Hurricanes, 9-11, and mass school shootings, have all tragically claimed victims. Acute stress reactions are highly prevalent among survivors. In the aftermath of mass violence, terror, or disaster, most people can fully recover from even moderate stress reactions in several months. While resilience is a common observation, some survivors experience readjustment issues and develop chronic problems with disturbed mood and behavior in the second stage of recovery.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a diagnosis of post-traumatic stress disorder (PTSD) may be made with the following criteria:
(1) Exposure to actual or threatened death or serious injury;
(2) Subsequent persistent and involuntary re-experiences (such as flashbacks, nightmares, or intrusive thoughts);
(3) Avoidance of external reminders of the event;
(4) Worsening negative thoughts, disturbed mood and behavior;
(5) Increased reactivity (such as hypervigilance or exaggerated startle response);
(6) Symptoms last for more than one month;
(7) Symptoms result in functional impairment at home or work; and
(8) Symptoms are not attributable to medication, substance abuse, or other illness.
Last year, Social Security Administration updated their mental health listings to include Listing 12.15, for trauma and stressor-related disorders, effective 1/17/17. The criteria appear similar to those outlined in the DSM-5. Additionally, to meet the new listing, the medical documentation must show marked to extreme limitations in mental functioning in areas such as the ability to concentrate, interact appropriately with others, or adapt to changes. Even without these factors, the listing may still be met if the mental disorder persists for over two years with treatment or psychosocial support and only marginal adjustment.
With professi0onal treatment and support from a strong community, individuals can overcome tragedy and eventually attempt to re-enter the workforce over time. In the interim, Social Security Administration may provide relief for the disabled.