Post-Traumatic Stress Disorder (PTSD)

PTSD is commonly associated with, and was first ascribed to, war veterans suffering from ‘shell shock’ and ‘combat fatigue’. It is a serious and often debilitating medical condition that can occur in anyone who has experienced a traumatic event themselves or have witnessed or heard of a traumatic event involving someone they are close to.

Most people have experienced a terrifying or traumatic event at some point in their lives. Initially, they may have difficulty coping with the trauma but usually, with time, emotions related to the traumatic event tend to decrease. Gradually feeling better, they tend to get on with life.

However, some people struggle to escape the experience, remaining anxious and severely distressed for an extended period to the extent that it may impact their ability to function in everyday life. If this is the case, they may have a medical condition known as PTSD.

Violence (rape, physical assault, domestic abuse, kidnapping, or the violence associated with military combat)
Natural disasters (floods, earthquakes, tornadoes or hurricanes)
Serious accidents such as a car crash or house fire causing injury or death
Sudden or unexpected death of a partner, friend or family member
Diagnosis of a life-threatening illness

For someone with PTSD, mentally reliving an event can be as traumatic as the actual event.

The physical and psychological symptoms associated with such an experience are worsened by feelings of embarrassment, confusion and frustration and can drastically affect a person’s ability to function at work, at school, and in the home.

Living with PTSD can place significant strain on relationships as people with PTSD tend to withdraw from everyday social and interpersonal activities. Often co-occurring with depression, substance abuse or other anxiety disorders, in extreme cases, if untreated, PTSD can become so distressing that the person attempts suicide.

During a trauma, your body responds by going into threat sensitivity ‘fight’ or ‘flight’ mode. PTSD keeps your brain stuck in threat sensitivity mode and keeps the body on high alert, overreacting to potential threats, long after the traumatic event has taken place.

1. Reliving or re-experiencing the traumatic event through intrusive memories, flashbacks or recurrent dreams and nightmares, and experiencing feelings and behaviours as intensely as if they were actually happening.
2. Avoidance of anything associated with the traumatic event, experiencing a feeling of emotional numbness towards others, losing interest in activities, and steering away from people and places that could remind them of it.
3. Hyperarousal symptoms include difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hyper-vigilance, and an exaggerated startle response.

Worldwide, PTSD potentially affects people of all ages including children and from all socio-economic backgrounds. However, women are twice as likely to develop the condition as men. In South Africa, as a result of the high violent crime rate (physical and sexual assault, hijacking and domestic violence) PTSD diagnoses are relatively common with reported rates as high as 20%. Importantly, not everyone exposed to trauma will develop PTSD.

PTSD is a disorder characterised by very specific symptoms but it can be misdiagnosed. It is critical therefore that you consult a healthcare professional if symptoms persist for a month a more.

Someone suffering from PTSD is likely to experience various symptoms that ultimately lead to a formal diagnosis. Chronic PTSD applies to cases where symptoms persist for 3 months or more.

In other cases, symptoms do not present until several months or years after the trauma. This is known as delayed onset PTSD.

As no one can predict when or if a traumatic event will occur, health practitioners focus on early intervention rather than prevention. There is some preliminary evidence to suggest that starting treatment (medications and/or psychotherapy) within a short time after a traumatic event may prevent the onset of PTSD, but further studies are required. If you or someone you know has experienced a traumatic event, educate yourself on common reactions to trauma and on PTSD.

Try not isolate yourself – rather take the time to talk to people who are likely to offer help and support
Do things you enjoy particularly activities that help you to relax for example, listening to music or going for walks
Find a clinician experienced in treating PTSD and be honest and open with them remembering that you are entitled to get a second opinion
Find and join a support group for people with PTSD
Try to maintain a healthy lifestyle with balanced nutrition and regular exercise

There is no cure for PTSD but, starting with a proper diagnosis, it can be successfully treated. See your doctor if you suspect that you, a friend or a family member may be experiencing symptoms of PTSD. When formally diagnosed, treatment requires a combination of medication and psychotherapy (talk therapy).

Medication and psychotherapy

Anti-depressants are commonly prescribed but are most effective when combined with psychotherapy. Medication acts to relieve PTSD symptoms and makes a person more susceptible to techniques used in psychotherapy.

Widely used as a form of psychotherapy, cognitive behavioural therapy (CBT) has shown to be effective in helping people with PTSD to return to functioning normally. A therapeutic environment (group or individual) provides a safe space for sufferers to discuss traumatic events and express the fears and reactions associated with PTSD. Most people who seek treatment ultimately enjoy a better quality of life.

Remember that treatment responses vary from individual to individual and what works for one person may not necessarily work for another.