Events that are traumatic- such as an accident, assault, natural disaster can have lasting effects on a person’s mental health. While few of them have responses that are short term and they cope with it, some of them may have long lasting effects that can lead to diagnosis of PTSD- post traumatic stress disorder. Some effects are so persistent and severe. There are feelings of fear, helplessness, and horror that is generally seen.
PTSD involves intense, unpleasant and dysfunctional reactions to an overwhelming traumatic event.
Such events may be experienced directly or indirectly (being a witness) or learning of traumatic events that have occurred to close family members. People can experience a single trauma or even multiple traumas.
About 28.2% of the Indian population was seen to be suffering through PTSD during the coronavirus pandemic itself. Women are significantly more likely to experience PTSD than men.
This disorder co- exists with other conditions as well like depression, anxiety and substance abuse.
It can last for more than 1 month or develop separately up to 6 months after the event. It is a little confusing to understand why the same event may cause no symptoms in one person and lifelong PTSD in another. And also that some people witness or experience the same trauma many times without developing PTSD but then develop it following a similar episode.
Symptoms of PTSD:
A diagnosis of PTSD requires a consultation with a psychologist and psychiatrist. Symptoms usually fall into the categories below:
- Re-experiencing symptoms- Recurring, involuntary and intrusive distressing memories that include flashbacks of the trauma, bad dreams and intrusive thoughts.The event may repeatedly reappear in the form of nightmare, thoughts, flashbacks. These people feel as if the event is actually happening.
- Avoiding or staying away from certain areas, places, objects that are reminders of the traumatic event. The person may actively avoid a place or person that may cause overwhelming symptoms. For eg- they may avoid entering a park where they were assaulted. There can also be avoidance of thoughts or conversations regarding it.
- Cognitive and Mood symptoms that include difficulty recalling the event, having negative thoughts about self. The person may also feel worried, depressed, guilty and numb. Cognitive symptoms may include out of body experiences and derealization ( the world is not real).
- Arousal symptoms such as hypervigilance, being startled by anything similar to trauma, difficulty sleeping and having anger outbursts. There can be difficulty sleeping or concentrating. They may become extremely cautious about warning signs.
Other symptom-
- Developing ways/rituals to reduce anxiety
It is important to know that it is not just adults who can suffer through this, young children can also develop PTSD. The symptoms are different from those of adults. They find it difficult to convey some aspects of their experience and may cling to their parents as their way of expressing and some may slip back in their developmental milestones.
Criteria for diagnosis-
- Psychologist & psychiatrist evaluation
- Being exposed directly or indirectly to traumatic events.
- Symptoms have been present for 1 month or longer
- Significant distress and impaired day to day life
- Symptoms from categories of PTSD.
Treatment:
- Psychotherapy-
Psychotherapy- Therapy is the most crucial treatment for PTSD. One of the 1st steps is education about PTSD. It may sometimes feel confusing and this psycho-education is also useful for people and loved ones.
- Stress management techniques- Relaxation, breathing is very important. This helps reduce and control anxiety. It may also make you feel relieved of your symptoms by reducing the intensity.
- CBT- Cognitive behavioural therapy is one of the focused psychotherapy. A part of CBT is exposure therapy that helps extinguish the fear from the traumatic event.There is gradual exposure or reimagination of the event with the help of a therapist. Often, treatment may shift from exposure to a more supportive, open-ended treatment, to help people be more comfortable with exposure therapy.
Broader and more exploratory psychotherapy may also ease return to a happier life, such as by focusing on relationships that may have been fractured by PTSD. Other types of supportive and psychodynamic psychotherapy can also be useful as long as they do not shift the focus of treatment away from exposure therapy.
- Eye movement desensitisation and reprocessing (EMDR) is treatment in which people are asked to follow the therapist’s moving finger while they imagine being exposed to the trauma. Some experts think that the eye movements themselves help with desensitisation, but EMDR probably works mainly because of the exposure, not the eye movements.
- Medicines- Antidepressants are the 1st line of treatment for PTSD. SSRIs are highly recommended. There are drugs given to treat insomnia and nightmares.
Note from Siraya:Mental Wellness Centre-
If you have experienced a traumatic event and have been struggling, it is important to seek help. Connect with our experienced psychologist today!