PTSD (Post-Traumatic Stress Disorder) is a complex anxiety disorder that usually occurs after some type of extreme, traumatic event.
Everybody reacts differently to a life-threatening or traumatic experience. For some, PTSD will develop either immediately after the traumatic experience, or any time in the future, sometimes even months or years later.
Post Traumatic Stress disorder can be acute; the symptoms arise shortly after the traumatic event and resolve within 3 months. This anxiety disorder can also develop into a chronic condition that can last for many, many years if left untreated.
The National Vietnam Veteran Longitudinal Studies examined Vietnam soldiers 40 years after the conflict ended. Research has concluded that around 271,000 soldiers who served in Vietnam are still suffering with posttraumatic stress disorder PTSD over forty years later.
Traumatic events that can trigger PTSD
Symptoms of PTSD
1) Re-experiencing Symptoms:
- Flashbacks: People with ptsd have involuntary flashbacks of the traumatic experience. These flashbacks involve a re-living of the event with all the fear-based emotional
reactions that went with it. The intense fear and the fight-or-flight reaction is re-experienced. Other anxiety symptoms associated with PTSD include shaking, trembling, sweating, heart palpitations and shortness of breath.
- Nightmares, night terrors and bad dreams related to the traumatic event or intense anxiety are common.
- Intrusive thoughts or memories: Disturbing, frightening thoughts can play over and over in the mind. Invasive thoughts can seriously affect daily life.
2) Avoidance Symptoms:
3) Increased Anxiety and Emotional Reactivity symptoms
When the stressed-out nervous system becomes stressed out, the symptoms can be constant and exhausting. Heightened emotional arousal signs include:-
- Easily startled: Any loud noises, sudden noises or unexpected events may trigger an exaggerated startle response.
- Difficulty relaxing: A person with PTSD will often be tense and ‘on edge’ most of
the time. They may have difficulty relaxing.
- Problems concentrating: One of the majaor PTSD symptom includes difficulty concentrating or maintaining a train of thought. ‘Phasing out’ or experiencing ‘mental blanks’ are common. Work and social situations can become very difficult.
- Sleep disturbances: Insomnia, nightmares, night terrors and disturbed sleep patterns
- Anger and Irritability: Often PTSD sufferers will have angry outbursts and are extremely irritable.
- Hypervigilance: Sufferers may be constantly on the look out for danger or threats even in safe environments.
4) Mood and Cognition Symptoms
- Negative thoughts about the world or yourself. There may be a mistrust of people.
- Feeling guilty or to blame in some way for the negative event.
- Experiencing the extreme emotions related to the traumatic event such as horror and sadness. Clinical depression often accompanies PTSD.
- Loss of interest in people and hobbies that you previously found enjoyable.
- Substance Abuse: Many people misuse drugs or alcohol, or indulge in other self-destructive behaviour.
Diagnosis of PTSD
With regards to the groups of symptoms listed above adults must suffer from at least:-
- One re-experiencing symptom
- One avoidance symptom
- Two anxiety/emotional reaction symptoms
- Two mood and cognition symptoms
for at least one month to be diagnosed with post-traumatic stress disorder ptsd.
Complex Post-Traumatic Stress Disorder (C-PTSD)
When we speak of Post-Traumatic Stress Disorder most of us will think of war veterans or rape survivors.
However, for some people it is repeated exposure to ongoing trauma that causes Complex Post-Traumatic Stress disorder. Complex PTSD is not so well known. (not to be confused with acute stress disorder which is a milder form of PTSD).
Usually the defining repetitive trauma involves the sufferer feeling they have no control, helpless with no means of escape.
Some typical scenarios that may lead to C-PTSD include:-
- Ongoing emotional, physical, sexual or domestic abuse in adulthood
- Ongoing emotional, physical, sexual abuse or neglect in
childhood
- Experiencing kidnapped or entrapped
- Enforced slavery or enforced labor
- Imprisonment and torture (such as a prisoner of war situation)
- Taking care of mentally ill or chronically ill close family members
- Long-term exposure to gaslighting
- Crisis conditions such as homelessness and war.
