you consider a person who isn’t getting enough sleep, who is easily startled and who is always aware of what is going on around them (by the way, they often have amazing peripheral vision), what would be the expected outcome?  You got it!  Irritability and a bad temper are common in PTSD sufferers.  But when considered in the context of PTSD, anger and irritability are perfectly logical outcomes.

Not everyone who is sexually abused gets PTSD, but it is very common.  It begins from a need to put the originating trauma at a distance, but ironically creates many problems.  It is treatable with therapy and occasionally, medication.

Remember the rules of this blog: No diagnosis.  But if some of these symptoms match your experience, contact a mental health professional who can help you determine what’s going on and start you on the road to healing.

Additional information came from: http://www.upliftprogram.com/article_ptsd.html and

http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm

Questions? Comments?  Did this raise the hair on the back of your head?  Let me know and I’ll repond.

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About Louise Behiel

Author, coach, therapist, mother and grandmother. I'm on a spiritual journey and consciously work to grow every day.
This entry was posted in child abuse, Louise Behiel, Sexual Abuse and tagged , , . Bookmark the permalink.

51 Responses to PTSD as an Outcome of Childhood Abuse

  1. Roxy Boroughs says:

    Thanks, Louise. Another fascinating blog.

  2. Fantastic insight and information as always, Louise! And once again, I’m reminded of people I know. How do people with PTSD overcome that hyper-vigilance that interferes with sleep? (Do they??)

    • They do recover, August, but it’s a long slow process. For severe sufferers, medication is available. But for those who odn’t choose to use meds, then meditation, relaxation tapes and warm herbal tea help. All in combination with Therapy to get the memories out and exposed to an adult’s point of view.

  3. The Foothills Hospital in Calgary (and likely most large urban hospitals) have a fabulous program to deal with the sleep issues that may be caused by PTSD, including nightmare therapy and re-training your sleep habits. It is a long process but so worth it for a peaceful life and restful nights of sleep. Louise, you are filling such a huge need in bringing these issues into the light and encouraging people to seek help rather than just ‘putting up with’ conditions like PTSD. Thanks.

  4. This is really helpful to me. I’ve thought for awhile that I had PTSD. It’s something to look into.

  5. Wonderful info here. This will be especially helpful as I am getting ready to write a story with a character who has PTSD or thinks he does.

  6. Amy Jo Fleming says:

    Another excellent post Louise. I think that PTSD can also really affect the spouses and families of the sufferers. In a way, its like alcoholism. If the husband can’t sleep, then neither can the wife. If the dad can’t sleep and is miserable, then the kids feel like there is something wrong with them. Dad doesn’t like any of them, let alone anyone best. For so many of the boomer generation, Dad came home from the war changed, withdrawn and angry. Mom was always exhausted and depressed. And the kids learn to be careful and silent.

    Even if the kids reach a level of understanding and forgiveness, how do they learn to enjoy life? I am interested in your thoughts Louise.

    • Very good questions, Amy Jo. Obviously, I think the children and mom and dad need to do therapy of some sort. PTSD has some wonderful medical outcomes now with drugs, therapy and mindfulness training. Sometimes, it’s too late for the vets – PTSD is most successfully treated in the early stages – the sooner the better. But for the children, these leanred behaviors can be overturned and overcome. again, it takes time and energy but it is possible. I know that because I’ve worked with a few of them.

      totally heartbreaking Amy Jo. Thanks for sharing.

  7. Reading your blog is research for the next book in the series I’m working on. My wounded heroine fits right into everything you’ve been saying.

    As always, very good information.

    Patricia Rickrode
    w/a Jansen Schmidt

  8. Fascinating and insightful.

  9. lynnkelleyauthor says:

    Your posts are so insightful, Louise. Very sad, though, when I think of so many people dealing with this condition. It’s hard to fathom children having to deal with such horrible circumstances. Thankfully there are people like you who are there to help them. 🙂

  10. colourtheday says:

    Thanks for an interesting post.
    It is interesting to see that the criterias are changing, and I believe (haven’t checked though) that Complex PTSD will enter the hierarchy of related diagnoses, and be a more important subject for future research. How to heal, is an even more interesting subject 🙂

  11. Terrel Hoffman says:

    Louise, I’m really enjoying your thoughtful posts. Thank you for letting SavvyAuthors subscribers know they’re available. I wouldn’t have found you otherwise. I have a question that you might or might not have an answer for. How does PTSD affect the Amygdala? Does such an affect complicate treatment outcomes?

