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Comment by asimuvPR | Hacker News Reader

What about PTSD developed in non-combat zones? Or people who develop it and are not even in war zones? Do you know if there is any information on that?

Not trying to start a flame war. Just interested in the PTSD thing itself.

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Pretty much any environment that causes your body to frequently flood with cortisol is a breeding ground for PTSD. The brain interprets the constant threats to its well-being as a signal to rewire itself to be trigger-happy on the flight-or-fight response to conditions that most others would not react as intensely to.

Examples: childhood poverty; abusive/neglectful parents; societal discrimination (especially if violence or a heightened possibility is a factor).

Interesting idea - any resources that discuss this that you can provide?

There is so much about PTSD we don't understand (or more accurately there is very little we do understand about it) that your claims are simply not true. We aren't sure what causes PTSD, we don't understand what physiological, neurological or psychological conditions are needed for "PTSD" to evolve.

As far as cortisol goes well it is again not that simple, both elevated and lowered cortisol levels have been recorded in PTSD cases which is why it's still debated if lower or higher levels of cortisol cause or are a symptom or an indicator of PTSD, and since cortisol levels are only usually tested in cases where the person has already been or being diagnosed the correlation is even harder to identify, especially when considering that both lowered and elevated levels of cortisol can be recorded in nominal people and in people suffering from other mental disorders.

PTSD is just another placeholder akin to "shell shock" and the later "combat fatigue", in the end it would be an umbrella of various disorders with various preconditions and causes expressing themselves in a similar fashion.

I find it ironic that while critizing someone for making bold claims, you make the unreserved assertion that their claims are false.

They could be correct, regardless of evidence.

Also, there's apparently evidence that prior trauma puts you at greater risk of PTSD from subsequent trauma. Which helps explain why different people in more or less the same situation can have very different responses, because of their different experiences earlier in life.

One thing I've noticed is that there's a very severe bias in culture against PTSD. There's this idea that PTSD should be a "really big deal" and it only exists in the "goes to 11" mode and nothing else, that it has to be "earned" through truly great trauma. PTSD that exists from more minor things (such as childhood emotional trauma that didn't involve physical violence) is often ignored and sidelined. Consider, for example, the character of Clarice from The Silence of the Lambs. The event that gave that movie its name likely gave Clarice lasting PTSD that she had not overcome even as an adult. Her PTSD wasn't as life damaging as a veteran incapable of holding a job or staying sober, she obviously managed to prevent it from impacting her daily life too powerfully, but it still existed.

There are tons of people walking around with similar or even more "minor" forms of PTSD. And it's causing them stress and giving them potentially harmful behaviors like hypervigillance. Many of them will go through their lives not knowing or even recognizing the possibility that they're experiencing PTSD, because society says PTSD has to be a 500 pound gorilla, and a 2 pound monkey on your back is not even worth worrying about.

I suspect we'll find that there's a difference between what was called shell shock (brain damage from blast waves) and PTSD (psychological trauma), and that it's possible to suffer from one or the other, or both.

It has already been confirmed, using a microscope:

http://www.nytimes.com/2016/06/12/magazine/what-if-ptsd-is-m...

(NOTE: This is for some of what goes under the umbrella term "PTSD", so of course not for every single diagnosis. Only the people exposed to such shock waves.)

Shell Shock wasn't about brain damage it's what it just was called because it was a convenient name, later in Korea it was called combat fatigue and after vietnam we had PTSD. PTSD cases have been recorded in cases with or without physical trauma including TBI, and not everyone gets it even under the same circumstances. You can have a platoon of troops on the same deployment, going through exactly the same stuff day in and day out but not everyone would develop PTSD.

I think there are probably /some/ cases called PTSD which are actually physical injury from blasts, that have been conflated with other cases where people have lasting psychological damage after ongoing trauma.

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