Nostalgia. Most would attribute nostalgia to something happy. Nostalgia was the first reference to depression, specifically depression related to trauma. During the Seven Years War (1756–1763), a physician from Austria, Joseph Auenbrugger, observed and documented symptoms in some troops such as excessive physical exhaustion, anger, irritability (angst), and depressed mood (Shrader & Ross, 2021). Fast forward to 1980,” the American Psychiatric Association (APA) added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) nostologic classification scheme (2). Although controversial when first introduced, the PTSD diagnosis has filled a significant gap in psychiatric theory and practice” (Friedman, 2007). Post-traumatic stress disorder, better known as PTSD, is a prevalent mental health diagnosis that has become a social epidemic. Specific criteria diagnose PTSD, and its evolution over the years, has changed how it is diagnosed and treated. The question arises as to how the prevalence of PTSD can be decreased in a world that is full of trauma.
          To find ways to help decrease PTSD, the history of the illness needs to be looked at more in-depth. Along with most illnesses, they had to begin somewhere. According to Christian Shrader and Abigail Ross’ article A Review of PTSD and Current Treatment Strategies, “Sigmund Freud hypothesized that the individual has stages of psychological development: that of forming an unconscious defense against pain and shock through the turning away from the triggers of unpleasure and finally the conscious disapproval of an impulse through use of judgment. Much of his early work focused on the traumatic shocks that his patients had endured through their lifetime, many of them through workplace accidents, loss of life or loved ones, involvement in war, and sexual assault.” (Shrader & Ross, 2021)
          Freud’s studies occurred in the 1800’s, so it is known that depression has been around for quite some time. Depression can even go back as far as Biblical times. Even though depression was referenced in the Bible as sadness, loneliness, sorrow, or hopelessness, it can easily be correlated to depression, as stated in Matthew 11:28-30: “Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light” (Zondervan, 2002). One could go down the rabbit trail of the history of depression and almost get lost. As long as there has been humanity, it can be assumed that depression has been here and it is real. It is important to understand the history of depression, to understand its evolution, and how it has been treated throughout history to make progress with better ways to treat or, hopefully, decrease its prevalence.
          Another way to help with the prevalence of PTSD is to look at the advancements in terminology that have made it easier to diagnose PTSD and separate it from other forms of depression. Along with the changes in terminology, understanding patients' symptoms will make identifying their diagnosis and needs easier. The American Psychiatrists Association defines PTSD as

A psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event, series of events, or a set of circumstances. An individual may experience this as emotionally or physically harmful or life-threatening and may affect mental, physical, social, and spiritual well-being. Examples include natural

disasters, serious accidents, terrorist acts, war/combat,  rape/sexual assault, historical trauma, intimate partner violence,   and bullying (2022).

If you have heard the terms “shell shock,” “combat fatigue,” or “nostalgia,” then these names are directly related to PTSD. When most people hear the term PTSD, they assume they are victims of war. However, PTSD affects more than those who were immersed in war, focusing on today’s social epidemic of depression, specifically PTSD. It is easy to see why the diagnosis has become more prevalent. Therefore, it is important for people to keep this in mind since there are more people walking in society who are struggling with PTSD.
          With advancements in technology and more studies, it has become easier to diagnose PTSD. With this, it is easier to separate PTSD from other mental illnesses and forms of depression. The U.S. Department of Veteran Affairs states that “PTSD is diagnosed by a mental health provider. This may involve several steps, including assessment” (Va.gov: Veterans Affairs, 2018). There are specific assessment tools to help reach the diagnosis. These assessments can be done by oneself, but a professional mental health provider must administer the evaluation for an accurate diagnosis. PTSD, sadly, affects a huge population. It is not just pinpointed to those who have been to war. According to The National Center for PTSD, “about 5 out of every 100 adults (or 5%) in the U.S. has PTSD in any given year. In 2020, about 13 million Americans had PTSD” (Va.gov: Veterans Affairs 2018). This is just in the United States and does not account for children.
          How can the prevalence be decreased in a world full of trauma? War, pandemics, sexual abuse/assault, murder, terrorism, neglect, and poverty are thriving in the world. How can PTSD be decreased when we live in a world that seems to be so evil? Support. It is not shameful to have a PTSD diagnosis. Mental health needs to become more of a priority in America. Friends need to support friends, more treatment centers need to open, and the human population needs to accept the fact that PTSD is real. Many situations prevent people from seeking help. As stated earlier, many things can cause PTSD. A more recent example would be the COVID-19 pandemic. “COVID-19 has a substantial impact on mental health and poses a significant risk for the development of trauma-related disorders, including PTSD”  (Gionnopolou, et al., 2021). Think of life before COVID-19. You can see the massive rise in PTSD. Fear, death, reclusiveness, OCD symptoms, and the worry of the unknown have impacted the world.
          While psychotherapy is the preferred treatment, it takes a very committed patient to follow through with the treatment. The other, more popular option for treatment is prescription medications. There are several types of medications to treat PTSD, but “Selective serotonin reuptake inhibitors (SSRI) such as sertraline and paroxetine are FDA-cleared for the treatment of PTSD” (Mann et al., 2024). Medications can be highly addicting but also have adverse side effects. Those side effects are why patients tend to quit taking the drug. Thankfully, medical professionals have a better understanding of PTSD nowadays. Treatment for PTSD has also evolved over the years. It is sad to think that several years ago, patients would lose part of their brain as a treatment for their symptoms. This refers to the time when lobotomies were used to treat psychiatric disorders. An article published by Frontiers in Neuroscience states, “Freeman and Watts performed hundreds of procedures and described relative success in the treatment of depression, agitation and aggression” (Staudt et al., 2019). Thank goodness for medical advancement. “Trauma-focused psychotherapy is the preferred treatment for PTSD. This includes cognitive behavioral therapy, exposure-based therapy, and eye movement desensitization and reprocessing therapy (EMDR) (Mann et al., 2024).
          Fear is another reason why help is not sought after. Fear of the one that hurt them, fear of family repercussions, fear of not being believed, and fear of reaching out for help. The National Institute for Mental Illness states that “resilience factors” (U.S. Department of Health and Human Services, Post-traumatic stress disorder 2023) may reduce the likelihood of developing PTSD. These factors are “Seeking out and receiving support from friends, family, or support groups, learning to feel okay with one’s actions in response to a traumatic event, having a coping strategy for getting through and learning from a traumatic event, and being prepared and able to respond to upsetting events as they occur, despite feeling fear” (U.S. Department of Health and Human Services, Post-traumatic stress disorder 2023). Some would say that people need to be more resilient. Those are more than likely people who have not experienced trauma severe enough to alter their mindset. It would be unfair to tell that to a person who watched the tragic death of a loved one, someone who survived 9/11, someone who was on the front lines at war, or someone who a family member raped. Recognizing the history, diagnosis, and treatments can hopefully reduce the trending uptick in PTSD diagnosis, along with an acceptance that it is okay for people to seek help. Will this end PTSD? Doubtfully so. If there is some trauma in the world, there will be PTSD. However, one can hope that with a sound knowledge of what PTSD is, more people can get the help they need and help decrease the significance of the trauma they experienced, and hopefully save more lives.

