Trauma changes people.
It can feel like the real you has gone. And when you can’t even remember what ‘real you’ feels like? It’s easy to loose hope.
What is PTSD?
Post Traumatic Stress Disorder (PTSD) is a stress disorder caused by a traumatic event or events.
Originally called “shell shock” or “combat stress”. The term PTSD was first described in the 1980 third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-111). And is now known to be far more wide reaching than to just military personnel or combat exposure.
So why do people get PTSD?
The traumatic memory or memories fail to move to the long term memory. Instead staying locked in the short term memory. This leads to symptoms such as intrusive thoughts and distressing memories, flashbacks, hyper arousal and avoidance symptoms. Long term? If PTSD is left untreated? It can lead to issues such as guilt, substance abuse, eating disorders or anger.
But given the nature of the stressful event or events the person has suffered?
PTSD should be regarded as a normal response to an abnormal event.
So while most people will mentally process a traumatic event within about a month? For some the event gets ‘stuck’ in the short term memory where the event continues to feel vivid, real, ongoing and emotionally charged. This causes common symptoms such as flash backs, insomnia, hyper-vigilance, avoidance and or angry outbursts.
PTSD has been described as ‘the horror of the mind’ and frankly? It’s a good description.
Who can get PTSD?
Anyone. Either through:
- Direct exposure (to a trauma)
- Witnessing the trauma in person
- Indirectly by learning that a close relative was exposed to the trauma
- Indirect exposure to adverse details of the event, usually in the course of professional duties.
What is a traumatising event?
The Diagnostic and Statistical Manual of Mental Disorders version 5 (DMS-5) describes a traumatising event as:
“The person was exposed to death, threatened death, actual injury or threatened serious injury, or actual or threatened sexual violence”
The International Classification of Diseases version 10 (ICD-10) more broadly describes a trauma as:
A delayed or protracted response to a stressful event or situation of either brief or long duration) of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone.
Causes of post-traumatic stress disorder (PTSD)
Common causes of PTSD include but are not limited to:
- physical or sexual assault,
- domestic abuse
- terrorist attacks
- natural disasters
But PTSD can occur after any experience that causes a person to feel unsafe, helpless or deeply scared.
And in almost all cases, where there isn’t an actual loss of life, there is however a potential for loss of life or a belief that loss of life could occur. So interestingly, the event itself doesn’t have to meet the definition of ‘traumatic’ to cause trauma.
So the cause of PTSD can be far more nuanced than the event itself.
Which means sometimes the traumatic response has more to do with what thoughts went through the person’s mind during the experience (sometimes described as ‘time travel’), the finer detail of the event or how the person was treated after the event.
Symptoms of post-traumatic stress disorder (PTSD)
There are four main symptoms of PTSD:
Intrusion or Re-experiencing
Re-experiencing is the most typical symptom of PTSD. This includes involuntary & intrusive thoughts about the experience in the form of:
This is when a person involuntarily and vividly relives the traumatic event in the form of:
- repetitive and distressing images or sensations
- physical sensations, such as pain, sweating, feeling sick or trembling
And it’s common to have constant negative thoughts about the experience. Such as repeatedly asking how or why it could have happened or blame or regret that then prevents the person coming to terms with what happened.
Typical responses include avoiding thinking about the event & pushing thoughts about it out of the mind. Or avoiding reminders of it such as activities, places, people and more generally avoiding situations that may trigger reminders of the event.
Feeling anxious or on edge and finding it hard to relax. Feeling on edge, suspicious and watchful of dangers. Hyper arousal can lead to irritability, lack of concentration, outbursts of anger and insomnia.
Cognition and Mood Symptoms
Cognition and mood symptoms can get worse over time and can include:
- Difficulty in remembering key aspects of the traumatic event
- Negative thoughts about oneself, the world or other people
- Feelings of guilt or blame
- Loss of interest in previously enjoyable activities
Are there different types of PTSD?
PTSD is a clinical diagnosis that can only be given by a suitably trained doctor (e.g. a psychiatrist) or a clinical psychologist.
There are two types of PTSD: PTSD and CPTSD.
But there are other, broader terms used to describe types of trauma which I have also included below.
Complex post-traumatic stress disorder (CPTSD or Complex PTSD)
Complex Post Traumatic Disorder may be diagnosed after a person has suffered a prolonged period of trauma or after multiple traumatic events. Examples include domestic violence, childhood abuse or military combat. But can equally be caused by multiple unconnected events making emergency responders such as police officers, fire fighters or paramedics particularly susceptible. Or of course, medical staff during the covid pandemic.