Symptoms of Complex Post-Traumatic Syndrome
Treatment of Post-Traumatic Stress Disorders
Many people with PTSD and C-PTSD do not recognise that their combination of symptoms is a treatable anxiety disorder. Like the other main anxiety disorders, PTSD DOES respond well to therapy.
It is essential that ptsd treatment is sought as soon as possible. If you recognise any of the symptoms in yourself or a loved one please seek out help from a mental health care professional.
Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioural therapy is a form of psychotherapy designed to rapidly and effectively reduce or eliminate the problematic psychological symptoms.
Cognitive means ‘thinking‘ or cognition, and Cognitive-behavioral therapy cbt focuses on changing people’s thoughts and feelings surrounding an event.
There is a skill development in cognitive-behavioral therapy and evidence suggests that when people learn to think and behave differently they rapidly reduce anxiety. If they can identify, evaluate and change their thinking styles behavioural changes follow which improves psychological problems.
Many studies show that CBT is one of the most effective treatment for ptsd.
Eye Movement Desensitization and Reprocessing (EMDR)
Some studies have shown that Eye Movement Desensitization and Reprocessing (EMDR) is a successful treatment of ptsd. EMDR was specifically designed to relieve the distress connected to traumatic memories.
Eye movement desensitization involves moving the eyes side to side and centrally up whilst remembering the traumatic event. Similar to the REM movements in dreams, it is thought that eye movements help the brain to both access and process the traumatic memory.
Sounds may be played to the right ear (move the eyes to the right), the left ear (move the eyes to the left) and then both ears (move the eyes centrally and up).
Sometimes a therapist will guide the eye movements by having you follow his finger left or right or tapping the finger to the left or right.
Group Therapy
Exposure Therapy
Exposure Therapy has traditionally been successful in treating phobias. Clients are gradually exposed to the memories of the trauma in a controlled, safe way.
Photos, smells, descriptions or actual visits to the place where the trauma happened can all be used in this process, with the help of a therapist.
Medications
Talking therapy treatments are the recommended first-line treatment for PTSD. If symptoms are severe or persistent medication and therapy may be prescribed in combination.
Selective Serotonin Reuptake Inhibitors (SSRI’s)
SSRI’s have been shown in medical studies to be very effective in treating PTSD.
Commonly used SSRI’s:-
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Fluvoxamine (Luvox)
Serotonin–Norepinephrine Reuptake Inhibitors (SSNRI’s)
Benzodiazepines
Another anti-anxiety medication used to treat PTSD are a group called Benzodiazepines. Benzodiazepines work by calming the nervous system. These drugs are tranquilizers and can work very well in decreasing anxiety symptoms in the short term. The medications do have side effects including dependency and addiction.
Commonly used Benzodiazepines:-
- Diazepam
- Alprazolam
- Chlordiazepoxide
- Clobazam
Post-traumatic stress disorder: A Personal experience by Megan
Life is beautiful to most people who have only ever experienced the joys of life; for people who wake up each day, facing the same pleasant experiences with no worries or fears.
But for a long time life has not felt beautiful to me. My life has been a living hell for the last four years . . . maybe more . . . it’s all a bit blurry.
This is not because I am poor; I have enough food and a roof over my head. In fact, I have everything that I need as a human being. Indeed, I own a beautiful apartment and drive my own car, I wear expensive clothes and so much more. In addition, I have a beautiful daughter whom I love so much. So, why am I saying my life is a living hell?
How it all Began
It all began five years ago. I still remember snippets of that day like it was only yesterday; hearing the shouts, screams and pools of blood everywhere on the floor. I remember running into an open door written ‘authorized personnel only‘ and hiding under a table.
On the day that changed my life, I had gone shopping to one of the busiest malls in the city of Chicago. My plan was to spend around an hour in the mall and to pick my niece up after school, which was at least half an hour drive from where I was. I love shopping, I can spend hours just window shopping for things I need and for things that l really don’t need.
