I suffer from Complex PTSD and to help others and me who suffer this condition, it is important that friends and family understand just what PTSD is and how it affects people suffering with this condition as well as the type of support needed to help.
What Is PTSD?
PTSD stands for Post Traumatic Stress Disorder. PTSD is an anxiety disorder that can develop after an individual has experienced or witnessed a major trauma.
There are many different types of symptoms that someone can have after a trauma, but PTSD symptoms fall into 3 categories:
- Reliving or re-experiencing the trauma
- Attempts to avoid thoughts, situations, or people that are reminders of the trauma
- Increased anxiety or arousal, including being constantly on guard for danger, and being easily startled
What Kind Of Trauma Leads To PTSD?
There is no one type of trauma that can lead to PTSD. Rather, there are several different kinds of traumatic situations that can do this, all of which have certain common elements:
- The trauma was life threatening
- The trauma leads to an actual or potentially serious injury
- The individual reacted to the trauma with intense fear, helplessness, or horror
You can develop PTSD if you have been directly involved in a serious traumatic event, or if you witnessed a traumatic event. Some common traumas that can lead to PTSD include:
- Being in, or seeing, a serious car accident
- Being sexually assaulted/raped
- Experiencing long-term sexual, emotional, or physical abuse
- Undergoing major surgery (bone marrow transplant, extensive hospitalization, severe burns)
- Experiencing or witnessing natural disasters (earthquakes, hurricanes, floods, fire)
- Experiencing torture of any form
- Experiencing a terrorist attack, or being a prisoner of war
- Experiencing or witnessing a violent crime (kidnapping, physical assault, assault or murder of a loved one)
- Being involved in the field of law enforcement or criminal investigations
- Being involved in a war or military combat
- Witnessing violence or death of a loved one or by a loved one
Symptoms Of PTSD
In order to receive a diagnosis of PTSD, you need to be currently experiencing at least one symptom from each of the following three categories.
- Stomach problems
- Changes in breathing patterns (i.e. shortness of breath)
- Lack of energy OR
- Sometimes being very active and over-energetic
- Sleep problems
- Feeling of emotional pain that you have never felt before
- Anxiety problems
- Hypervigilance (always on alert)
- Mood swings
- Memory problems
- Addiction/Self Medication
- Loss of personal hygiene/housekeeping
- Risk taking behavior
- Depression (thinking “what’s the point”)
- Paranoid thoughts
Signs And Symptoms Of PTSD Explained In Detail:
- Insomnia (not being able to fall asleep or stay asleep)
- Having nightmares
- Waking up covered in sweat
- Kicking during sleep
- Constantly waking up and falling back asleep, possibly due to bad dreams
- Waking up and being easily startled and/or being confused about where you are
- Irregular sleep cycles. Often these symptoms will lead an individual to avoid sleeping as much as possible or turn to alcohol or other drugs to try and self medicate the problem.
It is important to remember that self-isolation or society imposed isolation is one of the worst treatments for a person that suffers PTSD.
- Early Stages: The individual will begin to slowly start cutting him/her self off from society. These symptoms can be shown by a lack of wanting to go out to social places that they used to find enjoyable. The individual may not show an interest in meeting new people or feels uncomfortable or alert if placed in a situation with a large crowd of unknown people. They might begin eating meals alone or may become workaholics, throwing themselves into materialistic things rather than people. At this stage, the person usually begins to sever many social ties, only leaving those close members of family or closest friends who he/she trusts and feels enough comfort around to allow the relationship to last. Human interaction is an important part of emotional growth and recovery. Without it, the soldier will continue on a downward spiral.
- Later Stages: Usually by this time the person is nearly crippled by other symptoms and often can be misdiagnosed as being depressed. By this stage the person has most likely completely cut him or herself off from society including friends and family and will most likely surround themselves only with materialistic things. They usually will only go out on a required basis (to get food or medication). Often, to reach this level of isolation, the person is in a severe, deep stage of PTSD and needs immediate medical attention. Without it, things will only get worse if left untreated.
- Hypersensitivity and anxiety usually go hand-in-hand. The most common symptoms are sensitivity to bright light, loud noises, large crowds, unfamiliar places and/or being easily startled.
- At first these symptoms may appear to be slight or almost unnoticeable, but a soldier will be able to begin to feel an increase in an anxiety levels and discomfort when exposed to some of these elements.
