Post Traumatic Stress Disorder (PTSD)

A Brief Summary of General Information

Table of Contents

Causes

It is accepted that PTSD is caused by exposure to trauma in which the person experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of that person or others. The person' response involves intense fear, helplessness or horror.

Symptoms

The symptoms of PSTD include:

• Tension and agitation
• Sleep disturbance including dreams and nightmares
• 'Flashbacks' - intrusive memories and feelings
• Emotional detachment - 'coldness'
• Social withdrawal
• Self-preoccupation and/or egocentric behaviour
• Irritability
• Avoidance of reminders associated with trauma
• Moods swings
• Depression
• Anxiety, panic attacks
• Fearfulness
• Continual alertness for future emotional or physical threats
• Physiological reaction such as headaches, stomach upsets, rashes
• Poor concentration, loss of confidence
• Alcohol and other drug abuse

Is PTSD New

PTSD is not a 'new' problem. History reveals that negative reactions to traumatic events have been known for thousands of years, only the name is new. The Greeks wrote of it, so did Shakespeare. During WWI it was known as 'shell shock', and during WWII the terms used were 'combat neurosis', combat fatigue' or 'combat exhaustion'. Korean War veterans were accused of feigning illness to gain compensation, and this view persisted until recently.

Current research is tending to show that the intensity of the traumatic event is more significant than the level of personal adjustment in determining if someone is likely to suffer from PTSD.

Development

PTSD is often only noticed after there is a pronounced change in a person's behaviour. At first the change is subtle, developing until it occurs more commonly and more rapidly.

It begins with situational stresses until these reach the personal threshold level, where the traumatised person is pre-occupied and overwhelmed by the previous trauma.

The individual becomes less able to deal with stress, frustration and anticipated difficulties. Their often highly irritated demeanour is increasingly triggered by trivial events.

They 'switch off', becoming emotionally detached and losing interest in family matters. Clear patterns of emotional isolation develop, and depressive patterns become more frequent and pronounced.

Anxiety patterns also become more frequent and pronounced, to the stage of worrying about things which have been done so often they should be automatic, and developing into panic attacks.

Patterns

PTSD is the normal reaction to abnormal events. It is not related to race, religion, skin colour, education, class or culture.

It is episodic, with situational stress bringing on feelings related to the traumatic event.

Less commonly, it can link into other psychiatric predispositions such as manic behaviour.

Triggers

Triggers are part of the re-experiencing phenomena displayed by those who suffer from PTSD. They are often unbidden, occurring without warning. Triggers are not just physical prompts, but can also be emotional, occurring when the individual is placed in a situation where the same emotion is experienced. These emotional triggers include guilt, fear, or lack of control, and they are just as strong as physical triggers.

Triggers occur unpredictably, and as a result the veteran and his or her family can be greatly concerned and confused. Sleep disturbance often results and there are very strong 'fight or flight' reactions.

Common triggers include:

• Specific scenes - crowded streets, sunsets, sunrises, familiar clothing
• Movement - someone rushing towards the individual
• TV - even if the story is unreal, the subject or the environment may cause thoughts which act as a trigger
• Sound - helicopters, songs, unexpected loud noises
• Smell - jungle or bush, rain, smoke, blood, cordite or explosives
• Reading - or discussion about subjects of trauma
• Touch - gun metal, webbing, blood
• Situational - being crowded, walking across open spaces, feeling vulnerable or not in control

Related Problems

Substance Abuse

Substance abuse is common, and simply another sign that the individual is not coping. Self-medication with alcohol or other illegal drugs, far from masking intrusive memories, actually accesses them. Abuse of prescribed medication is also common.

Lifestyle

PTSD often leads to problematic lifestyles long before veterans or their families are aware that they are suffering PTSD. Problems with relationships, substance abuse or similar problems often arise, and are commonly misdiagnosed as personality disorders, anxiety, depression or bi-polar affective disorders. These problems are often episodic or cyclical, and can precipitate PTSD patterns.

Individuals often become overwhelmed by PTSD symptoms, and can think only of themselves, and how to survive the situation. This behaviour may have a bad effect on relationships, including those at home and at work.

Veterans often have trouble at work in coping with real or perceived pressure, frustration, the actions of others, and their emotions about these things.

Treatment

Medication on its own is often not sufficient to improve psychological function. Options to discuss with an Open Arms counsellor, local doctor or psychiatrist include counselling, group work, outpatient or inpatient hospital treatment.

Medication and its effects should be discussed with a doctor and pharmacist, and partners should be involved in this discussion. A method of managing medication through is available through Open Arms or DVA

Based on VVCS Brochure - for further information see Links