Post-Traumatic Stress Disorder (PTSD)

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PTSD is a mental health condition that some people develop after experiencing or witnessing life-threatening events, like a car accident, fire, war, violent or sexual assault or a natural disaster. Symptoms might include flashbacks, intrusive thoughts about the event, perhaps triggered by loud noises, or other reminders. They may also have trouble concentrating or sleeping, and may feel detached from other people, and have difficulty enjoying life. There can be physical symptoms such as increased heart rate, sweating etc, and sometimes anger and difficulty controlling feelings. In order to avoid reminders of the event, patterns of avoidance may arise, which can include places, people, activities or even thoughts or feelings.

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PTSD symptoms can spill over into more serious symptoms such as dissociation – episodes of being cut off from awareness – emotional numbing, or uncontrolled anger and reckless behaviour. People can experience negative self-perception, such as feeling diminished, defeated or worthless. Depression or alcohol or drug misuse may follow as people struggle to cope with symptoms.

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Current research suggests that PTSD may arise when the memories of traumatic events are encoded in the brain in a particular, maladaptive way. Rather than the trauma memory being held in the hippocampus, it may be represented more in the amygdala, the brain’s fear centre, ready to be triggered – or re-experienced – at the slightest reminder. The hippocampal memory of the event may actually be poorly encoded, so there is insufficient differentiation of what is happening now from what happened before. Hence the slightest reminder of the original event is experienced as threatening and overwhelming. For example an encounter with a lively poodle may trigger a re-experiencing of being attacked by a pit bull because the two events aren’t sufficiently differentiated.

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The good news is that PTSD does respond well to treatment. Psychotherapy can help people make sense of symptoms, so they feel less threatening, and to work through the memory of the traumatic event itself. This may include looking at some of the distorted conclusions drawn from the event (eg ‘I am never safe’ or ‘No-one can be trusted’). As above, paradoxically, some re-visiting of the memory of the original event may help it be seen in context, though this has to be done carefully and sensitively. CBT may be particularly useful in addressing avoidance, often through structured exposure work, to build confidence and a sense of mastery of different situations. Journaling, mindfulness etc can also be helpful. Psychodynamic therapy may be particularly effective in looking at how childhood experiences or trauma can sometimes set the stage for later PTSD. All the different therapies have something to offer. The aim is that a sense of renewal, hope and control over your life will follow.

 

These TEDx talks on different aspects of PTSD may be of interest:

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Understanding PTSD's Effects on Brain, Body, and Emotions

Return from Chaos: Treating PTSD

Operation PTSD: Veterans Healing Themselves Through Meditation

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The sites below also have some useful information on PTSD:

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Mayo Clinic

NHS

Mind

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