Post-traumatic stress disorder (PTSD)
Post Traumatic Stress Disorder is generally diagnosed after single incident event such as a single incident of sexual violence, a traffic collision
Trauma is a broader term used to describe the trauma like symptoms experienced within PTSD. But being told you are suffering from trauma is not a diagnosis of PTSD or CPTSD.
Birth trauma is a similarly broad term used to describe a traumatic birth experience. People suffering from birth trauma may go on to have a full diagnosis of PTSD. Birth trauma is slightly different from other traumas because there are constant, annual reminders. And birth trauma is not defined by the events of the birth but rather the way the birth feels which typically include feeling helpless, out of control, unsafe, undermined or ignored.
A term first coined by Professor Amy Brown breastfeeding trauma can be caused by numerous factors such as not being able to achieve breastfeeding goals with premature cessation of milk an evolutionary indictor to the body that a baby has died. A difficult journey can lead to pain, injury and illness. As well as self-blame, guilt and grief.
Police Trauma Syndrome
A generic term used to describe trauma within the police service. A study by Cambridge University showed PTSD rates with the police to be almost fives times higher than the general public. A shocking statistic that reflects the disproportionate number of traumas emergency services attend in their day to day life.
Post Traumatic Stress (PTS)
While PTS sounds very similar to PTSD it is merely a term used to describe the normal fight, flight, freeze in response a trauma. So the normal feelings of increased heart rate, tunnel vision, distortion and fear during a traumatising event
What are the risk factors for PTSD?
Let’s face it. Anyone could find themselves suffering from PTSD or trauma symptoms.
But some people are more at risk than others:
Risk factors for post-traumatic stress disorder (PTSD) include the type of traumatic event with rates of PTSD being higher after serious sexual assault and physical assault than accidents. And the severity of the event.
Certain groups of people are more at risk of developing PTSD including:
- Military Personnel
- Emergency services personnel & medics such as paramedics, doctors and nurses. Fire fighters, prison and police officers. (PTSD rates in the police are 5 times higher than the general public). Doctors and nurses.
- Women are on average, being more likely to suffer from PTSD than men. PTSD rates in women are 2-3 times higher at 10-12% compared to 5-6% in men. This in part due to more high-impact trauma (e.g. sexual trauma) that women are more likely to be subjected to and at a younger age.
- Young people and children are more at risk of PTSD than adults.
- Previous trauma including but not limited to childhood abuse.
Treatment of PTSD and Trauma
Common treatment options and trauma-focused therapies include CBT, RTT, EMDR, EMI, Hypnotherapy, NLP & Mindfulness.
Cognitive Behavioural Therapy (CBT)
Cognitive behavioural therapy (CBT) is based on the idea that our thoughts, feelings, physical sensation and actions are interrelated, and that we often get stuck in an unhelpful pattern because of these connections. Whilst success rates are good, CBT is not a fast working therapy with a treatment plans often being 12 months or more.
CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. (NHS)
Rewind Trauma Therapy (RTT)
Rewind Trauma Therapy is different from other therapies in that whilst particularly fast and effective (just 2-6 sessions), the sufferer does not need to talk about the trauma for RTT to result in closure & healing.
Neuronal research suggests the mechanism of the intervention may be explained in terms of memory restructuring through the mechanism of re-consolidation. Riccio,D.C. Millin,P.M. & Bogart,A.R. (2006).
Eye Movement Desensitisation (EMDR)
EMDR involves recalling the traumatic incident in detail while making eye movements, usually by following the movement of your therapist’s finger. It’s not clear exactly how EMDR works, but it may help you change the negative way you think about a traumatic experience.(NHS)
Eye Movement Integration (EMI)
EMI is similar to EMDR. But unlike EMDR is a technique offered by alternative therapists unlike EMDR which is only offered by clinical psychologists and medical doctors such as psychiatrists.
What you really need to know about PTSD
PTSD is survivable. It is recoverable. And it is possible to move on, get your life back and THRIVE.
There are many therapies out there that can help you. Both free on the NHS. Or privately.
My personal favourite is Rewind Trauma Therapy. It’s fast, effective and you don’t need to talk about the trauma for it to be successful.
Why put yourself through long draw out therapy sessions if you don’t have to?
Why put yourself through difficult & emotional sessions talking about the most horrific details when you don’t have to?
There is another option:
A fast work therapy and healing without revealing.