    • Terrel, I love SavvyAuthors – what a great group. You haven’t asked an easy question and I need to qualify my response by saying I’m not a brain specialist but here’s what I understand: When we are frightened, the brain kicks out lots of hormones to trigger fight or flight. they in turn affect the Amygdala and cause us to remember those events more clealry. Way back when, that would have been a survival technique but now…not so much. But it is part of why we hold onto fearful memories for so long. The other thing that is becoming clear is that these traumatic events actually change the structure of the brain – for both adults and children. If recognized soon enough, those changes can be reversed by healing the PTSD but if not, they may be permanent. HOw’s that for a long answer to a short question? if I’ve confused you, let me know and I’ll take another run at it.

      cheers

  12. jeffssong says:

    Actually, it’s not just “PTSD” – it’s “C-PTSD” as defined by the DSM “no perceivable escape” – because what child can escape their childhood? I know as a child my brother and I figured out there was no escape – none at all – forever (or at least until we grew up). Here’s some blog entries I wrote on exactly this sort of subject:
    http://jeffssong.wordpress.com/2011/04/11/childhood-ptsd-unrecognized-undertreated
    http://jeffssong.wordpress.com/2012/02/28/c-ptsd-and-me
    and to give a child’s view of that world of “C-PTSD” –
    http://jeffssong.wordpress.com/2011/05/09/nowhere-to-run-nowhere-to-hide

    Hope this helps you and others on defining this all important – and too long ignored subject of Childhood PTSD as well as Childhood C-PTSD – since it appears I’ve gone through it.

    • thanks for the clarification. the DSM -V did not specify the difference but I’m sure it will in the final version.

      • jeffssong says:

        🙂 I think the folks who are developing those definitions just haven’t considered the consequences of childhood and abuse and the inability for a child to escape – it’s taken them *this* long to even consider applying a “PTSD” label to a childhood trauma! And the thing is: labels don’t cure someone. They just help others to understand, albeit a bit; not much.

  13. I have dealt with some things in my life that likely caused some degree of PTSD, but was only diagnosed after the car accident. Unfortunately, due to several therapies at the same time, I never followed through with what the doctor recommended. Partly because I just couldn’t deal with anything else at the time…and partly because it sounded a little ridiculous. Have you ever heard of ‘tapping’ as a way to overcome it?

    • Kristy, I know people who swear by ‘tapping’, otherwise known as Emotional Freedom Technique. I tried a time or two (after a blog somewhere) with little success (are you surprised?). so I can’t recommend it, but some people love it.

      • LOL…glad I didn’t waste my time on it then. Although I still tend to get a little (sometimes a LOT) nervous at intersections, worried that someone else might run a red light or stop sign, it’s not bad enough that I’d seek treatment for it. Your post just reminded me of it and I thought I’d ask.

        Someday you’ll have to explain how, exactly, it’s supposed to work, because the explanations I got three and a half years ago just made it sound weird. 🙂

  14. Thank you again for such a wonderfully resourceful post! Love the WANA logo btw 😉

  15. I’ve been Dxd with PTSD before. In fact, I have layers of it from various life events – not the least of which is some of my long-term exposure in child protective services. A lot of folks in emergency services work end up with PTSD from the traumas they deal with every day. Some of it resolves, but the issues with sleeping require meds and the hyper-alert thing is probably going to be with me for life. Not all bad. I’m hard to sneak up on even though I have major hearing problems. And despite the major hearing problems a loud, abrupt sound I can hear is likely to send me through the roof. I bet you also find most of us are safety conscious as well.

    Kristy, I’ve used a variety of things to deal with various PTSD issues. I’ve tried EFT (works if you do it all the time, works better with a trained EFT therapist). NLP (It is the granddaddy of EFT and works better but is very expensive). I’ve done desensitization work on some issues – batiks and the empty chair – gestalt thing on others. Overall, if it didn’t cost so bloody much I’d say a highly skilled Neurolinguistic Programmer like like Richard Bandler is the best investment. Takes little time, keep the memory/lesson and lose the trauma. Of course, if we figure in therapy time over years then paying a few thousand for a desensitization quick fix over a short period of time pretty much equals out. You can read the book, “Using Your Mind For a Change” and see what you think.

    • Our provincial government has just authorized our Workers Compensation to include PTSD for first responders as a covered injury from work. it’s about time, although we’re the first province in canada to do that.

  16. Forgot to add that the Red Book of Adult Children of Alcoholics (and Dysfunctional Families) addresses PTSD in some of the kid from those families. Likely most of us.

  17. Vanessa says:

    This is just a theory I have, but… adults who were abused as children are more likely to get involved in abusive relationships as adults. However, adult abuse victims are revictimized by a society and a psychotherapy industry that places the blame for ‘accepting abuse’ on the victim, and doesn’t ‘punish’ the abuser. Domestic Violence is more often than not considered a ‘civil matter’, and when an woman with an abusive husband seeks shelter, she is treated as though she needs to be held to a curfew because she can’t make proper choices as evidenced by the fact that she ‘allowed’ this man to abuse her. I believe that this injustice is a major cause of PTSD associated with abuse.

