Post-traumatic stress disorder (PTSD)

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PTSDThough many mental health conditions are triggered or exacerbated by life events, post-traumatic stress disorder (PTSD) is one of only a few that can only occur when its sufferers experience a trauma. Trauma doesn’t just affect your emotions. It also changes your brain and body chemistry, altering the way you react to future stress, how you behave in your relationships, and how you feel about yourself.

Most people experience trauma at some point during their lives, but only a small percentage will develop PTSD. Research into this phenomenon is still in its infancy, with experts unsure precisely why some people develop post-traumatic stress and others don’t. No matter how or why you developed PTSD, Three Seas can help you begin putting the pieces of your life back together.

What is PTSD?

Post-traumatic stress disorder is a complex set of reactions to a traumatic event. Most people experience acute short-lived symptoms in the wake of a trauma. They might have nightmares for a few days, worry about their safety, or be overwhelmed with sadness or anger, for example. PTSD, however, is a longer-lived reaction. Long after the trauma has passed, and even after its after-effects—such as physical injuries or a trial—have disappeared, people with PTSD continue to relive their experience.

PTSD is as variable as the people who experience it, and the exact symptoms often depend on the type of trauma. A war veteran might develop symptoms of anger, or respond to an apparent threat—such as a loud noise—with an immediate rage outburst. He or she might also “snap” in response to threats, getting into dangerous fights and altercations. For other trauma sufferers, PTSD primarily triggers crippling fear or sadness. And of course, it’s possible for a trauma survivor to vacillate between several reactions. A rape survivor might be overwhelmed by rage one day, only to be debilitated by fear and guilt the next.

What Causes PTSD?

Although not everyone who experiences a traumatic event develops PTSD, PTSD is extraordinarily common among trauma survivors. Indeed, some treatment provides have labelled it as an ordinary reaction to extraordinary circumstances.

We don’t fully understand what happens in the brain and bodies of people with PTSD, but most research suggests that trauma changes biochemistry. Thus people who have survived trauma might be “stuck” in the traumatic experience, perpetually living and reliving a fight-or-flight reaction that kept them safe at the time of the trauma, but which offers no benefits now.

Some of the most common causes of PTSD include:

  • Participating in military combat.
  • Witnessing or being harmed by military combat, such as when civilians’ homes are bombed.
  • Being the victim of physical abuse in either childhood or adulthood.
  • Sexual abuse, rape, and sexual assault.
  • Surviving a natural disaster.
  • Living through a catastrophic medical diagnosis.

Mental health experts also increasingly recognise the role that witnessing another person’s trauma can play in the development of PTSD. Children who see their parents abused or who witnessed the death of a loved one, for example, may exhibit symptoms of PTSD.

Any trauma can trigger symptoms of PTSD, but most studies suggest that deliberate traumas are more frequent culprits. Rape victims suffer PTSD at much higher rates than natural disasters or cancer survivors. The aftermath of the trauma can also play a role, and survivors of natural disasters rarely face the sort of traumatic aftermath or blame that those who have been attacked face. This form of secondary trauma can include:

  • Having to testify against an assailant in court.
  • Facing financial problems as a result of a trauma.
  • Being dishonourably discharged from the military.
  • Facing loved ones who did not take the trauma seriously, or who do not believe that it happened at all.
  • Facing ongoing threats from an assailant.

Who is at Risk for PTSD?

The single most important predictor of PTSD is trauma, with between 10-25% of trauma survivors experiencing symptoms of PTSD in the aftermath of their trauma. The more serious the trauma, the longer it lasted, and the more often it is repeated, the more likely a person is to develop PTSD. That’s why a childhood sexual abuse survivor who was abused over many years is typically more likely to develop PTSD than a person who was attacked just once. The following risk factors further increase the likelihood that a trauma survivor will develop PTSD:

  • Being female; women face more traumatic events than men do, and the types of traumas women more typically face often produce stronger symptoms of PTSD.
  • A family history of mental illness, particularly of PTSD.
  • A previous history of trauma.
  • A previous history of depression, anxiety, or other mental health problems.
  • Experiencing other stressful life events at the time of the trauma.
  • Lack of good support at the time of the trauma.
  • Experiencing physiological side effects, such as headaches or an amputated limb, as a result of the trauma.

