- Unravelling post-traumatic stress disorder
We most commonly hear of PTSD as something that affects people like war veterans who have lived through extended traumatic high-risk situations, but PTSD is a disorder that can affect anyone.
[caption id="attachment_160420" align="alignright" width="283"]
CAFS Psychologist Senuri Gunawardene[/caption]
To learn more about PTSD, Brunch spoke to Child and Adolescent Family Services (CAFS) Psychologist Senuri Gunawardene to understand the subject better.
What is PTSD?
PTSD is a psychiatric disorder that can be experienced by those who witness a traumatic event. These traumatic events can be anything that is difficult for these individuals to experience. This can be abuse, the exposure to extended periods of stress without a resolution, or, in the cases of war veterans, for instance, the exposure to violence.
What are the risk factors for PTSD?
We cannot contest that there is a genetic component to this. In addition to this, research has shown that women are more likely to have PTSD as well as experience a lack of social support, should they be suffering from PTSD or from a traumatic event. It is essential for any individual to have a solid support system after a traumatic event. We need to pay attention to the fact that those who may have an avoidant personality may not necessarily ask for help after a traumatic event. If somebody is likely to be anxious, isolates themselves, is fearful and worrisome, angry or guilty – which all describe a personality trait called neuroticism – they may be at a higher risk. However, everybody who lives through traumatic experiences may not develop PTSD.
Another risk factor for PTSD could be an existing struggle with anxiety issues and life stresses. So, in general, if you consider those who live in low-socioeconomic situations, they may be at a higher risk.
Another possible risk factor could be those working in the armed forces or first responder occupations that are highly stressful. These individuals may not want to necessarily admit that they are experiencing these difficult situations, due to social conditioning.
What are the diagnostic criteria of PTSD?
In order for PTSD to be diagnosed, there needs to be recurrent and distressing memories which cause intrusive thoughts and can be incredibly distressing, such as being able to feel certain smells or sights as if they were in the original situation. These memories can also bring about sudden expressions of anger, feeling rigid, uncontrollable crying, nightmares, and an inability to communicate.
Another symptom is severe avoidance, which impairs their daily routine. For instance, a sexual abuse victim who was abused in a parking lot may avoid all parking lots – even those in her office, university, and so on.
Thirdly, feelings of guilt, shame, loss of interest in activities, numbness, and so on need to be looked out for.
The fourth symptom would be people being on edge excessively, where they are overly defensive, reactive, or very jumpy.
What are the different forms of PTSD?
Traumatic events come in different forms and people experience them in different levels too. Acute stress disorder (ASD) is something that would occur between three days and a month, but does not exceed that time period. However, people who have ASD can develop PTSD if they do not find the right treatment and support.
In uncomplicated PTSD, the symptoms will be aligned with a singular traumatic event that occurred. However, with complex PTSD (C-PTSD), which is very common wth sexual abuse, domestic violence, etc. that have been ongoing for extended periods of time, whether active or passive, can lead to self-esteem, substance abuse, and trust issues consistent with the recurring trauma. This can continue for extended periods if these individuals have no support system as well. Those who belong to a “low-socioeconomic status” may be more prone to this, as they may not have any resources available to them.
Can PTSD become a risk factor for another mental health disorder or vice versa?
This can go both ways, really. Those with PTSD can be at risk for other mental health issues, because of the fact that they are already challenged with an affliction. On the other hand, those who already have such mental health challenges can be more vulnerable to be impacted by PTSD, if they are exposed to a traumatic event. This can also be seen with individuals who have substance abuse disorder, where they ingest substances so much that they put themselves in dangerous and vulnerable situations. On the other hand, those who already have PTSD may turn to substances to numb themselves to the pain they undergo as a result of the conditions.
What are the methods of treatment that are available for PTSD?
There are many ways of reaching out for help, and the foremost would be therapy. That includes cognitive behavioral therapy (CBT) and exposure therapy, which help one desensitise to triggers and require help from family members and loved ones. There is also EMDR (eye movement desensitisation and reprocessing); however, if you are not a professional, what would be immensely helpful is to educate oneself on PTSD and ensure that you know what the symptoms are, and how you speak to somebody going through it.
Brushing aside or undermining the emotions of the person experiencing PTSD is not something that will be helpful. Most people experiencing PTSD have lost faith in humanity and you being there – your presence – can help restore that. I would request that we ask two questions without assumption: “How do you feel?” and “how can I help?”
What stigmas have you come across in your work with regard to PTSD?
There is a misconception that those who have suicidal ideations may later on experience PTSD, but it is in fact the other way around. Those who already have PTSD may be more vulnerable to suicidal ideations because of the intense and helpless emotions that they experience. Another stigma is that those who are experiencing PTSD are violent, out of control, and harmful. However, a lot of the time, these are just people like you and me, who are reeling from a really terrible experience. Perspective is important, which is why judging does not help. PTSD does not have to control one’s life, and with the right help, people can recover.
Perspective matters. Empathy and understanding matters. If we have the ability to listen to somebody experiencing PTSD and not judge them, we would have won half the battle.
If you or someone you know is feeling suicidal, or dealing with any similar issues, please reach out through the following hotlines:
Courage Compassion Commitment (CCC) Foundation helpline – 1333
National Institute of Mental Health helpline – 1926
Sri Lanka Sumithrayo (in operation from 9 a.m. to 8 p.m. daily) hotline – 011 269 6666
Shanthi Maargam hotline – 071 763 9898