PTSD: Post-Traumatic Stress Disorder

Trauma and or Loss

Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. However, if the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.

 

It is important to understand that Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms normally cause significant problems in your social, work environments and in your relationships. They can also interfere with your ability to go about your normal daily tasks.

PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you’re stressed in general, or when you come across reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.

PTSD symptoms are generally grouped into four types:

Symptoms of intrusive memories may include:

  • Recurrent, unwanted distressing memories of the traumatic event.
  • Reliving the traumatic event as if it were happening again (flashbacks).
  • Upsetting dreams or nightmares about the traumatic event.
  • Severe emotional distress or physical reactions to something that reminds you of the traumatic event.

Symptoms of avoidance may include:

  • Trying to avoid thinking or talking about the traumatic event.
  • Avoiding places, activities or people that remind you of the traumatic event.

Symptoms of negative changes in thinking and mood may include:

  • Negative thoughts about yourself, other people or the world.
  • Hopelessness about the future.
  • Memory problems, including not remembering important aspects of the traumatic event.
  • Difficulty maintaining close relationships.
  • Feeling detached from family and friends.
  • Lack of interest in activities you once enjoyed.
  • Difficulty experiencing positive emotions.
  • Feeling emotionally numb.

Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:

  • Being easily startled or frightened.
  • Always being on guard for danger.
  • Self-destructive behavior, such as drinking too much or driving too fast.
  • Trouble sleeping.
  • Trouble concentrating.
  • Irritability, angry outbursts or aggressive behavior.
  • Overwhelming guilt or shame.

For children 6 years old, and younger, signs and symptoms may also include:

  • Re-enacting the traumatic event or aspects of the traumatic event through play.
  • Frightening dreams that may or may not include aspects of the traumatic event.

If you, or someone you know, has suicidal thoughts, get help right away.

When someone we care about dies in a sudden and/or traumatic situation, there are additional problems which add to the grieving we feel when anyone we love dies. You may have witnessed the death, or the deaths and injury of others. The same applies to braking up with your partner, boyfriend, girlfriend or seeing your friends immigrating. Covid19 is another example of a huge pandemic that is causing huge strain and trauma on individual’s life’s, their income, their families, their future, their ability to be social.

These are just some examples. Everyone’s experience and responses will be different and there is no right or ‘normal’ response. However, there are some common reactions and feeling you may experience in the hours, days, weeks and months after a traumatic event or time in your life. These feelings can sometimes be very strong and frightening.

When we suffer a trauma or a loss, there are typically four main types of problems which may arise after such traumatic circumstance:

‘I can’t believe it’s true’.

Losses for which we are unprepared, particularly if we can’t be present or to hold or touch those we have lost, are difficult to comprehend these, as real. It takes a long time to take in what has happened. Spend time talking it through with others, and don’t worry that you are being a burden to them, that’s what friends are for. Many people might find it helpful to:

  • visit the place where the disaster took place.
  • talk with others involved, perhaps someone you know that got divorced or lost a lot of friends through immigration to other countries.
  • place a wreath in a significant place.
  • attend memorial services or other rituals of remembrance.

Lockdown regulations resulted in job loss or financial strain for you – Your job loss or less income is a reality. It’s also a time to reflect on all the skills you have learnt and acquired in your life. Make a list of all the things you are capable of doing, and think outside the box, your normal job you have been doing. Look at how well equipped you really are in this world and see where else you could apply these or some of the skills or lessons you have learnt to better your situation.

In the end, there may be aspects of the loss that will never be explained. Be prepared to live with the uncertainty of not knowing; we cannot explain or control everything. I like to believe that one needs to focus on dealing with your loss day by day and instead of looking for the ultimate answer or “how to get over it”, learn to live and accept it just a little more and better than the previous day, week or month.

 

‘I can’t get it out of my head’.

Many people are haunted by pictures in their minds of the traumatic event. Such images may occur spontaneously or, in a distorted form, as recurrent nightmares. They may be triggered by any reminder of the loss, e.g. loud noises, cries, shouts or a place.

Some people go to great lengths to avoid any such reminders because the images are so painful. They may shut themselves up at home, avoid talking about the loss, or distract themselves with hectic activity.

Haunting images can sometimes be eased by talking to others, going over the events again and again until you get used to them. The images will not disappear, but they will become less painful and easier to live with. If the images are stopping you from grieving or getting on with your life, then you should seek assistance.

‘I feel numb’.

Numbness is our mind’s way of protecting itself from mental pain, of what threatens to overwhelm us. Sometimes we may be unable to think clearly or become confused and lose our bearings. At other times we may be unable to express feelings of any kind. In an emergency it is such ‘dissociation’ that enables us to keep going. It is only if it continues after the disaster is over that it becomes a problem. Usually this manifest as fear, that if we do not keep our feelings firmly under control, we will lose control and feel weak, which is naturally not true and healthy for all situations.

Grief is the natural response to the loss of a loved person. It is more likely to give rise to problems if it is bottled up than if it is expressed. At times of loss it is normal and appropriate to express grief in any way that feels natural. Some people need to cry, others will rage, and others just talk endlessly about what has happened. Try to find someone you can trust who will be a good listener and don’t worry if, for a while, you look or feel helpless, that will pass. In grieving we do not forget the people we love, we gradually find new ways to remember them. Memories of the past are sometimes painful, but they are our treasure, it is best not to bury them for too long.

