Dr. Zahid QutabDr. Zahid QutabDr. Zahid Qutab
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Lahore & Gujranwala
Dr. Zahid QutabDr. Zahid QutabDr. Zahid Qutab

Post Traumatic Stress Disorder​ پوسٹ ٹرامیٹک اسٹریس ڈس آرڈر

Post-traumatic stress disorder (PTSD) and Complex PTSD

Post-traumatic stress disorder (PTSD) and Complex PTSD
This information will be helpful for anyone who is suffering from post-traumatic stress disorder (PTSD), or who knows someone who has it.

Introduction about PTSD:

Post-traumatic stress disorder (PTSD) is a condition that happens to someone who has suffered from traumatic stress /event for example ; death of loved ones ,sexual abuse , divorce, or road accidents , etc
Many people suffering from traumatic event will experience continuous negative emotions, thoughts and memories in the form of flashbacks.
Most of people feel better with time. When these negative emotions continue to linger on , and start interfering with someone’s daily routine , then they might be suffering from PTSD.

Causes of PTSD:

PTSD is caused when someone has been exposed to actual or threatened;

  • death
  • serious injury like in car accident etc
  • sexual or physical abuse

They can be exposed in one of the following ways:

  • Directly – it has happened to them
  • Witnessing – they saw something bad happening to someone else
  • Learning – they have found out that it has happened to loved ones
  • Repeated exposure – they are being  repeatedly exposed to traumatic events themselves or to repeated traumatic events affecting other people, for example, sexual abuse happening continuously.

Examples of traumatic events can include:

  • Eye-witnessing a violent death
  • Serious road  accidents, e.g. a car crash
  • Physical or sexual abuse
  • Life threatening health problems or being in intensive care units
  • Complicated childbirth experiences
  • Diagnosed with a life-threatening illness, e.g. cancer.
  • Eye-witnessing horrific scenes in war zones
  • Survived from Bomb blasts /Suicide attacks
  • Natural or man-made disasters, e.g. tsunamis or fires.

What happens when someone has PTSD?

Many people can experience negative emotions like grief, sadness, anxiety, guilt and anger after a traumatic experience. This does not mean that they have PTSD. Person suffering from it must have following symptoms ;

Re-living the traumatic event:

Memories: Repeating unwanted memories of the event, also called as intrusive thoughts that becomes very overwhelming and distressing.

Dreams: Having vivid dreams or nightmares about the event.

Dissociative reactions: Suddenly feeling or acting as if the traumatic event is happening again and again( flashbacks).

Physical and psychological distress: Starting to have physical symptoms (e.g. fast breathing, rapid pulse), when exposed to things or even  memories  that remind you that event.

Avoidance symptoms

Dissociative amnesia: Being unable to remember most parts of the traumatic event.
Detachment: Feeling detached to everyone around.
Avoiding talking and thinking: Deliberately not wanting to speak or think about the traumatic event.
Avoiding associations: Avoiding thoughts, memories , feelings, things, and places associated with the traumatic event.

Mood symptoms

Negative beliefs:  Always thinking negatively about yourself, others or the world.

Blaming :  Blaming yourself or other people for the event.

Negative emotions: Consistently  experiencing  horror, fear, anger, guilt or shame.

Loss of interest: Losing interest in previously enjoyable activities.

Unable to feel positive : Not being able to experience happiness or loving feelings.

Alertness and reactivity symptoms

Hypervigilance :Being always more aware of what’s happening around you and being unable to relax or anticipating something bad would happen. Being startled: Easily having startled responses , overreacting to noises or movements. Difficulty concentrating: Finding it so hard to focus on simple tasks. Difficulty sleeping: Finding it so difficult to fall asleep and stay asleep. Especially due to recurrent nightmares or vivid dreams. Irritability: Having outbursts where you are verbally or physically aggressive towards people or things. Recklessness: Doing dangerous or self-destructive things.

What are the treatments options for PTSD?

There are different treatment options for PTSD. That includes ;

Psychotherapy

Psychotherapies for PTSD  focus on the traumatic experience. They will help you with the following things:

  • Acceptance: Learning to accept the things, you can’t change or what has happened in the past.
  • Remembering the event: Patients are told to remember the event without  being overwhelmed by fear and distress emotions.
  • Emotional venting out: Writing it down or talking about what happened so that your mind can store the memories and process them.

Other therapies for PTSD include:

Trauma-focused cognitive behavioral therapy:

It’s a talking therapy that helps you  to change your ways of thinking. This can help you to feel safe  and secure.

EMDR (Eye Movement Desensitization & Reprocessing)

This technique uses eye movements to help the brain process traumatic memories.

You will be asked to recall the traumatic event in detail and how it makes you think and feel.

EMDR should be delivered by a trained practitioner. EMDR is done over 8-12 sessions that can last from 60-90 minutes.

Medication

If you have tried therapies for  PTSD and  these are not working,

Selective serotonin reuptake inhibitors (SSRIs) can help to reduce PTSD symptoms.

If SSRIs also don’t work , you may be offered other medications such as antipsychotics or benzodiazepines to reduce fear related symptoms and improve sleep.

What is complex PTSD?

Some people can develop complex post-traumatic stress disorder (complex PTSD). This is caused by repeatedly experiencing an event or series of events that are extremely threatening or horrifying. These events can happen during childhood or as an adult. E.g. ongoing sexual abuse in childhood.

Often these events are difficult or impossible to escape from or avoid. For example:

  • genocide campaigns
  • living in a war zone
  • prolonged domestic violence
  • repeated childhood sexual/rape or physical abuse. 

They suffer from symptoms like PTSD but more severe in intensity.

Treatment of complex PTSD:

Lack of trust in other people  is the hallmark and also regarding the world Treatment is aimed often longer to allow them to develop a secure relation with others and themselves.
It is done in three stages:

Stabilisation :

In the stabilisation stage, you will start learning  to trust your therapist, understanding and controlling  your feelings of distress and detachment.

Stabilisation helps  you to ‘disconnect’ your feelings of fear and anxiety symptoms from the memories and emotions that produce them.

Trauma-focused therapies :

Therapy that focuses on trauma, including EMDR  can help you to process your traumatic experiences.
Psychodynamic psychotherapy can also be helpful.

Reintegration :

Reintegration is a way to integrate you into a routine way of life where you no longer see the world and people around you as a threat.
Reintegration will help you to:

  • relating compassionately to yourself and others
  • re-establishing trust in yourself and others
  • Re-making friendships, intimate relationships and other activities that promote your health and wellbeing

Medication

Antidepressants or other medication  can be used along with psychotherapy

Self help Techniques

If you have complex PTSD, it can be helpful to try and do normal things that have nothing to do with your past experiences of trauma. This could include:

  • making new friends
  • getting a  job
  • doing  daily  exercise
  • learning relaxation techniques
  • developing a new hobby

These things will  help you to slowly gain the trust in people and world around you.