ptsd

What is post-traumatic stress disorder?

The term post-traumatic stress disorder (PTSD) or post-traumatic stress syndrome (PTSS) is used to name a range of symptoms you may develop in response to experiencing a traumatic event, which is outside of your 'normal' human experience. It is often a delayed response.

Just hearing news of events, such as the London bombings in July 2005, incidents in the war in Afghanistan, or the Hillsborough football stadium disaster, can have a lasting effect on you. If you are actually present during a disaster of this nature it’s likely that you will become extremely distressed.

Likewise, if you are involved in, or witness, events such as road accidents, muggings, and sexual or physical assaults, these experiences may also cause you deep emotional injury. There is no doubt that the reactions that may follow can seriously hamper and interfere with your life.

Some survivors have objected to the use of the term ‘disorder’, because they see such reactions as an entirely normal and understandable response to abnormal events. But regardless of whether the term ‘disorder’ or ‘syndrome’ is used, the diagnosis recognises that there are events and experiences that are beyond our control, and which may fill us with fear or horror, and can cause extremely disturbing psychological symptoms.

What are the symptoms?

If you have faced a traumatic experience, you may simply feel emotionally numb to begin with, and feelings of distress may not emerge straight away. But sooner or later, you are likely to develop emotional and physical reactions, and changes in behaviour, which may include some of the following: http://www.mind.org.uk/help/diagnoses_and_conditions/post-traumatic_stress_disorder

 These are all quite common reactions to a traumatic event, and many people find the symptoms will disappear in a relatively short period of time. But if they last for longer than a month, or they are very extreme, you may be given a diagnosis of PTSD.

You may also have other symptoms, such as severe anxiety, a phobia or depression. You may develop a dissociative disorder (see Mind’s booklet Understanding dissociative disorders) and suicidal feelings. There’s no time limit on distress, and some survivors may not develop post-traumatic symptoms until many years after the event.

Fearing for your life

Events in which others die, or where you thought you were going to die, may lead to more long-lasting stress responses. A study of Falkland War veterans found that people who had actually been involved in combat were most likely to get PTSD.

Harmful intentions

Man-made disasters, particularly those involving deliberate acts of violence, terrorism, or exploitation, seem to cause longer-lasting and more painful emotional consequences than natural disasters. The crucial factor may be that such experiences destroys people’s trust in others, particularly if they involve someone you have depended on.

Conscious memories

People who remain conscious throughout the experience are more vulnerable to PTSD because of the horrific memories etched on the mind, whereas those who lose consciousness or suffer head injury are protected.

Personal circumstances

Your personal history can make you more prone to PTSD. If a traumatic event triggers memories of an earlier distressing experience, the effect may be much worse. Similarly, if you are already going through emotional problems, you are also much more vulnerable.

Guilt feelings

Sometimes survivors of trauma feel guilty, as though they were responsible for the event, or could have done more to save themselves or others. One study showed that those who blamed themselves in some way for the outcome of the disaster were more at risk of severe and long-term distress.

How can I deal with a traumatic event?

After a traumatic event, people often feel numb, dazed and disorientated. Talking about what has happened to them may be the last thing they want to do. Many survivors have said that what they found most useful, to begin with, was practical advice, followed by information and support with day-to-day tasks.

Talking about your feelings may be the best way of coming to terms with the experience. Everyone will have their own unique responses, and will need to proceed at their own pace. You may turn to friends, relatives and colleagues, or seek professional help when you decide you do want to talk about what you’ve been through.

It is important that you have an opportunity to talk to someone when you are ready to do so. However, you should not be made to talk before you are ready, or even at all, if you do not want to. Research has shown that debriefing immediately after traumatic events, by making you describe every detail, may make PTSD more likely, because it may help to establish memories of the event by bringing them into the conscious mind, increasing the risk of flashbacks or nightmares.

Many people go through a period of denial after a bereavement or a traumatic event. Researchers have suggested that this allows you time away from the trauma, similar to unconsciousness. This research also suggests that challenging or interrupting this by insisting you talk about the trauma is harmful. It is also possible that while you are apparently ‘in denial’, you may subconsciously be beginning to face the trauma.

However, if you bottle up stress responses over months or years, they may become deeply ingrained and cause serious problems. You may remain in a state of extreme tension long after the trauma has passed. You may find yourself avoiding situations, in case they remind you of the trauma, so that life becomes increasingly restricted. Not uncommonly, you may turn to alcohol or drugs in an attempt to avoid painful feelings and memories. In trying to avoid the problem though, you are also avoiding getting appropriate help. There are various organisations that can provide the details of counsellors experienced in treating PTSD. For more information, see ‘Useful contacts’.

It can be very helpful for you to share your experiences with others who have been through something similar. This can be an extremely important step in moving away from isolation and towards regaining control of your life. You may find it especially useful to contact an organisation specialising in your particular type of experience; for example, soldiers who have seen combat, victims of violent crime or sexual assault, and people who have been tortured or who are refugees. (see ‘Useful contacts’).