Symptoms of PTSD

Symptoms of PTSD generally fall into three distinct, yet broad, categories: 1) reliving the trauma; 2) avoiding reminders of the trauma; 3) physical and mental health symptoms associated with the trauma. Most PTSD sufferers experience symptoms in all three domains, but few experience every symptom of PTSD. The more specific symptoms of PTSD include:

  • Intrusive memories known as flashbacks. During intense flashbacks, the person might feel as though he or she is actually reliving the trauma, and may behave as such. Stimuli that reminds the survivor of the trauma, such as sights and sounds, may trigger flashbacks.
  • Depression, thoughts of suicide, feelings of hopelessness or worthlessness.
  • Guilt or shame about surviving the trauma.
  • Anger about the trauma.
  • An enhanced startle response.
  • A strong fight-or-flight response.
  • Difficulty concentrating.
  • Changes in mood or personality.
  • Persistent avoidance of people, places, or things that serve as reminders of the trauma. Some people with PTSD may also struggle to remember portions of the traumatic event.
  • Nightmares about the trauma.
  • Changes in overall health; some trauma survivors suffer chronic pain, unexplained illnesses, and poor overall health. Gastrointestinal distress is also common.
  • Changes in fertility. Research increasingly points to the ability of PTSD to disrupt the endocrine system. One study even found that women with PTSD who had survived rape were more likely than other groups to experience slowed labour during childbirth.

Post-traumatic stress disorder: Not Just in the Mind

PTSD is not all in the heads of sufferers. Indeed, a mounting body of research suggests that trauma is stored in the brain and body, disrupting the endocrine system and changing the way the body functions. The good news is that, just as trauma can change the body, therapy can help steadily reverse those changes.

Some of the most common physiological effects of PTSD include:

  • Headaches
  • Muscle aches
  • Disruptions in the menstrual cycle
  • Autoimmune issues
  • Unexplained chronic pain
  • High levels of the stress hormone cortisol in the blood
  • Fertility issues
  • Insomnia and other sleep disturbances
  • Frequent diarrhoea
  • Difficulties with sexual arousal, functioning, or orgasm

Treatment for PTSD

Though a number of medications are available to treat PTSD, no single medication works for everyone. Instead, doctors adopt a piecemeal approach, targeting medications to specific symptoms. They might prescribe sleeping medications for insomnia, antidepressants for depression, and anti-anxiety medication to cope with a heightened startle reflex. Ultimately, though, the goal of treatment is to reduce or even eliminate the need for medication. Although symptoms of PTSD are often dramatic and life-altering, the disease is highly treatable. At Three Seas, we partner with clients to develop a customised, workable solution for their PTSD symptoms. Some strategies include:

  • Therapy to identify the source of the trauma and to develop coping skills. Approaches such as prolonged exposure therapy and eye movement desensitisation and reprocessing (EMDR) are especially beneficial.
  • Lifestyle changes designed to help you better manage your trauma. For instance, a rape survivor might benefit from moving, installing an alarm system, or even something as simple as remodelling her bedroom so that it no longer reminds her of the attack.
  • Nutritional changes. Caffeine and sugar can make you more anxious. Some research also points to the value of certain foods, notably antioxidants such as blueberries, for combating PTSD. And of course, caring for your body is a great way to care for your mind.
  • Regular exercise is one of the very best things you can do for your body and mind. Study after study has documented its effectiveness for combating both depression and anxiety.
  • Family counselling and support groups can help you discuss your struggles with others, educate them about how best to help you, and help you feel less alone on your journey to recovery.

Complex Trauma and Other Manifestations of PTSD

PTSD is just one way trauma can manifest. Some people develop depression, phobias, or somatoform disorders. People who suffer from multiple traumas may experience another form of PTSD, known as complex PTSD (C-PTSD). Particularly common among sexual abuse survivors and children who were abused, C-PTSD has symptoms similar to traditional PTSD, but also comes with a significant fear of abandonment. Some people with C-PTSD are erroneously diagnosed with a personality disorder. The symptoms of C-PTSD include:

  • Dissociation: detaching from the present moment.
  • Intense fear of abandonment, and frantic efforts to avoid perceived abandonment.
  • Difficulties forming attachments to others, or a tendency to form attachments that are too strong too quickly.
  • A fragmented sense of self.
  • Difficulties with concentration and impulse control.
  • Sleep difficulties.
  • Forgetting all or portions of the traumatic event.
  • Sudden changes in perceptions of the perpetrator of the abuse or trauma.
  • Despair.
  • Alterations between withdrawal and isolation and frantic attempts to make friends and sustain lasting relationships.

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