- Over time, and without treatment, symptoms can get worse. In several cases, those who suffer from PTSD and have not sought proper help can suffer severe anxiety attacks (panic attacks) and often complain of migraine headaches if they are triggered by one of these symptoms.
- Memory problems are probably the most commonly shared symptoms of PTSD sufferers. As first, memory problems may be somewhat hard to diagnose, but often it is a progressive symptom and will get worse as time passes without proper treatment.
- Early Stages: The first stages of memory problems might show up as absent-mindedness. Easily forgetting things like important dates, appointments, names of new people that you meet, are some examples as well as constantly misplacing or losing things. If the returned soldier never had problems in any of these areas before he/she deployed, it is important to keep a watchful eye on them. Without proper care, memory problems can become progressive and debilitating.
- Later Stages: By this time, the returned veteran is most likely showing many other symptoms of PTSD. Late stages of memory problems will be very obvious. The person most likely will forget things on a day-to-day basis. They might even have trouble remembering things from the past. Sometimes the returned soldier may be in the middle of a sentence and pause and forget what they were talking about. Or, they might tell you something and minutes later; tell you the exact same thing because they forget they have already said it in the first place. Another thing to be aware of is that our military is trained to adapt and to keep functioning. In many cases, if a returned soldier begins to realize they are having problems with memory and they are unaware that it might be PTSD or they are resistant to getting help, they might purchase note pads, post-it notes, or dry erase boards to try to compensate for their memory loss.
- When this level of memory challenges has been reached people with intense PTSD often compare it to feeling like their memories have been put into a blender and pulled out. It leaves a feeling like everything is mixed up. It can also feel as if some of the memories were left out of the blender, evidenced when we draw a blank trying to recall certain events: Leaving holes of missing information.
Mood Swings and Risky Behavior:
- These are both common symptoms of PTSD and can be interrelated. Mood swings are very apparent and easy to notice. Usually, when it comes to a PTSD suffers, and they begin to experience problems with mood swings, it will almost always appear as aggressive or violent.
- Mood swings can often appear to be mild temper tantrums, or irritability towards others, but can often get worse. The best way to describe why a soldier might deploy appearing “normal” and return from deployment showing any of these traits is described below.
- Violence, aggression and/or risk-taking behavior is part of “everyday life” when a soldier is in a war zone because they are risking their life everyday for their country. So that behavior becomes “normal”. If there isn’t someone to show the soldier that the violence, aggression and risk-taking are “normal” for the war zone, but “extreme” when coming home, then they often don’t know the difference.
- This is one of the most important symptoms to watch out for, and the most dangerous. If it is not caught early enough, or if the suffer is misdiagnosed, they can be sent down a dangerous and painful path of drug or alcohol abuse.
- This is another important symptom that is common among PTSD sufferers. It is progressive and the person can easily be diagnosed with Depression when it is really a symptom of PTSD.
- Early Stages: The individual will begin to show signs of not maintaining a clean appearance, such as combing hair, shaving on a regular basis or wearing clean clothes. They might also begin to stop picking up after themselves on a regular basis and/or not keeping a clean and organized home.
- Later Stages: By this time the individual most likely has no regard for their own appearance and most likely doesn’t shower or bathe on a regular basis. They probably can hardly clean up anything after themselves due to the fact that by this stage, even small, simple tasks seem almost overwhelming. If the suffer has reached this level of illness, then immediate medical attention should be sought. By this stage, if there is no one to care for the suffer, and then it becomes dangerous because they are struggling to even make it day to day.
Symptoms of reliving or “re-experiencing” the trauma
- Upsetting memories about the event. This usually involves having vivid images about the trauma come up again and again even when you do not want to have them. For example, if you were physically attacked, you might keep remembering your attacker’s face. Or, if you were in a car accident, you might have strong memories about the sound of the crash or a vivid picture of blood all over yourself or someone else involved.
- Nightmares about the trauma. People with PTSD will often have very vivid nightmares of either the trauma or themes surrounding the trauma. For example, if you were in a car accident, you might have frequent nightmares about being in the accident yourself, or about other people being involved in accidents. Some people with PTSD who were assaulted will have nightmares of being chased, and the person chasing them in the dream might not be the person who assaulted them.
- Acting as if the trauma were happening again (“reliving the trauma”). This is also called “dissociation”, where an individual loses touch with the present, and feels as if they are living through the trauma again. Some people with this symptom might speak and act as if they are physically in the traumatic situation, whereas others might appear to simply stare off into space for a period of time. Some people with PTSD will also have “flashbacks”, which are very vivid images of the trauma they experienced. Flashbacks can seem very real, and some people describe it as a picture or movie that they can see clearly in their minds.