After one hour, I received a phone call from my sister telling me that she had decided to pick up her daughter because her appointment had been cancelled. She wasn’t happy telling me this but I was relieved as it meant more hours in the mall for me.
The Trauma at the Mall
I remember going up the escalators to look at a different collection of handbags. People were moving up and down, popping in and out of shops just like in any other busy shopping mall.
Suddenly, out of nowhere there was the most enormous bang. It was like a bomb or an explosion. I initially thought that maybe a floor had collapsed and I thought about running down the stairs, avoiding the elevator in case the building collapsed.
Before I even had time to fully formulate my escape plan, the ongoing screams and another gunshot made me realize that the building had not collapsed. This must be a terrorist attack, a robbery or something else.
I had to do something else fast. My fight-or-flight response fully kicked in and I was shaking, breathless and terrified. Thank God my hand was suddenly grabbed by one of the employees of the mall telling me she knew a perfect spot to hide. I remember a room full of boxes and empty cartons which I later realized was a store. We hid under an old table behind the boxes. The room had signs that stated ‘authorized personnel only’ and weirdly I was actually worrying if I was authorized to be in there.
It took a total of three, long, never-ending hours in the store room for all the chaos to end. When the police finally came to search for survivors I was paralyzed with fear. Furthermore, I was totally mute, I could not make a sound or even move.
We were gently led out of the room. Walking past the dead customers and dead cashiers was even more traumatizing. These are the images that I have lived with ever since and they have become part of my daily life to date.
The Aftermath
In the long months that followed, I didn’t sleep at night. Regularly, I would see images of the dead people and wake myself (and my boyfriend) in the night screaming.
I guess it explains one of the main reasons why we broke up, I was no longer fun. The anxiety symptoms that I experienced each and every day were crippling. In fact, I remember my (now ex) boyfriend told me that my cries and screams at night were making him uncomfortable.
Our relationship broke down and I ended up moving back to my parent’s house. I had not planned on suffering with Post-traumatic stress disorder and I hated the person it had changed me into.
After the Aftermath
It took me another year of cognitive-behavioral therapy and anxiety medication to keep me sane. My last therapist and my supportive family did everything they could to help. They read and learned everything about PTSD, even so, I still felt incredibly alone and unsafe.
My family understood my triggers which included boxes, cartons, shopping malls, enclosed spaces and loud noises. They kept the environment as calm and soothing as possible.
I hate thinking about death and why one person would kill someone else but I guess the world is different and each of us think and behave differently. It is an ugly fact but we have to accept that.
Healing
One piece of advice I would give anyone reading this, or who is going through post-traumatic stress disorder, is never to give up hope. You will get better.
If you suspect you have PTSD please seek professional help.
Make sure you surround yourself with people who understand your condition and are willing to help you overcome it. Look for those who will stay by your side when those memories burst in and overwhelm you, even in the middle of the night.
Most of all – YOU be kind to YOU. Surround yourself with lovely music, food, people, anything that makes you calm and happy. Get help from whoever can give it to you. Read everything you can about your condition. Forgive yourself for how you feel and know that it is not your fault.
Resources
- National Center for PTSD
- Gift From Within: PTSD Resources for Survivors and Caregivers
- PTSD Chat Room and Forum: Online FREE support for mental illness and PTSD sufferers including a self-esteem group
- Psych Central: A peer-reviewed, and large index of online post-traumatic stress support groups. From non-profit counseling to online therapy groups and forums.
- Real Warriors: A site devoted to war veterans and their families
- The PTSD Association: Take the test and discover if you are suffering from PTSD. As well as a whole plethora of information on PTSD. Learning as much as you can about your condition is the first step to healing.
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References
- Iribarren J, Prolo P, Neagos N, Chiappelli1 F. (2005) Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium Evid Based Complement Alternat Med. 2005 Dec; 2(4): 503–512. (Retrieved October 9th 2016)
- Javidi H, Yadollahie M. (2012) Post-traumatic Stress Disorder. Int J Occup Environ Med. 2012 Jan;3(1):2-9. (Retrieved October 9th 2016)
