As with many conversations surrounding mental health, there are a few common misconceptions when it comes to understanding the course and development of posttraumatic stress disorder (PTSD), a mental illness that many suffer with after experiencing a traumatic event. Dr. Joe Bates, brain expert and double board certified psychiatrist, has a particularly clear and personal understanding of this disease, as he’s also a combat veteran who served as an army doctor in Vietnam and witnessed firsthand the atrocities of war. Bates will first explain how this illness can differ from person-to-person—a significant piece to this puzzle of misconceptions—and then delve further into five common misbeliefs:

“The most important part of PTSD is the letter ‘T’… and that stands for trauma. However, it is important to remember that trauma comes in all sorts of shapes and sizes. Events that evoke the tell-tale symptoms of intrusive thoughts, anxiety, nightmares, avoidance, paranoia, anger, and over reactivity are not the same, and often not even similar from one person to another. Some people just blow it off and go on with life—that’s where the individual’s resilience and coping mechanisms come into play. Yet those same individuals who weather a major catastrophe and come through seemingly unscathed may succumb to what most would consider a much milder stressor,” he concludes.

Now that you have a basic understanding of PTSD as an often unpredictable illness—which can play varying roles in each victim’s life—here are five significant misunderstandings, which Bates addresses and corrects:

    1) There is a clear treatment plan for those with PTSD.
    While there are certain interventions commonly used to treat PTSD—such as cognitive processing therapy (CPT) and trauma-focused cognitive behavior therapy (TF-CBT)—there are no guarantees when it comes to effectively relieving the harmful symptoms of this disorder. For example, one individual may find relief in taking anti-anxiety medications, while another need only the support of his loved ones, as explained by Bates: “There is no one standard treatment for all patients with PTSD–it must be individualized to the person and usually includes a combination of medications and therapy. Some individuals do not need any treatment at all, other than supportive family and friends who lend friendly ears to listen and hearts to encourage.”

    2) Victims often wake up terrified and drenched in sweat.
    Common images of PTSD, including those of someone jolting awake and covered in sweat, aren’t always accurate depictions of what it’s like for individuals post-trauma. “Waking up drenched with perspiration may or may not be associated with PTSD nightmares,” Bates explains. “Medications and medical conditions are the most common causes of night sweats. When someone is experiencing a nightmare related to trauma, the dream is usually fresh on the mind and can be described in detail.”

    3) PTSD gives sufferers an excuse to be aggressive and violent.
    Many also associate PTSD with angry or aggressive outbursts. And while these outbursts are sometimes characteristic of the disease, Bates says PTSD sufferers never get a free pass for acting violently or aggressively: “Anger and aggression can occur with PTSD but can never be used as an excuse to make a conscious decision to harm or threaten another person. That’s a cop out.”

    4) The illness strikes right away.
    Another misconception is that PTSD hits immediately following the given traumatic event. While this happens in certain cases, there are also many individuals who don’t present symptoms of the illness until much later: “PTSD symptoms do not always present within a brief time after the actual event. There can be a delayed onset, particularly with war-related experiences. Triggers, such as odors, or sounds, can result in experiencing the event as if it just happened yesterday, even after years or decades of being suppressed.”

    5) There is no hope for healing.
    Many believe that once a person is diagnosed with PTSD, there is no hope of recovering. However, Bates says that’s just not the case. More often than not, individuals with PTSD do find healing and relief from the harmful symptoms that come with the illness: “PTSD can, and most often, does get better with time. Individuals do not have to allow events from the past to forever color their present and future,” Bates explains.