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Gift From Within - Questions & Answers with Frank Ochberg on PTSD
|How long does PTSD last?
Q: Dear Frank, I was recently asked, "Is there any study that knows how long the average intense symptoms to PTSD are after initial diagnosis by a professional?" What do you know about the duration of PTSD symptoms?
A: Dear Joyce, The answer to this question is like so many other situations: It depends.
It depends on the trauma that resulted in PTSD. If your spouse was murdered you have the possibility of survivor guilt, death imagery, prolonged grief and a feeling of rage that complicates and fuels the usual PTSD symptoms. If you survived a plane crash you may never be comfortable in a plane again, but your PTSD may be relatively uncomplicated and brief.
It depends upon whether you were physically injured as well as emotionally scarred. A physical wound can be a source of continuing or episodic pain, triggering traumatic memory. A loss of a limb or an eye can change ones ability to work and to function as before. Any significant disability extends the duration of emotional strain.
It depends upon the number of traumatic events in your life, particularly in formative years. A body of research evidence now concludes that the duration and the difficulty of current PTSD is related to the presence of childhood trauma and to multiple traumas. Think of it this way: victim status is the belief that things will go wrong. Survivor status is the belief that something did go wrong, but you can prevail. Faith in oneself is shaken after multiple traumas and is undermined by childhood trauma. The self-confident person has a shorter period of PTSD than the person with less self-esteem.
It depends upon whether you get effective treatment. Some flashbacks persist for years then turn into unwanted traumatic memories. Without some form of exposure therapy (voluntarily re-experiencing the original trauma in the company of a trusted professional who helps you face your past with confidence) these symptoms may last years longer.
The National Comorbidity Survey found that the median duration of PTSD associated with worst lifetime trauma is between 3 years among respondents who obtained treatment and 5 years among respondents who did not receive treatment. (Kessler RC, Sonnega A, Bromet E, et al. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 1995;52:1048-1060)
In my recent attempt to find a study that answers the question, "How long is the average duration of PTSD?," this three to five year estimate is the best overall figure. It doesn't say that the symptoms are intense. It just says that the definition of the disorder is met. The definition of PTSD includes this paragraph: "The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning."
So the short answer to the question of average duration of PTSD, according to Ron Kessler, a Harvard psychologist, is, "three years when treated and five years when untreated." An even shorter answer is, "It depends." But please note, although the median duration of PTSD is 3 - 5 years, that is a median of all diagnosed cases. The median would be higher for chronic PTSD (longer than 3 months). Once PTSD lasts many months, there is a good chance it will last many more years. But that short answer has a long explanation based on some important considerations. GFW helps everyone with PTSD by sharing ideas, improving morale, and reducing the stigma of the diagnosis and its treatment.
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