Understanding Post-Traumatic Stress Disorder

What is PTSD?
Post-Traumatic Stress Disorder (PTSD) is a particular set of reactions that can develop in people who have been through a traumatic event. A traumatic event is an overwhelming or uncontrollable experience that can happen to anyone at any age. It may be a personally life-threatening experience or may involve witnessing something that causes you to feel horrified, helpless, or intensely fearful for your life or the lives of others. Traumatic events can include child abuse, domestic violence, combat violence, sudden or unexpected loss of a loved one, car accident, sexual abuse and natural disasters.

People with PTSD often experience feelings of panic or extreme fear, similar to the fear they felt during the traumatic event. A person with PTSD experiences four main types of difficulties:

1. Re-living the traumatic event – the person relived the event through unwanted and recurring memories, often in the form of vivid images and nightmares. There may be intense emotional or physical reactions such as sweating, heart palpitations or panic when reminded of the event.
2. Being overly alert or hypervigilant – the person experienced sleeping difficulties, irritability, and lack of concentration, becoming easily startled and constantly on the lookout for signs of danger.
3. Avoiding reminders of the traumatic event – the person deliberately avoids activities, places, people, thoughts or feelings associated with the event due to the reliving of painful memories.
4. Feeling emotionally numb – the person loses interest in day to day activities, feels cut off and detached from friends and family or feels emotionally flat, numb or apathetic.

Negative Impacts of PTSD:

• Experiencing trauma may result in the following negative impacts.
• Emotional well-being: difficulty tolerating and expressing negative emotions, including anxiety, sadness and anger, alternating between numbness (no feelings) and out of control (too much feeling)
• Sense of self: the person may feel helplessness, shame, guilt, engage in self-blame, feelings of not being normal and an altered sense of age
• Relationships: people with PTSD tend to isolate themselves, they can experience difficulties in having close relationships due to distrust, they may experience difficulties with resolving conflicts, they may have a skewed view of others such as others being rescuers/victims/aggressors as well as repeating problematic relationship patterns.
• Memory and perception: people with PTSD can experience memory problems, dissociation (feeling outside of the body, losing time, not feeling real)
• Sense of meaning: loss of faith, despair, feeling that you do not have a future, hopelessness
• Physical well-being: sleep problems, eating problems, substance abuse, other health problems.

Who it impacts:
All Australians, including ADF members, have the potential to be exposed to trauma that may contribute to the development of PTSD. However, the rates of both military and non-military related traumas are higher in the ADF than in the Australian community.

From the findings of the 2010 ADF Mental Health Prevalence and Wellbeing Study, it has been estimated 90% of ADF members have experienced at least one potentially traumatic event at some time in their life, compared to 73% of an age and employment matched sample of the Australian community.

Recent research suggests PTSD was diagnosed in 17.7% of Australian military veterans over the first four years following discharge. Studies also indicated that ADF members who had never deployed experienced PTSD at the same rate as those who had deployed, and that length of deployment was not a useful marker of risk for PTSD. However, the number and type of traumas as well as roles on deployment, such as combat or explosive ordinance roles, may assist to identify those most at risk. Additionally those who experienced multiple traumas across their lifetime, including on deployment, were at greater risk of PTSD.

Treatments available:
Recommended treatment for PTSD includes trauma-focussed Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitisation and Reprocessing (EMDR). Trauma-focussed CBT is intended to help an individual come to terms with trauma through exposure to and emotional processing of memories of the event. This includes prolonged exposure, cognitive restructuring, cognitive processing therapy, and cognitive therapy. Typically, this therapy involves homework and includes psychoeducation, exposure work, cognitive work and more general relaxation/stress management.

EMDR is a standardised, eight-phase, trauma-focussed therapy involving the use of bilateral physical stimulation (eye movements, taps or tones). EMDR assumes that, during a traumatic event, overwhelming emotions or dissociative processes may interfere with information processing. This leads to the experience being stored in an ‘unprocessed’ way, disconnected from existing memory networks.

In EMDR the person is asked to focus on the trauma-related imagery and the associated thoughts, emotions, and body sensations while bilateral physical stimulation, such as moving their eyes back and forth occurs. Processing targets may involve past events, present triggers, and adaptive future functioning. It is proposed that this dual attention facilitates the processing of the traumatic memory into existing knowledge networks, although the precise mechanism involved is not known.

If you would like to find out more about PTSD or need assistance in managing your psychological health please call 1300 4 62 837.

Written by Mates4Mates Psychologist, Tamsin Waller