Post-traumatic Stress Disorder (PTSD) and Aging

Post-traumatic Stress Disorder (PTSD) is a mental health condition characterized by an experience of a traumatic event and following psychological impact so severe that it impairs normal function for an extended period of time.

The initial emotional shock, fear, anxiety, sadness, and anger may subside over months, but PTSD can persist for decades. As PTSD sufferers age, it is not uncommon for symptoms to increase, emerge, or re-emerge. As family members and caregivers of senior loved ones, it is important to learn how the process of aging impacts the experience of PTSD, how to detect and how to manage symptoms.

Symptoms of PTSD

The three groups of symptoms common to PTSD sufferers are:

1. Repeatedly experiencing the traumatic event as nightmares or flashbacks
2. Avoidance of trauma-related circumstances
3. Increased anxiety

Self destructive behaviour may also follow the experience of a traumatic event, such as alcoholism, substance abuse, self-harm, and suicidal tendencies. Depression, irritability, insomnia, and other complications may also arise as a result of PTSD.

PTSD Causes

Some events that may be responsible for the development of PTSD are:

• Violent physical assault
• Sexual assault or abuse
• Combat, such as with war Veterans
• Serious accidents
• Natural or man-made disaster
• Diagnosis of a life threatening illness
• Witnessing the above or their impact on another person

Aging and PTSD

Symptoms of PTSD can increase with age. Chronological age (the increased probability that an individual may be exposed to at least one traumatic event over a longer period of time) and the developmental process of aging are important factors.

Veterans, especially male combat Veterans, are the most studied group of older adults with PTSD, since 85% have had lifetime exposure to traumatic events. The research of PTSD in older women is growing in order to gain insight on the effects of traumatic events that are most commonly experienced by women, such as rape and domestic violence. Studies show that 72% of older women have experiences at least one type of trauma in their lifetime.

In these seniors suffering from PTSD, there is an increase in physical medical problems (likely as a result of poorer self-care) including arterial disorders, gastrointestinal complaints, dermatological problems, and musculoskeletal disorders. Mental concerns like lowered social functioning, anxiety, and addiction are also prevalent. It is also suspected that older adults with PTSD are twice as likely to develop dementia.

Assessment and Treatment of PTSD in Older Adults

A full mental examination, including a cognitive screening, is recommended to assess elderly patients for PTSD. Family members and caregivers should inquire about such examinations with a senior’s medical doctor. It is also helpful to watch for trauma and related symptoms, as older adults tend to minimize their importance since traumatic events are likely to have been experienced long ago.

Treatment of PTSD typically involves both medication and psychotherapy. A physician should create a treatment plan that is customized to the patient’s unique symptoms. Medication may include anti-psychotics, anti-anxiety, and anti-depressant drugs. Counseling in an individual or group setting is necessary, which may also be paired with cognitive behavioral therapy.