What is PTSD?
PTSD stands for Post-Traumatic Stress Disorder.
As the name suggests, PTSD refers to the stress that people experience even after the traumatic experience or event(s) is over.
Simply put, it can be described as “THE AFTERSHOCK”. This stress is a result of the individuals’ inability to recover from the anxiety associated with the trauma.
This extremely unpleasant event(s) could be anything that:
- Exceeds one’s capacity to COPE,
- Is beyond one’s EXPECTATION and
- Far from one’s ABILITY to ADJUST.
People with PTSD may have disturbing, intense thoughts and feelings related to their experience that last long after the traumatic event has ended.
They may relive the event through flashbacks or nightmares, fear or anger, they may feel sadness, and they may feel detached or estranged from other people.
They may probably avoid people or situations that remind them of the traumatic event, also they may have strong negative reactions to something as ordinary an accidental touch or as a loud noise.
History of PTSD
The origin of PTSD dates back to ancient texts such as “The Iliad and The Odyssey” where descriptions of PTSD can be traced.
It came to be first classified and included in DSM after the Vietnam war, where the soldiers started displaying severe distressing symptoms like insomnia, anxiety, severe guilt, restlessness and flashbacks (to name a few) after the war was over.
However, prior to this such symptoms were casually referred to as either “shell shock, battle fatigue, war neurosis, or combat stress reaction (CSR)” and were believed to wane with time.
Thus, not much attention was paid to it, neither specific medical or psychological treatment was available for the same.
However, it’s criticality was soon realised when the ‘Nam war soldiers’ condition deteriorated further. Thus, it was then, that it began to be identified as a major psychological disorder and not a lingering condition.
Kinds of events leading to PTSD:
There have been many cases where people who haven’t been on the war front and still diagnosed with PTSD and it is because they faced a situation which was so traumatic that they were not able to forget the pain or the event in which they were.
Here are some examples of traumatic events:
- Community violence (e.g., shooting, mugging, burglary, physical or sexual assault, bullying)
- Domestic or family violence, dating violence
- Sexual violence
- Terrorist Attacks
- Being held hostage
- Natural disasters such as a hurricane, flood, fire, or earthquake
- Being in or witnessing a serious car accident
- Sudden unexpected or violent death of someone close (e.g., suicide, accident)
- Serious injury (e.g. burns, dog attack), major surgery (e.g. heart surgery), or life-threatening
- Illness (e.g. childhood cancer)
- War or political violence (e.g. civil war, refugee)
Signs & Symptoms of PTSD:
PTSD comprises of a variety of symptoms occurring on regular (or even irregular) basis. Some of them occur immediately after the trauma ends whereas others (which are said to be far deeper & severe) establish with time. For e.g.: after 6 months or 1 year past the trauma.
In the latter’s case, it then becomes hard to distinguish whether the symptoms are “lately seen” results of the trauma or signs of newly developing disorder. Which then greatly affects the treatment recovery plans.
However, to know whether you or anyone else is suffering from PTSD, check the list of symptoms here:
- Reliving/Re-experiencing the trauma:
The individual seems to be having flashbacks, nightmares, & intrusive thoughts about the TRAUMATIC event that makes him/her feel anxious, uncomfortable or disturbed.
- Unable to resolve or forgive oneself: “survivors guilt”
They keep on thinking about the trauma, worrying, fearing & regretting that ‘why did it happen?’ ‘why me?’ Or ‘what if it happens again?’ This guilt could also be when they survived and others dint e.g. accidents, prisoners of a war situation, etc. As a result, they may even find difficult to sleep at night (Insomnia), shows loss of appetite and disinterest in pleasure, as well as may have difficulty concentrating & other memory problems.
People will purposely try to avoid places, things, events & people that remind them of the trauma.
- They may even become emotionally unresponsive or hyper-responsive, asocial, shut and sad or may appear lost.
- Many people feel that everything is unreal & the trauma never happened (denial /suppression). In some cases, people may even find difficult to recall the details of the trauma.
- OR just the opposite; they may remain constantly aroused, hyper-vigilant, in ready to run away mode and exhibit excess or retarded motor activity.
- Along with that, they may also exhibit:
- A sense of helplessness and hopelessness
- Loss of interest in life or living & may even, therefore, express suicidal ideation and attempts in subtle yet persistent ways.
- For children generally 6 years or younger it may manifest into different forms:
- Excessive crying
- Bed Wetting
- Not wanting to play anymore
- Being fearful and cling
- Resisting to go to school or sleeping alone
- Always demanding to be around parents
- A notable change in nature (earlier use to be bubbly but now remains restricted) etc.
- Children may even try to express the terror through their play, stories, drawings, etc. a close inspection of the same can be helpful.
If any of these symptoms are visible and you think you (or someone else) needs help then it’s always better to take the help from the experts, and the best option for PTSD would, therefore, be to go for counselling/therapy!
However, before considering what / when / & how of the treatment & counselling its first important to know what possibilities make oneself vulnerable to PTSD. As based on those possible causes it’s then easier to plan the treatment!
