Portfolio of Hope

  1. What is PTSD?

Post Traumatic Stress Disorder, commonly referred to as ‘PTSD’, is an anxiety disorder which arises in people who have experienced a very stressful, frightening, and/or distressing event in their life, or a prolonged traumatic experience. The event/experience to have triggered the diagnosis of PTSD is hard to erase from their memory, frequently reoccurring in the form of nightmares and flashbacks.

2. What are the possible causes of PTSD?

Research suggests that approximately one in three people who have experienced severe trauma go on to develop PTSD, with the risk of developing it increasing if a pre-existing mental health condition is present (e.g., depression or anxiety) in either the individual themselves or their parents.

It can be concluded that the biggest cause of this mental illness is undoubtedly traumatic events that occur in one’s life. Examples of such events that can trigger PTSD include serious accidents, physical or sexual assault, domestic or childhood abuse, exposure to traumatic experiences at work, serious health problems, childbirth experiences (e.g., losing a baby), war and conflict, and torture. The people subjected to events such as these will be likely to endure long-term suffering as a result, with that long-term suffering diagnosable as being ‘PTSD.’

PTSD is thought to arise in response to traumatic events as a form of ‘protection’ or as a ‘survival mechanism’, equipping you with the mindset you need to survive further traumatic experiences that may occur in the future. The flashbacks that many people with PTSD experience, according to this theory, are serving a purpose. They are making you recap the events that caused you so much pain, forcing you to remember every detail, so that you are prepared in the event of it ever happening again.

PTSD can cause changes in the brain, with a malfunctioning hippocampus preventing flashbacks from being properly processed. This is what causes people with PTSD to experience the same unwaveringly high sense of anxiety every time they think about the event, rather than the memories fading and getting easier to cope with, as they would in people without the condition.

3. What feelings might an individual have when experiencing PTSD?

Someone with a diagnosis of PTSD is likely to experience intense negative emotions, such as feelings of anxiety, sadness, anger, guilt, and shame (to name just a few.) Having such negative emotions on such a regular basis can be emotionally exhausting, causing the individual suffering to feel drained of energy as a result. They may feel out of control if they are unable to manage these emotions. This can lead to people turning to unhealthy coping skills, such as self-medication with drugs or alcohol, to try and gain back some control. This does not work; however, as such addictive substances only serve to intensify the negative feelings one is subjected to.

In contrast, people with PTSD might not feel any emotion at all, instead feeling emotionally and physically numb or ‘cut off’ from their feelings and/or their body. The sense of detachment they might feel in this situation could lead to them engaging in reckless, self-destructive behaviour.

4. In what ways can PTSD affect:

  • The Individual

People with PTSD can often seem distant from the perspective of onlookers, as they frequently internalise their thoughts and feelings to avoid reliving the painful memories associated with the trauma they have experienced in the past. This can cause them to isolate themselves from their loved ones as they might avoid situations in which they have to communicate, so as not to risk expressing their emotions and being ‘unable to stop.’ By internalising all their emotions however, people with PTSD are made to ‘suffer in silence’, ignoring any offers of help that may come their way from concerned loved ones. The effect of such long-term isolation can result in someone with PTSD developing further mental health problems, such as depression and anxiety, or turning to substance misuse, in an attempt to ‘block out’ the painful memories of their past.

In addition to their risk of developing additional mental health problems, individuals with PTSFD are also more likely to develop physical health problems, often as a direct result of their heightened levels of stress. Stress can result in heart and respiratory problems, and it can also impair their immune system, putting them at a high risk of becoming seriously ill with conditions that might have otherwise not caused so much as a sniffle.

  • Their Life

PTSD can have a major impact on the lives of those diagnosed with the condition, effecting their ability to partake in their usual day-to-day activities, whether that be going to school, work, or socialising with others.

The difficulties experienced when trying to engage in ‘normal’ life are often intensified due to the lack of energy that many people with PTSD feel, a result of the effect that the condition has on their sleep.

AS PTSD can lead to people making potentially dangerous mistakes at work due to difficulties concentrating and paying attention, a consequence of their mind being ‘on other things’, unemployment can be rife in people with the condition. This can cause financial insecurity and in extreme cases, it could even lead to homelessness.

Relationships are also likely to suffer as many people with PTSD report feeling as though they are a ‘burden’ to others, and therefore they may withdraw from society, leading to them becoming severely isolated. This can cause individuals to feel like nobody understands what they are going through and might make them lose trust in people.

