Trauma often occurs in different people’s lives, yet its consequences are not the same for everyone. Some might face more difficulties after the physical and emotional violence and assaults, developing what is known as a posttraumatic stress disorder. More precisely, PTSD is “a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape” (The American Psychiatric Association, n.d., para. 1). According to the data from the U.S. Department of Veterans Affairs (n.d.), “about 6 out of every 100 people (or 6% of the population) will have PTSD at some point in their lives” (n.d., para. 5). More than a half of the registered cases of PTSD are testified in women (U.S. Department of Veterans Affairs, n.d.). The life of people with PTSD is full of mental struggling and problems with integration into society. In the following paragraphs, the background of the disease is explored in greater detail and PTSD following refugee trauma is given special attention.
The History of PTSD
The history of PTSD can be viewed from different perspectives. First of all, the condition that is now known as PTSD was present in ancient times and described in several historical sources. As such, Mesopotamian warriors had issues mentally recovering after battles; yet, they were considered to be obtained by evil spirits (Blakemore, 2021). Furthermore, the traces of PTSD are present in the literature: both in Herodotus and Shakespeare’s works, individual soldiers struggle because of their traumatic experiences (Blakemore, 2021). People observed the symptoms of PTSD after railway stations’ catastrophes, female rape, and combats (Stein & Rothbaum, 2018). Thus, the illness was known in civil life and war conditions.
However, the symptoms became significant only with the emergence of psychiatry. From this point, a second perspective for viewing the PTSD history can be discussed, namely, the history of the medical diagnoses. At different points, experts named it “traumatic hysteria from railroad injury,”… rape trauma syndrome,… “shell shock,” “soldier’s heart,” and “effort syndrome” (Stein & Rothbaum, 2018, p. 509). The attitudes towards the yet not fully recognized disorder were also different due to “factors such as socio-cultural and political changes, as well as developments in evidence-based understanding of trauma and its sequalae” (Finch, 2021, para. 1). The psychiatrists finally recognized PTSD in the first version of the Diagnostic and Statistical Manual of Mental Disorders after the mass occurrence of similar symptoms in Vietnam veterans (Finch, 2021). The definition gradually expanded from military trauma to the stress disorder caused by disastrous situations involving life-threatening conditions. Hence, the syndrome became widely known and treated by pharmaceutical and psychological practices.
The Diagnosis and Psychobiological mechanism of PTSD
So far, the diagnosis of PTSD has not been discussed in the paper yet, as well as its psychological mechanisms. The multiple symptoms of PTSD are usually categorized into “intrusion, active avoidance, negative alterations in cognitions and mood as well as marked alterations in arousal and reactivity” (Miao et al., 2018, p. 1). Moreover, professionals consider that a traumatic episode is crucial for the diagnosis. Although some people can recover from PTSD in a short period, other persons struggle with it persistently in the long term (Kessler et al., 2017). If the traumas have occurred often in a patient’s life, the symptoms are more severe (Brewin et al., 2017). The biological mechanism behind PTSD has not been comprehensively described yet. Yet, some researchers point to the neuroendocrine’s role in the further development of the disease and immune system issues. The most common reaction to stress in people who experienced trauma is related to glucocorticoids and catecholamines exchange (Miao et al., 2018). Finally, previously existing mental disorders, such as depression and anxiety, increase acquiring PTSD (Miao et al., 2018). Thus, the experts have different views on the mechanisms and symptoms related to PTSD.
The Consequences of PTSD
Obviously, PTSD consequences are harmful to mental and physical health and problems in social life. As such, continuous psychological arousal leads to heightened stress; thus, the individuals use strategies for coping with the stress. The defensive reactions of people who are likely to develop PTSD are different from usual. Expressing and determining the emotional state becomes a challenge for these individuals, and they undergo even greater stress as a result (Fang et al., 2020). Next, the consequences for the social lives of people with PTSD are more unsatisfactory performance in work (which might lead to lesser pay), family problems, and lack of social well-being. Moreover, relationships with close people suffer the most in these conditions (Vogt et al., 2017). Finally, the patients tend to have insomnia and excessive stress reactions resulting in “oxidative stress and inflammation in chronic PTSD and the neurobiological consequences of these processes including accelerated cellular aging and neuroprogression” (Miller et al., 2018, p. 57). Therefore, the trauma causes irreversible harm to the lives of people who fail to manage them due to external factors.
PTSD Related to Refugees’ Trauma
One of the most lingering problems in society’s mental health is the frequency of PTSD in refugees. According to Suhaiban et al. (2019) review of multiple data, “between 30% and 80% of refugees screen positive for posttraumatic stress disorder” (p. 2). Even the minimal estimate exceeds the usual PTSD occurrence among civilians and veterans mentioned earlier. The syndrome might develop in these people because of various causes; these can be divided into pre-migration and post-migration. As such, before a forced migration, the individuals are reported to experience trauma due to physical and mental torture. Such torture includes sexual assault and rape, which worst affects the mental health of the refugees (especially females) (Suhaiban et al., 2019). Moreover, discrimination, persecution and violence towards people of a specific religion, ethnicity, or race also cause severe trauma. In this way, the refugees might acquire PTSD before entering new conditions or gain a high stress level.
Next, the situation worsens for the forced migrants when they try to adapt to a new environment. Apart from the existing haunting traumas, refugees begin to suffer from unemployment, oppression from foreigners, acculturation problems (Tuomisto & Roche, 2018). Some migrants are separated from their families or observe the torture of their close ones, which might lead to depression and anxiety in addition to PTSD (Rathke et al., 2020). Even in the next generation, the children of the migrants suffer from PTSD-related issues. As such, the mother can affect their children’s mental health and general well-being because of the traumas (East et al., 2017). The symptoms and consequences of PTSD in these cases are researched thoroughly. Namely, “human-instigated trauma potentially alters the survivor’s long-term social behavior and fundamental thoughts about the world and oneself” (Tuomisto & Roche, 2018, p. 2). One of the most common issues resulting from this condition is anger outbursts and separation from society. In turn, aggressive behaviour often leads to self-injury or cardiovascular diseases. Hence, it is crucial to deliver proper treatment or attempt to prevent the development of PTSD in refugees.
Solutions for the Refugees’ PTSD Issue
The treatment of PTSD among refugees requires specific cautions and includes several fundamental approaches. The traditional treatment involves Cognitive Behavioral Therapy, which is help from a psychiatrist, and pharmacotherapy. However, one must consider the patients’ culture since some might be reluctant towards the therapy or specific practices (Suhaiban et al., 2019). Next, the comorbidity of PTSD with depression often causes the ineffectiveness of the treatment; for this reason, it is better to deal with the depression first (Haagen et al., 2017). Furthermore, the core approach to the treatment is within the ADAPT model. Namely, the treatment requires the guarantee of “safety and security; the integrity of interpersonal bonds and networks; access to justice; ability to pursue roles and maintain identities; and freedom to pursue activities that confer meaning” (Tay & Silove, 2017, p. 1). Finally, the most recent solution for the PTSD problem can be neurofeedback therapy, which activates the function of mental self-regulation; yet, the method is not fully recognized and described (Askovic et al., 2017). In this way, the treatment for the refugees is accessible but requires special attention from the professionals.
Conclusion
To conclude, PTSD is a complex and highly harmful disorder that affects multiple aspects of human lives. Its main characteristic is the inability to cope with stress in someone who has experienced an event involving threat or violence. As such, forced immigrants often became the disease victims due to the tragic circumstances that accompany their lives before and after fleeing their homeland. These people deserve adequate treatment, guided by their cultural values and guaranteed safe conditions.
References
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