My holiday hell has driven me to drink
AN INTRUDER came into my hotel room when I was abroad about six weeks ago. I had a lucky escape but am haunted by nightmares and flashbacks. Since then, I have avoided driving alone and started to drink a bit more. It’s like I am waiting for it to happen again. How can I get over this? I don’t want to go to my GP because I’m scared I will end up on tranquillizers.
Fionn, Carlow
IT SOUNDS as if you may have post-traumatic stress disorder (PTSD). This occurs after a stressful, frightening or distressing event or experience and affects an estimated 8 per cent of the population at some point in our lives.
Everyone exhibits an acute stress response after an event like you experienced, but about one in three of us becomes locked in the stress response and can’t break the cycle.
Typical symptoms include flashbacks and nightmares, emotional numbing or thought blocking and the feeling that you are on the alert all the time — what doctors call a state of hyperarousal.
In addition, someone with PTSD may experience aches and pains, diarrhoea, headache, palpitations, panic attacks, insomnia, anger outbursts, poor concentration, social withdrawal and low mood. You mention your increased alcohol intake, which is not uncommon in this situation. Many sufferers also resort to drugs, especially prescription painkillers.
The first thing to do is see your GP. In spite of what you think, doctors don’t throw pills at people with this condition; instead we refer them for a talking cure. Trauma-focused cognitive behavioural therapy (CBT) enables you to work with a therapist to change your way of thinking and your behaviour from negative to positive.
In another treatment, eye movement desensitisation and reprocessing (EMDR), the patient recounts their trauma while concentrating on the therapist’s finger, which moves from side to side. It is thought that EMDR helps the hippocampus (memory centre) in the brain to process information about the event rather than relive it through flashbacks.
Medication is prescribed, such as Paroxetine and Mirtazapine (drugs used to treat depression), but never in isolation. You are likely to stay on medication for at least 12 months and have eight to 12 therapy sessions, each lasting at least an hour — this is a lengthy process.
Thankfully, two thirds of those with PTSD get better in time, but it is imperative that you are open to getting help and see a specialist who has a particular interest in this condition. Picking a counsellor randomly is illadvised — this disorder needs highly specialised management. Seeing the same person for each session is also important, and so is staying off alcohol or you risk becoming dependant. I HAD a dose of piles years ago and I think I have them back again. I have passed fresh blood into the toilet bowl the last three mornings. I’m away at a wedding next weekend and I don’t want to be caught out. Any advice would be most helpful. David, Donegal
FIFTY per cent of people have piles by the time they hit 50. Annoyingly, it is not unusual for them to flare up when you least expect or want them to.
Constipation, straining on the loo, poor diet and weight gain may all contribute to problematic piles.
Unclogging the constipation is key. Creams and suppositories are available at the pharmacy so make this your first port of call. If you find this problem a bit embarrassing to discuss openly, most pharmacies have consultation rooms available for privacy.
If you are in severe pain, feel the piles when you are sitting or experience extreme discomfort trying to pass a stool, see your GP for something stronger.
There are several causes for passing blood from the back passage, some more serious than others. If simple, over-thecounter remedies don’t rectify things in a week then you can’t avoid a trip to the doctor. A physical examination will confirm piles is the problem and put your mind at rest.