Jun 22nd 2023
Post-traumatic stress disorder (PTSD) is a mental health condition that may occur in certain people who have gone through traumatic events. PTSD is characterized by symptoms such as intrusive memories, nightmares, anxiety, and flashbacks. In some individuals, symptoms can become worse with age. 
The severity of PTSD symptoms can vary over time. Symptoms may even go away for a while and then come back later in life. In other cases, symptoms may not even start until later in life. 
There are several reasons why symptoms may become more severe or start at a later age. When people are younger, they may distract themselves from their traumatic experiences by focusing on work or staying active. However, once individuals hit retirement, they have more time on their hands to think about the pain. 
Older PTSD patients may also face other medical problems, leaving them feeling more helpless and more susceptible to focusing on their past.  Loss of loved ones and their usual support system can increase this.
Furthermore, many individuals never learn healthy coping mechanisms so they may rely on self-medication.  If they must quit drinking in old age, it can be difficult to confront their emotions. On the other hand, others may rely on substances more with increased time on their hands. Both can lead to an increase in symptoms.
Late onset stress symptomatology (LOSS) is a condition that sometimes develops in old age in individuals who experienced a traumatic event earlier in life but never had PTSD symptoms.  While the symptoms of LOSS are similar to those of PTSD, they are typically less severe.
In older adults, psychotherapy and lifestyle changes are generally the preferred treatment option since this population is often more susceptible to medication side effects.  Older individuals are also more likely to already be managing other medications and health conditions, so interactions are an important consideration.
Trauma-focused cognitive-behavioral therapy (TF-CBT) is generally the first line of treatment for PTSD, regardless of age.  In CBT, the patient challenges their thoughts about the traumatic event in order to create more adaptive patterns of thoughts and behaviors.
Other commonly used therapies include prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR).  PE, often incorporated into CBT, involves gradually revisiting traumatic memories to recognize that they are not harmful. EMDR involves associating memories with guided bilateral eye movements.
It’s important to note that, while these treatment plans are commonly used and successful, there have not been sufficient empirical studies on their use in the senior population. 
In terms of lifestyle changes, it’s important for older adults with PTSD to keep their minds and bodies active.  This includes regular exercise, developing new hobbies, and spending time with others. Joining a support group may also be helpful.
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