Post-Traumatic Stress Disorder
A
In the 1970s, in the aftermath of the Vietnam War, a pattern was observable in many of the returning American soldiers. They were emotionally distant, irritable, had trouble sleeping and were prone to severe fits of anger. Anti-Vietnam War activists and anti-war groups advocating on behalf of the troubled veterans coined the term “post-Vietnam Syndrome” to describe their myriad of severe psychological symptoms. By 1980, this condition became officially termed by the medical community as post-traumatic stress disorder, or PTSD.
B
PTSD is a clinical mental illness that results from trauma that is either life threatening, led to an actual or potential serious injury, or is something that the person affected responded to with intense fear, helplessness or horror. Patients usually experience PTSD symptoms within months of the trauma, although sometimes the symptoms can take a year or longer to manifest itself. The kind of trauma that leads to PTSD is almost always unexpected, and leaves the affected person feeling powerless to stop or change the traumatic event. Situations that are likely to result in such trauma include accidents, serious crimes, sexualised violence, combat experience, and the sudden death of loved ones. Often, the trauma is profession-related, and is reported at higher rates by first responders, nurses, police officers, and military personnel than by other professionals. However, not everyone who experiences trauma develops PTSD, and researchers are still trying to find out why. What studies have conclusively determined at this point is that women are more likely to develop PTSD than men, and that children under the age of 10 are far less likely to suffer from the illness. Studies also indicate that persons with inherited risks for mental health issues such as depression and anxiety have increased vulnerability to PTSD.
C
Symptoms of PTSD can be broken down into three categories. The first is having intrusive and upsetting memories or nightmares about the event that causes the person’s nervous system to relive or re-experience the trauma. The re-experiencing of the trauma can further result in dissociation, in which the person loses touch with reality. This can either present as the person speaking and acting as if they are physically in the traumatic situation or staring off into space for an extended period of time.
The second category of symptoms is avoidance. People with PTSD try to avoid anything associated with the traumatic experience, or anything that could possibly remind them of it. As an example, a person who experienced trauma in the form of an accident may avoid driving or being a passenger in a vehicle. PTSD suffers can also avoid thoughts, feelings or memories that were related to the trauma, such as intense anger or fear. This often makes it difficult for those with PTSD to function in a world where daily emotional triggers are inevitable, and where navigating such emotions are essential for maintaining healthy interpersonal relationships.
Unsurprisingly, the final category of symptoms is increased anxiety, or “hyper arousal.” People with PTSD are constantly on guard for danger even when there is no indication of threat in their immediate environment. This is very common in war veterans who, upon returning from combat, can’t shake the feeling that they are being followed or targeted by enemy forces, and will suddenly drop to the ground upon hearing a noise akin to gunfire. This heightened state of anxiety or irritability has other consequences as well, such as being prone to outburst of anger or violent aggression, having difficulties concentrating, and having trouble sleeping.
D
Fortunately, PTSD is a treatable disorder, and there are several ways to approach the healing process. Once a patient is diagnosed with PTSD, they are almost always put on some form of anti-anxiety or anti-depressant medication. In most cases, the pharmaceutical drugs can help the patient to calm down to a functional state and get a good night’s rest, but is only temporary. Drugs are always used in conjunction with some form of therapy. The most effective therapeutic models for PTSD sufferers are exposure therapy, eye movement desensitisation and reprocessing (EMDR), and cognitive-behavioural therapy (CBT). As the name suggests, exposure therapy involves exposing the patient to what they are afraid of in a safe environment so that they can desensitise to the triggers. EMDR combines exposure therapy with guided eye movements that help you process traumatic memories.
Then there is CBT, which teaches patients skills such as relaxation and mindfulness techniques that bring them into the present moment and allow them to observe how their thoughts, feelings and behaviours work together. CBT is derived from and modeled after mindfulness meditation techniques brought to the West by Asian monks in the last century. The premise behind both meditation and CBT is that by becoming aware of one’s own emotional and mental processes, a person is more capable of identify real versus perceived threats, and thus have more control over their reactions to them.