Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is a condition where you have recurring distressing memories, flashbacks and other symptoms after having or witnessing a traumatic event.
What is post-traumatic stress disorder?
Post-traumatic stress disorder (PTSD) is a condition which develops after you have been involved in, or witnessed, a serious trauma such as a life-threatening assault. During the trauma you feel intense fear, helplessness or horror. In some people PTSD develops soon after the trauma. However, in some cases the symptoms first develop several months, or even years, after the trauma.
Who develops post-traumatic stress disorder?
The strict definition of PTSD is that the trauma you had or witnessed must be severe; for example: a severe accident, rape, a life-threatening assault, torture, seeing someone killed, etc. However, symptoms similar to PTSD develop in some people after less severe traumatic events.It is estimated that up to 3 in 100 people may develop PTSD at some stage in life.
Some studies have found that PTSD develops in about:
- 1 in 5 firefighters.
- 1 in 3 teenage survivors of car crashes.
- 1 in 2 female rape victims.
- 2 in 3 prisoners of war.
What are the symptoms of post-traumatic stress disorder?
- Recurring thoughts, memories, images, dreams, or flashbacks of the trauma which are distressing.
- You try to avoid thoughts, conversations, places, people, activities or anything which may trigger memories of the trauma, as these make you distressed or anxious.
- Feeling emotionally numb and feeling detached from others. You may find it difficult to have loving feelings.
- Your outlook for the future is often pessimistic. You may lose interest in activities which you used to enjoy and find it difficult to plan for the future.
- Increased arousal which you did not have before the trauma. This may include:Difficulty in getting off to sleep or staying asleep.
- Being irritable, which may include outbursts of anger.
- Difficulty concentrating.
- Increased vigilance.
- Being more easily startled than you were before.
Note: it is normal to feel upset straight after a traumatic event. But for many people the distress gradually eases. If you have PTSD the distressing feelings and symptoms persist. In some cases the symptoms last just a few months and then ease or go. However, in some cases the symptoms persist long-term.
Up to 4 in 5 people with PTSD also have other mental health problems such as depression, persistent anxiety, panic attacks or phobias, or misuse drugs or alcohol. Having a mental health disorder before the trauma seems to increase your chance of developing PTSD. But also, having PTSD seems to increase your risk of developing other mental health disorders.
What is the treatment for post-traumatic stress disorder?
You may need no treatment if your symptoms are mild, particularly if the trauma happened less than a month previously. However, if your symptoms are prolonged and moderate or severe, treatment can help you to adjust. If you have severe symptoms 2-4 weeks after the incident, you are likely to need treatment.
- Cognitive behavioural therapy (CBT) may be advised. CBT is based on the idea that certain ways of thinking can trigger or fuel certain mental health problems such as PTSD. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful and false ideas or thoughts. The aim is then to change your ways of thinking in order to avoid these ideas.
- Eye movement desensitisation and reprocessing (EMDR) is a treatment that seems to work quite well for PTSD. Briefly, during this treatment a therapist asks you to think of aspects of the traumatic event. Whilst you are thinking about this you follow the movement of the therapist’s moving fingers with your eyes. After a few sessions of therapy, you may find that the memories of the event do not upset you as much as before.
Other forms of talking treatments such as anxiety management, counselling, group therapy and learning to relax may be advised. Joining a group where members have similar symptoms can also be very useful.
Medicines are usually reserved for people who do not respond to talking treatments or other non-medicinal treatments.
- Antidepressant medicines, particularly paroxetine and mirtazepine, have been found to help reduce the main symptoms of PTSD even if you are not depressed. They work by interfering with brain chemicals such as serotonin which may be involved in causing symptoms.
- A combination of treatments such as CBT and an SSRI antidepressant may work better in some cases than either treatment alone.
How can family and friends help people with post-traumatic stress disorder?
Family and friends can:
- Keep a look out for behavioural changes, such as taking time off from work.
- Look out for mood changes such as anger and irritability.
- Provide a sympathetic ear and ask general questions.
What is the outlook for post-traumatic stress disorder?
Statistics show that about 2 in 3 people with PTSD eventually get better without treatment, although the improvement may take several months. In about 1 in 3 people the symptoms last longer, sometimes for many years and can be quite severe in some people. The response to treatment can vary from person to person but it is very treatable.