At a Glance :
- Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder developed by people who have lived through a traumatic event
- Feeling painful and difficult emotions after a trauma experience is a normal response. In some cases, those feelings can persist and develop into a post traumatic stress disorder or they may even appear much later (having been initially repressed in order to cope)
- Feelings of intense fear, horror, sadness, continual weeping, helplessness and other painful experiences, as well as reliving or re-experiencing the events through sudden flashbacks or dreams are common symptoms of PTSDAround 12% of Australians will experience post traumatic stress disorder at some time during their lives
- People with a direct family member with PTSD, anxiety or depression are more likely to develop PTSD after a traumatic event
- Trans-generational trauma exists where trauma is transferred across the generations (for example, children and grandchildren of holocaust survivors and the stolen generation)
- Trauma experiences have been linked to addiction issues (alcohol, drugs, porn, sex, gambling etc) and self-harm as a way to cope and to self-medicate some very painful emotions and memories.
What is Post Traumatic Stress Disorder (PTSD)?
It’s normal for people to experience feelings of fear, worry, sadness and anxiety after experiencing trauma, and it is important that support exists to help process these emotions. If the feelings persist, it may be a sign of PTSD. Sometimes the initial reaction to a trauma is shock, followed by high functioning (or addictive behaviour including substance abuse) with the emotions buried deep inside. These emotions can eventually surface showing signs of PTSD.
A traumatic event can include sexual assault, domestic violence, war, torture, serious accident, fire or other natural disasters. Military combat is the most common cause of post traumatic stress disorder in men. Developmental trauma is a term particularly used to describe childhood trauma such as physical, emotional or sexual abuse and neglect.
According to Beyond Blue , around 12% of Australians will experience PTSD during their lifetime.
Experiencing trauma first hand can be a direct cause of post traumatic stress disorder. Additionally, witnessing a traumatic event or being in the role of having to pick up the pieces afterwards, emotionally or even physically (in the case of emergency personnel) can also be a cause of PTSD (this is known as vicarious trauma).
Symptoms of Post-Traumatic Stress Disorder
Symptoms of PTSD are typically grouped into four categories or groups of symptoms - re-experiencing the trauma, avoiding reminders or the traumatic event, negative changes to personality, thoughts and mood, and constant feelings of being on edge or aroused.
Re-experiencing the Trauma
People living with PTSD will often re-experience their trauma in some manner. Symptoms include:
- Distressing thoughts and memories of the trauma that may intrude without warning
- Flashbacks to the traumatic event
- Reliving physical sensations, such as a rapid heartbeat, shortness of breath, muscle stiffness and other symptoms associated with anxiety or a panic attack
- Nightmares and night terrors
- Constant crying and distress over small things
- Severe reactions to things that remind them of the traumatic event. The reminder doesn’t necessarily have to be direct - someone who was traumatised by war may have a severe reaction to a verbal disagreement
Avoiding Reminders of the Traumatic Event
Any number of things could remind someone of their traumatising event, including:
- Activities that they may have taken part in prior to or during the traumatic event or are related in some way
- Conversations on topics related to the traumatic event
- People that may have been involved with the event or share similar traits or appearances
- Places - the area or similar areas in which the event took place (for example, large bodies of water for someone who nearly drowned)
Changes to personality, mood and thoughts
People living with PTSD may display changes in the way they think or react to things as well as show changes in personality, including:
- Specific memory problems - an inability to remember all or part of the traumatic event
- An exaggerated or heightened sense of danger and tension
- An inability to take pleasure in things that they previously found enjoyable
- Feeling very down (depressed), experiencing muted emotions or emotional numbness
- Misplaced blame for the traumatic event or its aftermath, focussed inwards or towards an innocent third party
- Persistent anger, guilt, fear or horror
- A sense of detachment from the world or people around you
Feelings of Being “Wound Up” or Aroused
People living with post traumatic stress disorder often display symptoms of being “wound up” and quick to negatively react:
- Violence and anger with little provocation
- Hypervigilance - a heightened sense of danger verging on paranoia
- An overactive startle response making them easily startled or jumpy
- Reckless behaviour or a lack of awareness of danger
- Difficulties with sleeping (insomnia or broken sleep)
- Issues with concentration and focus
People living with PTSD may also experience anxiety, panic attacks or depression, and may also abuse alcohol and other drugs as a way to cope.
