PTSD In The United States: Symptoms, Prevalence, And Treatment Options

Historically associated with military personnel and people in high-risk jobs such as EMTs and firefighters, post-traumatic stress disorder (PTSD) was formerly referred to as “shell shock” and is typically viewed as an illness resulting from war or fighting. Over the past years, we have come to understand that shell shock is in fact PTSD, and it can affect anyone who experiences trauma, regardless of age, gender, or ethnicity.

Although there is more awareness around the subject of PTSD, including PTSD awareness month every June, there are also some misconceptions and misinformation about the disorder. In this article, we'll discuss the symptoms of PTSD, as well as PTSD prevalence in those with high-risk careers, survivors of sexual abuse, and youth. Treatment options are available for people living with PTSD, and online therapy can provide a safe space to discuss disturbing thoughts or imagery with a professional, licensed counselor.

What is PTSD and what are the symptoms?

In the U.S., it is thought that 70% of Americans have experienced at least one traumatic event in their lifetime. Of these individuals, 20% (roughly 44.7 million Americans) have previously struggled or continue to struggle with symptoms of PTSD, a mental illness that can develop after someone witnesses or experiences life-threatening events. 

According to the National PTSD Awareness Day organization experts, at any given time in the past year, the prevalence of PTSD in adults living in America has been about 8%. Some of the symptoms include:

Although PTSD is not gender-specific, some gender differences do exist among people living with PTSD. Some studies reveal that PTSD prevalence is higher in men, compared to women. Men are three times more likely to experience a traumatizing event. However, other studies find that the lifetime prevalence of PTSD is twice as high for women, compared to men.

What’s with the variation? The research on this is not entirely sure; however, it may be linked to the fact that women are more likely to report experiencing traumatizing sexual events while men are more likely to have a higher lifetime prevalence of combat-related events or serious accidents.

PTSD and high-risk careers

Many individuals have careers in which they inevitably experience more traumatic events than the general population. Below are some careers with high-risk factors and the highest rates of PTSD:

• Military personnel: Many military veterans or soldiers develop PTSD after returning from combat where they experienced a dangerous event or a series of dangerous events. The estimates vary widely depending on the type of conflict, but statistics from a study of National Guard soldiers who served in the Iraq and Afghanistan conflicts estimate between 9% and 31% for PTSD in adults faced with military conflict.
• Police officers:The development of PTSD in police officers varies widely depending on the officer's daily duties, whether they've had to use their firearm in the line of duty, and how high the crime rate is where they serve. Some studies estimate that 15-18% of police officers experience PTSD. Exact rates are difficult to obtain since many departments unfortunately do not have adequate resources for officers and many people are simply unaware that they have symptoms.

• Firefighters:The prevalence of PTSD among firefighters has been estimated at 20%, and that rate is possibly higher for volunteer firefighters. Statistics will vary based on how firefighters experience traumatic events. Additional contributing factors include regular exposure to trauma, performing in life-threatening scenarios, and working long hours with inadequate sleep.
• Emergency medical services:First responders are often called to the site of gruesome car accidents, homicides, natural disasters, and other potentially disturbing scenes. They very often witness death and trauma. Many of these individuals experience burnout from long shifts and additional stressors. It is estimated that roughly 22% of EMS professionals show all or most of the symptoms of PTSD.

Given today's awareness around PTSD, most of the careers listed above place a high priority on mental well-being and wellness. If you are working in one of these areas and are concerned about your mental or physical health, you can reach out to Human Resources or the Personnel Unit at your workplace to find out what resources are available. Your place of employment ideally has a team of counselors in place to help and support you, whether you just want to vent about a bad day or talk about PTSD symptoms. In fact, you are strongly encouraged to speak to a therapist on a regular basis because it allows you to express your feelings and find a healthy release from the trauma you may be witnessing regularly.

PTSD in veterans

Not long ago, combat-induced PTSD was thought to be a sign of weakness in soldiers; World War I and World War II war veterans were viewed as not being “tough enough” to handle the perils of war. Thankfully, most higher-ups in the military and the US Department of Veterans Affairs (VA) have dispelled this myth through initiatives like the National Center for PTSD. They're now at the forefront of providing treatment to current military personnel and veterans.

Statistics show that the vast majority of United States Army and Marine soldiers who served in Iraq experienced stressors such as seeing dead bodies (95%), being shot at (93-97%), being attacked or ambushed (89-95%), receiving rocket or mortar fire (86%-92%), or knowing someone who was killed or seriously injured (87%). U.S. soldiers serving in Afghanistan experienced similar traumas, although to a lesser extent. Among soldiers who served in Iraq and Afghanistan, the VA estimates in their veteran statistics that 10-18% of returning soldiers are likely to develop PTSD.

There are several factors which increase the likelihood that a soldier will develop PTSD:

• Serving longer deployment times
• Being exposed to severe combat
• Getting deployed to “forward” areas close to the enemy
• Seeing others wounded, killed, or facing serious injury
• Experience severe physical injury or a traumatic brain injury
• Having a lower rank and/or level of schooling
• Feeling low morale and having poor social support within the unit
• Not being married
• Having difficulty with family problems or a lack of support systems back home
• Being part of the National Guard or Reserves
• Having prior exposure to trauma
• Identifying as female
• Being Hispanic

Military PTSD statistics have also gathered rates of PTSD for veterans from other wars. Between 1986 and 1988, about 31% of men and 27% of women who served in Vietnam were found to have symptoms of PTSD. More than 30 years later, many Vietnam vets still experience PTSD. Of those who served in high-combat zones, 17% of Vietnam vets over age 60 and 22% under age 60 still live with PTSD. In addition, information shows that approximately 12% of Gulf War veterans are impacted by PTSD.

