When people see the term Post Traumatic Stress Disorder (PTSD), many associate this with the armed forces or war veterans. PTSD was indeed first recognised in soldiers returning from war, but today the condition can be diagnosed in anyone who has experienced trauma.
When someone experiences a traumatic event in their lives, such as a sudden death in the family, or while witnessing a serious accident, they will often feel numb or they may find disruption to their sleep patterns. These symptoms are usually referred to as ‘acute stress reaction’. Most people will find these symptoms disappear after several weeks. However, when symptoms last longer than a month, PTSD could be the problem.
GPs often categorise PTSD as mild, moderate or severe, depending on the symptoms and how they are impacting a person’s life. Regardless of the category of PTSD, it is important to recognise when someone is suffering from the condition, so that they can seek help.
It is really important to remember that any traumatic event can cause PTSD. Different people will react differently when faced with trauma in their lives. Some people have very high thresholds while others will experience symptoms soon after the event.
Typical events that trigger PTSD
Traumatic events in life are unfortunately all too common. The sudden death of a family member or a close friend can be extremely disturbing. However, so too can other events that come along. A car accident for example can sometimes bring on delayed reactions, called delayed-onset PTSD. Witnessing a serious accident or a crime can also be a trigger.
One of my recent clients worked for a construction company. He was at work one day, working at height with a colleague on a scaffold. His colleague reached over the handrail, which failed, and he fell 40ft to the ground. My client rushed down to help his chum, who had suffered serious head injuries. My client came to see me four months after the accident because he was experiencing flashbacks and nightmares. He definitely had PTSD.
Witnessing a crime can also be traumatic for many people. In fact, it doesn’t necessarily have to be witnessed to become a problem. Many people who have their property broken into and personal items stolen suffer PTSD symptoms. Fear of living in the property or, in very serious cases, fear of going outside are often experienced by victims of crime.
One of the most common symptoms of PTSD is when someone relives aspects of the event. Flashbacks and the feeling that the event is happening again can be very disturbing. Nausea and trembling while recalling the event are important signs that something is wrong.
Feeling on edge is another symptom that should not be ignored, especially when there are feelings of panic when reminded of the event. Hypervigilence is common too, which is often described as a ‘constant state of alertness’. This is often accompanied by being jumpy or easily startled.
Another serious symptom that can follow traumatic events is the feeling of being unsafe. Many people think they can’t trust anyone anymore, while others feel that the world has become unsafe or unhealthy. Blaming themselves for what happened is another very common symptom, which, if left untreated, can be very harmful.
If someone experiences PTSD symptoms while also suffering from associated issues, such as anxiety, depression or self-harm, their condition may be classed as ‘complex’. Although not a definitive list, complex PTSD can be caused by; ongoing domestic violence or abuse, childhood abuse, being a prisoner of war, repeatedly witnessing trauma or violence, neglect or abandonment.
People who suffer trauma at an early age can sometimes experience complex PTSD in later life, particularly if the trauma lasted over a long period of time or if the child was harmed by someone close to them.
Complex PTSD needs careful and planned treatment and therapy, possibly for many months and even years.
Therapies for PTSD
Trauma-focussed cognitive behavioural therapy (TF-CBT) is a very important treatment for PTSD. Adapted from CBT, this type of therapy was developed 25 years ago to help children recover from early trauma. Essentially, the technique aims to help those who have suffered from trauma to learn to recognise their symptoms and to learn coping strategies.
There are three distinct phases of treatment with TF-CBT. The first phase, known as stabilisation, involves teaching the client about trauma; what it is and how it affects us. Relaxation techniques is an important part of this phase too.
The second phase is to recreate the trauma, through a trauma narrative. This is done while allowing the client to explore their feelings and emotions during the recreation. Many think this is a negative thing but recalling the event while thinking about emotions can be extremely positive. Talking through the event is a really powerful way to help a person.
Finally, phase three consolidates the lessons learned from the first two phases, while continuing to build coping skills.
A short questionnaire to help diagnose PTSD
Proper diagnosis of PTSD can only be carried out by a trained and experienced therapist or doctor. However, there is a useful set of questions to help assess whether PTSD might be an issue.
Take the simple test to find out if you are suffering from the symptoms of PTSD.
I would love to hear if anyone has tried trauma-focussed CBT as a therapy.