Post-Traumatic Stress Disorder (PTSD)

Written by: Ashley Gilmour
Clinical Psychologist

Have you or someone you know experienced a past trauma which continues to
impact on you or their life? If so, read below for information about PTSD and trauma symptoms
and how to identify it.

What Is PTSD? & Doesn’t it Only Happen to War Veterans?

What Is PTSD? & Doesn’t it Only Happen to War Veterans?

PTSD is one of the more severe mental disorders which can be highly distressing and debilitating for the person with PTSD. Many people with PTSD find that simple tasks they used to be able to engage in (e.g., waiting in a que, or paying a bill, or driving to the next suburb) are now highly difficult and cause significant amounts of distress. The more severe the PTSD symptoms, the more distress and impairment in daily functioning tends to be experienced.

When people think of Post-Traumatic Stress Disorder (PTSD), many people think that it is a mental health condition that tends to only occur in war veterans. While many war veterans do suffer from PTSD, PTSD can be experienced by absolutely anyone, both children and adults, in response to the experience of any event which is traumatic. In America, the life-time risk of experiencing PTSD is about 8.7%, while it is less in Europe, Asia, and Africa (0.5-1.0%). PTSD tends to be more common among police, firefighter, emergency services, and military personnel due to the higher exposure of trauma in their jobs).
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Such traumas which can result in PTSD can include, but are not limited to:

Accidents (e.g., car, boat, machinery)
Natural disasters (fires, storms, tornadoes)
Physical assault (rape, domestic violence, fights, war/combat)
Childhood and adulthood sexual abuse
Crime (robberies)

It is also worthy to note that a person can experience PTSD from either one or multiple traumas. In the case where it is in response to multiple traumas, this is what is referred to as Complex PTSD. For such a trauma that evokes PTSD, the trauma is usually experienced with a sense of horror, helplessness, and fear for one’s life or physical integrity, however this does not need to be the case. Some people experience trauma symptoms following a traumatic event without it turning into a full-blown PTSD, in which this case is often diagnosed as Acute Stress Disorder. For this condition, the trauma symptoms are present only up to one month after which they resolve, or if warranted, are considered part of a PTSD.

To experience PTSD, the person does not have to directly experience the trauma themselves, but can result from witnessing someone else experience a trauma. Interestingly, some people experience PTSD in response to hearing about a traumatic event that occurred to someone else, without actually experiencing or witnessing the event themselves. This is what is referred to as a ‘vicarious trauma’ response.Additionally, trauma symptoms which lead to a presentation of PTSD can present themselves at any time after the experience of the trauma, including months or at times years. More often however, trauma symptoms tend to emerge fairly soon after the trauma has first been experienced.

About PTSD: What are the Signs & Symptoms?

About PTSD: What are the Signs & Symptoms?

There are a wide range of symptoms which occur together to form the condition PTSD. These include in intrusive symptoms, avoidant behaviours, changes to thoughts and mood, and changes to arousal and reactivity. At times, there can also be some dissociative experiences.

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SIGNS & SYMPTOMS OF PTSD:

Intrusive Symptoms:

Frequent intrusive memories of the trauma where you seem to find it difficult to stop thinking about the trauma
Traumatic dreams or nightmares which represent the actual trauma experienced
Flashbacks of the trauma which is where the person feels as though the trauma is happening all over again. For some people, flashbacks can be a short-lived experience, and for other people these flashbacks can be quite intense where they lose full consciousness and are back there at the time the trauma occurred, i.e., they have lost touch with present moment.
Intense psychological distress (i.e., high levels of anxiety, stress, upset) and physiological reaction (physical feeling) in response to internal or external triggers that are reminders of the trauma. External triggers can include: talking about the event; people, smells, places, objects such as a particular type of car or cologne smell. Internal triggers can are physiological feelings such as a rapid heartbeat or trouble breathing; some type of somatic symptom.

Avoidance Symptoms:

Avoidance of distressing memories, thoughts, or feelings about or associated with the trauma experienced
Avoidance of, or efforts to try and avoid triggers which are reminders of the trauma (e.g., people, places, smells, sounds, activities etc) and cause distress

Cognitive & Mood Symptoms:

Not being able to remember an important part of the trauma where it seems that you have forgotten that this part of the experience occurred
Negative thoughts about yourself, other people, or the world in which it is difficult to not think in these ways (e.g., I’m a terrible person)
Feeling unnecessarily guilty for causing the trauma to occur or angry for the consequent of the trauma or that others are to blame
Not feeling much interest in, or reduced engagement in activities which used to be enjoyed
Feeling detached or estranged from others
On-going difficulty being able to feel positive emotions such as happiness, satisfaction, or loving feelings

Reactivity Symptoms:

Onset of irritable behaviour and angry outbursts
Behaving recklessly or being self-destructive
Increased need to be aware of your surroundings (e.g., looking over your shoulder more than you used to)
More “jumpy” or “on edge”
Trouble concentrating
Trouble getting to sleep or staying asleep, or tossing and turning during sleep

Dissociative Symptoms:

People with PTSD can also experience Derealisation and Depersonalisation. The experience of derealisation involves feeling either detached from yourself mentally or from your body (e.g., feeling as though you are in a dream, or as though you are outside of your body watching yourself). A depersonalisation experience involves the experience of your surroundings seeming unreal, dreamlike, distant, or distorted.

