Post-traumatic stress disorder can occur after experiencing or seeing a traumatic event involving the threat of injury or death.
Causes, incidence, and risk factors
Post-traumatic stress disorder (PTSD) may occur soon after a major trauma, or it can be delayed for more than 6 months after the event. When it occurs soon after the trauma, it usually gets better after 3 months. However, some people have a longer-term form of PTSD, which can last for many years.
PTSD can occur at any age and can follow an assault, domestic abuse, rape, accidents (such as car accidents), diagnosis of a life threatening illness (such as a heart attack), natural disasters (such as a flood or fire), war, or a prison stay. Witnessing any of these can also be the trigger. These kinds of events produce stress in most people, but not everyone develops PTSD. Although a group of people may be affected by the same trauma only some will develop PTSD. There are psychological, genetic, physical, and social factors involved in PTSD developing but predicting those more likely to develop it is not possible yet. It is very common in people returning from wars and people working in Police and other emergency services.
PTSD changes the body’s response to stress. It affects the stress hormones and chemicals that carry information between the nerves (neurotransmitters). Having been exposed to trauma in the past may increase the risk of PTSD.
Good social support helps to reduce the effect of trauma and protect against PTSD. In Vietnam veterans, those with strong support systems were less likely to get PTSD than those without social support.
Symptoms of PTSD fall into three main categories:
1. Repeated “reliving” of the event, which disturbs day-to-day activity
• Flashback episodes, where the event seems to be happening again and again
• Recurrent distressing memories of the event
• Repeated dreams of the event
• Physical reactions to situations that remind you of the traumatic event
• Emotional “numbing,” or feeling as though you don’t care about anything
• Feelings of detachment
• Inability to remember important aspects of the trauma
• Lack of interest in normal activities
• Less expression of moods
• Staying away from places, people, or objects that remind you of the event
• Sense of having no future
• Difficulty concentrating
• Exaggerated response to things that startle you
• Excess awareness (hypervigilance)
• Irritability or outbursts of anger
• Sleeping difficulties
You also might feel a sense of guilt about the event (including “survivor guilt”), and the following symptoms, which are typical of anxiety, stress and tension:
• Agitation or excitability
• Feeling your heart beat in your chest (palpitations)
Signs and tests
Diagnosis is based on the symptoms present after you’ve had extreme trauma. Your doctor may do psychiatric and physical exams to rule out other illnesses.
Treatment will initially help you to cope with the symptoms better and then ‘desensitise’ the memories. This will include ways to cope with disturbing memories aiming to give you more sense of control. It can be important to get you more relaxed, sleeping more normally and going back to things you used to do.
Some people with PTSD may need to treat depression, alcohol or substance abuse, or related medical conditions before addressing symptoms of PTSD.
Antidepressant medications and/or other medications can help reduce anxiety and other symptoms of PTSD making it easier to go ahead with treatment. You may need to see a psychiatrist to ensure you are provided with the best medication.
The ‘desensitisation can involve Eye Movement Desensitisation and Reprocessing (EMDR), Cognitive Behaviour Therapy (CBT) or a Neuro-Linguistic Programming (NLP) technique. The aim is to reduce the emotional reactions associated with the traumatic memory.
As new treatments and better medications have been developed, outcomes have improved (as they have with many psychological conditions). The outcome to treatment will depend on how soon the symptoms develop after the trauma, and on how quickly you get diagnosed and treated.
• Alcohol and Drug Abuse – many will ‘self medicate’ their symptoms with the risk that you end up with PTSD plus an addiction.
• Depression and Anxiety – some people get misdiagnosed and fail to get the specialised psychological therapy for PTSD because the symptoms are very similar to other mood and anxiety disorders.
If distressing feelings and memories trouble you longer than a week, or are getting worse, contact your doctor or me.
Help is available immediately by calling the Sutherland Acute Community Treatment Team 24 hour number 9540 7831 or calling the Wollongong Mental Health Emergency Service on 1300 552 289 or going to the emergency room at your closest hospital.
Seek immediately help if:
• You feel overwhelmed
• You are impulsive
• You are thinking of hurting yourself
• You are unable to contain your behaviour
• You have very distressing symptoms of PTSD.
Michael Guy is a Clinical Psychologist offering specialised psychological therapy in southern Sydney’s Sutherland Shire at Miranda and in Wollongong. The practice focuses on providing psychological therapy to those with a history of trauma including PTSD (Post Traumatic Stress Disorder).
For more information or to book an appointment please contact
Ph: 0435 24 24 24
Fax: 02 8072 6228
Email: michael @ lifeaftertrauma.com.au
Suite 202, 29 Kiora Road, MIRANDA NSW 2228
Alive Psychology, 109 Church Street, WOLLONGONG NSW 2500