Post-traumatic stress disorder (PTSD) is a condition often associated with soldiers and ex-military veterans, but in fact it can affect people from all walks of life. PTSD is a psychological disorder that can develop after someone has experienced or witnessed a traumatic event. Depending on the nature of the event that triggered the condition, the symptoms can vary in terms of severity.
What causes PTSD?
When someone experiences or witnesses a traumatic event, this can cause a change to their brain chemistry.
PTSD causes our bodies to release cortisol and adrenaline, which are hormones associated with our instinctive reaction to a threat – known as ‘fight, flight or freeze’ – see our previous blog, Stress vs. Anxiety: How to Spot The Difference.
Therefore, PTSD has both an emotional and physical impact on our bodies, which can change the way we think, feel and behave. The difficulty with self-diagnosing PTSD is the fact that symptoms can often emerge years after a traumatic event and may be misinterpreted as other conditions.
PTSD is very common in those who have been in combat or have been abused, assaulted or have survived an accident, act of terrorism or a natural disaster.
PTSD can also affect people with serious health conditions, who have had childbirth issues, who have lost a loved one, or those who have witnessed an emotionally traumatic event.
We explore ten common symptoms of PTSD below:
- Flashbacks – re-experiencing an event
A flashback is where someone relives the memory of a traumatic event, as if it is happening in the present. This can be a very vivid and distressing experience, as if you’re watching a video or looking at a photograph of a past event. However, a flashback experience may not always involve seeing visual images. Certain sounds, smells, tastes, emotions or physical sensations can arise that are connected to a traumatic event. Flashbacks can last for a few seconds or a few days, and be triggered by specific places, situations or even people.
Tip: There are many ways to try and deal with a flashback. One helpful method can be to carry around an object that reminds you of the present, so that in the event of a flashback, you can hold the object to help bring you back to the present.
- Avoiding certain memories
Avoidance of any potential trigger that can remind someone of a previous trauma is a common sign that someone may be experiencing PTSD. For example, refusing to talk about something that has happened and avoiding certain conversations. Or, this could be a refusal to go to a certain place or travel by a certain mode of transport. You might distract yourself from negative thoughts by working long hours or spending a lot of time on hobbies. However, if problems are not addressed then this can lead to people becoming socially isolated and withdrawn. Eventually, people may give up activities they once enjoyed.
- Inability to remember
People can lose the ability to remember a traumatic event, or certain aspects, leaving them feeling emotionally numb. Depending on the nature of the trauma, it is important to consider whether any loss of memory has been caused by a head injury, or through alcohol or drugs. If this is not the case, then the inability to remember important aspects of a traumatic event could be a sign that you are suffering from PTSD.
- Unable to sleep or feel at peace
PTSD sufferers are often restless, finding it hard to fall asleep or stay asleep, but then feeling fatigued throughout the day. Some people re-experience a traumatic event in the form of a nightmare, which can also lead to sleep disruption or the person feeling fearful about going to sleep. Over time, a lack of sleep will have serious implications for both mental and physical health, so if this is something you are experiencing, then it is important to address the underlying cause.
- Having difficult feelings or negative beliefs
If you suffer from PTSD, you might feel angry or sad, you might struggle to trust people, or you might feel unsafe. You may also experience distorted feelings of guilt or shame. For example, “survivor’s guilt” can occur after someone has survived an accident where others have lost their lives. In some cases, people may blame themselves for what has happened, despite this seeming irrational to others. This can often lead to people feeling a sense of shame; this is common amongst people who have been abused.
- Always on the alert for danger
We call this “hyperarousal” or feeling “on edge”. You might find yourself looking out for potential threats around every corner. In this state of mind, you will find it hard to concentrate or sleep, and you might be easily startled by a noise. In this state of mind, people are much more prone to irritability and angry outbursts, which can have a knock-on effect on both professional and personal relationships.
- Feeling depressed or anxious
It is very common for someone with PTSD to experience other types of problems, such as depression and anxiety. Depression and PTSD are very similar in the way they can affect your mood, emotions and energy levels. If you are suffering from depression, you may feel sad, hopeless, tired or low on energy, as well as experiencing an inability to focus and feelings of worthlessness. Anxiety is a condition where people feel tense, experiencing excessive worry and restlessness. It is common for people to have both conditions, as well as PTSD. Over time, if left unchecked, this can lead to serious relationship breakdowns.
- Feeling afraid – “panic attacks”
Sometimes, even years after a traumatic event, people can start experiencing “panic attacks”. A panic attack is an extreme form of anxiety; a sudden onset of fear that escalates until it reaches a peak. You might feel short of breath – as if you cannot catch your breath – and feel dizzy or experience chest pain, as if you are having a heart attack. You may not even associate the panic attack with an obvious trigger relating to a past traumatic event. However, if you are experiencing panic attacks, it is very important to seek medical help, as this can be a frightening experience which will eventually take its toll on the body.
- Alcohol or drug abuse
When people start to self-medicate with alcohol or drugs, this can be a response to a traumatic event. The changes in brain chemistry that occur with PTSD are similar to the way addiction and substance abuse affects our brains. Therefore, the same trauma that triggered the PTSD can also trigger a substance misuse disorder. This is further exacerbated by the fact that the brain produces fewer endorphins (the chemical that helps us feel happy) after a traumatic experience, which only leads people to seek mood-enhancing drugs or alcohol as a way of increasing their endorphin levels. Over time, this can lead to a long-term addiction and a reliance on drugs or alcohol as a way of masking feelings of depression or anxiety.
- Destructive behaviours, including self-harming
When people start exhibiting destructive behaviour, it’s often a sign that something is wrong and needs addressing. This can be visible in the form of self-harm – for example, scratching, cutting, burning. People might hurt themselves as a reaction to a traumatic experience – this is most common when people have been sexually abused. Other destructive behaviours could be violence towards others or other reckless tendencies.
How do I know if I have PTSD?
As the symptoms of PTSD are different for everyone and range from mild to severe, it is important to seek medical advice. Your GP may recommend different treatment options, but one of the most popular approaches is Cognitive Behavioural Therapy – CBT. Although this is offered through the NHS, there can often be a long waiting list, so you may decide to arrange this privately.
CBT can help you manage PTSD
CBT is a type of talking therapy and psychological technique that can help you come to terms with a traumatic event.
As PTSD has an emotional and physical impact on how we think, feel and behave, CBT can help to replace any negative patterns of thoughts, feelings and behaviours.
Trauma-focused CBT usually involves confronting your memories of a past event. Your therapist may ask you to think about the experience and help you identify any negative or unhelpful thoughts, so you can start to gain control over your fears and distress.
They may encourage you to restart certain activities that you may have avoided since your traumatic event – for example, driving a car if you have had a past accident.
Your therapist will agree treatment goals with you and the number of sessions that may be needed, either weekly or fortnightly (this will depend on the severity of your PTSD). CBT sessions usually last around an hour, but the first session tend to be longer. Your therapist may also ask for your medical background. Always use a professionally trained and registered CBT therapist.
CBT is recommended by the NHS as a suitable treatment for Post-Traumatic Stress Disorder, which is supported by the National Institute for Health and Clinical Excellence (NICE).
For more information on the background of Cognitive Behavioural Therapy, please read our previous blog, What is CBT?.
If you are worried that you might be suffering from Post-Traumatic Stress Disorder (PTSD), please visit our directory to find a registered, qualified Cognitive Behavioural Therapist in your local area.