When people think of Post Traumatic Stress Disorder (PTSD) they often associate this type of mental disorder with military veterans. But soldiers are not the only people who go through traumatizing experiences and battlefields are not the only places where people can develop PTSD.

People in prison, in car accidents, in animal attacks, and particularly those who are abused as children can all experience stress that manifests and develops as PTSD as well. But what about homeless people?

Sure, there’s plenty of homeless people that are veterans and may have suffered from a traumatic event while in the military. But there’s also many homeless people with PTSD that have never been in the armed forces or in a war zone.

While many people may refer to areas of Los Angeles and other large cities as “war zones”, it’s obvious that sleeping on Skid Row or anything similar to it is nothing like being in an actual war. A person might have to stay hypervigilant to protect themselves from strangers. They might have to sleep with one eye open, which can cause unnecessary worrying and tension. But all of this isn’t quite the same as having artillery fire directed at you by enemy combatants on the battlefield.

However, experiencing homelessness and living on the streets can still be one of the most traumatizing things that a person can go through. This is particularly true when they first find themselves without many options and have a mental breakdown.

The breakdown can be a result of all the stress they suddenly find themselves dealing with when sleeping outside, or related to other aspects of homelessness that most average people would struggle heavily with. So, of course homeless people suffer from PTSD as well, and the following are just some of the main causes and evidence of that.

Trauma
When you’re homeless, you’re at more risk of experiencing traumatic experiences that those living normal lives might not ever experience. An example of this would be if you witnessed one homeless person brutally attacking another homeless person, or someone dying in front of you.

While many people might not be affected by seeing these types of things, there are some people who are sensitive or who were otherwise sheltered before ending up on the streets. These types of people might experience stress after seeing these things, particularly if they start to worry about these things possibly happening to them.

Fear, paranoia, worry, and stress can all occur when the reality of a dangerous situation becomes apparent and obvious after witnessing something bad happen to someone else who’s in the same situation as you.

When I was sleeping outside a local homeless shelter, I witnessed many things from stabbings to people dying for unknown reasons. While none of this caused me to experience any PTSD (that I’m aware of), I can understand how others might later develop mental illnesses such as PTSD or depression as a result.

You have to take into consideration the fact that when you’re homeless, you’re spending most of your time outside and this often means you’re in areas of a city where bad things are more likely to happen. There’s a higher rate of violence, crime, and drug use within the homeless communities, so it makes complete sense that these specific populations of people would see more tragedies and traumatic events.

Lack of Social Structure
When a person becomes homeless, they don’t normally have the same social support as non-homeless people or they often lose much of the social support they thought they had. Many of my so-called friends disappeared and stopped trying to keep in contact with me when I first became homeless.

Social support can play a major role in whether PTSD develops in a person or not. There are countless studies on the link between social support and PTSD, as well as many other mental illnesses.

One such study was conducted on people in New York after the events of 9/11 happened. Researchers dug deep into these people’s lives to find out why some people in the area developed PTSD and why others didn’t, when most of them were all exposed to those same events in the media and in their community.

They found that among the factors that were noticed in the PTSD groups and the healthy groups, a lack of social support leading up to the development of PTSD was at the top of the list. People who don’t have friends and family to talk to about problems and who have to deal with traumatic events alone are much more likely to develop PTSD.

Researchers have proposed many different reasons for this effect. Another study, published in 2008, also recognized a trend in those with PTSD and a lack of social structure in their lives. One of their possible explanations for this was that socially bonding with others during or just after traumatic experiences can help the victim feel more safe.

If you think about it, most people have a natural reaction to want to turn to others during hard times to gain a sense of solace or comfort. This desire or need we all have most likely goes back to childhood when we were first born and turned to her parents for comfort when things were scary or when we needed help.

It serves as a therapeutic effect and can provide a level of mental protection during tough times. Because most of my friends and family had abandoned me when I became homeless, I formed friendships with other homeless people around me and a few of these people I became very close to very quickly. I knew this was probably not a very good idea, because you want to keep your guard up when living on the streets and shouldn’t let too many people know too much about you. But this may have been a natural reaction, or an inert desire of mine to protect my brain from the depression and initial shock of having to deal with homelessness and adapt to everything.

Health
Believe it or not, having major health problems or concerns can cause PTSD as well. The National Health Service (NHS), made up of physicians and experts, lists this as one of the big causes, alongside trauma and all the usual causes you might think of. It makes sense when you think about it, because health problems can be scarier to some people than any other types of traumatic events.

During my first month on the streets, I met a very kind man by the name of Carl. He had a failing liver as a result of liver disease, had gout in his legs, and was living in a truck at our homeless encampment outside a shelter we all ate and showered at. He told me had less than a year to live and had to regularly visit the hospital while homeless so that they could remove bile from his liver to try to keep him alive longer.

Imagine being homeless, dealing with all the problems and worries that come with that, and then knowing that you also have serious health problems at the same time. Being aware that you’re going to die from a disease or health condition, or even thinking it’s a possibility, can make anyone snap when already experiencing homelessness-related stress.

PTSD doesn’t discriminate in what type of mental stress it likes best. It arrives and wreaks havoc after any type of shock or mental trauma, regardless of what actually caused that trauma. Being told you have a year or less to live could cause shock in just about anybody. So, it’s very possible that Carl was experiencing PTSD as well, in addition to his physical health problems.

The Link Between Childhood and Adult Homelessness
Of course, not all homeless people developed their PTSD as a result of being homeless. As I mentioned before, there’s many veterans who become homeless and these veterans often served in wars and battles which caused their PTSD.

But PTSD can be caused many other things in life, especially when a person is a child and their brain is more sensitive because it’s still developing. Many people, possibly even the majority of those with PTSD living on the streets, had rough upbringings or problems in their life before being homeless.

There’s been plenty of studies regarding this as well, with one published in 1992 which found that almost 75% of homeless people with PTSD most likely developed it sometime before they were on the streets as a result of family fighting or traumatic experiences in their household as a child.

However, sometimes PTSD might be caused by something early on in life, but won’t actually manifest itself until many years later. An interesting study in 2015 found that negative or traumatic events when being homeless were more likely to cause PTSD if the person also had bad experiences or events in childhood.

In other words, a person might have been abused by family members or suffered other negative events as a child, but did not develop PTSD until much later in life when they became homeless and suffered more traumatic experiences on the streets.

The negative events they experienced as adults may have served as a trigger for PTSD symptoms to start, after many years of a person suppressing their negative thoughts and feelings or the brain being able to withstand these things until it’s just too much. One might even look at this as being a case of “the straw that broke the camel’s back”.