Delayed onset post-traumatic stress disorder (PTSD), which can occur as a result of a severely disrupted childhood, is defined by the DSM (Diagnostic Statistical Manual) as PTSD which develops at least six months after the traumatic event/s; however, PTSD can take much longer than this to manifest itself.
One reason why PTSD may not become apparent immediately is that the individual who has been affected by trauma is able, for a period of time, to employ coping mechanisms (either consciously or unconsciously) which keep the condition at bay. During this period, some of the effects of the traumatic experience/s lie dormant. However, due to the experiencing of further triggers (stress-inducing reminders of the original trauma), the person’s neurobiological processes (already harmed by the original trauma) may be further adversely affected until a ‘tipping point’ is reached and the s/he meets the criteria for being diagnosed with the disorder.
In other words, there is an interaction between the original damage caused by the trauma and exposure to further stressors later on in life. It follows from this that the more severe the original trauma, and the more severe the stressors life throws at the individual subsequently, the greater is his/her accumulated risk of developing PTSD. Indeed, this is borne out by the research.
ORIGINAL TRAUMA LEADS TO GREATER VULNERABILITY TO EFFECTS OF FURTHER STRESS :
The original trauma, then, makes the individual more susceptible to being affected adversely by further life stressors. In neurological terms, this is thought to be because the original trauma can damage an area of the brain known as the amygdala; damage to this region makes a person’s fear/anxiety response to stressors much more intense than is normally the case (click here to read my article on how the effects of childhood trauma can physically harm the brain).
The more the individual affected by the original trauma subsequently experiences stressful triggers (see above) which cause him/her to relive it, the more damaged, and hypersensitive to the effects of further stress, the amygdala (see above) becomes. Eventually, the amygdala’s response to perceived threat and danger (there does not have to be any real threat or danger; indeed, one of the hallmarks of PTSD is that it causes the sufferer to see threat everywhere, where it does not, in fact, exist) become so exaggerated that the individual finds him/herself living in what amounts to a state of almost constant terror (indeed, I myself was in just such a state for more time than I care to recall).
As the individual starts to perceive, irrationally, threat everywhere, the range of triggers (see above) s/he experiences grows ever wider; this, in turn, yet further sensitizes the amygdala and reinforces the individual’s stress response. Thus, a vicious cycle develops.
CRITICAL PERIOD OF BRAIN VULNERABILITY :
I will finish with a quote from the psychologist Shalev, which I think speaks for itself and requires no further elucidation from me :
‘Following trauma, there is a critical period of brain plasticity during which serious neuronal changes may occur in those who go on to develop PTSD.’
NB. To learn more about BRAIN PLASTICITY, and how we can take advantage of the phenomenon to aid our own recoveries, click here to read my article).
David Hosier BSc Hons; MSc; PGDE(FAHE).