Difficult situations are part of life. We all must cope with tough
circumstances, such as bereavement or conflict in our personal and
professional relationships, and learn to move on. But sometimes people
experience an event which is so unexpected and so shattering that it
continues to have a serious effect on them, long after any physical
danger involved has passed. Individuals with this kind of experience
may suffer flashbacks and nightmares, in which they re-live the
situation that caused them intense fear and horror. They may become
emotionally numb. When this condition persists for over a month, it is
diagnosed as post-traumatic stress disorder.
Post-traumatic stress disorder (PTSD) is one of several conditions
known as an anxiety disorder. This kind of medical disorder affects
approximately 1 in 10 people. They are among the most common of mental
health problems. Children and adults can develop PTSD. The disorder can
become so severe that that the individual finds it difficult to lead a
normal life. Fortunately, treatments exist to help people with PTSD
bring their lives back into balance.
What causes it?
PTSD is caused by a psychologically traumatic event involving actual
or threatened death or serious injury to oneself or others. Such
triggering events are called 'stressors'; they may be experienced alone
or while in a large group.
Violent personal assault, such as rape or mugging, car or plane
accidents, military combat, industrial accidents and natural disasters,
such as earthquakes and hurricanes, are stressors which have caused
people to suffer from PTSD. In some cases, seeing another person harmed
or killed, or learning that a close friend or family member is in
serious danger has caused the disorder.
What are the signs?
The symptoms of PTSD usually begin within 3 months of the traumatic
event. However, sometimes they surface many years later. The duration
of PTSD, and the strength of the symptoms, vary. For some people,
recovery may be achieved in 6 months; for others, it may take much
longer.
There are three categories of symptoms. The first involves
re-experiencing the event. This is the main characteristic of PTSD and
it can happen in different ways. Most commonly the person has powerful,
recurrent memories of the event, or recur-rent nightmares or flashbacks
in which they re-live their distressing experience. The anniversary of
the triggering event, or situations which remind them of it, can also
cause extreme discomfort. Avoidance and emotional numbing are the
second category of symptoms. The first occurs when people with PTSD
avoid encountering scenarios which may remind them of the trauma.
Emotional numbing generally begins very soon after the event. A person
with PTSD may withdraw from friends and family, they may lose interest
in activities they previously enjoyed and have difficulty feeling
emotions, especially those associated with intimacy. Feelings of
extreme guilt are also common.
In rare cases, a person may enter dissociative states, lasting
anywhere from a few minutes to several days, during which they believe
they are re-living the episode, and behave as if it is happening all
over again. The third category of symptoms involves changes in sleeping
patterns and increased alertness. Insomnia is common and some people
with PTSD have difficulty concentrating and finishing tasks. Increased
aggression can also result.
Other illnesses may accompany PTSD
People with PTSD may develop a dependence on drugs or alcohol. They
may become depressed. It is not uncommon for another anxiety disorder
to be present at the same time as PTSD. As well, dizziness, chest pain,
gastrointestinal complaints and immune system problems may be linked to
PTSD. These are often treated as self-contained illnesses; the link
with PTSD will be revealed only if a patient volunteers information
about a traumatic event, or if a doctor investigates a possible link
with psychological trauma.
How is PTSD treated?
Medication can help with the depression and anxiety often felt by
people with PTSD, and assist them in re-establishing regular sleep
patterns.
Cognitive-behavioural therapy and group therapy are generally felt
to be more promising treatments for PTSD. They're often performed by
therapists experienced in a particular type of trauma, such as rape
counsellors. Exposure therapy, in which the patient re-lives the
experience under controlled conditions in order to work through the
trauma, can also be beneficial.
Research into the causes of PTSD and its treatment is ongoing.
Determining which treatments work best for which types of trauma is
currently under study.
Where to go for more information
For further information about post-traumatic stress disorder,
contact a community organization like the Canadian Mental Health
Association to find out about support and resources available in your
community.