What is Post Traumatic Stress Disorder?
Post Traumtic Stress Disorder (PTSD) is essentially a memory filing error. It can happen when people are exposed to an extraordinary life-threatening situation which is perceived with intense fear, horror and helplessness.
At the time someone is being exposed to this intensely fearful situation, their mind 'suspends' normal operations and it copes as well as it can in order to survive. This might involve reactions such as 'freezing to the spot' or instead the opposite 'flight away' from the danger. Usually the individual is aware of coping in an automated manner. Many Veterans will say later that their 'training took over' and they survived.
The individual also finds that his or her levels of arousal (awareness) change. People can become hyper-aroused and suffer intense symptoms of anxiety (both physical: with shortness of breath and a racing heart, as well as emotional: feeling on edge, looking out for signs of danger and being 'on patrol' all the time or feeling panicky).
Many also feel emotionally numb and have trouble communicating with others without feeling numb or irritable or both.
These hyper-arousal and emotional numbness symptoms become so unpleasant that then individual then starts to avoid anything linked to the original trauma, this happens automatically. The person then avoids anything that causes upset or irritation or that might represent danger occurs. Avoidance can become the main coping mechanism in most situations.
The more the individual avoids things, including confronting what happened, the less likely is it that any memory processing will occur, and the more likely it is that further attempts at filing a memory will occur automatically. This leads to further re-experiencing nightmares, flashbacks and intrusive memories. These re-experiencing symptoms then lead on to further hyper-arousal and emotional numbing, and this in turn leads on to more avoidance and so on. This is how the symptoms clusters perpetuate themselves in a vicious cycle which can go on for years.
PTSD comprises three symptom clusters:
- Re-experiencing of the traumatic experience
- Hyper-arousal and emotional numbing
People react to traumatic experiences in different ways. Here are some of the symptoms:
- Feeling isolated
- Frequent periods of withdrawal into oneself
- Anger or aggressive behaviour
- Feeling distrustful and suspicious/blaming others
- Misuse of alcohol/drugs/gambling and/or food
- Seeking out high-risk/dangerous pursuits
- Work-related or relationship problems
- Feeling numb and empty
- Feeling suicidal
- Self harm and self-destructive tendencies
- Being easily moved to tears
- Avoidance of people and places
- Panic attacks/anxiety/depression/mood swings
People often struggle to understand mental health and trauma because these injuries that Veterans have cannot be seen.
PTSD is one of the mental illnesses most associated with military service but there are also other more common mental illnesses which might affect Service and ex-service personnel. These include depression, feelings of anxiety, panic attacks and substance misuse, most commonly alcohol misuse.
Other commonly associated symptoms
The other symptoms that are commonly associated with PTSD relate to feelings of guilt, and difficulty relating to authority figures.
Guilt can take two forms:
- Guilt in relation to what one should or should not have done during the traumatic exposure.
- Survivor guilt: while the individual survived relatively intact (physically, at least), others involved in the traumatic experience did not.
In many traumatic exposures, the individual may perceive that the system or hierarchy has let them down, and therefore anger and hostility can be a major factor in the presentation of PTSD.
It should be noted that the most common co-morbid presentations with PTSD are depression and alcohol abuse or dependence. Co-morbid illness needs to be addressed and treated alongside PTSD.
The information on this page is provided courtesy of Combat Stress the UK's leading veterans' mental health charity.
Call their 24-Hour Helpline on 0800 138 1619
Don’t feel you’re alone – if you serve, or have served your country, as a regular or reservist, the 24-hour Helpline can provide confidential advice on mental health problems and how to get help.
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