What is PTSD?

Post-traumatic stress disorder (sometimes called PTSD) is a form of anxiety disorder. The Australian prevalence rates for PTSD are 4.4% (12 month) and 7.2% (lifetime)

Some people develop this condition after they have experienced a traumatic event. This event might be a serious accident, physical or sexual assault, war or torture, or a natural disaster such as a bushfire or a flood. Strong reactions such as fear, horror, anger, sadness and hopelessness are natural after events like these, of course. In most cases, these feelings will pass after the normal working-through of emotions and talking things over in your own time with family, friends or colleagues.

When these feelings are intensely distressing and go on for more than four weeks, however, it is important to ask for help from a doctor or other health professional, as they may be symptoms of a more persistent condition such as PTSD. About 25% of people who are exposed to traumatic events develop PTSD. As well as being very upsetting, the symptoms interfere with the person’s ability to carry on their everyday life, work and relationships. Treatment helps deal with the symptoms so that people are able to get on with their life again.

What are the symptoms?

Post-traumatic stress disorder is identified by three main groups of symptoms:

Flashbacks of the traumatic event through intrusive memories or nightmares. As well as strong emotions, there may be physical symptoms such as sweating, heart palpitations or panic attacks.
Feeling emotionally numb and avoiding situations that are reminders of the trauma. Avoiding possible reminders of the trauma can cause someone to lose interest in day-to-day activities and become detached from friends and family. Some people experience ‘dissociation’ – a feeling of watching from a distance as events unfold.
Feeling anxious and ‘jumpy’ for no reason. Heightened vigilance can mean the affected person is constantly on the lookout for danger, possibly leading to irritability and a lack of concentration.

Other indicators of PTSD may include:

Panic attacks
Uncontrollable crying
Uncontrollable rages
Eating disorders
Suicidal feelings
Self mutilation
Somatic pain
Terror
Addictions (alcohol, drugs, sex)

Overreaction to minor stress
Sleep disorders
Sense of defilement or stigma
Nightmares
State of fight or flight
Extreme mood swings
High risk behaviours
Shame, guilt and blame

Someone who has experienced a traumatic event may sometimes feel that they have ‘got over’ it, until they are confronted with a reminder that triggers symptoms again. Those affected may also develop other anxiety disorders (such as phobias or social anxiety), depression, or problems with alcohol and drug use. These conditions can be present at the same time as the PTSD, and require additional treatment.

Symptom Checklist

Have you experienced or seen something that involved death, injury, torture or abuse and felt very scared or helpless?

Have you then experienced any of the following:

upsetting memories, flashbacks or dreams of the event?
feeling physically and psychologically distressed when something reminds you of the event

If you answered yes to all of these questions, have you also experienced at least two of the following:

had trouble remembering important parts of the event
had very negative beliefs about yourself, others or the world
persistently blamed yourself or others for what happened
persistently felt negative, angry, guilty or ashamed
felt less interested in doing things you used to enjoy
feeling cut off from others
had trouble feeling positive emotions (e.g. love or excitement)

And have you experienced at least two of the following:

had difficulties sleeping (e.g. had bad dreams, or found it hard to fall or stay asleep)
felt easily angered or irritated
engaged in reckless or self-destructive behaviour
had trouble concentrating
felt on guard or vigilant
been easily startled?

If all these things have been happening for a month or more, you may be experiencing post traumatic stress disorder.

How common is PTSD and who experiences it

Anyone can develop PTSD following a traumatic event, but people are at greater risk if the event involved deliberate harm such as physical or sexual assault or they have had repeated traumatic experiences such as childhood sexual abuse or living in a war zone. Apart from the event itself, risk factors for developing PTSD include a past history of trauma or previous mental health problems, as well as ongoing stressful life events after the trauma and an absence of social supports.

Around 12 per cent of Australians will experience PTSD in their lifetime. Serious accidents are one of the leading causes of PTSD in Australia.1

If you feel very distressed at any time after a traumatic event, talking to your doctor or other health professional is a good first step. If you experience symptoms of PTSD that persist beyond two weeks, a doctor or a mental health professional may recommend starting treatment for PTSD.

What are the treatments?

Treatment usually involves psychological (talking) therapy with the person directly affected (and sometimes their family) by a qualified health professional such as a doctor or psychologist. The sooner someone is diagnosed and receives treatment, the more likely it is they will recover sooner. With help, a person can learn to manage their response in unavoidable situations that previously would have triggered a flashback. Medication can also be helpful for a time. With appropriate treatment and support people with PTSD are able to recover and get on with their lives.

Tips on managing psychological trauma

There are several things you can do to look after yourself and promote recovery from a traumatic event or situation. The following points provide some general advice.

Recognise that you have been through a distressing experience and give yourself permission to experience some reaction to it. Don’t be angry with yourself for being upset.
Remind yourself that you are not abnormal and that you can and are coping.
Avoid overuse of alcohol or other drugs to cope.
Avoid making any major decisions or big life changes.
Do not try to block out thoughts of what has happened. Gradually confronting what has happened will assist in coming to terms with the traumatic experience.
Don’t ‘bottle up’ your feelings – share your experiences with others when opportunities arise. This may feel uncomfortable at times, but talking to understanding people that you trust is helpful in dealing with trauma.
Try to maintain a normal routine. Keep busy and structure your day.
Make sure you do not unnecessarily avoid certain activities or places.
Allow yourself time to rest if you are feeling tired, and remember that regular exercise is important.
Let your friends and family know of your needs. Help them to help you by letting them know when you are tired, need time out, or need a chance to talk or just be with someone.
Make time to practise relaxation. You can use a formal technique such as progressive muscle relaxation, or just make time to absorb yourself in a relaxing activity such as gardening or listening to music. This will help your body and nervous system to settle and readjust.
If the trauma that you experience stirs up other memories or feelings from a past unrelated stressful occurrence, or even childhood experiences, try not to let the memories all blur together. Keep the memories separate and deal with them separately.
Express your feelings as they arise. Whether you discuss them with someone else or write them down in a diary, expressing feelings in some way often helps the healing process.

