June is PTSD Awareness Month - PTSD and Seniors
by Don Drake, Connelly Law Offices, Ltd. 6.7.24
"This month is National Post-Traumatic Stress Disorder (PTSD) Awareness Month," said professional fiduciary and certified elder law Attorney RJ Connelly III. "This observance is dedicated to increasing public understanding of the challenges associated with PTSD, combating the stigma surrounding this condition, and advocating for the provision of effective treatment for individuals impacted by the hidden scars of trauma. Despite the effectiveness of available PTSD treatments, many individuals suffering from this disorder do not receive the support they require."
"PTSD is a complex and challenging mental health condition that can have a profound impact on the well-being of older adults," continued Attorney Connelly. "Left untreated, PTSD can lead to significant emotional and psychological challenges, impairing an individual's ability to function in their daily life."
Traumatic events that can lead to PTSD include natural disasters, war, serious accidents, or assaults. Additionally, there is a closely related condition known as complex PTSD, which can be caused by prolonged, stressful life events such as homelessness, childhood neglect, or living in a war-affected area.
In later life, PTSD can result from the trauma of early life experiences or can occur following traumatic events that take place for the first time in old age, such as serious illnesses, falls, automobile accidents, or the death of a loved one. For individuals who experienced trauma at a younger age, PTSD in later life might manifest as a re-emergence after a period of dormancy, or it may represent the continuation of a chronic disorder that has been experienced throughout adulthood.
"Not everyone who experiences trauma will develop PTSD," said Attorney Connelly. "However, the condition is more common than one may think. According to the American Psychiatric Association, about 3.5 percent of adults in the U.S. have PTSD, and one in eleven people will be diagnosed with PTSD in their lifetime. This underscores the need for increased awareness, understanding, and support for individuals affected by this condition."
Ellen's Story
Ellen's journey with PTSD began when she was diagnosed with the disorder in her mid-fifties. The trigger was the devastating loss of her husband to a senseless street crime, which brought back a flood of traumas from her past, including a childhood marked by physical, mental, and sexual abuse. One particularly harrowing event from her early twenties was a sexual assault at knifepoint, which left an indelible mark on her life. Despite reporting the assault to the police, the attacker was never apprehended, leaving Ellen with a pervasive sense of insecurity in her community and even in her own home.
"After losing my husband, I started experiencing terrifying flashbacks and nightmares," shared Ellen. "The shock of the crime, the funeral, and the probate process intensified these emotions, making me hesitant to be alone at home and causing me to seek comfort by spending more time with my daughter. Even my daily commute to my job as a daycare provider became overwhelming when driving on Route 95 and experiencing intense anxiety in the heavy traffic."
Compounding matters, Ellen's PTSD prevented her from properly grieving her husband's passing, and the relentless onslaught of violent images in her mind made it difficult for her to focus or engage in her community of small business owners or with the parents of children in her daycare. She experienced disorientation and a profound sense of losing touch with reality, struggling to remember even the most basic details of her life. As time went on, she began to disengage from her social support system and spiraled into a deep depression.
Upon confiding in her primary care provider about her challenges, the physician recommended a local counseling center for Ellen. Following an evaluation at the center, Ellen received a diagnosis. She learned about effective strategies for managing her PTSD to prevent the recurrence of the intense distress she had previously experienced. With the appropriate treatment, she gradually experienced a sense of liberation from the constraints of her condition, no longer being held captive by its incapacitating impact.
"If I can pass on one thing I've learned from this experience, it is that it is never too late to seek help, and treatment can be the key to reclaiming one's life from the grip of PTSD," said Ellen.
Aging and PTSD
As individuals age, they may be at a higher risk of developing PTSD compared to the general population. This increased vulnerability can be attributed to a range of factors related to aging. The U.S. Department of Veteran Affairs acknowledges that role changes associated with aging can make it more challenging for older adults to cope with past trauma. Even individuals who did not exhibit signs of PTSD earlier in life may find themselves struggling with unresolved trauma as they age and encounter significant life changes such as retirement, declining physical health, and cognitive and functional limitations.
The prevalence of PTSD in older adults can also be influenced by diminishing opportunities for self-medication (using alcohol or drugs). Many individuals employ avoidance-based coping mechanisms, such as immersing themselves in work, to divert attention from the psychological impact of traumatic experiences. However, as individuals grow older, these coping strategies may become less accessible, leaving them to confront their trauma more directly.
In addition, older adults face an increased risk of developing PTSD following a serious fall. A study published in the General Hospital Psychiatry journal revealed that twenty-seven out of one hundred individuals aged sixty-five and above who were hospitalized after experiencing a fall exhibited symptoms indicative of PTSD. This underscores the need for greater awareness and support for the mental health of seniors, particularly in the context of traumatic events associated with aging.
The manifestation of symptoms of post-traumatic stress disorder (PTSD) in elderly individuals may differ from those observed in younger cohorts, which can complicate the diagnosis process. Common manifestations include:
Trauma re-experiencing: Elderly individuals may experience vivid flashbacks, intrusive recollections, or distressing dreams related to past traumatic incidents.
Avoidant behaviors: The elderly demographic may systematically avoid individuals, places, or activities that trigger memories of the trauma.
Hyperarousal: This may appear as heightened irritability, disturbances in sleep, exaggerated startle responses, or hypervigilance.
Affective alterations: Elderly individuals with PTSD may exhibit sustained negative emotions, including feelings of guilt, fear, shame, or a sense of a limited future.
Cognitive impairments: Additionally, challenges with memory retention, concentration, and decision-making may be noticeable in elderly individuals with PTSD.
Treatment
Recognizing PTSD in older adults can be challenging, as the symptoms may be mistaken for signs of aging, cognitive decline, or social isolation. It is crucial to be vigilant and look out for potential signs of PTSD in aging family members or friends. Older adults tend to prioritize physical symptoms such as pain, sleep disturbances, or gastrointestinal issues while overlooking the emotional aspects of PTSD. They are also more inclined to seek help from a primary care doctor rather than a mental health clinic. Despite the increasing understanding and acceptance of mental health issues, some older adults may experience feelings of shame regarding their trauma and its emotional impact.
It's important to note that therapy is often recommended as a primary treatment for PTSD in older adults. Major organizations such as the VA and the American Psychological Association advocate for various forms of therapy, including Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy, Cognitive Therapy, and Prolonged Exposure Therapy, all of which have shown promise in helping older adults cope with PTSD.
A Final Note
"Therapy sessions for older adults differ from those catering to younger or middle-aged adults," said Attorney Connelly. "Seniors, particularly those grappling with cognitive decline affecting memory and focus, may face challenges in articulating their emotions and experiences during therapy. Nevertheless, engaging in PTSD therapy can lead to favorable results for seniors. Therapists specializing in older adults are proficient in addressing their unique requirements through customized support and motivation. Participation in PTSD therapy presents older adults with a valuable opportunity to manage and regulate their cognitive processes, emotions, and behaviors stemming from traumatic experiences."
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