PTSD in Children
The symptoms of post traumatic stress disorder in children can vary from those in adults and may include:
- Separation anxiety - fear of being apart from a parent or guardian figure
- Losing learned skills or regression in behaviour (such as losing potty training or wetting the bed)
- Problems with sleep and frequent nightmares
- Phobias and fears that aren’t necessarily related to the trauma (fears of the dark, monsters under the bed, etc)
- Play that involves repetition of elements of the traumatising event, or displaying elements of the trauma in stories and drawings
- Pain and discomfort with no obvious cause
- Irritability and aggression, sometimes accompanied by physical violence such as biting and kicking
What Causes PTSD?
A traumatic event that leaves a person feeling helpless or hopeless can lead to post traumatic stress disorder. Like a number of other mental health conditions, there do appear to be elements of genetic predisposition when it comes to developing PTSD, but these genetic factors only increase the possibility of trauma leading to the disorder. Previous exposure to trauma and a history of other mental health conditions such as anxiety or depression can also increase chances of a traumatic event leading to PTSD.
For some, the events that caused the trauma were prolonged, such as ongoing abuse, imprisonment or torture, whereas for others a single event, such as a terrible accident or natural disaster may have been the cause.
Traumatic events do not have to be directly experienced to cause PTSD - indirect exposure, including seeing or reading reports of multiple traumatising events can also lead to the disorder – for example, a number of moderators employed to keep violent and sexual content off Facebook and YouTube display symptoms of PTSD .
Although any traumatic event can be a cause of post-traumatic stress, some of the more common triggers include:
- Sexual or physical assault
- Domestic violence or abuse
- Childhood abuse - physical, sexual or emotional
- Serious accidents
- Witnessing violence or seeing someone killed or injured
- Being held against your will
- Terrorist events
- Natural disasters
- Repeated exposure to the details of traumatic events
- Having your life threatened with a weapon
- Being a first responder to an event in which someone has been seriously injured or killed (for example, paramedics or nurses working in intensive care)
- being threatened with a gun, knife or other weapon
Most people who display symptoms of post-traumatic stress disorder recover without the need for professional help within a few weeks, either on their own or with the help of a support network. As such, treatment for PTSD usually doesn’t start until around two weeks after the traumatising event.
A number of treatments, both psychotherapeutic and medicinal can be used to treat PTSD. These treatments include:
- Cognitive Behavioural Therapy (CBT) - CBT including elements of exposure therapy can help people with PTSD challenge and replace irrational thoughts and behaviours as well as helping people become desensitised to feelings or situations that may remind them of the traumatising event.
- Family Therapy - PTSD can have a serious effect on interpersonal relationships as a person experiencing PTSD may distance themselves from loved ones, show signs of personality change or become aggressive or violent. Family therapy can help loved ones understand what is going on giving them the chance and ability to work through interpersonal problems.
- Eye Movement Desensitisation and Reprocessing (EMDR) - A therapy related to CBT, EMDR uses eye movement or other forms of left/right stimulation like hand or foot tapping to “interrupt” the brain, helping to break negative behaviours or interrupt spiralling emotional states or pervading memories of the traumatic event.
- Medication - While medications may be prescribed for secondary symptoms of PTSD, like anxiety, panic attacks or depression, medication isn’t a treatment for post traumatic stress disorder itself.
It is important to note that people will often push their traumatic experience out of their conscious awareness, as a way to function and cope. Over time, these repressed experiences and emotions can translate into difficult behaviour and painful emotions (and in serious cases can lead to substance abuse, addictions and self-harm). If things feel a bit off, for example, if you are suddenly crying every day or prone to raging bursts of anger that come out of the blue, you may want to consider seeking some support through therapy.
If you’ve experienced a traumatic event or think you may have experienced developmental trauma in childhood, consider seeking support.
If you would like to book a doctor’s appointment for a mental health care plan, or would like to find a psychologist , psychotherapist or counsellor to help support your mental health, an easy accessible way to do this is to book online via MyHealth1st .