Post Traumatic Stress Disorder
What Is PTSD?
PTSD is the name given to a set of symptoms that some people develop after experiencing major traumatic events. The traumatic event can be a single incident or take place over many months and years.
Many people think of PTSD as something that affects people who have had traumatic experiences whilst serving in the military, but it can affect anyone who has experienced a traumatic situation.
The condition can be brought on by events such as serious traffic accidents, rape or sexual abuse, domestic violence, physical assault, traumatic childbirth, witnessing a violent death or virtually any other situation that is exceptionally threatening or catastrophic and likely to cause distress in almost anyone.
Up to one third of people who have experienced a traumatic event develop some PTSD symptoms. Studies estimate that around 7% of people will suffer with PTSD at some point in their lives.
Other problems such as depression and anxiety disorders are common alongside PTSD. Increased alcohol use and drug use can also become a problem for some people.
Symptoms of PTSD
PTSD sufferers often experience:
- Repeated and intrusive distressing memories of the event.
- There may also be a feeling of reliving (or ‘re-experiencing) the event through ‘flashbacks’ or ‘nightmares’, which can be very distressing and disorientating.
- There can also be physical reactions such as shaking and sweating.
Because these memories can be very intense and upsetting, some PTSD sufferers may avoid people or situations that remind them of the trauma, or try to ignore the memories and avoid talking about what happened. Some people may also forget significant parts of the traumatic event.
Other people will think about the event constantly, which stops them coming to terms with it (they may, for instance, ask themselves why the event happened to them or how it could have been prevented)
PTSD sufferers may have emotions or feelings that are difficult to deal with, such as guilt or shame, or they may feel that they do not deserve help.
They may also feel anxious or irritable, and find it difficult to concentrate or sleep.
Increased jumpiness and vigilance can also be present.
For some people, it can mean that doing ordinary things like going to work or school or going out with friends become very difficult.
If you think you might have PTSD you should first see your GP who will perform an initial assessment. Depending on the outcome of this, your GP will decide whether you need a referral to a primary care mental health worker, your local Community Mental Health Team (CMHT) or another service, depending on your needs.
If you are referred to your local CMHT you will receive a further more detailed assessment, and you may then be referred on to a specialist traumatic stress service or receive help within the team.
Psychological therapies are considered to be the most effective treatments for PTSD. In particular, there is good evidence that two types of psychological treatments which focus on the traumatic event called Trauma Focused Cognitive Behavioural Therapy (TFCBT) and Eye Movement Desensitisation and Reprocessing (EMDR) are effective.
Both techniques have been shown to reduce the symptoms and the distress experienced by PTSD sufferers.
- The term TFCBT ecompasses a number of forms of Cognitive Behavioural Therapies (CBT). Broadly speaking, these treatments help the sufferer to confront their traumatic memories often through talking and writing about the event. TFCBT helps individuals to identify and challenge negative feelings and thoughts, including ideas related to feelings of guilt and shame. The treatment can also involve gradually returning to avoided activities that have become frightening because they are connected in some way with the trauma.
- EMDR techniques can help people with PTSD to confront their traumatic memories. The individual is asked to focus on memories, thoughts, feelings and sensations associated with the trauma, whilst also focusing on something else at the same time. Usually the other focus is on following movements of the therapist’s finger.
Other treatments such as medication and stress management techniques are sometimes used to treat PTSD and can be helpful, although these have not been shown to be as effective.
Tips for Living with PTSD
- Give yourself time and space to acknowledge what you have been through, and that you are having strong emotional reactions to it.
- Avoid being self critical about the problems that you are having. Many people experience similar problems, and it is not a sign of weakness.
- You may be tempted to withdraw from social activities and your loved ones, but it’s important to stay involved with the people who care about you. Support from other people is vital to your recovery from PTSD.
- Avoid using alcohol and drugs to make you feel better. Although these may make you feel better in the short term, it can cause serious problems for you and your loved ones. They can also worsen symptoms and interfere with treatment.
- Try to be healthy. Do what you can to eat a balanced diet and get some regular exercise - even if it’s just going for a walk.
- Stick to normal routines as much as possible. If you have problems with sleep try to keep to a regular time when you wake up and get up, and avoid caffeinated drinks after 4pm.
- Set yourself small daily goals and challenges to confront the things that you avoid.
- Remember the strengths that you have. It’s important to remind yourself that you have strengths and coping skills that can get you through tough times.
- Don’t be afraid to seek help. Discuss your problems with someone that you can trust. Make an appointment to see your GP. There are a range of treatments that may be able to help you.
Tips for Helping a Loved One with PTSD
- Try to be patient and understanding with the person with PTSD.
- Avoid being critical of how the person is coping. Remember that they have been through some extremely distressing experiences.
- Try not to take symptoms like emotional numbness, anger, and withdrawal personally. If the person with PTSD seems distant, irritable, or closed off, remember that this may have nothing to do with you or your relationship.
- Don’t put pressure on the person with PTSD to talk about their experience, but do allow them time and space to talk about it if they want to.
- People with PTSD sometimes feel hopeless or ashamed of how they are coping. Try to help the person to recognise their strengths and positive qualities.
- Try to encourage the sufferer to establish normal routines; this helps to restore a sense of order and control in their life. Help them to start with small daily goals and to recognise each success.
- If they haven’t already done so, try to encourage them to seek professional help. A good place to start is discussing things with your GP.
National Center for PTSD - ptsd.va.gov
Tools and information to help with a range of PTSD related symptoms and problems
NICE - guidance.nice.org.uk/CG26
Information on recommended treatments and downloadable leaflets.
Royal College of Psychiatrists - rcpsych.ac.uk
Information about PTSD with versions in other languages. Search ‘PTSD’ from the homepage.
All Wales Veterans Health and Wellbeing Service - veteranwales.co.uk
Support for military veterans and those trying to help them.
International Society for Traumatic Stress Studies - istss.org
Information and resources for the public, for professionals and those involved in research.
Journeys - journeysonline.org.uk
This Wales-based organisation offers information and self help resources for depression, and runs support groups for people suffering with the illness.
Samaritans - samaritans.org
Available 24 hours a day to provide confidential emotional support for people experiencing feelings of distress, despair or suicidal thoughts.