PTSD and Trauma
Post-Traumatic Stress Disorder (PTSD) is a condition individuals can develop after being exposed to an extremely disturbing or horrific life event, that either threatened or harmed their own or another’s physical or emotional safety. Common examples are when an individual in some way experiences either directly themselves, or indirectly observed through others, scenes including a serious accident, witnessing another’s death, a natural disaster such as bush fire or flood, experiencing war or torture, or physical or sexual abuse. All of these situations would invoke feelings of intense fear, hopelessness, sadness or shock, and usually pass in due time with the support from loved ones. However, when these emotive reactions are heightened and prolonged to such an extent that the distress begins to take over their everyday functioning it is time to get an assessment.
To differentiate between the typical coping behaviours that occur after experiencing a traumatic event, to that of an individual developing PTSD. However typically the three hallmark symptoms include:
- Re-living the event: the individual has constant flashbacks or nightmares of re-living the traumatic event, as they experience vivid imagery and memories of the scene replaying in their mind. This causes them overwhelming levels of distress, as they are once again flooded with their emotive responses that were triggered during the event itself. These episodes are usually associated with the physical responses such as a racing heart, nervous sweating, or panic attacks.
- Hyper-vigilance, increased edginess & arousal: the individual experiences constant feelings of extremely nervousness, accompanied with a heightened sensitivity and over caution for potentially dangerous situations to occur. Often this will affect their ability to concentrate on other tasks, which may also lead to disrupted sleep patterns, and increased irritability. The symptoms of over arousal may also be present, including aggressive, reckless, or self-destructive behaviour.
- Avoidance of reminders: the individual avoids any reminders of the traumatic event, including people, places, activities or objects. This may lead to neglecting their health and isolating themselves from their friends and family.
- Becoming emotionally numb: They may feel like an ‘empty shell’ of a person, losing interest in the activities they once enjoyed, or the motivation to carry out daily tasks. Individuals may also experience an excessive and distorted perception of blame regarding the event, in either themselves or others.
Additional symptoms can also be present, and for more than one month after the event an individual with PTSD may:
- Try to avoid situations or things that remind them of the traumatic event
- Not remember important parts of the traumatic event
- View themselves, others and the world in a negative way
- Lose interest in activities they used to enjoy and feel detached from family and friends
- Feel a sense of emotional numbness, feel irritable or have angry or violent outbursts
- Engage in dangerous or self-destructive behavior
- Feel as if they’re constantly on guard or alert for signs of danger and startle easily
- Have trouble sleeping or concentrating
- Access: a support team of being who have a positive effect on you and who you feel able to be vulnerable around.
- Commit: It can be helpful to commit to regular activities and structure you day. This can minimize excessive reflection on negative thoughts. Some people keep to a daily schedule (e.g wake at a certain time, walk in the morning) to gain a control and accomplishment.
- Physical Exercise: Take time out for yourself, making sure you engage in regular physical exercise. Not only can the extra endorphins help to elevate your mood, but exercise can be a great method to release your tension and angst (not to mention keeping your health in check!)
- Abstinence: Try to avoid alcohol, stimulants and other substances during this hard phase, as there is a higher risk that consuming these will lead to dependencies and/ or abuse.
- Accept: Try not to block out the negative memories and dismiss how you are really feeling to friends and family. Letting yourself experience these challenging emotions and being able to talk through them when the opportunity arises is part of the recovery process. Accepting a painful emotion does not mean liking it, it just means processing it.
- Journal: Keep a journal. If you can’t talk about how you are feeling with others, write your thoughts down on paper. It can aid in insight and reflection later.
- Express: Try to express your emotions in any way that you can. Trying something new and creative such as art, cooking, dance, music, or yoga, you may find to be very therapeutic, relaxing and enjoyable.
Everyone’s sense of “trauma” is different. For example what one person finds traumatic may not be so for another. However, some people may have an increased likelihood of developing PTSD if they:
- Directly received harm from the event itself
- Have a past history or genetic predisposition of other mental health conditions
- Have had previous, repeated exposure to harm, such as physical, psychological or sexual abuse during childhood or otherwise.
It is also common for individuals to develop other mental health issues as a response to the traumatic even itself, or as an associated consequence after developing PTSD. The most common of these include depression, specific phobias, drug and alcohol abuse, or any other forms of addiction or dependencies.
It is recommended that anyone who has experienced high, unmanageable levels of distress, or any of the obvious PTSD symptoms previously outlined, for a timeframe exceeding one month seek advice from a doctor or psychologist. They will be able to make a formal assessment and possible diagnosis, for the necessary treatment to commence.
People of all ages, including children can develop PTSD. The criteria for PTSD in children is much the same as for adults, although the benchmark standards have been recently updated to include children under the age of six.
The criteria for children with PTSD now include the following characteristics:
- The child has been exposed to a serious emotional or physical event, either directly themselves, as a witness to, or through the learning of a traumatic event that occurred to a loved one.
- They experience one or more highly distressing responses to the event, such as:
-excessive and intrusive memories of the event or flashbacks of reliving the event
-re-occurring nightmares of the event
-high emotional distress over a prolonged period after the event, or after exposure to the cues associated with traumatic event
-elevated behavioural responses when traumatic memory or reminder of the event arises, such as rapid heart rate, sweating or heavy breathing
- The child exhibits avoidance behaviours or significant changes in their mood that either begin or worsen after experiencing the event, such as:
-avoidance (or attempted avoidance) of event reminders, including people, conversational topics, places or objects
-becoming withdrawn to friends and family
-losing interest in hobbies or activities that were once enjoyable
-prolonged reduction in feeling and expressing positive emotions
-experiencing detachment from their mind or body, or having distorted perceptions of the world
- The child experiences changes in their arousal, or reactivity after experiencing the traumatic event, such as:
-aggressive behaviour or increased irritability and tantrums
-becoming hyper-vigilant and over cautious
-exhibiting exaggerated responses when startled
-high levels of agitation
These symptoms are considered a problem in children if they persist greater than one month after the child experiences the traumatic event, and if these are significantly impacting on their ability to manage and partake in everyday activities.
PTSD can be treated with Cognitive Behavioural Therapy (CBT), where the therapist helps them to identify their existing negative and irrational thoughts, and replace these with more adaptive ones. Following this, the patient will learn alternative coping methods to reduce their distress to a more manageable level. With the psychologist’s support the individual will gradually challenge their traumatic memories through exposure therapy.
Who we recommend
Dr. Daphne Bryan
For adults with PTSD we would recommend Dr Daphne Bryan who is one of our skilled clinical psychologists here at Anxiety House, who works with phobias, grief and loss. Daphne uses a variety of psychotherapeutic techniques, including: Cognitive Behavioural Therapy, Mindfulness, Schema and Acceptance, and Commitment Therapy. These various treatment options may be particularly beneficial to those suffering from grief and loss and individuals who have developed PTSD.