By Will Sutherland
A traumatic event involves fear-inducing circumstances, like actual or threatened death (war and natural disasters), serious injury and sexual violence1. However, people can experience trauma by witnessing or repeatedly being exposed to details of a fear-inducing event (first responders seeing dead bodies and police officers hearing details of child abuse). It’s normal for these circumstances to cause people distress. However, for some, that distress continues long after the event, including: hypervigilance, panic attacks and intrusive memories of the event2. Often, people will then avoid circumstances or stimuli to try and stop those symptoms from occurring. This prolonged experience of symptoms and avoidant behaviour are the main components of Posttraumatic Stress Disorder (PTSD).
75% of Australian adults have experienced a traumatic event at some point in their life2. 12% will develop PTSD3 from those events. Genetics factors, level of support and comorbid conditions are correlated with higher levels of PTSD. Additionally, sexual assault is more likely to lead to PTSD than other traumatic events. Although relatively few people will develop PTSD from a traumatic incident, prolonged PTSD can have serious effects. This includes using illicit substances to attempt to avoid their symptoms5. Others may have difficulty with their work and relationships due to difficulty concentrating, self-destructive behaviour and aggression. 80% of those with prolonged PTSD will also experience comorbid disorders like anxiety and depression.
So, why does this happen? An evolutionary perspective suggests this was a survival advantage. Our brains likely developed a way of fortifying fear-inducing situations to memory to ensure we remember to avoid danger later7. In fact, the neurochemicals that help strengthen memories are mostly induced by stress and fear, like norepinephrine, and cortisol8. So, PTSD may be an unhelpful extension of what was an evolutionary advantage.
Fortunately, there are many effective treatments for PTSD, including cognitive behaviour therapy, Eye-movement desensitization reprogramming, exposure therapy and medication. These can help people to manage their symptoms and reduce their severity and frequency. Trauma Informed Care (TIC), is a recently developed framework that assists many different practitioners to provide effective PTSD treatment. TIC takes into consideration the specific needs of those with PTSD, like safe spaces and empowerment6. Others find support and recover through PTSD support groups. Eye Movement Desensitisation Reprogramming involves guiding the patient through remembering the traumatic event whilst engaging in bi-lateral eye movement (left-to-right)9. This is a relatively recent development but is very effective at desensitizing someone to the intense negative symptoms associated with the memory.
There are many promising treatment options for those with PTSD. However, it’s important to ensure the provider is trauma-informed and qualified. Unfortunately, improper treatment can re-traumatize people and make their symptoms worse6.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Post-traumatic stress disorder (PTSD). (2015, August 11). SANE. https://www.sane.org/information-and-resources/facts-and-guides/post-traumatic-stress-disorder#:~:text=How%20common%20is%20PTSD%3F
- Australian Bureau of Statistics. (2018). National Health Survey: First results [Review of National Health Survey: First results]. Australian Government. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-first-results/latest-release
- Australian Bureau of Statistics. (2008, October 23). National Survey of Mental Health and Wellbeing: Summary of Results, 2007 | Australian Bureau of Statistics. Www.abs.gov.au. https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/latest-release
- Health Direct. (2019, February 3). Anxiety – symptoms, treatment and causes. Healthdirect.gov.au; Healthdirect Australia. https://www.healthdirect.gov.au/anxiety
- Trauma and young people: Moving toward trauma-informed services and systems. (2015). Orygen. https://www.orygen.org.au/trauma
- Cantor C. (2009). Post-traumatic stress disorder: evolutionary perspectives. The Australian and New Zealand journal of psychiatry, 43(11), 1038–1048. https://doi.org/10.3109/00048670903270407
- Sherin JE, Nemeroff CB. Post-traumatic stress disorder: the neurobiological impact of psychological trauma. Dialogues Clin Neurosci. 2011;13(3):263-78. doi: 10.31887/DCNS.2011.13.2/jsherin. PMID: 22034143; PMCID: PMC3182008.
- American Psychological Association. (2017, May). Eye Movement Desensitization and Reprocessing (EMDR) Therapy. American Psychological Association. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing