PTSD Post Traumatic Stress Disorder

Your guide to PTSD

To begin with, post traumatic stress disorder is often referred to simply as PTSD. Whether you are told you have PTSD or post traumatic stress disorder, it means the same thing: you have a mental disorder that has been caused by an event or events rather than another underlying physiological or psychological cause. Consequently, PTSD is a disorder that is acquired through experience, usually a highly traumatic one. What tends to happen is that the natural fight or flight response mechanism we all have that kicks in when something triggers us goes into overload among people with PTSD. However, just because you have suffered from a traumatic event does not mean that you will necessarily go on to develop post traumatic stress disorder. Some people appear to be more susceptible to it than others which makes it a complex disorder to study and treat.

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The term post traumatic stress disorder first entered popular usage in the 1980s. Studies into the effects of combat in the 1970s, especially among Vietnam war veterans in the United States, led to researchers initially coining the term. However, it is likely that the term shell shock, which dates back to the First World War, was also a way of describing PTSD before all of its effects were known. People have always associated large-scale trauma, such as shock or grief, with certain mental outcomes. However, it was by studying the more acute examples of trauma among military personnel that psychologists began to understand just how long-term and diverse these effects could be. By 1952, the term gross stress reaction was being used in the US to describe the condition that today we would call PTSD. A 1972 study into airmen who had flown sorties into Vietnam used the term dysphoria to describe a PTSD-like mental state, but it was not until 1978 that the term post traumatic stress disorder was first used by academics.

Anything, so long as it is stressful or sustained enough, can cause PTSD to occur. Psychologists will primarily relate it to frightening or distressing events – the sort of thing that creates the well-known fight or flight response whereby we become very aware of our environment and muscles tighten, ready for combat or running away. According to the NHS, PTSD will affect about a third of people who suffer from serious trauma. Although what constitutes serious trauma will vary according to individuals and circumstances, it tends to include things like serious accidents, assault, serious sexual misconduct, domestic abuse, grief and torture. Remote exposure to trauma, for example, by witnessing it, is also known to cause post traumatic stress disorder in some people. Consequently, simply being in a war zone – even if you are a non-combatant – can lead to PTSD.

Generally speaking, people with PTSD will have higher than usual levels of adrenaline released into their body. This can make people behave as though they are in situations where there is a high risk or threat even though there may be none. Typically, something will trigger a person with PTSD into an inappropriate fight or flight response which means they could run, freeze or even become violent irrationally. Some people who have PTSD will have flashbacks whereby they effectively relive moments of trauma in their minds with no control over it. Others will find their initial trauma seeps into their subconscious, so they suffer from nightmares. There again, others will get repetitive images or sensations running through them. Symptoms like anxiety, depression, sweating, trembling, feeling sick or being in pain are also common. Sometimes, people suffer from all of the above and may even go on to develop suicidal thoughts in the worst cases.

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There is no set time that you can expect to suffer from post traumatic stress disorder once you are first diagnosed with the condition. Often, although not exclusively, the symptoms of PTSD will begin to present themselves a few months after a particularly harrowing event. In some cases, these will come about up to a year or two afterwards. It simply depends on the person and their reaction to the event or events that have released lots of adrenaline into their brain. It is possible to stop the symptoms of PTSD with professional help. However, some people find that it starts to become less severe with time on its own, so there is no hard and fast rule. In the worst cases of the condition, PTSD can last a lifetime, so it is more a question of learning to live with it than curing it.

Post traumatic stress disorder is preventable. However, it is hard to say exactly how this might be achieved. Put simply; it would mean the avoidance of the sort of traumatic events that might cause PTSD to occur. Therefore, avoiding high-risk situations would be a good idea, but, there again, there is no knowing when an individual might fall foul of an abusive situation or from crime. Indeed, it is impossible to completely rule out the potential for nasty accidents or deaths in childbirth from occurring. However, it is possible to seek peaceful and negotiated settlements instead of inflicting the trauma of war on populations. Furthermore, it should be possible to prevent certain crimes, thereby lessening the likelihood that PTSD will occur. After a shocking event, seeking counselling at an early stage can be a good way of helping to deal with it rather than waiting for a disorder to potentially develop.

Complex PTSD is a way that clinicians describe some of the worst cases of PTSD they come across. Whereas the initial studies into the condition focussed on military personnel who were trained for a certain degree of exposure to stress, the concept of complex PTSD began to emerge when psychologists started to notice similar symptoms in certain civilian groups and especially children. Complex PTSD is usually more severe because the trauma that a person has suffered either happened to them in childhood or was conducted over a long period, perhaps throughout their teenage years. It is often found in people who have suffered abuse, including mental and sexual abuse, from a parent or a carer they should have been able to trust. When people still have contact with the culprit of such abuse, complex PTSD is found to be more likely to occur. Sometimes people who were completely alone during a traumatic event with no one to turn to at all will also develop this condition which often means feeling ashamed or out of control.