OTHER PSYCHOLOGICAL ISSUES WHICH TEND TO OCCUR WITH PTSD

It is not uncommon for people with PTSD or trauma symptoms to also experience or suffer from other psychological issues or difficulties. In fact, about 80% of people with PTSD will also meet diagnosis for another diagnosable psychological condition including:

Depressive symptoms or depressive disorders
Bipolar Disorder
Panic attacks or panic disorders
Anxiety for social situations
Chronic worry about day to day situations you cannot control
Substance use issues (alcohol, drugs, pain medications abuse) and is more common for males than females
Chronic physical pain issues, whether somatic complaints (including where not shown up in medical tests) or due to physical injury
Traumatic Brain Injury
Borderline Personality Disorder
Separation Anxiety Disorder (mainly for children with PTSD)

PTSD Treatment

HOW IS PTSD TREATED?

There are a range of effective psychological therapy treatments available for treating PSTD and trauma symptoms which do not quite meet the diagnostic criteria for PTSD. Therapy treatments for PTSD are generally quite active in their approach and focus on:

Helping you to understand that what you are experiencing is a normal reaction to an abnormal situation
Identifying and reframing the unhelpful thoughts and shifting unhelpful beliefs (cognitive distortions) associated with the trauma
Graded exposure therapy techniques to help you confront the feared situations which tend to be avoided and thus maintain the fear and cognitive distortions
Reprocessing of the traumatic event, sleep management strategies
Anxiety and arousal reduction strategies
Dealing with disturbing dreams/nightmares and flashbacks
Dealing with day to day stressful situations

When there are co-morbid psychological issues going on, your Clinical Psychologist will evaluate what are the issues of concern that need to be addressed and managed first before delving further into working through the trauma to help you heal from it. For e.g., if there are substance use issues, it would be a good idea to get some help to deal with this first.

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HOW LONG WILL IT TAKE FOR ME TO RECOVER FROM PTSD?

How long it will take a person to recover from their PTSD varies from person to person as there are many factors that affect the effectiveness of treatment. Typically, milder symptoms of trauma or PTSD and PTSD without any other separate psychological issue or disorder as described above will take a shorter recovery time and less treatment sessions than more severe PTSD presentations or PTSD with another psychological issue or disorder (e.g., PTSD + Major Depressive Disorder). In cases where the PTSD is severe and particularly when there are high levels of anxiety to avoid thinking or talking about the trauma, psychological treatment tends to focus on reducing and managing symptoms so they are less severe and do not cause as much distress, rather than aiming to fully resolve the PTSD.

Things that help progress treatment include:

Attendance of psychology appointments as scheduled by your Clinical Psychologist
Minimizing the use of alcohol and not using drugs
Not over-using or abusing prescription drugs
Trust in your Clinical Psychologist to help you with your recovery
A willingness to understand and change how you experience your emotions and thoughts in response to situations
Patience to let yourself heal for as long as it will take
Self-love and willingness to let go of any guilt in relation to the trauma

WILL MY PTSD GET BETTER ON IT’S OWN WITHOUT TREATMENT?

Unfortunately PTSD is one of the psychological conditions that does not tend to get too much better without psychological treatment, as the brain tends to keep reacting as though the threat is still happening or highly likely to happen again, which is all the on-going PTSD symptoms the person continues to experience. For mild trauma symptoms, the chances of the symptoms resolving on their own is more likely, however the more severe the trauma symptoms are or become, the less likely this is to happen and the more likely professional psychological treatment will be required to overcome your trauma.

BUT WHAT IF I AM NOT READY TO DEAL WITH MY TRAUMA?

At Vitality Unleashed Psychology, we understand the extreme anxiety that people can experience at the idea of having to work through their past traumas. When working through trauma, like with any other psychological issue, our primary concern is first do no harm. Working through trauma can be quite distressing for the person if the therapy is trying to progress faster than what the client is ready to face. Thus, it is important that your treatment goes at your own pace that you feel able to manage the therapy progress without becoming distressed or more experience discomfort than what you can handle. What people can cope with is different for everyone as no two people are the same. Your Clinical Psychologist at Vitality Unleashed Psychology will regularly talk with you about how you are feeling and coping with the treatment to ensure that it is not more than what you can handle. Until you are ready to work through the trauma, there are many things that your Clinical Psychologist can help you with to improve your symptoms and functioning so that you can experience more happiness such as helping you with your sleep, reducing your anxiety symptoms, dealing with day to day stressors, dealing with nightmares and flashbacks, helping you reduce any substance use issues, helping you get more involved in activity including daily hygiene etc.

READY TO MAKE AN ENQUIRY OR TO BOOK AN APPOINTMENT?

Here at Vitality Unleashed Psychology, Ashley Gilmour, Clinical Psychologist specialises in the assessment, diagnosis and treatment of depression, and we are able to help you recover from your depression with an evidenced-based psychological approach.

Vitality Unleashed Psychology provides Bulk-Billing psychology consultations to individuals with a Mental Health Care Plan from their GP. To find out more information about psychology treatment under Medicare, click here.

To make an enquiry about how we can help you or to book an appointment over the phone, call us on 07 55743888.

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