- Anxiety or distress when reminded of the trauma. Some people with PTSD become extremely upset or feel very anxious whenever they are confronted with a person, place, situation, or conversation that reminds them of the trauma. This can include becoming very upset when hearing tires squeal if you were in a car accident, or feeling anxious when watching violence on TV if you were assaulted.
Symptoms of avoidance
- Avoiding (conscience or unconscious) reminders of the trauma. Many people with PTSD will try very hard to avoid anything that is associated with, or reminds them of, the traumatic event they experienced. Reminders can include:
- Circumstances (e.g., the actual date of the event, clothes worn, place where the event occurred, etc.)
- Things associated with the trauma (e.g. being in a car if the trauma was a car accident)
- General signs of danger (e.g. TV shows about violence, news programs, police or fire department sirens, fire alarms, etc.)
- Avoiding (conscience or unconscious) thoughts, feelings, or memories related to the trauma. Although many people with PTSD will avoid any reminders of their traumatic experience, it is also common for people to avoid even thinking about what happened. For example, you might avoid talking to anyone about the trauma, and if you have thoughts or memories about what happened, you might try to push them out of your head.
- Not able to recall (conscience or unconscious) parts of the trauma. It is not uncommon for people who have lived through a trauma to have difficulty-remembering parts of it, or the entire trauma, or to be confused about the timeline of events.
- Reduced interest in previously enjoyed activities. For example, after a trauma, you might stop wanting to spend time with friends and family, or you might stop all activities that you used to enjoy (such as sports or hobbies).
- Feeling detached/estranged from others. People with this symptom describe feeling cut off from others, even though they might have family and/or friends around them.
- Feeling numb/unable to experience feelings. Some people with PTSD will say that they generally feel numb, and don’t experience loving feelings anymore (such as love, joy, or happiness). People with this symptom might have a hard time even describing how they feel, and are not able to recognize when they are happy, sad, or angry.
- Feeling of foreshortened future. It is not uncommon for people with PTSD to say that they have a feeling of “impending doom”; that is, they say that they don’t expect to live long, that something bad is likely to happen again soon, or that they feel hopeless about the future.
Symptoms of increased anxiety or “hyperarousal”
- Sleep difficulties. Some people with PTSD will have trouble falling asleep or staying asleep. This often happens when you feel quite anxious throughout the day.
- Anger outbursts or irritability. It is not uncommon for people with PTSD to feel more irritable and angry. If you have this symptom, you might find yourself snapping at people, or getting extremely angry in a situation that reminds you of your trauma. For example, if you were in a car accident, and while driving someone cuts you off, you might get very angry and even yell or act inappropriately.
- Concentration difficulties. Many people with PTSD report that they have a hard time paying attention or concentrating while completing daily tasks. This is often the result of being very anxious; it is not a sign that there is something wrong with your memory.
- Hypervigilance. Often, people with PTSD feel as if they are “on guard” or “on alert” all the time. People with this symptom will be very easily startled, and will jump at the slightest sound (for example, the telephone ringing, someone tapping you on the shoulder).
- Memory Lapse. A person who suffers from intense PTSD will often have difficulties remembering important detail or entire post trauma events. These episodes are known as “black outs” or unconscious fugues.
- Tip. It is normal to feel more anxious right after a trauma. But over time, these anxious feelings will settle down. Remember: not everyone who lives through a trauma will develop PTSD. But if your symptoms have been present for over one month, and you find that they are interfering significantly in your life, then you might have PTSD.
How To Recognize PTSD?
- Many adults with PTSD have strong feelings of shame, guilt, or despair about what happened. It is also not uncommon to have increased feelings of hostility or anger; this is sometimes directed towards entire groups of people (for example, you might find yourself being very angry and suspicious of men if you were raped, or you might get extremely angry at drivers who speed if you were in a serious car accident).
- Because living through trauma is such a life-changing experience, some people with PTSD find that their relationships with others are different after a trauma. For instance, they might have difficulty trusting other people and/or they might have sexual or intimacy problems.
PTSD: The Facts
- Several studies have shown that a majority of people will likely experience at least one traumatic event in their lives; but many of them will NOT develop PTSD.
- The chance of developing PTSD goes up if the trauma was very severe, chronic (that is, lasted a long time), or you were physically close to the event, that is, if the trauma happened right next to you or in front of you.
