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Post Traumatic Stress Disorder
(Extract from the Mind Publication "Understanding Post Traumatic Stress Disorder ")
'The depth of my sorrow was not surprise to me, but I was totally unprepared for the other reactions - the shakes, nightmares, panic attacks, memory and concentration problems and the unrelenting exhaustion.' (Aileen Quinton whose mother ws killed in the Enniskillen bombing, Nursing Times, 23.3.94)
'I still have nightmares. They can be triggered by something on television, or the smallest tings, like having the duvet caught round my fact. The number of times is lessening, but they do come ... I'm learning how to cope. I put the light on, I open the window and say, "Yep, look, that was a dream." ' (Helen, survivor of the Clapham Junction rail crash in 1988, The Sunday Times, 10.12.89)
'One of my problems resulted from experiencing upsetting flashbacks - people badly injured, the shocked faces of fellow passengers and staff at the hospital, my husband and brother-in-law splattered with blood and mud. They came to me when I was at my most vulnerable. I don't think they will ever go completely, but they are fading and are easier to cope with.' (Louise Bowles, a survivor of the Purley train crash in 1989, Nursing Times, 10.2.91)
Everyone remembers the King's Cross Fire, the Clapham Junction rail crash, the Hillsborough football stadium disaster, the sinking of the Herald of Free Enterprise at Zeebrugge, not to mention the Gulf War. It is not surprising that the survivors of such catastrophes are likely to experience extreme distress. On a more everyday level, many people are emotionally injured as a result of road accidents, witnessing a violent crime or being mugged or sexually assaulted. In recent years the term post-traumatic stress disorder has been used by mental health professionals to describe the range of disturbing psychological symptoms people may experience as a result of the impact of traumatic events.
What is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder is defined as the development of symptoms following a psychologically distressing event which is outside the range of normal human experience. Some survivors have object to the use of the term 'disorder' since the symptoms we may experience in response to large-scale or personal trauma are really normal reactions to abnormal events. But there is no doubt that symptoms of post-traumatic stress can seriously hamper survivors' ability to lead their lives as they would choose. This relatively new label amounts to a recognition that extremely disturbing psychological symptoms may be caused by events and social conditions which are beyond our control.
What are the Symptoms?
Not everyone will develop PTSD after being involved in a traumatic event. But initially everyone experiencing trauma will be affected to some degree. Some survivors may react by becoming emotionally numb and won't feel distressed until much later, as this description of a survivor of the King's Cross underground disaster illustrates:
'Dick had a very interesting response - he'd almost denied what happened, didn't want to talk about it, didn't want to read any of the articles ... Then one day a student nurse mentioned to him that she was worried about her cat because she had left it that morning trapped up a tree, and it was as though that pushed a button. Dick broke down and shed lots of tears.' (Out of the Fire' by Angela Neustatter, The Sunday Times, 16.10.88).
There is no time limit on distress and some survivors may not develop disturbing symptoms until many years after the event. Sooner or later anyone who has been through a traumatic event may develop emotional and physical reaction and changes in behaviour which fall into the following three groups:
Re-experiencing phenomena
Reliving aspects of the trauma through:
- Intrusive thoughts and images
- Nightmares
- Intense distress at real or symbolic reminders of the trauma
- Flashbacks - you feel as though the traumatic event is happening again in the present.
Avoidance
- Keeping busy
- Avoiding situations that remind you of the trauma
- Repression - you may be unable to recall some aspect of the trauma
- Inability to express affection
- Feeling detached, cut off and emotionally numb
- Feeling that there's no point in planning for the future
Increased arousal
- Sleep disturbance
- Irritability and aggression
- Inability to concentrate
- Extreme alertness
- Physical panic responses to anything related to the trauma
- Being easily startled
These are regarded as normal symptoms and many people do come to terms with a traumatic experience with a matter of months.
Topics also included in this leaflet are:
Why do some people develop PTSD?
What causes PTSD?
What's the best way to deal with a traumatic event?
What sort of help is available for PTSD?
Behavioural therapy
Cognitive therapy
Eye Movement Desensitisation and Reprocessing (EMDR)
What should friends or relatives do?
Useful organisations
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