What Is Post Traumatic Stress?
Post-Traumatic-Stress is a natural response to more or less any trauma in our
lives. Many people will naturally recover from even the most challenging
events after a month or two of the incident. Some, though, will go on
to be disturbed by intrusive thoughts, images and fears, respond to sudden noises
or changes around them, avoid social contact, crowds, any reminders of the traumatic
event and be anxious and frightened most of the time. And the problem
can persist for years or even decades and it has the potential to completely ruin lives.
Trauma can be divided into a number of different categories:
- Simple Trauma:
- A 'one off' relatively uncomplex incident
- Complex Trauma:
- Post Trauma outcomes can become complex for a number of reasons, such as
- A more severe incident
- Repeated trauma
- The place it occurred
- The presence of loved ones or children
- Pre-existing conditions or health difficulties
- Substance abuse
- A new life event that 'takes me back there', to the original trauma
that had previously been coped with successfully
- Chronic Trauma, rather than being caused by a 'big event' this
is often the result of long-term exposure to threatening and frightening
environments, which can include childhood neglect, abuse, domestic violence and so on.
What Is 'Normal'?
The natural response of our brains and bodies to a frightening event is to treat
it as significant and then to set about processing it - to make sense of
it. The ways we do that is to keep thinking about it - even
when we don't want to - talk about it to anyone that will listen and to
dream. All of these things are our attempt to make sense of what
happened and in time, to move it from the 'just happened' to the 'once
happened' part of our memory and eventually off to the 'almost forgotten' memories.
While we are doing that, our bodies can go through some quite alarming
changes. We might find we can't sleep, or perhaps that we can't
wake up and want to sleep all the time, we might often be 'away with the
fairies', or what war veterans used to call 'the thousand mile stare',
where we are looking off into the distance at nothing in particular.
Other symptoms a person might experience include
- Limited ability to concentrate and short attention span
- A tendency to 'drift off' when someone is talking or while watching
a television programme, etc.
- Feeling detached from other people, giving up previously significant activities
- Sudden intrusive thoughts and memories
- Constant vigilance
- Exaggerated startle response
- Churning guts, cramps, IBS, feeling sick, loss of appetite
- Angry or emotional outbursts
- A loss of motivation, such as getting to work but not seeing the point of
going in or going to the supermarket and just walking away again because the point
of shopping has vanished.
And all of this is normal and healthy - so long as it doesn't go on
for too long. Under most circumstances, many people that experience
some or all of these symptoms would still find that they naturally and spontaneously
recover over a period of weeks. This is more likely to be the case if
the traumatic incident was a 'one off' and when there have been no previous
traumatic experiences or previously existing difficulties, that might include things
like anxiety disorders, significant depression, substance abuse difficulties,
eating disorders and so on.
If any of the above or similar problems continue and cause you difficulty enough to
disrupt your work, social or family relationships, it's time to consider getting
some professional help.
When Should You Get Help?
In the case of a recent, 'one off' incident:
- If you thiink you are suffering from PTSD symptoms, your first port of call
is your GP. See your GP soon after the incident to let them know what
happened and that you are in difficulty.
- As a rough guide, you should be seeking professional support, assessment or treatment if
your symptoms persist for more than six weeks.
- NICE (National Institute for Clinical Excellence) recommend a 'Watchful
Waiting' period if symptoms are mild and have been present for less than four
weeks, to see if you will recover on your own
- Where symptoms are severe, no waiting period is recommended and you should be
referred immediately to appropriate NHS services.
- If local waiting times are long, you should be referred to your local NHS
services for assessment in time to catch you at the end of the 'Watchful Waiting' period
- If that doesn't happen or what they do doesn't help, you can refer
yourself to see someone like me.
An individual struggling in this way may not realise that they are suffering
with PTSD or they will be unable to access the treatment offered. There
are any number of possible reasons, but often it is because the trauma was so severe
and their difficulty so marked that they cannot bring themselves to think about the
problem - yet they cannot bring themselves to forget about it either.
- An individual suffering with a chronic or complex trauma outcome is likely to be
- Expriencing frequent disturbing dreams
- Have significantly disturbed sleep
- Be socially isolated
- Be trying to 'medicate' or support themselves in whatever way they can
- Be experiencing frequent 'reminders' of the event or people involved
- Suffering from intrusive images and thoughts, which may be reliving the actual
event or may be imaginary/invented
- Be expecting 'it' to happen again at any moment
- Be suffering with other, aparently unrelated and often inexplicable symptoms,
such as pain, chronic fatigue, anger, depression etc.
- May be suffering from other difficulties and conditions that
must be dealt with alongside the PTSD.