Veterans are encouraged to contact a health professional and seek help to minimize their symptoms and begin to treat PTSD. No matter how long it has been, it is never too late to get help.

PTSD from sexual trauma

Men, women, and children can all experience significant trauma from sexual abuse, which can ultimately result in the development of PTSD or other mental illnesses. Some statistics are below:

• Of the estimated 683,000 women who are raped annually, 94% experience symptoms of PTSD in the first two weeks after the rape while 30% report symptoms approximately nine months later.
• One out of every 10 rape survivor is male.
• Men who are raped are much more likely to develop PTSD compared to non-abused men.
• One in four girls and one in six boys are survivors of some form of child sexual abuse.
• Children who are sexually abused may develop PTSD immediately or years after abuse, sometimes well into their twenties or thirties.
• Children who have been abused may show behavioral problems, inappropriate sexual behaviors, depression, or substance use.

Anyone can experience abuse. It is still difficult for many to speak out about sexual abuse as there are negative perceptions about what being abused means and what it says about you. Regardless of your gender or the type of abuse you experience, seeking help and getting the treatment you need is imperative to your future well-being.

PTSD in children and teens

Although PTSD is more common in adults than in other age groups, some events can cause PTSD in children and teens. These may include:

• Witnessing natural disasters or death
• Grieving a friend’s death after they died violently or by suicide
• Being a survivor of physical or sexual abuse
• Witnessing or surviving a car accident

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

On average, Child Protective Services receives calls out of concern for 7.1 million children. Of those, 30% have experienced abuse in the form of neglect (65%), physical abuse (18%), sexual abuse (10%), and mental abuse (7%).

These numbers don't consider all the children who are witnesses to family violence and abuse, nor do they account for other types of abuse that might go unreported. According to the National Center for PTSD, up to 40% of girls and boys experience at least one trauma as a child or teen. Of these, 3-15% of girls and 1-6% of boys develop PTSD. 

Factors that increase the chance of developing PTSD include the severity of the trauma, how the parents reacted to the potentially traumatic event, the child or teen's physical proximity to the trauma, and the support they received (possibly in the form of adolescent psychiatry) following the trauma.

For example, numerous studies investigated the rates of PTSD in children after the 9/11 terrorist attacks, discovering that rates of PTSD were much higher for children near ground zero (up to 35%) compared to other schoolchildren living in New York City (10-18%). The rates of PTSD were also higher among children who witnessed their parents crying or who watched the attacks on television.

Given all of this, it cannot be emphasized enough how important it is to seek treatment not only for PTSD in adults but also for PTSD in children and teens. Early intervention and timely treatment can make a world of difference, especially where children are concerned.

Seeking treatment for PTSD

PTSD is not the same for everyone. With PTSD, people may experience varying levels of impairment. PTSD can impact a person’s ability to cope. That’s why it’s so important for adults and children to learn a diagnosis and seek treatment quickly.

A PTSD diagnosis is made by a professional therapist using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V). This manual is trusted by medical professionals to diagnose everything from anxiety disorders and substance use disorders to PTSD or a variety of other mental illnesses, including co-occurring conditions. 

Receiving a diagnosis of PTSD can be very scary. You may feel anxious about what mental illness means for you or your family, or hopeless at the thought of living with PTSD. Thankfully, PTSD is highly treatable. With the right treatment and support, you can go on to live a happy, fulfilling, and successful life, moving beyond distressing memories. 

Studies have shown that within six weeks of starting psychotherapy treatment, 46% of people with PTSD show improvement in their symptoms while 62% see improvement after taking medication. Mental health professionals use cognitive behavioral therapy (CBT) as a method for alleviating PTSD symptoms in children or adolescents who have witnessed potentially traumatic events. CBT focuses on identifying and understanding what the issue is before changing the individual's thoughts patterns and reactions to the trauma.

For American adults the main way of treating PTSD is also through psychotherapy, specifically:

• CBT places focus on how the individual views themselves, the world around them, and the people around them after they endure the trauma. How has it affected you? Shifted your perspective? It then looks at helpful ways to process the thoughts surrounding the trauma.
• Exposure therapy focuses on exposing the individual to the trauma by having them relive and recount it, essentially confronting their triggers. The goal is that repeated exposure to the trauma will take away its power and hold.
• Eye movement desensitization and reprocessing (EMDR) involves directing the individual to focus on the trauma while listening to or concentrating on a repetitive sound or movement.

Medications, such as antidepressants and anti-anxiety meds, are also used in specific cases to improve or lessen the severity of the symptoms.

Does online therapy for PTSD work?

Because there is an increased awareness and understanding of PTSD, it is now easier to get help and treatment. The stigma of having PTSD is decreasing for many, and it is becoming more common for those with PTSD to speak with others for relief from their mental health problems.

Because many people with PTSD may initially find it difficult to speak with others about what they're going through, the idea of seeking in-person help can be daunting and a hassle. Many people instead prefer seeking help and counseling online through mental health sites such as BetterHelp. Staffed with highly specialized, licensed mental health professionals, the site is an invaluable resource for anyone who needs support for their mental well-being. 

Not only is online therapy beneficial for people living with PTSD, it has also been proven as an effective treatment method. After 96 patients with post-traumatic stress symptoms participated in ten sessions of online CBT, PTSD severity and other symptoms like co-morbid depression and anxiety were considerably improved for the experimental group. Below, you may read some reviews of BetterHelp counselors, from people experiencing similar issues and seeking professional medical advice.