Post-traumatic Stress Disorder: key facts
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What is PTSD?
Any of us can, without warning, go through a traumatic event
that is overwhelming, frightening, life-threatening (to ourselves
or others) and beyond our control. This could be:
- getting a diagnosis of a serious
illness
- having (or seeing) a serious road
accident
- the unexpected injury or violent death of
someone close
- being taken hostage
- being a prisoner-of-war
After such an event, most people feel
distressed and can have symptoms for up to 6 weeks. Many people get
over it without needing help, but about 1 in 3 people go on with
these symptoms for many months or years – this is Post-traumatic
Stress Disorder, or PTSD.
Less dramatic, but longer-lasting traumas
can have a similar impact. These include continuing physical or
sexual abuse in the home, mistreatment in prisons and torture.
When does PTSD start?
The symptoms usually start within 6 months,
and sometimes only a few weeks after the trauma.
What does PTSD feel like?
After the traumatic event you can feel
grief-stricken, depressed, anxious, guilty and angry. In PTSD you
may also:
- have flashbacks and nightmares - you relive
the event in your mind, again and again;
- avoid thinking about it and feeling upset
by keeping busy and avoiding anything or anyone that reminds you of
it;
- be ‘on guard’ – you stay alert all the
time, can’t relax, feel anxious and can’t sleep;
- get physical symptoms – aches and pains,
diarrhoea, irregular heartbeats, headaches, feelings of panic and
fear, depression
- start drinking too much alcohol or using
drugs (including painkillers).
Why does PTSD happen?
There are several possible reasons:
Psychological
- Remembering things clearly after a shock
can help you to understand what happened and, perhaps, help you to
survive.
- Flashbacks force you to think about what
has happened. You can decide what to do if it happens again.
- Avoidance and numbing help you to stop
becoming tired and distressed from remembering a trauma. It
keeps the number of ‘replays’ down to a manageable level.
- Being 'on guard' means that you can react
quickly if another crisis happens. It can give you the energy you
need to carry on afterwards.
Physical
- Vivid memories of what happened keep your
levels of adrenaline high. You will feel tense, irritable and
unable to relax or sleep well.
- The hippocampus is the part of the brain
that processes memories. In PTSD, high levels of stress hormones,
like adrenaline, may stop it from processing the memories of the
event, producing continuing flashbacks and nightmares.
Getting through PTSD
Try to get back to your usual routine. Talk
about what happened to someone you trust and try relaxation
exercises. Eat regularly, take exercise and spend time with family
and friends. Try to go back to where the traumatic event happened.
Take care with driving – you are more likely to have an accident
while you feel like this. Speak to your doctor and keep
hopeful.
Don't be hard on yourself or expect too much
of yourself. PTSD symptoms are not a sign of weakness. They
are a normal reaction of normal people to terrifying experiences.
Don't avoid other people, drink or smoke a lot, miss sleep or
meals.
What helps?
Psychotherapy – by
remembering the event, going over it and making sense of it, your
mind can do its normal job of storing the memories away and moving
on to other things.
Cognitive
behavioural therapy (CBT) – helps you to think
differently about your memories, so that they become less
distressing and more manageable. It usually involves relaxation to
help you tolerate the discomfort of recalling the traumatic
events.
Eye movement desensitisation &
reprocessing (EMDR) - uses eye movements to help the brain
to process flashbacks and to make sense of the traumatic
experience.
Talking with a group of
people who have been through the same or similar traumatic
events.
Group therapy - this can
help you to feel less alone and isolated.
Medication - antidepressant tablets will both reduce the
strength of PTSD symptoms and relieve any depression. If the
antidepressants help, you should carry on taking them for around 12
months before slowly tailing them off.
If you are so distressed that you can't sleep
or think clearly, you may need tranquillising medication, although
not for more than 10 days or so.
Body-focused therapies such
as physiotherapy and osteopathy, massage, acupuncture, reflexology,
yoga, meditation and Tai Chi. These can help to control
distress and reduce the feeling of being 'on guard' all the
time.
What works?
CBT, EMDR and antidepressants seem to be most
helpful. The evidence for other forms of psychotherapy or
counselling is much weaker. Trauma-focused psychological therapies
(CBT or EMDR) should usually be offered before medication.
How do I know when I've got over
a traumatic experience?
When you can:
- Think about it without becoming distressed
- Not feel constantly under threat
- Not think about it at inappropriate times
How can I help someone who has PTSD?
Remind yourself that they are irritable and
jumpy because, in a way, part of them is, in a way, still in
the traumatic situation. Give them time to tell you about what
happened. Ask general questions, and don't interrupt or talk about
your own experiences.
This leaflet is made available through the
generosity of the Charitable Monies Allocation Committee of the
mental health charity St Andrew's, Northampton
December 2008. This is an
abridged version of our main
leaflet.
Copyright (2008) Royal College
of Psychiatrists www.rcpsych.ac.uk. You can
link to, download, print, photocopy and distribute this leaflet
free of charge. But you must not change it or repost it on a
website.
Charity registration number (England and Wales) 228636 and in
Scotland SC038369.
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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