What is Post-Traumatic Stress Disorder?

Post-Traumatic Stress Disorder (PTSD) is a psychological condition that develops in response to a significant and terrifying event. PTSD can be brought on by either experiencing or witnessing a traumatic event. The most common signs of PTSD include severe increases in anxiety, strong emotional response to trauma-related triggers or reminders of the event, flashbacks, nightmares, feeling on guard (hypervigilance), and ongoing severe anxiety. In addition to these symptoms, people can often experience a significant shift in their thoughts whereby they find it difficult to stop thinking about the event.

Most people will have experienced some form of trauma throughout their life. Often, people are able to manage these events, and the initial symptoms tend to resolve over time. In a lot of cases, people can continue to be affected by these symptoms for a significant period of time after the event. This tends to happen more frequently with more severe forms of trauma and/or greater exposure to traumatic events. When these symptoms continue for several months or more, they can have a significant impact on people’s everyday lives, relationships, and functioning. When this occurs, it is likely that the person has developed PTSD.

PTSD was first described in academic literature as ‘shell shock’ and referred to the cluster of symptoms experienced by combat veterans returning from active duty. This term was later changed to ‘combat fatigue’ and later to PTSD. It was later discovered that PTSD can affect anyone and that this condition was not limited only to those returning from active military service.

What are the symptoms of PTSD?

Whilst there is some variety in PTSD symptoms, they generally fall into a few main categories. These are outlined below and can vary significantly at times throughout the individual's recovery.

"It's like it's happening all over again"
Intrusions

Sufferers of PTSD will often experience recurrent, distressing memories of the event. This can often happen in response to reminders of the event within their everyday lives. When this occurs, it triggers many of the same senses as if it were happening again. Often people will experience many of the same images, emotions, sounds, thoughts, bodily sensations, smells, and even tastes as if they are going through the trauma all over again. This can impact people when they are awake (in the form of flashbacks) but also while asleep (nightmares). Often people’s dreams can have several themes related to the traumatic event.

"I can never go back there"
Avoidance

Often people who experience PTSD attempt to avoid anything that may remind them of the event. Whether that be a specific place, person, or situation, people with PTSD will generally make great attempts to not put themselves in a situation that may feel even remotely similar to the original traumatic event. For example, it is not uncommon for people who have almost drowned to never wish to go back to the ocean again or even to a local or friend's pool. Understandably, it is quite adaptive that people generally tend to avoid the thing that led to them feeling this way in the first place, often out of fear of a similar thing happening.

"Everything’s just different now"
Cognitive changes

For many people with PTSD, they can feel that the world is no longer how it used to be. Often people will describe changes in how they view the world, others, and themselves as a result of a traumatic event. Previously feeling safe walking down the street or visiting a local shopping centre can suddenly feel like a horror film. What used to feel safe is no longer. Often people’s beliefs about the world around them will shift to make sense of the traumatic event. For example, some people may feel that they can no longer trust anyone following an event of trauma.

"I’m just being careful"
Hyperarousal

Finally, one of the other main symptoms of PTSD is hyperarousal or hypervigilance. When people have been through a traumatic event, their alert system (i.e. anxiety) is often running overtime. People can often be on the lookout for anything that could be likely to go wrong or lead to a similar incident. Often people can describe feeling easily startled or frightened in response to noises or sounds that previously weren’t an issue.

It’s also common that people can experience heightened emotions of anger, irritability, aggression, and guilt in the aftermath of a traumatic event. Occasionally, people can attempt to cope with these kinds of feelings using alcohol or other substances in an attempt to ‘numb out’ from the feelings of PTSD.

Out-of-body experiences

At the other end of the spectrum, people can also experience symptoms of numbing and dissociation. This tends to occur when the trauma event is so severe that their brain attempts to manage this by ‘going offline’ or dissociating. Sufferers of this PTSD symptom can often feel like they’ve lost track of time or that they feel outside of their body.

The impact of PTSD symptoms

Taken together, the symptoms of PTSD can often be quite debilitating for people who are diagnosed with this condition. Moreover, the impact upon multiple domains of their life can also be quite severe. Often, these symptoms can interfere with people’s relationships, daily functioning, and occupation as they attempt to manage the symptoms associated with this psychological condition.

