Although you’d never know it from the news and most TV shows, being a guy isn’t easy. Men die younger, are more likely to be the victim of gun violence, and have a higher risk of death from COVID-19. They are also more likely to survive a traumatic event in their lifetime. Although women are more likely to report symptoms of post-traumatic stress disorder than men, only part of that may be due to differences in their physiological response. Some of that disparity may have more to do with how society has often discouraged men from seeking help. Indeed, over half of all U.S. women with a mental illness sought treatment; just one-third of men with a mental illness did so. So what exactly is post-traumatic stress disorder (PTSD) and what are the best treatment options?
Reliving Trauma
A single traumatizing event can be replayed throughout a lifetime. Sometimes your memory of a trauma will be triggered or you may experience it in a dream. It also could be something that never goes away, lingering in your thoughts like a song you can’t get out of your head. The way we react to an initial trauma is often normal, even healthy. After all, “fear is our survival response,” explains Northwestern Medicine Clinical Psychologist Zachary Sikora, PsyD. During the event your fight-or-flight response was likely awakened. Often referred to as our “reptile brain” because it represents the oldest, least evolved part of the organ, our twin amygdalae alert our nervous system. That triggers a flood of stress-related hormones like adrenaline and cortisol. Meanwhile, we start breathing more rapidly as our blood pressure rises and our heart rate accelerates. If we were suddenly jumped by a saber-toothed tiger, then this response is appropriate and potentially life-saving. The problem is when our body continues to deliver a fight-or-flight response months or years after the event occurred. That’s PTSD in a nutshell.
Women are more likely to report being traumatized by an emotional, mental, or sexual event but here again gender roles come into play. Growing up, when boys get hurt they are often encouraged to “tough it out.” That early conditioning can lead them to remain quiet about traumatic injuries. Even today men are often discouraged from talking about their feelings. Given recent revelations about the number of young males who have been emotionally, mentally, or sexually abused, it seems fair to suggest that thousands of men with PTSD are survivors of abuse.
However, throughout time, most PTSD experienced by men (and now women) has been a function of combat situations. Back as far as The Iliad, Homer describes symptoms of PTSD in the men fighting in the Trojan War. In World War I, it was described as “shell shocked,” and “combat fatigue” has also been used to describe the tragic mental consequences of warfare.
PTSD and Men
Most men who report symptoms of PTSD were traumatized by an accident, a crime, or combat. The organization #22ADAY gets its name from the number of suicides committed daily by veterans or as the organization puts it, “lose their battle to post-traumatic stress on American soil.” This speaks to another gender disparity. Although women attempt suicide at a higher rate than men, men are 3.5 times more likely to succeed. That’s because they often choose more lethal means including firearms. Of the nearly 48,000 people who died of suicide in the U.S. in 2019, almost 70% were White males (perhaps surprisingly, the number of suicides dropped during the COVID-19 pandemic in 2020).
Estimates are that since 9/11 four times as many veterans died from suicide than died in combat. Many were suffering the lingering effects of PTSD. Although dated, the film First Blood depicted a triggering event as John Rambo’s abuse at the hands of corrupt cops initiated a PTSD flashback to tortures he’d endured in Vietnam. His reaction, while extreme, is also typical of how men process PTSD. He got angry and acted out in a violent way. Generally men displaying PTSD symptoms are angry, irritable, and/or withdrawn. Other symptoms include hyper-vigilance, a sense of helplessness or shame, and, yes, flashbacks to the traumatizing event.
The National Institute of Mental Health advises that to be diagnosed with PTSD, over the course of one month adults must have at least one re-experiencing symptom, like a flashback, and one avoidance symptom, such as not visiting a relative’s home to avoid reliving the trauma. Additionally they must have at least two arousal and reactivity symptoms, like trouble sleeping or feeling on edge, along with at least two cognition and mood symptoms, like loss of interest in once pleasurable activities and feelings of guilt or shame.
Treating PTSD
There are a variety of approaches to treating PTSD. Medications can help, but the most promising help involves different types of therapy.
- Cognitive behavior therapy (CBT) is a type of therapy that focuses on thoughts, feelings, and behaviors and how they relate to each other. It can help change patterns of behavior, thoughts, and feelings that can keep someone from functioning when they are having PTSD symptoms.
- Cognitive processing therapy (CPT) is a subtype of CBT that helps modify beliefs about the experienced trauma that may or may not be true and teaches patients how to challenge and change those beliefs to improve levels of everyday function.
- Cognitive therapy, another derivative of CBT, helps a patient to change the negative memories of trauma and the evaluations of the experience so that the behaviors and/or thoughts that interfere with daily life can be interrupted.
- Prolonged exposure is another type of CBT that helps individuals approach memories and feelings related to the trauma in a gradual way to face and overcome what has been avoided.
If you or a loved one are suffering with PTSD, it’s important to reach out. The U.S. government maintains a helpline that can connect you with a qualified therapist: 1-800-662-HELP (4357). Through therapy, medication, or a combination of both, many men have been successfully treated for PTSD. However, it only works when men and those who love them are willing to talk.
Written by John Bankston
References
- Men Worldwide Have Shorter Life Spans Than Women | Health News
- Number of Deaths Due to Firearms per 100,000 Population by Sex | KFF
- Why COVID-19 Is Hitting Men Harder Than Women
- How Common is PTSD in Adults? – PTSD: National Center for PTSD
- Gender Differences in PTSD: Susceptibility and Resilience | IntechOpen
- Mental Health By the Numbers | NAMI
- 5 Things You Never Knew About Fear | Northwestern Medicine
- Know Your Brain: The Amygdala — Unlocking Your Reptilian Brain
- Catholic Church child sexual abuse scandal – BBC News
- Military Suicide Awareness #22ADAY Movement
- Men’s mental health: Common challenges
- Suicide statistics | AFSP
- Despite Stress of Pandemic, US Suicide Rate Dropped in 2020 | Healthiest Communities Health News | US News
- The Jail Escape in Rambo: First Blood (1982)
- PTSD Symptoms in Men | PTSD Treatment Center for Men
- NIMH » Post-Traumatic Stress Disorder
- SAMHSA’s National Helpline