About Post Traumatic Stress

WHAT IS POST TRAUMATIC STRESS

Post-traumatic Stress (PTS) is a set of mental health reactions that can develop in people who have experienced or witnessed an event that threatens their life or safety (or others around them) and leads to feelings of intense fear, helplessness or horror. This could be a car or other serious accident, physical or sexual assault, war-related events or torture, or a natural disaster such as bushfire or flood.

Other life-changing situations such as being retrenched, getting divorced or the expected death of an ill family member are very distressing, and may cause mental health problems, but are not considered events that can cause PTS.

Anyone can develop PTS following a traumatic event, but people are at greater risk if

  • The event involved physical or sexual assault.
  • They have had repeated traumatic experiences such as sexual abuse or living in a war zone.
  • They have suffered from PTS in the past

Symptoms of PTS

People with PTS often experience feelings of panic or extreme fear, which may resemble what was felt during the traumatic event. A person with PTS has three main types of difficulties, which include:

  • Reliving the traumatic event – through unwanted and recurring memories and vivid nightmares. There may be intense emotional or physical reactions when reminded of the event. These can include sweating, heart palpitations or panic.
  • Being overly alert or ‘wound up’ – sleeping difficulties, irritability, lack of concentration, becoming easily startled and constantly being on the lookout for signs of danger.
  • Avoiding reminders of the event and feeling emotionally numb – deliberately avoiding activities, places, people, thoughts or feelings associated with the event. People may lose interest in day-to-day activities, feel cut off and detached from friends and family, or feel flat and numb.

People with PTS can also have what are termed ‘dissociative experiences’, which are frequently described as

  • ‘It was as though I wasn’t even there.’
  • ‘Time was standing still.’
  • ‘I felt like I was watching things happen from above.’
  • ‘I can’t remember most of what happened.’

A health practitioner may diagnose PTS if a person has a number of symptoms in each of the three areas for a month or more, which lead to significant distress, or impact on their ability to work and study, their relationships and day-to-day life.

It is not unusual for people with PTS to experience other mental health problems at the same time.

Up to 80 per cent of people who have long-standing PTS develop additional problems, most commonly depression, anxiety and alcohol or other substance misuse. These may have developed directly in response to the traumatic event or have developed sometime later after the onset of PTS.

Impact of PTS on relationships and day-to-day life

PTS can affect a person’s ability to work, perform day-to-day activities or relate to their family and friends. A person with PTS can often seem disinterested or distant as they try not to think or feel in order to block out painful memories. They may stop participating in family life, ignore offers of help or become irritable. This can lead to loved ones feeling shut out.

It is important to remember that these behaviours are part of the problem. People with PTS need the support of family and friends, but may not know that they need help. There are many ways you can help someone with PTS.

Risky alcohol and drug use

People commonly use alcohol or other drugs to blunt the emotional pain that they are experiencing. Alcohol and drugs may help block out painful memories in the short term, but they can get in the way of a successful recovery.

When to seek help

A person who has experienced a traumatic event should seek professional help if they:

  • don’t feel any better after two weeks
  • feel highly anxious or distressed
  • have reactions to the traumatic event that are interfering with home, work and relationships
  • are thinking of harming themselves or someone else.

Some of the signs that a problem may be developing are:

  • being constantly on edge or irritable
  • having difficulty performing tasks at home or at work
  • being unable to respond emotionally to others
  • being unusually busy to avoid issues
  • using alcohol, drugs or gambling to cope
  • having severe sleeping difficulties.

Support is important for recovery

Many people experience some of the symptoms of PTS in the first couple of weeks after a traumatic event, but most recover on their own or with the help of family and friends. For this reason, formal treatment for PTS does not usually start for at least two weeks following a traumatic experience.

It is important during those first few days and weeks after a traumatic event to get whatever help is needed. This might include information and access to people and resources that can help you to recover. Support from family and friends may be all that is needed. Otherwise, a doctor is the best place to start, to get further help.

Treatment for Post Traumatic Stress

If problems persist after two weeks, a doctor or a mental health professional may discuss starting treatment. Effective treatments are available. Most involve psychological treatment but medication can also be prescribed. Generally, it’s best to start with psychological treatment rather than use medication as the first and only solution to the problem.

The cornerstone of treatment for PTS involves confronting the traumatic memory and working through thoughts and beliefs associated with the experience. Trauma-focussed treatments can:

  • reduce PTS symptoms
  • lessen anxiety and depression
  • improve a person’s quality of life
  • be effective for people who have experienced prolonged or repeated traumatic events, but treatment may be required for a longer period.

Where to get help

  • Your doctor
  • Veterans and Veterans Family Counselling Service (VVCS) – 1800 011 046
  • Mental health specialist, such as a psychiatrist, psychologist or social worker, with experience in treatment of PTS
  • Local community health centre
  • Australian Centre for Post-traumatic Mental Health Tel. (03) 9936 5100