By now most of us are all-too-aware that severe stress and trauma, such as from the recent terrorist attacks, can cause what doctors call post-traumatic stress disorder (PTSD). But even survivors of these horrific experiences who do not show the characteristic symptoms, and so are not diagnosed with PTSD, may have, according to a new study, an increased risk of suicide.
PTSD is an anxiety disorder in which exposure to a traumatic emotional or physical event is followed by frequent reliving of the event. Symptoms can include recurrent and distressing memories of the event, efforts to avoid feelings and reminders associated with the trauma, and severe anxiety.
But, according to a Columbia University team of researchers, led by Randall Marshall, M.D., the number of people in the U.S. who are significantly impaired by traumatic events may be much greater than previously realized. PTSD estimates are based on those who meet the full criteria for PTSD and do not include those who are "subthreshold," with only some of the symptoms of PTSD.
Dr. Marshall and his colleagues found that people with subthreshold PTSD were three times more likely to have suicidal thoughts characterized by hopelessness ("What's the point in going on? Nothing is going to get better.") and either/or thinking such as "I can't go on feeling this way." These kinds of thoughts are a known risk factor for actual suicide.
Asked to comment on this study, TheDoctor's stress expert, Dr. Bruce S. McEwen, Alfred E. Mirsky professor and head of the Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology at New York City's Rockefeller University, said, "this interesting study made me wonder what other psychiatric symptoms are also increased by this kind of stress. In the aftermath of the recent terrorist attacks psychological symptoms such as depression, sleep disturbances and generalized anxiety appear to be widespread. Perhaps future studies will be able to tell us more about the relationship between PTSD symptoms and other anxiety disorders such as depression."
According to the American Psychiatric Association, even before the terrorist attacks, 10 percent of the American population has suffered from PTSD at some point in their lives. Presumably, subthreshold PTSD is far more common, especially now.
People who suspect that they may be suffering from one of these disorders should seek immediate professional help. Various treatments, including psychotherapy, counseling and medication, often in combination, have proven effective. The report was published in the September 2001 issue of the American Journal of Psychiatry.