‘I can’t stop crying’.

Grief can continue much longer than most people expect. We need to recognise that fact and not expect too much of ourselves. This said, there are some types of grief which become “stuck”. Sometimes this reflects our need to punish ourselves. “Why should I be happy now that he or she is dead or have left?” This is most likely to arise if it is a child who has died, or if we blame ourselves for their death or for not being there for them when needed. At other times may be a feeling of rejection, abandonment or a question of why “they” left but I am still here and what is left for me?

Grief is not like the measles, we do not go back to being the person we were before our loss. We learn to live with it, and, little by little, the pain will diminish. Grief is not a duty to the dead or the people who have left our lives, those we love would not want us to suffer. Again, talking it through with a friend usually help. If that is not enough or you feel continually depressed or suicidal, you should not hesitate to seek help.

‘I feel so angry’.

Anger is a very natural reaction to loss, particularly if it was caused by terrorism, malicious intent or other human hands. It may be directed against the perpetrators of the trauma, or against all authorities or the people nearest to hand. Some people may find themselves hitting out wildly at the people they love the best. Occasionally ill-directed anger may even feed into, or bring about a cycle of violence.

Remember that anger can be a force for good if it is controlled and directed where it can do good rather than harm. Try to hold back from impulsive outbursts and, if you have said or done things that have hurt others, don’t be too proud to apologise. They will understand.

‘I blame myself, I feel so guilty’.

None of us is perfect and it is easy to seize on something that we did or didn’t do in our attempt to find someone to blame. Often, people end up blaming themselves. At the back of our minds we may even cling to the idea that, if we punish ourselves, we will make things right again and get back the person we have lost. Sadly, this magical thinking is doomed to fail.

Sooner or later we have to accept that what has happened is irrevocable and that punishing ourselves won’t change anything. Friends will often say ‘You shouldn’t blame yourself’, and maybe they are right. But you do not choose the way you feel. Guilt and anger are not feelings that can be switched on and off at will. Rather we should try to find a creative use for our grief, to bring something good out of the bad thing that has happened.

‘I feel so frightened’.

We all know that disasters happen, but most of the time we go through life with confidence that we are safe, protected from harm and immune from significant trauma. Then disaster strikes, like we currently experiencing the Covid19 pandemic, all in a moment the world has become a dangerous place, we can take nothing for granted, we are waiting for the next disaster. Fear causes bodily symptoms including tense muscles, racing heart, sweating, breathlessness and sleeplessness – all symptoms which, in the environment in which we evolved would have helped us to stay alive in situations of danger. But in today’s world they do no such thing and are more likely to be misinterpreted as symptoms of illness.

The first and most important thing is to recognise that the symptoms of fear are a sign of normality, at such times a racing heart is a normal heart, headaches, back aches, indigestion, even feelings of panic, are natural reactions that will decline as time passes, they are not symptoms that will lead to something worse. In addition, you are not as helpless as you feel. Relaxation exercises, meditation techniques, aromatherapy or whatever helps to relax you will put you back in control.

This said, you should not expect to go back to being the secure, confident person that you were before the disaster struck. You have learned the hard way that life is never – and never was – completely safe. You have lost the illusion of invulnerability and will never quite regain it. You are older and sadder as a result. But you are also more mature. You have learned that life has its dark side, but that does not mean that you need to live your life in perpetual fear. The world today is no more dangerous than it was before the disaster. Previously you had an illusion of safety, the feeling of danger is equally illusory, and it will grow less. Human beings evolved to cope with a much more dangerous world than the one in which we live today. You, and those with you, will survive.

‘Life has lost its meaning’.

Each person’s sense of purpose and direction in life arises from a hundred and one habits of thought and assumptions about the world that we take for granted. Then, all of a sudden, we can take nothing for granted any more. Perhaps the person who left or died is the one we would have turned to at times of trouble and now, when we face the biggest trouble in our lives, they are not there, or, if they are, they are so overwhelmed by their own challenges that we cannot burden them with ours.

When faced with a disaster of this magnitude it takes time and hard work to adjust. It is rather like learning to cope with the loss of a limb. For a while we will feel crippled, mutilated, as if a part of ourselves is missing.

We feel as if we had lost every good thing that relied on the presence of the person we loved, the job we had, the friends or partner who left. But take heart, all is not lost. Now is the time to take stock, and ask yourself what really matters? When we do that, we may be surprised to find that many of the things that made sense of our lives while what we lost were in our lives before, continue to make sense of our lives, after the loss. In times of loss, we easily tend to focus on the loss only and lock away the positivity and beauty we gained and had also had in addition to what we lost. In times like this, try see yourself and your life fully as an amazing human being and not only a person with a specific loss. Embrace the loss as part of your total self and not just focus on the loss itself.

As a Transformation Coach, it is very helpful to bring an awareness to the process of trauma in the physical body, how this connects with the mind / brain, and how it may manifest itself in both. This is good insight when uncovering and releasing anxious states.

The coaching process can alleviate symptoms in trauma survivors by helping to create new positive experiences and diffusing event flashbacks. Bringing awareness to other feelings that may or may not serve you at this time, such as anger and unnecessary arousal.

 

The Transformation Coaching process, support you to move towards mastery of your particular situation and supporting you to find and learn ways and practice tools and skillsets. This will help you to continually move towards a life that you want to create for yourself, perhaps a calm, peaceful and more enriched life.

Anger Management.