    • You raise some good points but I don’t completely agree with everything you’ve said Vanessa. Childhood abuse victims tend to swing either toward abusive partners or totally away from them. I have clients who have never been in a relationship because they’re afraid of who they’d choose (not healthy but common). there are also victims who become abusers. I don’t know of a single therapist who would blame the victim. Usually victims come to me feeling responsible – that they asked for it, somehow. I see a big part of my job with those clients is to help them move from responsibility to accepting they were victimized. but there are all kinds of therapists out there and not all of them agree with me. but I’d never recommend one who blamed the victim. I can’t speak to women being in shelters because I don’t work with that population. However, most of the people I know who work with abused women know that their biggest challenge is to get the woman to stay away from her abuser. the sense of responsibility for the abuse, the conditioning that the violence has perpetrated on the victim and probably her background make leaving a very hard decision. staying gone is even harder. But once the decision has been made, it’s the most dangerous time for the victim – going back may cost them their life.

      thanks so much for stopping by and sharing your opinions. we totally agree that abuse is a cause of PTSD – regardless of where it happens or by whom.

  18. Pingback: What’s going on: Mental Health Miscellany « Circadian Design

  19. Eli Lilly made $65 billion on the Zyprexa franchise.Lilly was fined $1.4 billion for Zyprexa fraud!
    The atypical antipsychotics (Zyprexa,Risperdal,Seroquel) are like a ‘synthetic’ Thorazine,only they cost ten times more than the old fashioned typical antipsychotics.
    These newer generation drugs still pack their list of side effects like diabetes for the user.All these drugs work as so called ‘major tranquilizers’.This can be a contradiction with PTSD suffers as we are hyper vigilant and feel uncomfortable with a drug that puts you to sleep and makes you sluggish.
    That’s why drugs like Zyprexa don’t work for PTSD survivors like myself.
    -Daniel Haszard FMI http://www.zyprexa-victims.com

  20. Rmarsh says:

    I was diagnosed a while back with PTSD from growing up in a verbally, mentally and physically abusive alcoholic home. A lot of secrecy and all that good stuff. Well, I started going to aalanon a few years back, therapy and it has made wonderful changes in my life. I have lost a lot of my resentments and worked the steps. This past December I was diagnosed with ADHD and have been taking medication for it which greatly improved my depression and concentration… I do however have a question…

    I feel the medication has helped me focus better but I think it might have given me tunnel vision. My emotions were a lot more controllable but somewhat bland… which for me, was really nice. Well, the past month I have noticed depression symptoms creeping back in due to life circumstances. Both from family and other things. Last week, my entire body shut down. I feel like I am paralyzed, numb, takes a great deal of energy to speak. I feel like I damn near put myself into a coma. Does this happen to people with PTSD?

    I didn’t think I was being affected by everything going on but I guess I was…? Wondering if there’s a reason from PTSD that can cause someone later in life to subconsciously shut down their entire body?

    Thank you very much.

    • Not that I am aware of. Please be sure to see your doctor or prescribing professional and talk about your symptoms. sometimes the very medications that help soothe us can cause long term effects on us emotionally. I wouldn’t guess about your situation, but I know that none of us can coast through experiences without emotion. So talk to some of your experts and handle your health carefully. You’ve survived some of the worst that life has to give us as children, so don’t let them win…get what you need to live a successful life. and that’s not shutting down. Good luck and keep us posted.

      • Rmarsh says:

        Thanks so much, Louise. I appreciate your fast response. It’s funny how ‘one day at a time’ is easy with my medication and yet other things build without me noticing. An experience I have taken much from without a doubt.

  21. Rmarsh says:

    I was diagnosed a while back with PTSD from growing up in a verbally, mentally and physically abusive alcoholic home. A lot of secrecy and all that good stuff. Well, I started going to aalanon a few years back, therapy and it has made wonderful changes in my life. I have lost a lot of my resentments and worked the steps. This past December I was diagnosed with ADHD and have been taking medication for it which greatly improved my depression and concentration… I do however have a question…

    I feel the medication has helped me focus better but I think it might have given me tunnel vision. My emotions were a lot more controllable but somewhat bland… which for me, was really nice. Well, the past month I have noticed depression symptoms creeping back in due to life circumstances. Both from family and other things. Last week, my entire body shut down. I feel like I am paralyzed, numb, takes a great deal of energy to speak. I feel like I damn near put myself into a coma. Does this happen to people with PTSD?

    I didn\’t think I was being affected by everything going on but I guess I was…? Wondering if there\’s a reason from PTSD that can cause someone later in life to subconsciously shut down their entire body?

    Thank you very much.

    • there’s lots of possible reasons for the situation and symptoms you’re describing. i’d suggest you see your physician as soon as possible. tell him or her whats going on and see if there’s any other drugs that can help you. good luck

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