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​https://ifhpclothing.com/blogs/news/ptsd-facts-volume-4-ptsd-awareness-month-2020

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References​

Friedman, M. J. (2007, January 31). PTSD History and Overview.
          https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.asp#:~:text=In%201980                                         %2C%20the%20American%20Psychiatric,in%20psychiatric%20theory%20and%20practice.
Giannopoulou, I., Galinaki, S., Kollintza, E., Adamaki, M., Kympouropoulos, S., Alevyzakis, E., Tsamakis, K., Tsangaris,              I., Spandidos, D. A., Siafakas, N., Zoumpourlis, V., & Rizos, E. (2021, October 1). Covid 19 and post traumatic                  stress disorder: The perfect “storm” for mental health (review). Experimental and Therapeutic Medicine.                      https://www.spandidos-publications.com/10.3892/etm.2021.10596
Mann, S. K., Marwaha, R., & Torrico, T. J. (2024, February 25). Posttraumatic stress disorder.
           StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK559129/
Morganstein, J. C., Wynn, G. H., & West, J. C. (2021a, February 26). Post-traumatic stress disorder: Update on                          diagnosis and treatment: BJPSYCH advances. Cambridge Core.                                                                                              https://www.cambridge.org/core/journals/bjpsych-advances/article/

           posttraumatic-stressdisorder-update-on-diagnosis-and-treatment/55DEDA034C201B05CE31CF1DBD6ADD68
Ned H. Kalin, M. D. [email protected], & Ned H. Kalin, M. D. [email protected]Department of P. (2021, February 1).                      Trauma, resilience, anxiety disorders, and PTSD. American Journal of Psychiatry.                                                              https://psychiatryonline.org/doi/10.1176/appi.ajp.2020.20121738
Schrader, C., & Ross, A. (2021). A review of PTSD and current treatment strategies. Missouri
           Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672952/

Staudt, M. D., Herring, E. Z., Gao, K., Miller, J. P., & Sweet, J. A. (2019b, February 15). Evolution in the treatment of                                    psychiatric disorders: From Psychosurgery to psychopharmacology to neuromodulation. Frontiers in                                                neuroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384258/
U.S. Department of Veteran Affairs. (2018, September 13). Va.gov: Veterans Affairs. How
            Common is PTSD in Adults?https://www.ptsd.va.gov/understand/common/common_adults.asp#:~:   

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U.S. Department of Veteran Affairs. (2018, September 18). Va.gov: Veterans Affairs. How Is
            PTSD Assessed? https://www.ptsd.va.gov/understand/isitptsd/measured_how.asp#:~:text=PTSD%20assess                                   ment%20may%20begin%20using,you%20know%20what%20to%20expect
U.S. Department of Health and Human Services. (n.d.). Post-traumatic stress disorder. National Institute of Mental                                 Health. https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-                                                                   ptsd#:~:text=Resilience%20factors%20that%20may%20reduce,learning%20from%20a%20traumatic%20even
Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018, October 15). Treating PTSD: A review of evidence-based                                           psychotherapy interventions. Frontiers.
            https://www.frontiersin.org/journals/behavioralneuroscience/articles/10.3389/fnbeh.2018.00258/full
What is posttraumatic stress disorder? (PTSD)? Psychiatry.org - What is Posttraumatic Stress
            Disorder (PTSD)? https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

Zondervan. (2002). Matthew 11:28-30. In The Holy Bible, New International Version (p. 758)
 

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