Post Traumatic Stress Disorder (PTSD)

What is Post Traumatic Stress Disorder?

PTSD can develop following involvement in a critical incident such as a life-threatening assault or traffic accident. PTSD can also develop among people who witnessed these events. During the traumatic incident people can feel intense fear, helplessness, horror and a sense of being overwhelmed and unable to cope. It’s difficult to predict who will develop PTSD after such an incident, and not everyone will do so. In some people PTSD develops soon after the trauma. It’s not unusual, however, to see a delayed onset of symptoms, sometimes months or even years after the initial trauma.

The strict definition of PTSD is that the trauma you had or witnessed must be serious. Examples of this are - a severe accident, rape, a life-threatening assault, torture, seeing someone killed or a natural disaster such as a strong earthquake. However, symptoms similar to PTSD can develop in some people after less severe events. What they all have in common, however, is that the problematic symptoms begin with the incident.

So who can suffer from it?

Certain groups of people are more prone to PTSD than others:
  • Emergency services, especially rescue workers such as fire fighters
  • Survivors of road traffic accidents
  • Rape victims
  • The majority of people who have been tortured develop PTSD
  • Military personnel involved in combat


Symptoms
  • Recurring and intrusive thoughts and memories surrounding the incident. Flashbacks can happen and these can be distressing
  • Avoidance: this is when people try to avoid anything that reminds them of the incident. This includes thoughts, conversations, associated places, people, activities or anything which may trigger memories of the trauma. A common trigger is reports in the media, especially at anniversaries of incidents
  • A feeling of emotional numbness and feeling isolation from others. Some people report that ‘nothing feels real’ anymore. Relationships with those close to you may suffer
  • You may lose interest in previously enjoyable activities and only be able to look on the dark side of life
  • Hypersensitivity - This includes Irritability and bouts of temper


Post traumatic stress disorder is generally defined as a condition where the sufferer experiences recurring distressing and intrusive memories and other symptoms after involvement in a traumatic event.

The important thing to remember about PTSD is that it is a normal reaction to an abnormal event which is outside the range of normal experience.

Post Traumatic Stress Disorder symptoms can include the following:
  • Being constantly on guard and aware of every ‘danger’
  • Exaggerated startle response, jumping at every little thing
  • Problems sleeping or staying asleep, awakening very early and unable to return to sleep
  • Difficulty concentrating and short term memory problems.


All of the above are normal reactions to an abnormal event and are easily understood in relation to the ‘fight or flight’ response.. In most cases, PTSD resolves itself in about 6 months. In some cases the symptoms of PTSD persist long-term. Modern research now means that trauma specialists have effective techniques they can use to help people.

There is no need to wait and see if your symptoms are going to persist beyond 6 months. You can seek help immediately after a traumatic incident

What about treatment?
The aim of treatment is not to wipe away the memories. What happened has happened and that can’t be changed. The aim is to desensitise the memory so it no longer causes you distress. We all have unpleasant or disturbing memories but they don’t interfere with our day to day lives. Successful treatment for PTSD will return you to a state where you can function well in your day to day life without the distress you previously experienced.

Many thousands of people have left PTSD behind and gone on to live full and active lives.

The following treatment options have been shown to be effective for those already suffering from PTSD:
  • Hypnotherapy
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • The Rewind Technique
  • Anxiety management
  • Relaxation training
  • CBT – Cognitive Behavioural Therapy


Can it be prevented?
  • Critical Incident Debriefing is often available shortly after an incident. Debriefing is not a treatment but is aimed at prevention, to stop PTSD developing in the first place. It should always be carried out by an experienced trauma specialist, trained and qualified to carry out a debrief
  • Debriefing should not be confused with counselling or therapy as the procedure is completely different. It is a specific, targeted and highly effective intervention


What is Critical Incident De-briefing?
Critical Incident Debriefing is a psychological intervention implemented after a major incident such as war zone trauma, civilian disaster, terrorist incident or natural disaster.

The aim of Critical Incident Debriefing CID is to prevent or limit the onset of Post Traumatic Stress Disorder (PTSD) and other stress related problems. Ideally, this intervention will take place within two to three days after the incident but can be still be beneficial many years after the event.

Debriefing was originally developed for the benefit of emergency services and military personnel but is now available to benefit the general population where they are exposed to a traumatic incident. The most common model employed by debriefers is the Mitchell and Dyregrove model. This consists of a seven-stage process which people are guided through by the debriefers. It can be used on groups of people or on individuals.

Working with emotionally traumatised individuals, or those who have been exposed to a traumatic event, is a highly specialised area and debriefers need to be properly trained and experienced in trauma related issues and PTSD. The aim of Critical Incident Debriefing is to minimise unnecessary psychological distress or responses in the aftermath of a traumatic event. Additional support in the form of follow up counselling or support may be required afterwards. This may be done by your debriefer if they have the necessary skills, or by way of referral to a suitable professional service.

Susan Reynolds is a member of the Register of Trauma Specialist and holds a diploma in Critical Incident De-briefing.