Post-traumatic stress disorder (PTSD) is a psychiatric condition that can develop in people who have witnessed or experienced a life threatening event. These events could be anything from natural disasters, military combat, terrorist attacks, a serious accident or abuse in child or adulthood.
Most people that experience any kind of trauma return to normal soon after. However, on some occasions these stresses don’t go away on their own and can even get worse. The people whose symptoms get worse may develop PTSD, and therefore constantly relive the experience through flashbacks, difficulty sleeping, nightmares and even hallucinations. Symptoms of PTSD are always severe, but sometimes they can be severe enough to impair their daily life.
Although the symptoms of PTSD can begin straight after the event, the condition cannot be diagnosed until the symptoms have been ongoing for a month.
Symptoms of PTSD
There are three types of symptoms that can affect people with PTSD:
These symptoms cause the sufferer to relive the traumatic event in a number of ways. They could experience upsetting memories that come back when least expected or they could be triggered by a reminder such as hearing a car backfire, watching a war movie, a car accident or seeing reports of a recent assault.
Sometimes victims can even experience flashbacks where they completely relive the event, causing physical and/ or emotional reactions.
These symptoms can cause intense feelings that are similar to the ones experienced when the event originally took place.
Avoidance and numbing symptoms
People suffering with PTSD may try to avoid situations that could trigger memories of the event. This includes going near to places where the event occurred and watching TV programmes or listening to radio shows about similar instances. Some sufferers will also avoid certain sights, smells and people that remind them of their trauma.
Individuals with PTSD may also find it difficult to express their emotions towards other people. The emotional numbness that’s experienced as a result of a traumatic event can seriously affect their lives, causing them to isolate themselves from others. Some people will start to feel less enjoyment from activities they once loved; others will forget or be unable to talk about the event.
A feeling of alertness after the event is common for sufferers of PTSD. This symptom type is known as increased emotional arousal and can cause difficulty in normal, everyday activities, like sleeping and concentrating. It can also cause sudden mood changes including outbursts of anger and irritability.
Life with PTSD
Becoming stressed after a major incident or trauma is perfectly normal and over time the majority of people learn to deal with these situations and get back to normal. Sometimes this can take weeks, months or even years, but the majority of people will once again establish a normality, even if this normality is different from what was considered normal before the incident – i.e. if you were involved in a car accident where family members died, things will never be the same as they were before the accident.
It’s perfectly natural for the mind to protect itself from the effects of trauma by cutting off emotions. This can leave you feeling empty and emotionally numb. However, it’s also perfectly natural for the heart and mind to heal; although, be aware, that everyone deals with trauma in their own way and recovers at their own pace.
PTSD can make this recovery process take much longer, especially if it goes untreated. Living with PTSD can be extremely frightening and debilitating; you could exclude yourself from others, relive the traumatic experience over and over again or find yourself constantly trying to avoid people or situations that could remind you of the incident.
Around half of those that suffer with PTSD recover within a few months, but some people suffer with on-going or recurring symptoms that can be triggered by reminders of the event or anniversaries of its happening.
It is possible to be treated for PTSD. There are two main treatment types; some people will have only one whereas others may have a combination of the two. A bespoke treatment plan will be created based on your exact symptoms.
The two main treatments are psychotherapy and medication.
Psychotherapy is usually the first recommended treatment for PTSD sufferers; a combination of psychotherapy and medication is usually only offered to those who suffer with severe or persistent PTSD.
Psychotherapy is not only used for PTSD treatment, but also to treat other mental health issues including depression and OCD. The two main types of psychotherapy used are:
Cognitive behavioural therapy (CBT)
CBT focuses on managing your behaviour by changing how you think and act. When CBT is trauma-focused it will help you come to terms with a traumatic event. CBT is not an easy process and it will take time; you could be asked to think about and describe the event in detail – your therapist will help you cope with any distress you feel as a result. This will help you gain control of your fear and means your therapist can help change your negative thinking.
Most people that undergo CBT will have between eight and twelve sessions (one each week). However, if the treatment is started within one month of the event happening, fewer sessions may be required.
Eye movement desensitisation and reprocessing (EMDR)
EMDR is a new treatment that has been found to reduce PTSD symptoms; it involves making specific eye movements – usually side to side, following your therapist’s finger – while recalling the traumatic event.
Professionals are not certain how EMDR works, but it’s believed that it could help the hippocampus to process the flashbacks and distressing memories relating to the event, so that the influence that they have over your mind is significantly reduced.
A number of anti-depressants may be prescribed to treat PTSD in adults. Of the ones that it’s possible to prescribe – paroxetine, mirtazapine, amitriptyline or phenelzine – only paroxetine is licensed for PTSD treatment. However, the others have proved to be effective and are therefore often recommended too.
These medications will only be used in certain instances, for example:
- There is a threat of further trauma so psychological treatment would be ineffective
- You decide against undergoing trauma-focused psychological treatment
- The psychological treatment you have had has had little or no benefit
- You’ve got an underlying medical condition – i.e. depression – that inhibits your ability to benefit from psychological treatment
Medications will usually be prescribed for a minimum of 12 months and then withdrawn over a period of four weeks or more.