As politicians continue to debate the realities of climate change and the merits of future military action, some people are already experiencing the fallout – in the form of what’s being called pre-traumatic stress reactions.
It’s a phenomenon you won’t find in the Diagnostic and Statistical Manual of Mental Disorders, or DSM-V, but some psychologists are employing it in reference to the experiences of activists working on the front lines of climate change or human rights issues or soldiers facing deployment into possible combat situations. The symptoms are similar to post-traumatic stress disorder (including grief, sadness, worry, disturbing intrusive thoughts, sleep troubles and nightmares, and avoiding situations or activities that are reminiscent of the stressful event) but in this case, they stem from anticipatory anxiety about an event that may occur in the future.
In 2006, the irreverent publication The Onion published a satirical article about an increasing number of U.S. soldiers suffering from pre-traumatic stress disorder – a fictitious syndrome involving involuntary, intrusive images and flash-forwards of violent, haunting events the soldiers could experience during their future deployment. While the article was made up, here’s the irony: Some mental health experts say that pre-traumatic stress symptoms are no longer the stuff of fiction or satire because they see it among real people.
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“We’re hearing an Armageddon message every day,” says Dr. Lise Van Susteren, a psychiatrist in the District of Columbia and a member of the advisory board for the Center for Health and the Global Environment at the Harvard T.H. Chan School of Public Health. “When you read the headlines about mass extinction and climate issues that are exacerbating [world] states that are already fragile, it’s very difficult. People start wondering: Where are we going to be safe? Who’s going to take care of us? This can lead to anger, despair and paralysis, an inability to do things or a freezing out of emotions.”
Fearing the Future
While research on this phenomenon is sparse, there is some evidence it exists. To test the proposition, researchers from Duke University and Aarhus University in Denmark developed the Pre-traumatic Stress Reactions Checklist, a roster of potential pre-traumatic symptoms based on the 17 official symptoms of PTSD from the DSM-IV. But in this case, researchers tweaked some of the phrasing to reflect the possibility of pre-experiencing these symptoms and avoiding reminders of potentially traumatic events that might occur in the future. In a 2015 study, these researchers used the PreCL and the PTSD Checklist to measure levels of pre-traumatic and post-traumatic stress in 218 Danish soldiers before, during and after deployment to Afghanistan. Not only did the same intrusive, disturbing PTSD symptoms show up before the soldiers were deployed, but the researchers found that pre-traumatic stress reactions before deployment reliably predicted PTSD symptoms during and after deployment.
Similarly, a study in the June 2011 issue of the Journal of Psychiatric Research found that when urban police officers were exposed to a video depicting police-related scenes – such as a suicide, a homicide, an officer being hit by a car and an officer being killed by a bomb – as part of their academy training, those who had higher saliva levels of MHPG (a waste product produced when the hormone norepinephrine is metabolized), a measure of their stress response, were more likely to have PTSD 12 months after starting active duty.
To some extent, this effect comes with being realistic about what soldiers or police officers might encounter in action. Soldiers have been trained to imagine possible future events that could be deeply disturbing “because they are going to be walking down the road and a roadside bomb could go off,” says David C. Rubin, a professor of psychology and neuroscience at Duke University and Aarhus University. “Danish soldiers have to write letters to people that will be opened only if they don’t come back.”
Van Susteren says she sees similar symptoms among activists as they contemplate and prepare for the possible effects of climate change and natural disasters, as well as among citizens who fear for the country’s future given the current political climate. Pre-traumatic stress “results from reading the headlines and connecting the dots, imagining people being hurt and not surviving,” she explains. “It’s just like any other stress, but it’s exacerbated by a feeling of powerlessness. Chronic stress sends messages to your brain that you’re not safe, and when stress hormones [continuously] soar, that’s a health issue.”
“It’s good to be prepared, but this reaction is going too far because it paralyzes you, it adversely affects your life, and you don’t know what to do to get out of it,” Rubin says. If you’re anxious by nature or you have a tendency to worry intensely, you may be especially susceptible to pre-traumatic stress, he adds. “Some of it is perfectly understandable. People are worried about the future and they should be” given the state of the world.
What’s in a Name?
Even so, some mental health experts question the validity of pre-traumatic stress syndrome as a concept. “PTSD involves a specific set of psychological and physiological reactions that people have in response to a trauma or catastrophic event – including a fight-flight-freeze reflex,” says Steven N. Gold, a professor of psychology and director of the trauma resolution and integration program at Nova Southeastern University in Fort Lauderdale, Florida. “It’s hard to imagine how that reflex would be set off by thinking about the possibility of a future event.”
Nevertheless, Gold adds, “it’s certainly conceivable that someone facing combat or another life-threatening situation might experience anticipatory anxiety. Whether that takes the form of the whole range of symptoms that comprises PTSD is another issue.”
By any name or degree, these stress-related symptoms can have profound effects on a person’s well-being and quality of life, which is why it’s smart to address them. Practicing Transcendental Meditation can help calm your mind by increasing levels of the feel-good transmitter serotonin and increasing alpha waves in the brain, Van Susteren adds. Taking good care of yourself by getting enough sleep, eating the right foods and exercising regularly can also help mitigate some of the effects.
With any anticipated form of stress or trauma, it also helps to talk to other people who are currently grappling with similar issues or who have in the past “so you don’t feel alone,” Van Susteren says. “When you’re an outlier and everybody else is clueless or detached, it can be very alienating.” Talking to people who’ve gone through similar military or activism experiences can also be educational if you find out what the hazards and stumbling blocks are, how to pace yourself and take appropriate breaks, and what else you can do to prepare yourself. “It’s like the difference between being sucker punched versus knowing a punch is coming,” Van Susteren says.
It also helps to take constructive action on the issue making you feel stressed, Van Susteren says. If you’re worried about climate change, you might calculate your carbon footprint and take steps to reduce or offset it – perhaps by walking or riding a bike on errands instead of driving, insulating your home, buying energy efficient appliances or locally grown produce instead of imported. If you’re alarmed about the refugee crisis or civil rights issues, you could volunteer for a non profit dedicated to effecting positive change. “You’ll be taking all the energy that goes into feeling vulnerable and turning it into constructive action, ” Van Susteren says.
Fearing the Future: Pre-Traumatic Stress Reactions was originally published on U.S. News & World Report.