What Is Post Traumatic Stress Disorder?

Post Traumatic Stress Disorder (PTSD) was introduced into the American Psychiatric Association’s official manual (DSM) in 1980.  PTSD is a label for the range of symptoms that may be experienced days, weeks, months or even years after being exposed to a traumatic event or series of events.  These traumatic events range from experience of war, child abuse, domestic violence, rape, robbery, assault or car accidents. Sometimes PTSD arises from witnessing the trauma of another person, particularly a friend or relative.  The events usually involve threat to the person’s life or physical integrity.  The immediate feelings are helplessness, horror and/or intense fear.  PTSD is unique amongst mental disorders because the person has to have been exposed to a previous event that is considered traumatic to be diagnosed with PTSD.

What are the Symptoms of PTSD?

The symptoms that commonly occur in people suffering from PTSD have been divided into three categories:  intrusions; hyper-alertness; and avoidance.

Intrusions: Re-experiencing the events as flashbacks or nightmares that occur suddenly, without conscious control.  These are very distressing, disrupting sleep and normal activities of life.

Hyper-alertness: A state of hyper-vigilance or increased sensitivity to things such as a phone ringing or the sudden appearance of a person which leads to a physical reaction (eg jumping with fear; feeling nauseous) which is out of proportion to the stimulus.  The person is edgy, agitated and appears to be on the lookout for a perceived danger.

Avoidance:  The person tends to avoid anything (eg certain places, going out at night, being alone) that may result in a memory of or a feeling from the original traumatic experience.  This symptom particularly impacts upon interpersonal relationships.  The person may report feeling emotionally numb; unable to experience their usual feelings for people and things, and will often act very impersonally to people with whom they are closest.

Other Characteristic Symptoms of PTSD

Often the person finds it difficult to trust others or to feel safe and secure anywhere.  As this continues the person becomes detached from friends, colleagues and family, thus adding to his/her isolation.  Furthermore, the person may experience physical signs of anxiety such as rapid breathing, sweating and becoming agitated.  Poor sleep patterns (due to insomnia and nightmares) affect concentration and memory, and thus can lead to deterioration of work and study performance.

Post-Traumatic Stress Disorder is rarely diagnosed on its own.  It is often accompanied by depression, anxiety, panic attacks, social phobia, agoraphobia or other psychiatric illnesses.  Many people recovering from the after-effects of trauma abuse alcohol, nicotine and other drugs; thus complicating the situation further.  Substance abuse is addressed within PTSD treatment.

Most people who experience catastrophic trauma do not develop PTSD or depression. Grief and loss are frequently experienced but respond to social support and care of family and friends.  Providing for the person’s normal needs: shelter, food, financial support and a caring response are important in the immediate period after the trauma (‘psychological first aid’).  However, some people may experience high levels of distress following a trauma.

What Treatment is Available?

There is a range of effective psychological and pharmacological treatments available.  Therapists treating PTSD aim to provide a safe and trusting environment in which the person can deal safely with the impact of the event/s.  Treatment often involves basic counselling - listening and allowing the person to tell his/her story.  Further treatment may involve cognitive behavioural therapy and group work.

Reluctance to Seek Treatment

Almost all people with PTSD can be assisted to some extent by treatment.  However, often people are reluctant to ask for help, as avoidance is part of the disorder.  Reasons that a person may not want to seek help may include:

• Fear that instead of helping them, therapy will only make them feel worse about themselves
• Feelings that if they forget about things that the feelings will just go away
• Beliefs that nothing will help, that nothing could possibly work
• Beliefs that they ought to be able to handle it themselves, without any help
• Talking about what happened is painful

Families and Friends

• Listen when the person talks of his/her feelings: don’t judge
• Offer support, not pity.
• Acknowledge that the experience of a traumatic event has made a major impact on his/her life
• Recognise that the traumatic event/s was the cause: don’t blame the survivor
• Believe the victim; validate his/her experience
• Accept your own limits, and communicate this.  Encourage him/her to find professional help
• Take care of yourself; maintain a life of your own;
• Seek emotional support for yourself from other sources - a person with PTSD may not be able to be as emotionally available as before
• Avoid survivor guilt.  It isn’t your fault that it happened to others and not to you
• You cannot “fix” a person.  You can listen - that is good enough

Where to Get Help

Sydney Rape Crisis Centre: (02) 9819 6565 - 24 hr crisis intervention counselling for women experiencing trauma related to sexual assault (including from childhood)

STARTTS (Service for Treatment & Rehabilitation for Trauma & Torture Survivors): (02) 9726 1033 (Fairfield) or (02) 9794 1900 (Carramar) - counselling & various rehabilitation programmes available.

Traumatic Stress Clinic – (02) 86273314 – free psychological service for victims of crime, accident or other traumatic event. Westmead Hospital

Lifeline:  13 1114 - for 24 hour counselling/support

Victims of Crime: 1800 633 063 - telephone counselling for emotional trauma resulting from any crime

Vietnam Veterans Counselling Service: (02) 9635 9733 or 1800 043 503 (Sydney & country NSW)

References:

Mental Health Association of NSW Inc

www.mentalhealth.asn.au

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