It’s a pleasant winter afternoon, and Gretchen,* a junior at Grady, is walking through a shopping center with her boyfriend. He reaches out to hold her hand, but suddenly, Gretchen is hit with immense panic. He has accidentally grabbed her wrist, triggering an intense wave of flashbacks through her head of an event that happened months ago. Instantly, Gretchen breaks away, crying — all she can think about is the overwhelming feeling that she’s being attacked.
Gretchen has post-traumatic stress disorder, or PTSD, an anxiety disorder often associated with war veterans. But PTSD can occur in anyone who has witnessed or experienced trauma, whether it was combat, domestic violence, abuse, or in Gretchen’s case, sexual battery.
Normally, people who experience trauma are able to cope with it and recover in a healthy way, but in people with PTSD, something goes awry. The body’s defense mechanisms go into overdrive, and the lingering memory of the trauma, along with the vivid feelings of fear and anxiety, repeatedly resurface long after the event has passed. This leads to a wide range of symptoms which altogether create a difficult and debilitating disorder.
“My subconscious took this one event and placed it into every part of my life,” Gretchen said. “It’s nagging; it’s constant.”
Gretchen’s reaction to having her wrists grabbed is one example of how PTSD can manifest. Her brain associates that physical sensation with the traumatic event, triggering panic, even in a completely harmless situation.
PTSD is not only a matter of triggers, though. As with other mental illnesses, it can lead to significant, long-term changes in a person’s mood, interests and disposition. According to Dr. Sheryl Kataoka, a Professor of Child and Adolescent Psychiatry at the University of California Los Angeles, PTSD can cause people to lose interest in activities they used to enjoy.
“You can also have negative changes in your mood or way you think, so you may be much more irritable or emotional,” Kataoka said. “You may experience the opposite and feel totally numb to feelings.”
After Gretchen was a victim of sexual battery in the summer of 2018, she gradually began showing such symptoms of post-traumatic stress that got worse with every week. By the beginning of the school year, her functioning became so impaired that she could barely eat, sleep or do her schoolwork.
“Then the nightmares started coming,” Gretchen said. “I put my head down to sleep in class one time because I was utterly exhausted, and I woke up in a sweat — I had a dream that this guy’s parents were coming to kill me.”
Nightmares are a common symptom of PTSD, sometimes occurring without warning or triggers. Most people also experience flashbacks, in which their mind is overwhelmed with vivid and terrifying memories of the traumatic event.
“Oftentimes people describe to us that it’s almost like watching a movie over and over in their head,” Kataoka said.
Flashbacks can be triggered by ordinary objects, smells, sounds, or anything else that the person associates with their trauma, just as Gretchen is triggered by her wrists being grabbed. Moreover, these triggers could be things that a person encounters in their everyday life. In the same way that flashbacks can interfere with the work life of adults, they may be difficult to manage in a school setting.
“The memory really becomes ingrained in their mind, and often they can be sitting quietly in the middle of class, and suddenly that film in their head, that movie, starts playing,” Kataoka said. “That can be very distracting and impairing to their ability to even just function in the classroom.”
PTSD is closely connected to the memory. In addition to causing memories to resurface in the form of flashbacks, it can also cause negative changes in a person’s ability to retain new information. According to Kataoka, adolescents can have “a difficult time concentrating and remembering things, developing new memories, or focusing on schoolwork.” The ability to remember content is essential to being successful in many classes, so if PTSD interferes with that, a student may suddenly find it much more difficult to earn good grades.
Perhaps one of the most significant ways that PTSD can impact students’ lives is its effect on social and familial relationships. High school is a critical stage for developing friendships, romantic relationships and family bonds, and the symptoms of PTSD can cause tension in all of these.
For example, Gretchen faces unique challenges with her boyfriend, Jonathan,* that most couples never have to encounter.
“I’ll go to kiss my boyfriend or something, and he’ll put his hand gently on my face, and then I’ll think someone’s grabbing my neck, or he’ll reach for my hand, and I’ll think that someone’s grabbing my wrist,” Gretchen said. “It makes intimacy awkward because I’ll cry, or I’ll shut down, or I’ll shake, or I’ll have to remove myself from the situation.”
Although her crying doesn’t reflect her true attitude toward the situation or toward Jonathan, she can’t control her reaction. She describes her sensitivity as “a product of the past that lingers.”
Gretchen and Jonathan maintain a healthy relationship despite the barriers of PTSD. Nevertheless, it is difficult for Jonathan to watch Gretchen endure her symptoms.
“The worst part is probably just a feeling of helplessness, knowing that there’s nothing I can do to solve this immediately,” Jonathan said. “All I can really do is try my best to be supportive and hope that it helps in some way.”
Gretchen experiences similar issues with her family and friends, like when they touch her wrist on accident. Even so, getting an official diagnosis in October came as a relief to her family.
“Now that there’s actually a label for it, I can get specific help that I need, and it’s been really nice to actually have a path towards recovery,” Gretchen said.
Treatment for PTSD can come in several forms, including relaxation techniques and various types of therapies. Gretchen does prolonged exposure therapy, which is focused on desensitising the brain to triggers through means of directly encountering them.
“Little by little, I’m being exposed to more of my triggers for longer periods of time; most specifically, wrist-grabbing, or simple smells, or songs, or riding in a specific model of car,” Gretchen said.
When working with patients, Kataoka teaches skills such as problem-solving and reasoning that can help people work through the complicated web of emotions they experience as a result of PTSD.
“Oftentimes people have distorted thinking, so they start feeling that the whole world is unsafe because this one thing happened to them,” Kataoka said. “We do what we call ‘checking the facts,’ or helping to break down those distorted thoughts to have more reasonable thinking.”
Although schools cannot necessarily prevent people from suffering trauma, they do have the ability to support students who may be experiencing post-traumatic stress. According to Kataoka, certain coping mechanisms taught to PTSD patients can be demonstrated to entire classrooms.
“Anybody, all of us, can use relaxation skills, can use better problem-solving techniques,” Kataoka said. “These are common things that schools should be teaching, just like reading and math, because we all experience stress.”
Additionally, Kataoka thinks it is necessary for schools to detect signs of PTSD early, before a student develops problems such as depression and substance abuse. For some students, it is vital that their school also provides care, since they may be unable to obtain counseling anywhere else.
“We’ve found through our work across the country that the more that schools can provide these kinds of services on a campus, the better access students have to these kinds of treatments, because oftentimes, it’s hard for students to get to community resources, or there’s stigma related to it,” Kataoka said.
Overall, dealing with PTSD poses immense challenges for students, but with treatment and therapy, it can get better over time. Gretchen is living proof of this. She’s already noticed improvements in her ability to cope with triggers, and despite her disorder, she still maintains a robust extracurricular schedule and social life.
“If anything, this is the road to recovery,” Gretchen said.
*Names have been changed to protect the privacy of students.