Causes of PTSD:
The exact reason or cause as to why PTSD gets developed in a person’s system is not understood properly. It is highly likely that two people may go through the same event but one develops PTSD and the other doesn’t.
Combination of various factors & circumstances later affects the overall development of the disorder in one’s system.
- Genetic predisposition – i.e. genes, inherited biological/physiological thresholds, disability, etc.
- Situation itself – the situation being too stressful, demanding, chronic, acute, unmanageable, etc.
- Body’s response style/pattern towards trauma – How a person’s body responds to trauma plays a role to an extent. The body may go in a shock, some people experience total numbness, freezing, adrenaline rush, or a cortisol attack, increased arousal, heightened anxiety, panic attacks. In such cases with such combinations, there are higher chances for an individual to suffer from PTSD. (But this doesn’t mean that he/she will definitely suffer from PTSD)
- Individual characteristics are also known to increase the risk of PTSD. Characteristics that can contribute to post-traumatic stress disorder (PTSD) causes include:
- Exposure to previous traumas, particularly as a child
- Childhood adversity
- Pre-existing conditions like anxiety or depression
- Gender (more women than men develop PTSD)
However, the main criteria to give a diagnosis of PTSD is the occurrence of any major event, circumstances, or disaster “prior” to the showing up of PTSD symptoms & ‘the event’ is the main reason behind the development of the symptoms.
The events that mainly involve the risk of development of PTSD range from mild to extreme severity and carries the potential to harm us physically, mentally, psychologically, socially or financially.
PTSD and Cancer
Recently in a study, it was shown that that nearly 1 in 4 women who were newly diagnosed with breast cancer experienced PTSD.
Some aspects of the cancer experience that might trigger PTSD include:
- Being diagnosed with the disease
- Diagnosis of advanced cancer
- Painful tests and treatments
- Pain from cancer itself or other physical issues
- Test results
- Long hospital stays or treatments
- A cancer recurrence or the potential for recurrence
Case Study of PTSD due to cancer
Meenu a 20-year-old girl was diagnosed with breast cancer of stage 2. Everyone in her family, friends including her were initially shocked and terrified.
Her mother just collapsed after reading the report. Her father and brother were clueless. Meenu was very dear to everyone and they loved her a lot. No one in the family knew how to deal with this.
Meenu herself was very shocked. She just stood there like a frozen statue, not able to express anything. She literally went blank.
Slowly the parents gathered some courage and hope and held Meenu close. They told her; “Everything will be fine, we are here with you”.
Meenu started crying. She screamed “WHY ME?”, thinking that she didn’t deserve this, that she has always been nice to everyone.
Meenu who was a student had to miss her college, her lectures because of the treatments. She had to go through painful surgeries and chemotherapy. She practically had no social life now. She was suggested to remove one of her breasts by her doctor, this was another shocker for her and again didn’t know what to do and how to react!
As time passed by her thoughts started getting occupied with the fear of not looking attractive like other girls of her age. The chemotherapy sessions were very painful for her. She had lost the will to live. She felt phobic and worried about her future.
Meenu wondered will she be able to lead a normal happy life like other girls of her age. She kept worrying that the cancer is going to advance, she’ll have to go through a lot of pain and cancer will kill her. She started hating her body and herself. There was a lot of pent up anger. She also felt guilty about disturbing her family members routine.
She avoided visiting hospitals as they would trigger her with the memories of her chemotherapy sessions and the excruciating pain she had gone through after her surgeries held there. Once it so happened that she was accompanying her mother to shop for groceries. On the way to that shop, they had to pass a hospital. Meenu asked her mother to drive from some other route or pick groceries from some other shop. She insisted that they avoid the hospital.
There was another such incident where her brother was very sick and had to be admitted to a nearby hospital. Meenu did not visit him as the thought of the hospital triggered painful memories of chemotherapy and surgery. If anyone tried to speak to her about her illness, she would feel extremely anxious and have the flashbacks of her chemotherapy sessions lead to even more anxiety.
She would scream in the middle of the night because of the nightmares related to her sessions. This started hampering her treatment as she was afraid of hospitals and wanted to avoid her visits to the hospital.
For her, it was like living life with a leash on it. She could do a few things but always some or the other thing holding her back. Her memories always disturbed her and kept her from living a normal life like other 20-year-old girls.
The problems persisted. Everyone tried to help her deal with her problem but all in vain. She was asked to visit a psychiatrist, but her need to avoid hospital prevented her from visiting a psychiatrist as well.
Eventually, her family was able to find a psychiatrist who was willing to do a home visit. He diagnosed her with Post-traumatic stress disorder (PTSD). She particularly had developed this condition because of her chemotherapy sessions in the hospitals which eventually led to her avoiding the hospitals.
Meenu was to a large extent able to recover from PTSD as a result of her treatment which included a combination of Psychiatric medication and psychotherapy.
If you know someone or you’ve yourself experienced something similar to what Meenu faced and you think you need professional help. Feel free to contact ICHARS team by calling us on +91-8080208473 or using this contact us form.
If you are a psychotherapist who is looking for ways to help clients suffering because of PTSD, you may find the comprehensive course on Cognitive Hypnotic Psychotherapy™ very useful.