PTSD and the Believer

Ιt has been said, “Be kind, for everyone you meet is fighting a battle.” Post-traumatic stress disorder, or PTSD, is one such condition that requires our empathy for those fighting this battle.

It is estimated that about nine percent of Canadians will suffer from PTSD in their lifetimes and that Canada has one of the highest incidences in the world. What is PTSD and what can we do to help those, especially fellow believers, that are suffering with this disorder?

From the name of the condition itself, PTSD has to do with the psychological aftermath of a traumatizing event in a person’s life. If we read Deuteronomy 20:1-9, we can understand some of the psychological effects of warfare. It is then not surprising that the most common example would be related to psychological symptoms as a result of battlefield combat situations. Reviewing military history, PTSD symptoms can be noted after many battles, but it was during World War I that the term “shell shock” was popularized to describe similar symptoms that today we refer to as PTSD. The psychological aftermath for thousands of veterans from the Vietnam War contributed to the inclusion of PTSD as a diagnosable psychiatric illness in 1980.

Types of trauma that could lead to PTSD include serious accidents, physical or sexual assault, childhood or domestic abuse, exposure to traumatic events, serious health problems (such as an emergency admission), and childbirth experiences (such as losing a baby). The largest group of PTSD sufferers are victims of sexual assault. This likely explains why the female to male ratio for PTSD is 2:1. In addition to PTSD, trauma survivors often develop mood disorders, such as depression and anxiety. It should be noted that only 20 percent of people that undergo a traumatic event actually develop PTSD, but this would still involve a relatively high number since approximately 70 percent of all people are exposed to at least one traumatizing event in their lifetime.

It must be acknowledged that PTSD can have a profound effect on the everyday life of anyone afflicted but can also affect the believer in their spiritual life. It could lead believers to doubt the goodness of God in that they were allowed to go through the traumatic event; it could affect how believers interact with others, including other believers, and it could affect them in their ability to fully engage in assembly life.

The DSM-5 is a guide accepted worldwide, released by the American Psychiatric Association, that describes criteria to diagnose psychiatric illnesses. The following is a summary of the criteria needed before a health professional diagnoses PTSD. These criteria need to be met for at least one month and must be known to cause distress or functional impairment: There must be a “stressor,” which may include direct exposure or witnessing of trauma, learning that a relative or close friend was exposed to trauma or indirect exposure to aversive details of the trauma. There must be an “intrusion symptom,” which includes unwanted, upsetting memories, nightmares, flashbacks, emotional distress or physical symptoms after exposure to traumatic reminders. There must be at least two “negative alterations in thoughts and mood,” which can include inability to recall key features of the trauma, overly negative thoughts, exaggerated blame of self or others causing the trauma, negative affect, decreased interest in activities and feeling isolated. Finally, there must be irritability or aggression, risky or destructive behavior, hypervigilance, a heightened startle reaction, difficulty concentrating or difficulty sleeping.

The two main treatments available for PTSD are professional counseling and antidepressant medication. Medication, such as selective serotonin reuptake inhibitors (SSRIs), are beneficial for about half of the people with PTSD, but professional counseling is noted to be more effective. In patients that I have treated with this disorder, a combination of medication and counseling is often employed. Part of the therapy that I provide includes validating that the patient is not alone in his or her suffering, and empathically accepting their experiences as they try to deal with everyday life. Sometimes, by having patients reconstruct the traumatic experiences in a very detailed way, it can help patients “free” themselves from a lot of the associated negative feelings they have stemming from the traumatizing event.

In addition to the medical and psychiatric treatment of this disorder, how can we, as believers, be a help to those suffering from this disorder?

If you are a believer suffering from PTSD, please do not suffer in silence. A good point of contact would be your family doctor, who should be able to direct you to the care available for this condition. Also, as a believer, our God is always there to turn to. We cannot always understand why believers are called to not only go through traumatic events but to mentally suffer from them afterwards. However, there is no question that God understands what you are going through. In 1 Peter 5:7, we read, “Casting all your care upon Him, for He cares for you” (NKJV; see also Psa 27:14; 55:22; Heb 13:5). There also may be fellow believers or other friends that God can raise up to come alongside to be a help to you in your time of need. However, it is important that you find support from those you can trust and rely upon for their confidentiality.

Unfortunately, like many other mental health disorders, PTSD is generally “hidden.” Those believers afflicted with this problem, because of the stigma of mental health, do not want to disclose their problem except possibly to a small circle of close friends. This is true especially in the case of women if the trauma has involved a sexual assault, which has an additional societal stigma. On the other hand, if we are aware that a fellow believer has been through a traumatic event (e.g., a severe vehicular collision), we should try to be a help from the start. In this case, we should recognize that not everyone who undergoes a traumatic event develops PTSD, but to be aware of any changes in our fellow believer in case the time comes that support is needed. With any type of mental health disorder, we should never underestimate the value of a friend’s “listening ear.”

In closing, I will refer to my opening statement, which stresses the importance of how we relate with our fellow believers. We are generally unaware of what many believers are going through, which should give us pause to be “gentle” in our interactions. In 1 Thessalonians 2:7 Paul wrote, “But we were gentle among you, even as a nurse cherisheth her children” (KJV; see also 2Ti 2:24; Titus 3:2). Believers who suffer from PTSD are certainly in this class and would greatly benefit from our empathy and care.