Post Traumatic Stress Disorder

Courtesy of the University Hospital Birmingham

If you have been involved inย or even simply witnessed anything from a minor accident to a major disaster, you will probably experience stress for a few days or weeks after the event, and then expect life to return to normal. Some people, however, experience distressing and disabling symptoms for much longer, occasionally for many years.

A place of safety
After a traumatic event, people need to unburden themselves of intense or frightening feelings in an atmosphere of complete trust and confidence. This may be easiest to do with fellow survivors.

Whatever the crisis, your friends, family members, and work colleagues may have offered sympathy and practical assistance. Despite these reassurances, however, you may suffer from sleeplessness, nightmares, panic attacks, weepiness, and feelings of futility or guilt about what you did or did not do during the event. If these symptoms persist or intensify for more than eight weeks, you may be suffering from post-traumatic stress disorder (PTSD). Even soldiers or police officers, who are trained and are usually able to deal effectively with unexpected events, accidents, or life-threatening disasters, may suffer similar delayed reactions.

Talking prevents prolonged stress
Researchers have found that a procedure known as “debriefing” can alleviate and sometimes even prevent symptoms of PTSD. Debriefing is primarily a “talking cure” in which survivors, helpers, or witnesses of a crisis review how they felt or acted during or after a traumatic incident. Debriefing usually occurs in a group context, but even one-to-one support, perhaps from an insightful friend or member of the family can be helpful.

One of the great benefits of debriefing is the reassurance that many symptoms and reactions are very “normal” responses to abnormal events. A debriefing group does not encourage false optimism, but does allow people to express their feelings freely and in complete confidence. Participants often find that, once they acknowledge their feelings, they can mobilize their strength and devise their own strategies for recovery.

Rebuilding takes time
In an attempt to re-establish predictability in their lives, many people desperately want to return to their former activities. This need to restore what may well be an idealized past can be a flight from present pain or guilt, feelings that often accompany major trauma. Others, however, need to create new patterns, and radically change their career goals or relationships.

Although they appear to be motivated by “second-chance” optimism, many survivors find it very difficult to trust that the world is predictable. They often expect disaster to disrupt the fragile security of their re-established lives, and frequently are overwhelmed with feelings of futility.

The sword of Damocles
One study of adults who had survived childhood cancer described them as feeling like Damocles, a figure from Greek mythology who was made to sit through a feast with a sword suspended over his head by a single hair. In this way, he was forced to learn about the insecurity of happiness.

Many survivors of life-threatening illnesses or accidents live with this sense of fragility. The same feeling, however, can engender a belief that life is too precious to waste, and simple pleasures sharing joyful family occasions, making time for creative pursuitstake on new importance.

Go at your own pace
Perhaps the most important thing for survivors to remember is that every recovery is unpredictable: It takes time, and there are no set schedules or ready-made answers. Trauma may affect many people, such as when soldiers fight in a war zone, but each individual’s recovery from the crisis will be different from anyone else’s.

Brian Keenan, who was held as a hostage in Lebanon for four-and-a-half years, wrote that recovery is “a slow process of rediscovery, where denial or flight from the inward turmoil is the antithesis of self-healing…” He added, “We may be helped but we cannot be pushed or misdirected.”

When to seek help
The following warning signs will help you decide if you, or someone you know, is suffering from PTSD. If so, talking to an experienced counselor is advisable.

Physical effects

  • Sleeplessness and exhaustion
  • Nightmares or nightsweats
  • Inability to eat
  • Increased smoking or drinking
  • Hyper-reactivity to stimuli, such as an extreme startle response, and trembling
  • Hyperactivity (always needing to keep busy to avoid feelings)

Feelings

  • Loss of self-esteem
  • Loss of purpose and aim
  • Intense loneliness and lack of trust
  • Guilt and self-hatred
  • Constantly feeling vulnerable

Behavior

  • Inability to make decisions
  • Irritability and sudden, unpredictable outbursts of aggression or violence
  • Impulsive or “out of character” actions, such as shoplifting or reckless spending
  • Retreating into isolation
  • Problems with relationships.

Fear of feelings

A fear of letting in painful feelings could make you feel tense and tightly wound, and lead to incessant restlessness and hyperactivity as a way of distracting yourself from emotional pain.