Why do some people get PTSD after a trauma and others walk away unscathed?

Welcome to the Carlythe Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Akin, the editor-in-chief of the Carlat's Psychiatry Report.

And I'm Kelly Newsome, a psychiatric MP and a dedicated reader of every issue.

We're back.

With more coverage at the American Journal of Psychiatry's 2024 review of PTSD by Aria Shalev and colleagues from NYU.

In this episode, you'll learn who is at risk for PTSD after a trauma

and what goes on in the brain during PTSD.

Trauma is very common.

Around two in three people have had a traumatic experience,

especially accidents and assaults.

But most survivors of trauma don't develop PTSD. They may have

brief symptoms after the trauma or anniversary reactions, but otherwise function well, and not everyone

who develop significant symptoms after trauma has PTSD. Trauma can be part of the cause of nearly

every psychiatric disorder, depression, bipolar, addiction,

even schizophrenia. But PTSD is the only disorder that calls out trauma in the criteria. That can

lead to overdiagnosis. So think twice next time you see, say, a young man with a family

history of bipolar disorder,

who develops severe insomnia after a traumatic event,

followed by irritability, racing thoughts, impulsivity, and other manic symptoms.

Around one in 14 people will meet criteria for PTSD in their lifetime,

and gender plays a role here.

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