A ‘lesser’ trauma can trigger PTSD
Post-traumatic stress disorder (PTSD) is a condition I have come to know a little bit about over my years working with those who have survived sexual harm. I used to struggle to understand how impacting the symptoms could be, until I had a small taste of them myself – when my middle daughter was a tiny baby, I went outside to hang out the washing, holding her in my arms.
A massive gust of Wellington wind later, and the glass door I had just walked through shattered, cutting me in several places around my eyes, and showering my wee baby with shards of glass.
I was incredibly lucky that my sight was OK, and my baby was miraculously unscathed, but what has happened since that event years ago is interesting.
I never think about this accident, until I hear a door bang unexpectedly – then I am back in that exact moment, jumpy, agitated and very fearful of harm.
Even if there is no glass nearby. I suspect if you multiplied these feelings by 100, they might reflect what sufferers of true PTSD can experience.
PTSD results from exposure to major, potentially life-threatening trauma. This includes trauma that may not actually have been lifethreatening, but was frightening enough that the victim perceived it as such.
The most obvious and well-known traumas associated with PTSD include being involved in a war, or being the victim of sexual or physical violence, however it can occur after seemingly ‘‘lesser’’ traumas as well, especially if they happen to an individual who has already been exposed to trauma before in their life.
PTSD can come on a few weeks after exposure to a traumatic event, or not appear until years later, and the disability that it causes can be almost as bad as the trauma itself.
I have had conversations with hundreds of PTSD sufferers over the years, and what strikes me is that often explaining where their symptoms come from seems to be therapeutic in itself. It doesn’t necessarily make them go away, but it can be helpful and reassure them that this is an understandable, and quite normal, brain response.
When we are victims of unexpected trauma, our bodies release a huge amount of adrenaline – the ‘‘fight or flight’’ chemical that enables us to respond appropriately. This is a safety mechanism, and is normal.
For some reason, in certain people this response to a particular traumatic event can remain in our neurophysiological ‘‘memory’’, and elevated levels of noradrenaline can be released again, even when we are not in that traumatic situation.
In certain people, this response to a particular traumatic event can remain in our neurophysiological memory. This leads to awful feelings of overwhelming distress.
This leads to awful feelings of overwhelming distress, and the symptoms of PTSD:
❚ Flashbacks of the event – these can be incredibly real and make it feel as if the trauma is happening all over again.
❚ Nightmares – these can be repetitive, frequent and very intrusive, leading to an avoidance of sleep or insomnia.
❚ Triggering – specific ‘‘triggers’’ may remind your body of the event, and lead to the fight or flight response all over again, along with associated distress and anxiety.
These triggers might be simply seeing a car of the same colour as the one that injured you, or the face of someone similar to an assailant, or even a piece of music playing that you heard during the original traumatic event.
These seemingly benign triggers can provoke really extreme reactions, which is understandable when you think your brain is trying to ‘‘warn’’ you that you might be entering another dangerous situation.
❚ Rumination – this might include dwelling at length on the event, and therefore never really ‘‘coming to terms’’ with it. To my mind this is our brain trying to make sense of things, but never quite getting there as often there is no sense to be made out of trauma.
Rumination can involve thoughts such as ‘‘why me?’’, ‘‘could I have prevented that happening?’’ or ‘‘how can I take revenge?’’.
❚ Hypervigilance and hyperarousal – this is where we feel constantly ‘‘on edge’’, our brains being alert to any potential danger (even if we know rationally that none probably exists).
It can be exhausting, and for some people will cause irritability, poor concentration, depression, sleep problems, and a feeling of detachment from others (as your brain is so busy being on the lookout for risk that it is hard to be engaged with anyone or anything).
Anyone who has ever experienced significant trauma can develop PTSD, but it is thought to be more likely in females and those who have experienced recurrent trauma – refugees from traumatic backgrounds will be more likely to experience PTSD if they experience trauma in the future – and those with pre-existing mental illness.
We know that it also frequently co-exists with alcohol and drug abuse, probably used by the sufferer in an attempt to ‘‘self medicate’’ and alleviate their symptoms.
Sometimes good support, affirmation and an explanation for their symptoms may be all that someone suffering from PTSD will need.
With time, our brains usually realise that the danger has passed, and is unlikely to recur.
However, for some people it will be a longer journey – specialised therapy in the form of trauma-focused CBT or eye movement desensitisation and reprocessing (EMDR), and certain medications can help with recovery.
For more information, visit the Mental Health Foundation.