Post Traumatic Stress Disorder (PTSD)
What is PTSD?
Post Traumatic Stress Disorder, often shortened to PTSD, is the name given to a set of symptoms that some people develop after experiencing major traumatic events.
The traumatic event can be a single incident or take place over many months or years. Many people think of PTSD as something that affects people who have had traumatic experiences while serving in the military, but it can affect anyone who has experienced a traumatic situation. The condition can be brought on by events such as serious traffic accidents, rape or sexual abuse, domestic violence, physical assault, torture, traumatic childbirth, witnessing a violent death or virtually any other situation that is exceptionally threatening or catastrophic and likely to cause distress in almost anyone.
Up to one third of people who have experienced a traumatic event develop some PTSD symptoms. Studies estimate that around 7% of people will suffer from PTSD at some point in their lives. Other problems such as depression and anxiety disorders are common alongside PTSD. Increased alcohol use and drug use can also become a problem for some people.
Symptoms of PTSD
PTSD sufferers often experience repeated and intrusive distressing memories of the event. There may also be a feeling of reliving (or ‘re-experiencing’) the event through ‘flashbacks’ or ‘nightmares’, which can be very distressing and disorientating. There can also be physical reactions such as shaking and sweating.
Because these memories can be very intense and upsetting, some PTSD sufferers may avoid people or situations that remind them of the trauma, or try to ignore the memories and avoid talking about what happened. Some people may also forget significant parts of the traumatic event.
Other people will think about the event constantly, which stops them coming to terms with it (they may, for instance, ask themselves why the event happened to them or how it could have been prevented).
PTSD sufferers may have emotions or feelings that are difficult to deal with, such as guilt or shame, or they may feel that they do not deserve help.
They may also feel anxious or irritable, and find it difficult to concentrate and sleep. Increased jumpiness and vigilance can also be present. For some people it can mean that doing ordinary things like going to work or school or going out with friends become very difficult.
If you think you might have PTSD you should first see your GP who will perform an initial assessment.
Depending upon the outcome of this, your GP will decide whether you need a referral to a primary care mental health worker, your local Community Mental Health Team (CMHT) or another service, depending on your needs.
If you are referred to your local CMHT you will receive a further more detailed assessment, and you may then be referred on to a specialist traumatic stress service or receive help from within the team.
Psychological therapies are considered to be the most effective treatments for PTSD. In particular, there is good evidence that two types of psychological treatments which focus on the traumatic event called Trauma Focused Cognitive Behavioural Therapy (TFCBT) and Eye Movement Desensitisation and Reprocessing (EMDR) are effective. Both techniques have been shown to reduce the symptoms and the distress experienced by PTSD sufferers.
The term TFCBT encompasses a number of forms of Cognitive Behavioural Therapy (CBT). Broadly speaking, these treatments help the sufferer to confront their traumatic memories often through talking and writing about the event.
TFCBT helps individuals to identify and challenge negative feelings and thoughts, including ideas related to feelings of guilt and shame. The treatment can also involve gradually returning to avoided activities that have become frightening because they are connected in some way with the trauma.
EMDR techniques can help people with PTSD to confront their traumatic memories. The individual is asked to focus on memories, thoughts, feelings and sensations associated with the trauma, whilst also focusing on something else at the same time. Usually the other focus is on following movements of the therapist’s finger.
Other treatments such as medication and stress management techniques are sometimes used to treat PTSD and can be helpful, although these have not been shown to be as effective as TFCBT or EMDR.