Understanding Post Traumatic Stress Disorder (PTSD)
Many of us may have heard of post-traumatic stress disorder (PTSD) as the modern term used to describe what was once referred to as ‘shell shock’, a condition most notably suffered by ex-military personnel. But do we really understand what it is and could we spot the signs of someone who may be suffering with such a condition?
Recent media coverage has highlighted the rise in veterans seeking mental health treatment for PTSD, particularly following the conflict in Afghanistan. It is hoped that a contributing factor to the marked increase is due to a greater awareness of the condition as well as a reduction in the stigma associated with seeking treatment for mental health conditions such as the work tirelessly carried out by many mental health charities such as Combat Stress. Work conducted by charities like the Mental Health Foundation to create awareness events such as this week’s ‘Mental Health Awareness Week’ also play a huge part in battling the stigma and raising awareness.
What is PTSD?
Dr Paul McLaren of Priory Hospital Hayes Grove says: “PTSD is a condition that we know how to treat. It can be deeply distressing and disabling, and it is often part of the condition to feel estranged and to withdraw from social support and medical help, so making treatment readily accessible is vital.”
PTSD can affect anyone, at any age. It is a maladaptive response to the experience of extreme danger, whether on the motorway or on the battlefield, that can persist long after the danger has receded.
It can be understood as a disorder of the fear response and of memory. The fear response stays switched on, leaving the individual jumpy and on edge even when the threat has long receded. Rather than filing the memory in the usual way, the brain keeps it in the foreground in the form of flashbacks. Sometimes these can be so intense that the individual feels that they are reliving the trauma. They may remember intensely all aspects of the traumatic event, the tastes, the sounds, the images, the physical sensations and the smell. Flashbacks may be triggered by reminders, such as scenes in TV programmes, or just come to mind out of the blue. They may be so intense and distracting that it is difficult for the individual to get on with everyday life. They can lead to avoidance. Staying away from the scene of a battle is relatively easy. Avoiding driving past an accident site or the scene of a serious assault may be more difficult and disruptive.
Sometimes the bad event is re-experienced in nightmares. Emotional numbing and loss of interest can also occur with PTSD and can have a negative impact on close relationships. PTSD can hurt families and relationships. Anger and irritability may arise and be difficult for the individual to control. Alcohol abuse and depression are common complications.
Dr McLaren adds: “PTSD is now well recognised as a complication of military combat. It is accepted that psychological wounds are as worthy of care as the physical ones.” Combat stress is providing high quality psychiatric and psychological care for veterans but, for many people, getting timely and effective treatment for PTSD is more difficult. PTSD can arise from serious road traffic accidents, assaults, serious accidents at work, domestic violence, abuse or traumatic childbirth. For many people it is a transient self-limiting condition but for one in ten it can become long-term. Early recognition and understanding are key to getting effective treatment. Shame and stigma need to be challenged as they can delay help seeking.