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 include directly experiencing or indirectly observing or hearing about other people experiencing scenes including a serious accident, witnessing another’s death, a natural disaster such as bush fire or flood, 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 emotional reactions are heightened and prolonged and begins to take over everyday functioning, it is would be beneficial to seek help from a trained health professional.
To differentiate between typical coping behaviours that occur after experiencing a traumatic event, to the symptoms of PTSD, there are four hallmark symptoms:
- Re-living the event: the individual has constant flashbacks or nightmares of re-living the traumatic event, through 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 the same emotional responses that were triggered during the event itself. These episodes are usually associated with physical responses such as a racing heart, nervous sweating, or panic attacks.
- Hyper-vigilance, increased edginess & arousal: the individual experiences constant feelings of extreme 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 for more than one month after the event:
- Trying to avoid situations or things that remind them of the traumatic event
- Not remembering important parts of the traumatic event
- Viewing themselves, others and the world in a negative way
- Losing interest in activities they used to enjoy, and feeling detached from family and friends
- Feeling a sense of emotional numbness, feeling irritable or having angry or violent outbursts
- Engaging in dangerous or self-destructive behavior
- Feeling as if they’re constantly on guard or alert for signs of danger and startle easily
- Having trouble sleeping or concentrating
- Access: a support team of family and friends 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 to your day, to 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 achieve a sense of control and accomplishment.
- Physical Exercise: Take time out for yourself and engage in regular physical exercise. Not only can the extra endorphins help to elevate your mood, but exercise can be an adaptive way to release your tension and angst!
- Abstinence: Try to avoid alcohol, stimulants and other substances during this period, as there is a higher risk that consuming these can 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. This does not need to be in any structred manner; you can even draw a picture or use dot points. Journalling 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, can be very therapeutic, relaxing and enjoyable.
Everyone’s sense of “trauma” is different; 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 experienced harm from the event itself
- Have a previous 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 difficulties in response to the traumatic even itself, or as an associated consequence of developing PTSD. The most common of these includes 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 for longer than one month following the experience of a traumatic event, seeks advice and treatment from a trained health professional.
In the face of a traumatic situation, anyone can develop PTSD, including children. The criteria for PTSD in children is similar to the critera for for adults, although the benchmark standards have been recently updated to include children under the age of six:
- 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 a 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 began or worsened after experiencing the event, such as:
-avoidance (or attempted avoidance) of event reminders, including people, conversational topics, places or objects
-withdrawing from 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 for children if they persist for longer than one month after the child experiences the traumatic event, and if these significantly impact on their ability to manage and partake in everyday activities.
Psychotherapy has been shown to be effective in treating PTSD, and one such form of psychotherapy is trauma focused Cognitive Behavioural Therapy (CBT). This is a form of psycotherapy where the therapist helps individuals to identify unhelpful beliefs and irrational thoughts. Two common erraneous beliefs found in those experiencing PTSD are that the world is dangerous and that the individual experiencing distress is unable to cope. Once these beliefs are identified, your therapist will then provide you with strateiges to replace these with more accurate and adaptive thoughts. Following this, individuals are taught alternative coping methods to reduce distress levels to a more manageable level. With the psychologist’s support the individual can gradually challenge their traumatic memories through exposure therapy.