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Post Traumatic Stress Disorder, Heightened Arousal, and THE WOMEN by Kristin Hannah

Cover of the book The Women boy Kristin Hannah used to teach the mental health concept of Heightened Arousal and Post Traumatic Stress Disorder

Frankie was a stereotypical girl from a nice family who changed the course of her life when she enlisted to serve in Vietnam, completing two tours of duty. Aside: yes, women served in Vietnam. While deployed, Frankie lived with the background noise of rocket fire, cared for deathly ill patients, and provided a calm, gentle presence as people around her died.


Frankie returned home to her previously pleasant life in California haunted by Vietnam, wondering at times if a part of her died there. Frankie didn’t have a name for the problem but knew that the symptoms were intense and severe. She had nightmares of being back in-country and mood swings seemingly out of the blue. Newspaper articles or a car backfiring could trigger her into unstoppable thoughts about Vietnam, leaving her unable to concentrate. Once, when a waiter dropped a tray of dishes, Frankie threw herself to the ground for cover, momentarily feeling as if she was under attack.


Frankie experienced Post Traumatic Stress Disorder (PTSD), a psychiatric disorder that may develop after experiencing a traumatic event. PTSD is characterized by intrusive thoughts, avoiding thinking or talking about the traumatic experience, heightened arousal, and loss of interest in once-enjoyed activities. PTSD is a not a sign of weakness. It is indicative of a problem that, with help, can get better.


People with Post Traumatic Stress Disorder experience heightened arousal, meaning that they are chronically on guard to keep themselves safe from another attack. Here are common presentations of heightened arousal. The presence of these symptoms (and the included examples) indicates that professional help may be beneficial.


Angry Outbursts: Aggressive verbal or physical behaviors in ways that are disproportionate to the situation.


Impulsivity: Reckless behavior, excessive alcohol use, self-destructive actions.


Hypervigilance: Constantly feeling on alert.


Excessive Startle Response: Jumpiness when encountering unexpected noises or movements.


Sleep Disturbances: Unable to fall asleep or stay asleep.


Attention Issues: Difficulty concentrating and remembering things.


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