Post Traumatic Stress Disorder

Post Traumatic Stress Disorder (PTSD) is a serious condition describing the emotional responses to a traumatic event in a person’s life.

When someone is involved in a traumatic event, such as a car crash, assault or near death experience, it is very natural for that person to have emotional reactions such as anxiety and distress. This emotional response is known as Acute stress disorder and is used to describe feelings that last for less than a month. If these feelings stay for longer than a month and increase in severity, it might be that the person is suffering with PTSD.

PTSD can be difficult to understand – often symptoms can continue months or years after the event and it might be hard for others to understand. The sufferer may feel a pressure to ‘get over it’ or ‘stop dwelling on the past’, but the truth is PTSD is the bodies way of dealing with the trauma it has experienced.

What causes Post Traumatic Stress Disorder?

PTSD can be caused by a single traumatic event, or series of events that have happened in someone’s life. PTSD can be caused by:

• Terrorism
• Road traffic accidents
• War
• Natural disasters and fire incidents
• Assault, sexual or physical
• Victim or witness to a crime
• Childhood neglect
• Diagnosis of a long term or life limiting illness
• Childhood abuse
• Traumatic childbirth

Why do we get PTSD?

The jury is still out as to exactly why people experience feelings of extreme anxiety, depression, flashbacks and anger following a trauma.

The symptoms of PTSD are thought to be coping mechanisms for dealing with the stress the body and brain have gone through and even ways for the brain to come to terms with what has happened.

Flashbacks are thought to help the brain prepare in case the event happens again.

The feeling of being on edge is due to increased adrenaline in the system, getting the individual ready to ‘fight or flight’. In normal daily life adrenaline can be a useful chemical, but after a trauma levels can become elevated and struggle to return to normal.

Numbing and avoidance can be a mechanism for the brain to get some rest from constantly thinking about such upsetting events.

The hippocampus is a part of the brain which is responsible for memory creation and storage. It can be adversely affected by the levels of adrenaline in the brain, released after the event. The increased adrenaline levels can stop memories from being processed as they should, resulting in flashbacks.

Who is affected by PTSD?

Unsurprisingly, certain professions due to their working environments are much more likely to result in PTSD. For instance, up to 30% of those in the combat troops¹ and 25% of war reporters were found to suffer with PTSD symptoms.

But Post Traumatic Stress Disorder in the general population is much more common than you may think. 3% of the UK adult population tested positive for PTSD characteristics, with women twice as likely to suffer as men.²

You do not need to have been a victim of the traumatic event yourself; witnessing the event can still cause PTSD. Some people are also found to be more susceptible to PTSD than others. Sometimes this is due to how the brain processes stress chemicals released during traumatic times but a history of childhood abuse, previous mental health issues or exposure to trauma can all increase the risk of PTSD.

What are the symptoms of PTSD?

PTSD symptoms fall into four categories, many of which overlap. It is useful to know that you may not immediately show symptoms after the event.

In fact, in cases of complex PTSD where there have been repeated traumas (such as childhood neglect or domestic violence) it can take several years for the symptoms to appear.

Most people will show symptoms within three to six months of the event.

Intrusive memories

• Flashbacks and reliving the event
• Vivid memories
• Upsetting dreams about the incident
• Continuously thinking about the event
• Having physical reactions when thinking about the event, such as heart palpitations, anxiety or feeling sick

Negative feelings

• Loss of interest in social interaction
• Loss of libido
• Feeling despair about the future
• Being easily upset
• Physical ailments that are not explained

Numbing and avoidance

• Memory loss about the event
• Avoiding people or places that remind you of the event
• Feeling distant about the event when discussed with you

Emotional disturbances

• Feeling distressed and anxious
• Not being able to concentrate
• Sleep disturbances, trouble getting to sleep or waking
• Irritability
• Anger
• Feeling on edge all of the time

Not all people will experience all of these symptoms and some will suffer more than others; for instance avoidance is common with those who have complex PTSD but not as common in acute stress disorder.

PTSD Treatment - What can be done to help?

Seeking help for Acute stress disorder or PTSD is really important. Acute stress disorder can naturally disappear but approximately 1 in 3 people will go on to develop PTSD symptoms.

Left untreated PTSD can seriously impact on the individuals’ life – relationships with family and friends can deteriorate and it can become really hard to carry on working. Sadly many people turn to drugs or alcohol as a way of coping.

The good news is that both Acute stress disorder and PTSD respond well to treatment. Medication can help ease some symptoms such as depression and anxiety, but will not tackle the cause of PTSD.

Talking therapies such as psychotherapy, cognitive behavioural therapy and family therapy can help the individual come to terms with the traumatic event, develop coping mechanisms and deal with the aftermath of the event. EMDR can be very useful in reducing the distress experienced when remembering the event – it works by helping the brain unblock the memories which have become frozen on a neurological level.

¹Greenberger, N., Jones, E. et al The injured mind in the UK Armed Forces Philos T R Soc B 2011:36 6 216-7
²McManus, S., Meltzer, H. et al (2007) Adult Psychiatric Morbidity Study in England – Information Centre for Health and Social Care