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The symptoms that are most associated with PTSD can occur for other reasons. Consequently, it is important to rule out other things that may be causing them before the disorder can be diagnosed. Empathically, showing some symptoms and having suffered a trauma is not enough for a diagnosis. A doctor will need to make an assessment of any patient who suspects they are suffering from PTSD. This will usually involve a physical examination so that certain conditions can be ruled out. If there is no other potential cause of the symptoms, then a psychological assessment is likely to follow. Various systems are in place that helps clinicians to make a thorough assessment, usually based on a standardised scoring system. The Diagnostic and Statistical Manual of Mental Disorders outlines just such a system, for example, and it is widely used by American psychiatric professionals.

Some people with the disorder have no problem with their recall. In fact, some sufferers cannot stop remembering things that they would much rather forget. They will often see images in their mind's eye of events that they cannot put behind them. However, others will find that they do suffer from memory loss. Typically, this will be a problem they develop with their short-term memory function, however, not their older memories. In other words, the trauma they suffered may still be at the forefront of their mind, preventing them from concentrating sufficiently well to form new memories. Again, the picture varies widely from case to case but memory loss – or, at least, having poor recall – is a common symptom of PTSD. When the condition is treated successfully, sufferers will often find that their short-term memory function begins to improve.

According to some academics, PTSD can lead to bipolar disorder developing in some sufferers. However, there is no scientific consensus on this matter, and research is ongoing to examine the relationship between PTSD and bipolar disorder more closely. What may be happening is that PTSD is not causing bipolar disorder but unmasking it. By removing people's coping mechanisms that may mask an underlying condition like bipolar disorder, PTSD may simply be revealing what was already there. On the other hand, bipolar disorder is known to be related to other mental disorders, so it may be causal rather than coincidental, as some studies suggest. Other research looks into the likelihood that someone with bipolar disorder will go on to develop post traumatic stress disorder. There appears to be a higher incidence of PTSD among people with pre-existing mental conditions, such as bipolar disorder. Again, research is ongoing in this area, too.

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The simple answer is no. PTSD is not a curable condition. However, you should bear in mind that PTSD is no different from a raft of other mental health disorders. The vast majority of them cannot be cured in the sense that they will go away and never come back. And yet, PTSD can be successfully treated. Some people even feel cured and will say that they are. However, there is no guarantee that the condition will not rear its ugly head once more. Flashbacks can and do occur many years after the last one. The good news is that with a successful treatment pathway, the effects of the disorder are often less severe and occur less often. Most people find that a combination of a talking therapy and some medication will help them enormously and that the reliance on either will dissipate over time.

As well as making your heart rate increase, an episode of PTSD will have a neurological effect. As previously mentioned, adrenaline tends to get released in the body when we enter the fight or flight response to stress. This will have a more profound effect on the brain than other parts of the body. When the brain is exposed to stress hormones, such as adrenaline, it can get stuck in a cycle whereby more gets released because of the stress that is caused by being in this heightened state. Although this is quite normal, people who have PTSD are more likely to get stuck in such a state for longer and with more severity than would be the case in the general population. The amygdala is the part of the brain that controls stress responses, especially fear, and this will often be more active if you have PTSD.

Talking therapies are popular among people who have a PTSD diagnosis. The aim of such therapies is to lessen the impact of symptoms when they occur and to restore the self-esteem of the sufferer. One of the big problems with disorders like PTSD is that people are fearful that something is very deeply wrong with them. By normalising their behaviour and that understanding, it is in part or wholly down to their condition, so they will often become less fearful of the disorder itself, which can help to dampen its impact dramatically. CBT Cognitive behavioural therapy is often considered a good talking therapy, but others, such as group therapy, may be recommended. Some people opt for eye movement desensitisation and reprocessing, which focuses on remembering the trauma while doing a more pleasant task. In some cases, medications will be offered, such as antidepressants, antipsychotics or beta-blockers, and some people will say that ayahuasca has helped them with their PTSD.

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PTSD is a mental disorder that will come about if you have suffered a trauma that the brain has not been able to deal with in some way. Remembering it or coming into contact with something associated with it – even if that is in your subconscious – may mean that your body reacts as though the threat were really present. This means entering a highly agitated state of preparedness. All animals have this reflex, but in people living with PTSD, the effect is more profound. Indeed, the associated brain and hormonal activity associated with such a response can prolong and deepen the effect. Usually, people with PTSD will feel fearful of their own response – that they are out of control and may do harm to themselves or others, in many cases – which causes more panic and a stronger hormonal response.

Consequently, the best way of treating PTSD is to temper the response to it. This will usually involve obtaining a diagnosis in the first place. In other words, simply by understanding you have a condition, you are much better placed to be able to deal with it. Commonly, people with PTSD will go on a course of talking sessions with a counsellor or a psychologist to help them work out their triggers and how best to deal with them. Group and family therapies are quite commonplace these days for the condition. Finally, drug therapies are also offered to some people who have very severe forms of PTSD, especially complex PTSD. Such medications should only ever be sought under professional medical guidance, however.