This article appears in Fall Healthy Living 2018.

Commonly connected to veterans and first responders, post-traumatic stress disorder can be caused by myriad circumstances and affect anyone, including children.

“The majority of cases of PTSD are not combatants or military. Civilians make up the majority of cases,” said Dr. Terence Keane, director of the National Center for Post-Traumatic Stress Disorder’s Behavioral Science Division at the VA Boston Healthcare System and professor of psychiatry at Boston University School of Medicine.

PTSD can affect anyone who has been through a traumatic event, from sexual assault to violent crime, car wrecks to house fires, Keane said.

Trauma is not rare, with 60 percent of men and 50 percent of women experiencing it during their lifetimes, according to the National Center for PTSD, which estimates that 7 or 8 percent of people will have PTSD at some time in their lives.

That number rises to between 11 and 20 percent of men and women who served in operations Iraqi Freedom and Enduring Freedom in a given year. For Gulf War veterans that number is about 12 percent, and for Vietnam War veterans about 15 percent in a given year.

Former Spice Girl Mel B, real name Melanie Brown, recently shared her story publicly of struggling with PTSD and said in a statement that she is “reliving an emotionally abusive relationship and confronting so many massive issues in my life from the death of my dad to my relationship with men.”

Children and families separated at the U.S.-Mexico border this summer after fleeing extreme violence in Central American countries may later experience PTSD, according to a statement from the American Psychiatric Association.

“PTSD can be frequent and disabling and it can be chronic,” Keane said.

Symptoms

The most common symptoms are high levels of anxiety, depression and a preoccupation with the traumatic event. A person may be detached, on guard or filled with guilt.

“Often, a person has nightmares about the event. They relive it in their dreams. People don’t want to fall asleep — they have sleeping problems — because they are too scared of what will happen,” Keane said. “They wake up with their heart racing, soaked with sweat, highly afraid.”

While awake a person may be in a dissociative or fugue state, Keane said. They may see a person who looks like their assailant or hear the sound of a car crash and suddenly they are filled with adrenaline. It can trigger immediate acute stress and ruin their day, or the stress can last for several days, he said.

Treatment

However, PTSD is curable and help is available.

“There are successful, evidence-based therapies that help people work through their trauma,” Keane said. It may involve written, imagery and even “en vivo” therapies where participants go back to the scene of the trauma as part of the emotional healing process, he said.

No medications are available that consistently improve symptoms of PTSD, but treatment can include antidepressants such as selective serotonin reuptake inhibitors — or SSRIs — like Prozac and Zoloft.

The earlier that treatment is sought the better, because symptoms of PTSD can get worse with time. It’s never too late to seek treatment, though, Keane said.

For more information visit ptsd.va.gov.