Dealing with a traumatic event (cPTSD / PTSD)

There are times when we can all feel stressed at work or in our personal lives. Alternatively, an event occurs, such as an accident or assault, which results in our normal coping mechanisms feeling overwhelmed. Both scenarios can lead to significant psychological symptoms and an interference with day-to-day activities.

.

WHAT IS PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition which may develop after experiencing traumatic events. The condition was first recognised in war veterans. It has had different names in the past, such as 'shell shock', but it's not only diagnosed in soldiers. A wide range of circumstances can cause PTSD if you experience or witness an extremely traumatic situation where there was a threat to your safety or the safety of another person. Some examples include, but are not limited to, being in a serious accident, physical or sexual assault, childhood or domestic abuse, serious health concerns, and pregnancy and birth trauma.

What Are the Common Symptoms of PTSD?

People often relive aspects of what happened to them. This can include:

• vivid flashbacks (feeling like the trauma is happening again right now)
• intrusive thoughts, images, or physical sensations
• nightmares

Sufferers may experience feelings of alertness or being on edge, which may include:

• intense distress at real or symbolic reminders of the trauma
• being easily upset or angry
• extreme alertness, also sometimes called 'hypervigilance'
• disturbed sleep or a lack of sleep
• irritability or aggressive behaviour
• finding it hard to concentrate – including on simple or everyday tasks
• being jumpy or easily startled
• other symptoms of anxiety such as dizziness and a racing heart
• physical sensations such as pain, nausea or trembling

Having PTSD may lead to avoiding feelings or memories, including:

• feeling like you have to keep busy
• avoiding anything that reminds you of the trauma
• being unable to remember details of what happened

• feeling emotionally numb or cut off from your feelings
• feeling physically numb or detached from your body
• being unable to express affection
• doing things that could be self-destructive or reckless
• using alcohol or drugs to avoid memories.

If you are experiencing symptoms of PTSD, you might also find that you have difficulty with some everyday aspects of your life, such as:

• looking after yourself
• holding down a job
• maintaining friendships or relationships
• remembering things and making decisions
• your sex drive
• coping with change
• simply enjoying your leisure time.

It is also very natural to experience a change in the way you may view yourself, other people, or the world in general, such as:

• strong feelings of responsibility
• self-blame
• shame
• guilt
• worthlessness
• powerlessness or lack of control
• a persistent feeling that you are not safe

WHAT IS COMPLEX PTSD?

Complex post-traumatic stress disorder (complex PTSD, sometimes abbreviated to c-PTSD or CPTSD) is a condition that may develop if you are repeatedly exposed to trauma or experience trauma over a long period of time. This may include childhood abuse or neglect, domestic violence, sexual abuse, torture, sex trafficking, slavery or being involved in war. C-PTSD is more likely to develop if you experienced trauma at a young age, you were harmed by someone you trusted, and you were unable to escape the trauma. You experience some symptoms of PTSD along with some additional symptoms, such as:

• difficulty controlling your emotions
• feeling very angry or distrustful towards the world
• constant feelings of emptiness or hopelessness
• feeling as if you are permanently damaged or worthless
• feeling as if you are completely different to other people
• feeling like nobody can understand what happened to you
• avoiding friendships and relationships, or finding them very difficult
• often experiencing dissociative symptoms such as depersonalisation or derealisation
• physical symptoms, such as headaches, dizziness, chest pains and stomach aches
• regular suicidal feelings

HOW IS PTSD/C-PTSD TREATED?

PTSD and C-PTSD can be successfully treated, even when it develops many years after the traumatic event(s).

We offer a consultant-led diagnostic and treatment service for stress-related problems, such as post-traumatic stress disorder, using a multi-disciplinary approach to care. Patients are seen quickly and treatment interventions are focused and usually short term. A holistic approach is adopted and, if appropriate, family members can be seen.

We offer combined medical and psychological interventions in line with NICE guidelines

Any treatment depends on the severity of symptoms and how soon they occur after the traumatic event(s), with the following treatment options given as recommendations:

• watchful waiting – monitoring your symptoms to see whether they improve or get worse without treatment
• antidepressants – such as paroxetine or mirtazapine
• psychological therapies – such as trauma-focused cognitive behavioural therapy (CBT), eye movement desensitisation and reprocessing (EMDR), or narrative exposure therapy (NET)

OUTCOMES

There are three main goals for PTSD treatment:

1. Ease the PTSD symptoms, making them less frequent and less intrusive or impactful on your life.
2. Teach you how to manage the symptoms when they do occur.
3. Restore a positive sense of self and self-esteem.

It is possible to be successfully treated from the effect of trauma, so it’s never too late to seek help.