- Certain traumas are more likely to lead to PTSD than others. For example, you are more likely to develop PTSD if the trauma you experienced was a rape/sexual assault, combat exposure, or childhood neglect/physical abuse.
- If you develop PTSD symptoms within one month of a traumatic event, this is called acute PTSD. If you don’t develop any symptoms until at least six months after the trauma, this is called delayed onset PTSD.
- Adults with PTSD can have other problems as well, including depression, drug and alcohol abuse, or other anxiety problems (for example, panic disorder, social anxiety).
Types Of PTSD (Least Debilitating To Most Debilitating)
There are five main types of post-traumatic stress disorder: normal stress response, acute stress disorder, uncomplicated PTSD, comorbid PTSD and complex PTSD.
Normal Stress Response
The normal stress response occurs when healthy adults who have been exposed to a single discrete traumatic event in adulthood experience intense bad memories, emotional numbing, and feelings of unreality, being cut off from relationships or bodily tension and distress. Such individuals usually achieve complete recovery within a few weeks. Often a group debriefing experience is helpful. Debriefings begin by describing the traumatic event. They then progress to exploration of survivors’ emotional responses to the event. Next, there is an open discussion of symptoms that have been precipitated by the trauma. Finally, there is education in which survivors’ responses are explained and positive ways of coping are identified.
Acute Stress disorder
Acute stress disorder is characterized by panic reactions, mental confusion, dissociation, severe insomnia, suspiciousness, and being unable to manage even basic self care, work, and relationship activities. Relatively few survivors of single traumas have this more severe reaction, except when the trauma is a lasting catastrophe that exposes them to death, destruction, or loss of home and community. Treatment includes immediate support, removal from the scene of the trauma, use of medication for immediate relief of grief, anxiety, and insomnia, and brief supportive psychotherapy provided in the context of crisis intervention.
Uncomplicated PTSD involves persistent reexperiencing of the traumatic event, avoidance of stimuli associated with the trauma, emotional numbing, and symptoms of increased arousal. It may respond to group, psychodynamic, cognitive-behavioral, pharmacological, or combination approaches.
PTSD comorbid with other psychiatric disorders is actually much more common than uncomplicated PTSD. PTSD is usually associated with at least one other major psychiatric disorder such as depression, alcohol or substance abuse, panic disorder, and other anxiety disorders. The best results are achieved when both PTSD and the other disorder(s) are treated together rather than one after the other. This is especially true for PTSD and alcohol or substance abuse. The same treatments used for uncomplicated PTSD should be used for these patients, with the addition of carefully managed treatment for the other psychiatric or addiction problems.
Complex PTSD (sometimes called “Disorder of Extreme Stress”) is found among individuals who have been exposed to prolonged traumatic circumstances, especially during childhood, such as childhood sexual, physical, verbal, or emotional abuse. These individuals often are diagnosed with borderline or antisocial personality disorder or dissociative disorders. They exhibit behavioral difficulties (such as impulsivity, aggression, sexual acting out, eating disorders, alcohol or drug abuse, and self-destructive actions), extreme emotional difficulties (such as intense rage, depression, or panic) and mental difficulties (such as fragmented thoughts, dissociation, and amnesia). The treatment of such patients often takes much longer (years), may progress at a much slower rate, and requires a sensitive and highly structured treatment program delivered by a team of trauma specialists.
The Importance of a Strong Support System
- A strong support system (family and friends) is needed for PTSD suffers: This is absolutely necessary for recovery. Without their assistance there is no telling where the suffer would be or what in what situations will eventually be in. Without a strong support systems, people that suffer intense PTSD would most likely end up on the street, or in a hospital somewhere, or incarcerated, or dead.
Successful Recovery and Living with PTSD
- With proper counseling and medical treatment and support, it is possible (with time) to make a satisfactory recovery from PTSD: To be able to function in society with minimal apparent issues. PTSD will never magically disappear 100%. PTSD is something a person will live with for the rest of their life. Family, friends, and coworkers must understand and accept this fact about PTSD suffers.
Support of a PTSD Suffer
- Post Traumatic Stress Disorder is a very serious mental health issue if left unattended. Any person who has witnessed a traumatic event may suffer some degree of PTSD. The most important thing to remember is NOT TO IGNORE the symptoms or degrade suffers because of the symptoms. The earlier symptoms are identified and caringly addressed, the sooner that helpful intervention and the journey to healing can take place.
Sober hugs, Guy
August 9, 2011