Sourced: Sane, APS, Beyondblue, RACGP, Mindhealthconnect

Do you think you may be suffering from PTSD?

If you feel you may be suffering from PTSD, seek the advice of an experienced mental health professional. Visit your GP and discuss your concerns, book a longer appointment so there is time to explain your issues and how you are feeling.

Your GP may write a referral to a psychologist, which may entitle you to access Medicare rebates under the Federal Governments Better Access to Mental Health Care Rebate scheme.

Remember your Doctor and psychologist are there to help,and will not judge.

To book an appointment at Lifepath Psychology, or request further information about our services, please feel free call 6496 0039 and one of our friendly staff will more than happy to assist.

What is anxiety?

Anxiety refers to feelings of worry, nervousness, or a sense of apprehension, typically about an upcoming event where the outcome is uncertain, or where the person feels he or she might not be up to the task. Anxiety is commonly experienced in high pressure situations, for example, prior to a making a speech or sitting an exam. Feelings of anxiety can also arise following a stressful event, like an accident where the person is left feeling shaken. Anxious feelings are usually accompanied by physical sensations such as a churning stomach, light headedness, and a racing heart.

Signs and symptoms

Although the experience of anxiety will vary from person to person, feeling stressed, worried, and having anxious thoughts are common symptoms. Other common symptoms of anxiety include:

Difficulty concentrating
Restlessness
Avoidance behaviour
Rapid heartbeat
Trembling or shaking
Feeling light-headed or faint
Numbness or tingling sensations
Upset stomach or nausea
Sweating.

Anxiety disorders

While anxiety is considered a natural reaction to a stressful situation, for some people anxious thoughts, feelings, or physical symptoms can become severe and upsetting, interfering with their ability to go about their daily lives.Where symptoms of anxiety occur frequently, occur over a period of time, and interfere with daily life, it is typically considered an anxiety disorder.

Anxiety disorders are the most common type of mental disorders diagnosed in Australia. There are a number of different types of anxiety disorder, including:

Generalised Anxiety Disorder (GAD)
GAD is characterised by persistent and excessive worry, often about daily situations like work, family or health. This worry is difficult to control and interferes the person’s day-to-day life and relationships.

Specific phobia
People with a specific phobia experience extreme anxiety and fear of particular objects or situations. Common phobias include fear of flying, fear of spiders and other animals, and fear of injections.
Panic Disorder
Panic Disorder is characterised by the experience of repeat panic attacks – sudden surges of overwhelming fear and anxiety and physical symptoms such as chest pain, heart palpitations, dizziness, and breathlessness.
Agoraphobia
Agoraphobia involves intense anxiety following exposure to, or anticipation of, a variety of situations such as public transportation, open spaces, crowds, or being outside of the home alone.
Obsessive Compulsive Disorder (OCD)
Individuals with OCD have recurring, persistent, and distressing thoughts, images or impulses, known as obsessions (e.g. a fear of catching germs), or feel compelled to carry out certain repetitive behaviours, rituals, or mental acts, known as compulsions (e.g. hand-washing). These thoughts and acts can take over a person’s life and while people with OCD usually know that their obsessions and compulsions are an over-reaction, they are unable to stop them.
Social Anxiety Disorder
In social anxiety disorder the person has severe anxiety about being criticised or negatively evaluated by others. This leads to the person avoiding social events and other public situations for fear of doing something that leads to embarrassment or humiliation.
Post-Traumatic Stress Disorder (PTSD)
PTSD refers to a set of symptoms that can occur after exposure to a frightening and traumatic event. Symptoms include a sense of reliving the traumatic event (through ‘flashbacks’ or nightmares), avoidance of places, people, or activities which remind the person of the event, feeling numb or detached from others, having negative thoughts about oneself and the world, feeling irritable, angry, or wound up, and having trouble sleeping.

What causes anxiety disorders?

Whilst there is no single known cause of anxiety disorders, there are a number of risk factors or triggers that may contribute. These differ between the different anxiety disorders too. In general, the following factors may play a role:

Genes:
certain anxiety disorders appear to have a genetic component, with some anxiety disorders running in families.
Physical health:
Poor physical health can increase a person’s vulnerability to developing symptoms of anxiety.
Thinking style:
patterns of thinking characterised by anticipating the worst, persistent negative self-talk, low self-esteem, and unhelpful coping strategies (e.g., avoidance) are linked to problem anxiety.
Stress:
stressful events such as a marriage breakdown, work or school deadlines, financial hardship can act as a trigger for anxiety.

How a psychologist can help

Through discussion with the client and the possible use of questionnaires, the psychologist develops an understanding of the potential factors that might be contributing to the client’s anxiety. A treatment plan is then developed by the psychologist together with the person. For anxiety disorders, this can involve CBT, mindfulness, exposure therapy, relaxation and other helpful strategies.

The psychologist might also assist the person to address any lifestyle factors which may increase his or her capacity to better manage difficulties, and reduce symptoms of anxiety. They may also suggest involving a supportive family member or friend to assist in the understanding of the person’s situation and to support treatment.

(Article by Australian Psychological Society 2016)

Do you think you may be suffering from anxiety?

If you feel you may be suffering from anxiety, seek the advice of an experienced mental health professional. Visit your GP and discuss your concerns, book a longer appointment so there is time to explain your issues and how you are feeling.