PTSD – Post Traumatic Stress Disorder
PTSD or Post Traumatic Stress Disorder is often mentioned in the media these days, not just in connection with veterans returning from the theatre of war but also people who have been through other potentially damaging events such as mass shootings, bomb blasts, severe car accidents and so on. It has also provided cinema and television with endless material for films that vary considerably in their accuracy of how the condition is portrayed – and how sympathetically.
First identified in the First World War, where it was generally referred to as ‘shell shock’ as it was initially associated with the intensive shelling in the trenches and the concept was a combination of physical and psychological symptoms. In the early twentieth century psychiatry and what we would regard as modern medicine were in their infancy so very little was known about the function of the brain and how its different parts worked. Indeed we are still learning and new ideas about memory and how our brains are ‘wired’ are discussed all the time.
Nowadays it is recognised that PTSD is not something that just happens on the battlefield and can affect civilians too. Among war veterans it may be associated with various physical traumas such as blast injuries to the brain including TBI. For the purposes of this article we will be talking about the psychological impact of a traumatic event rather than physical injuries.
What is PTSD?
Not everyone subjected to a particular experience develops PTSD and not everyone who has been through one specific event will have the same triggers. So what is it?
To explain it simply, it is when your brain does not process a memory of a traumatic event properly. The memory of the event as experienced is not transferred from short term to long term and identified as in the past. As you know if you have read our articles on how memories are made and the importance of associations in recalling events, certain sights, sounds, smells and other stimuli can trigger the recall of an event. This can work to your advantage when studying for exams but it can also have serious implications in the case of PTSD.
What is a ‘Flashback’?
In PTSD this is an extreme situation where a stimulus acts as a trigger and sets off a whole chain of physical responses, as you ‘flashback’ to the original traumatic event. So a car backfiring can set off the panic of a bomb blast, flashing disco lights can bring back the hazard lights of an accident scene and so on. A television news bulletin, a film, meeting someone in the street who was with you at the time – these can be triggers.
Your response is not a rational one of ‘oh, that reminds me of such and such’. Instead your brain switches to danger mode – adrenaline pumps, heart rate increases and all the anxiety of the original event is re-experienced. You may want to run and hide. You may experience a very clear hallucination of the event that caused the PTSD in the first place. You may also experience total panic at something inexplicable because your conscious mind has blocked the traumatic event but still responds to the association that acts as a trigger.
What are Triggers?
Triggers are not always obvious or easy to avoid. Loud noises and flashing lights are obvious but triggers can be more subtle than that. How many people who were caught up in the recent mass shooting in Las Vegas will forever associate the country and western music they were listening to when the shooting started with the event? How many others may feel panicky when in a large crowd or even find that they are irrationally fearful when they bite into a hotdog because that was the association their brain made with the traumatic event? Each person’s responses will be different and it is not a sign of weakness to develop PTSD.
What is the Outlook?
Fortunately skilled therapists can help sufferers of PTSD to work through their trauma and identify their triggers and effectively ‘disarm’ them, putting the past safely in the past, where it belongs. Left untreated PTSD, can make life very miserable for the sufferer and can cause problems in relationships as well as with employment so do not be afraid to seek help for your symptoms. It is not a sign of weakness of character and should never be regarded as such, either by the sufferer or their loved ones and colleagues. No one knows how they will respond physically and mentally in a particular situation until it happens to them and PTSD is tied up with our primeval fight-or-flight mechanism, a part of what makes us human.