Question: "What does the Bible say about PTSD?"
Answer: The Bible does not say anything specifically about Posttraumatic Stress Disorder, or PTSD. However, we can glean much guidance from some indirect teachings in the Bible.
Posttraumatic Stress Disorder develops in some people following a traumatic event. The event, or “stressor,” could be exposure to death or threatened death, actual or threatened serious injury, or actual or threatened sexual violence. The sufferer may be directly exposed, indirectly exposed through a family member or close friend experiencing the event, or extremely or repeatedly indirectly exposed through his or her work (such as first responders, police officers, military personnel, or social workers). Common trauma experiences are combat, car accidents, natural disasters, abuse, rape, and mass violence. (It should be noted that combat PTSD is a bit different than other forms of PTSD; this will be discussed in more detail below.) After such an event, most people will show signs of stress such as feeling on edge, anxiety, fear, anger, feelings of depression, a sense of detachment, desire to avoid trauma-related reminders, flashbacks, difficulty sleeping, headaches, changes in appetite, irritability, self-blame, “survivor’s guilt,” or a sense of numbness. For most people, these reactions lessen and eventually subside with time.
Those who develop PTSD have persistent symptoms for more than one month. Other symptoms for PTSD sufferers include intrusive re-experience of the trauma such as through recurrent, involuntary memories, nightmares, or dissociation; avoidance of trauma-related thoughts or feelings or external reminders; negative changes in thoughts or behavior, including an inability to recall details related to the trauma, persistent negative beliefs about oneself or the world, loss of interest, feelings of alienation, or inability to express positive emotions; and changes in arousal or reactivity such as irritability, aggression, hypervigilance, reckless behavior, or sleep disturbances. In PTSD sufferers, these symptoms cause significant impairment in work or social functioning. The United States’ National Center for PTSD estimates there are 5.2 million adults suffering from the disorder in any given year.
The situations that cause Posttraumatic Stress Disorder are different for different people, and not everyone responds in similar ways to similar situations. It is unclear why some develop PTSD and others do not. It seems that biological make-up, type of support received following the event, presence of other life stressors, and having effective coping mechanisms may contribute to whether a person develops PTSD. Interestingly, though symptoms of PTSD usually emerge immediately following or within a few months of the traumatic event, that is not always the case. PTSD can develop years later. How long the PTSD lasts also varies—some suffer for years, whereas others recover in several months.
PTSD resulting from participation in combat seems to be unique from other forms of PTSD. In combat situations military personnel are often both victim and aggressor, a dynamic which adds complexities to the issue. Often those with combat-specific PTSD will exhibit depression, extreme feelings of guilt, hypervigilance, and low self-esteem. It can be particularly difficult for combat veterans to process through the atrocities they have witnessed, come to a place of acceptance over the things they have been tasked to do, and readjust to non-combat living. For Christian military personnel, it can be especially difficult to accept taking the life of another, even as an act of war. Christians know the deep value God places on human life and often feel extremely guilty for taking the life of another, even in what would be considered a justifiable circumstance. Many times Christian combat veterans are more deeply aware of their sinful state than are other Christians. They may feel unworthy of God’s love due to the things military service requires of them. Those who suffer from combat PTSD may find accepting God’s forgiveness to be extremely difficult. They may agonize over decisions they made in the many no-win situations in which they were placed during war. They may also have persistent flashbacks of the gruesome realities of war as well as consistently feel on high-alert from months of living in life-threatening situations.
Regardless of the circumstances, there is hope. First and foremost, that hope comes from God.
The treatment process should involve a combination of physical, mental, and spiritual healing. Many will require professional help. For those with combat-related PTSD, it is likely preferable to receive help from someone experienced in treating combat-specific PTSD. There are multiple therapeutic remedies for PTSD available, ranging from talk therapy (often Cognitive Behavioral Therapy) to cognitive reprocessing to eye movement desensitization and reprocessing (EMDR) and other methods. Medication may also help alleviate symptoms. Certainly, a network of support—counselors, doctors, family members, pastors, the church community—is important in the recovery process. Of course, the most important support is God, our ultimate Healer and Counselor. David wrote, “From the ends of the earth I call to you, / I call as my heart grows faint; / lead me to the rock that is higher than I. / For you have been my refuge, / a strong tower against the foe” (Psalm 61:2–3). It is our responsibility to exercise faith in God, to stay in the Word, to cry out to God in prayer, and to maintain fellowship with other believers. We go to God in our distress and make use of the resources He provides.
Those who suffer from PTSD from any experience should recognize that treatment will take time, and that is okay. Some have compared this to Paul’s "thorn in the flesh" (2 Corinthians 12:7–10). God does offer healing, but in the way and the timing He sees fit. In the meantime, He gives sufficient grace to bear up under hardships. Thorns are painful, and PTSD is certainly a big thorn. But we can continue to go to God and remind ourselves of His faithfulness (Lamentations 3; 1 Corinthians 1:4–9).
Truth is a key component to coping with or overcoming PTSD. Reminding oneself that God loves, forgives, and values His people is extremely important. Knowing who God says we are and defining ourselves by His standards rather than by what we have done or what has been done to us is important. We need not identify as either victim or perpetrator. In God, we can identify as beloved child (Romans 8:14–17; Ephesians 1:3–6; 1 John 3:1–3), sealed in the Holy Spirit (Ephesians 1:13–14), forgiven (Romans 5; Ephesians 1:7–10; 1 John 1:8–9), and redeemed. Losing a close friend or family member is incredibly difficult, and many can feel unworthy of being spared. But those with “survivor's guilt” can remember the truth of God’s sovereignty and that He has a purpose for everyone’s life. God loved the ones who were casualties of war or another crime or tragedy just as much as He loves the ones who survived. His purpose for each person is unique. Replacing the lie that we are unworthy to have lived with the truth that God has a plan and values our days on earth is key (Ephesians 2:10; 5:15–16).
Speaking truth about practical things is also important. Often, those with PTSD will feel endangered when the situation does not warrant it. Reminding oneself that this is not the traumatic event but is a new and safe situation is important. It is also important to speak the truth that PTSD is not an excuse for bad behavior. Likely, PTSD will contribute to some negative thought and behavior patterns. This is understandable, but it should be resisted.
Having a community of support who offers grace and forgiveness and speaks truth in love is incredibly important. And it is vital that the community who supports the sufferer of PTSD is also receiving support. Remaining connected to one’s local church is crucial. Time with God through prayer and reading His Word is important for both the sufferer of PTSD and his or her family. Self-care and doing things that are relaxing and refreshing are also important. PTSD often feels as if it overtakes one’s life. Doing things that are enjoyable and life-giving is just as important as confronting the PTSD head-on.
PTSD is a difficult challenge that will require strong faith in God and willingness to persevere. But God is faithful, and each day we can choose to surrender to God’s love, battle the PTSD as best we can, and ultimately rest in God’s grace and compassion. PTSD is not something to ignore but something to turn over to God and actively engage with. We are invited to approach God boldly and to pour out our hearts to Him (Hebrews 4:14–16). We are assured that nothing can separate us from His love (Romans 8:35–38). God can restore the mental health of the PTSD sufferer. In the end, God can even use the situation for His glory. “Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God. For just as we share abundantly in the sufferings of Christ, so also our comfort abounds through Christ” (2 Corinthians 1:3–5).