People with the condition can often struggle with intimacy, trust, and communication within their relationships, which can result in conflict and feelings of isolation (for both them and their partner). In occupational settings, it can also impact people's ability to perform their role with effects such as difficulty concentrating, irritability, and emotional numbing. Additionally, individuals may often find themselves avoiding triggers within the workplace. These effects can further limit people's careers and workplace performance.

Individuals with PTSD may also meet criteria for a depressive and/or anxiety disorder. It is also not uncommon for sufferers' symptoms to be so severe that they may experience suicidal ideation due to ongoing feelings of hopelessness.

Additionally, many who suffer from PTSD may find that they feel unable to cope without the use of substances such as alcohol or cannabis. Often this can have a compounding effect and lead to other issues in their lives.

What causes PTSD?

Symptoms of PTSD develop shortly after a traumatic event and often cause a high level of distress for the individual. They can emerge from directly experiencing, witnessing, hearing about, or learning about a traumatic event involving actual or threatened death, serious harm, or sexual assault.

The way in which these symptoms develop can depend upon a number of factors associated with the event itself and the individual who experienced the event. It is believed that the severity of PTSD is also determined by other factors such as:

• Adverse childhood events (i.e. traumatic events experienced early in life). Research into this area has demonstrated that the more adverse childhood events that someone has experienced, the more likely they are to develop PTSD symptoms (in addition to a number of other physical and mental health outcomes). The experience of stressful events throughout their lifespan. Similarly to childhood events, people who have also experienced severe stressful events in their adult life are also at significantly higher risk of developing PTSD than they otherwise would have.
  
  
• Family history People who have a family history of mental health conditions such as depression, anxiety, trauma, and other conditions can also be at increased risk of developing PTSD.
  
  
• Personality factors can also play a role in how individuals respond to traumatic events.
  
  
• Meaning making – Oftentimes, the individual’s own assessment of the event can also contribute to the severity of their symptoms. For example, in situations where someone believed that they had contributed to the event happening, feelings (such as guilt) can also heighten the severity of their PTSD symptoms.
  
  
• Close relationships - Another factor that is often overlooked is also the effect of having close relationships. Having a close relationship (i.e. with a partner or with close friendships) can lessen the impact of PTSD symptoms on the individual and help them to recover faster.
  
  

Other risk factors are things such as:

• The intensity and severity of the trauma
  
• The exposure (length of time, number of events)
  
• The experience of early childhood traumas
  
• Working in a profession where someone is exposed to traumatic events (law enforcement, paramedics, first responders, combat veterans)
  
• Having limited family and social support
  
• Having difficulties with substance and alcohol use
  

What kind of events can cause PTSD?

There are many types of events that can lead to the development of PTSD. Each of these events typically involves experiencing or witnessing an event (or series of events) that involves death or serious injury. The most common traumatic events are:

• Motor vehicle accidents
• Physical assault
• Domestic violence
• Being threatened with a weapon (e.g. gun, knife)
• Being a victim of crime
• Home invasion (break-ins)
• Sexual assaults and sexual violence
• Childhood abuse and neglect
• Life-threatening events

Additionally, there are several other types of events that can also lead to PTSD, such as traumatic births, life-threatening medical events, complications from medical procedures, robbery, kidnapping, and natural disasters. In addition, occasionally major news events covering traumatic topics (or similar) can also create symptoms of PTSD.

This is not a complete list and there are several events that individuals can find to be traumatic. It’s important to remember that not everyone who goes through these may be likely to go on to develop PTSD symptoms.

How EMDR can help

EMDR was specifically developed for the treatment of PTSD and, as such, has demonstrated the most research evidence supporting its use in treatment for the condition. EMDR can help individuals with trauma and PTSD by providing a range of strategies and resources for dealing with symptoms of the condition.

In the initial phases of EMDR, the clinician will work with the client to identify their goals, take a full clinical history, and provide resources and strategies for the latter phases of the treatment.

In the next phases of treatment, EMDR can further work with the client to alleviate the distress associated with unprocessed memories that contribute to the condition. It can also assist with alleviating the distress from past events whilst also assisting individuals to work through future scenarios within the therapeutic environment. The therapist also helps the client to desensitise to previously feared situations and address current triggers for PTSD. Overall, there is a wide variety of benefits that can be obtained via the use of EMDR in the treatment of anxiety.

To find out more, see our post on What is EMDR?.

If you are experiencing symptoms of trauma, PTSD, or complex trauma and would like to speak with someone, EMDR Brisbane is happy to help. Please reach out to our team to make an appointment.

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