Individuals who have PTSD may feel compelled to stop doing the things they once enjoyed if those things have any association with their traumatic memories, however loose those associations may be. Their PTSD can convince them that ‘nowhere is safe’, therefore having a direct influence on how they live their life, making every day seem incredibly hard and essentially ‘out of their control.’

5. How might an individual’s PTSD affect others?

People with PTSD are considerably more likely to have difficulties in their relationships compared to people without. This means that the rate of divorce is seen to be significantly higher in couples consisting of at least one partner who has the condition. This can have a profound impact on whole families, especially if children are involved, since the upheaval of a relationship breakdown is extremely difficult to comprehend, let alone be a part of. The stressors that caring for someone with PTSD has on the individual are immense. Such stressors include money worries, managing symptoms, dealing with crises, friendship breakdowns, and loss of intimacy, etc.

6. What are the common symptoms associated with PTSD?

Most PTSD symptoms develop in individuals in the following month after they have experienced a traumatic event. They can typically be categorised as the following: ‘re-experiencing, avoidance & emotional numbing, and hyperarousal.’

The first, and most common, category of symptoms, ‘re-experiencing’, involves the involuntary reliving of a traumatic event. Because it is involuntary, this means that it is out of their control. Re-experiencing can take the form of flashbacks and nightmares, of which usually contain the portrayal of repetitive and distressing images and sensations (e.g., pain, sweating, feeling sick, or trembling.)

The next category of symptoms, avoidance & emotional numbing, involves an individual actively trying to avoid certain people, places or things that remind them of a traumatic experience they had to endure in the past. Because they are so keen to avoid thinking about the distressing event, they are unlikely to want to talk about it, instead spending their time trying to push the memory out of their head or trying not to feel anything at all (aka emotional numbing.) This can usually be effectively achieved by focusing on work or hobbies to block out the bad memories, but in some cases, it is not so easy to do, which is why many PTSD sufferers turn to substance misuse. The result of their denial to talk about their past can lead to many people becoming isolated from wider society or seen to be a ‘hopeless case.’

The third and final category of PTSD related symptoms is ‘hyperarousal.’ This refers to the ‘on edge’ feeling that many people with PTSD do report having. These feelings can lead to further anxiety building whereby they may become irritable and angry, or they might experience insomnia and concentration difficulties.

There are other symptoms that do not fit into one of these three categories, such as the development of additional mental health problems. Being diagnosed with further mental illnesses, on top of PTSD, can lead to the individuals in question resorting to self-harming, such as via drug/alcohol abuse.

Aside from all the dangerous symptoms associated with one’s mental state that can arise in individuals with PTSD, there are also some physical symptoms that can occur, including headaches, dizziness, chest pains, and stomach aches.

7. In what ways can an individual with PTSD help to manage their condition?

An individual with PTSD is likely to spend a lot of time ‘in their own head’, a result of them constantly reliving their traumatic memories. It can therefore be of benefit for people with the condition to actively ensure that they are spending time with other people rather than isolating themselves all the time. This can provide a welcome distraction from the relentless negative thoughts going round in their head. Spending time with others would also reduce the risk of them developing additional mental health problems because of their lack of social interaction (e.g., social anxiety or depression.)

An additional way in which people with PTSD can surround themselves with support is by seeking out local support groups specifically for people with the condition. This will help them to feel understood and less alone by people who know exactly what they are going through, helping to reduce any feelings they may have of being ‘an outsider.’ Specialist groups are of great benefit since they allow people to share their experiences, including telling each other the tips they have for coping. Such groups can therefore significantly help people who might have otherwise felt rather isolated and alone in their condition.

Practicing mindfulness is another way in which people with PTSD can help to manage their condition. This could involve meditation and/or journaling, giving individuals an opportunity to get the thoughts that may feel ‘trapped’ in their head, out into the world via productive mediums, therefore serving to calm what is usually an extremely agitated mind.

An additional way that I would suggest an individual with PTSD tries to manage their condition is by exercising. Exercise is known to regulate our moods, a welcome result of the increase of endorphins (a ‘feel-good’ hormone), during physical movement.

Individuals with PTSD should refrain from taking drugs and alcohol, and even caffeine. They should be sure to restore their energy levels by making up for lost sleep, and they should limit their screen time to give them a chance of getting that rest they so desperately need.

Whilst the recommendations I have listed above are all ‘self-help’ strategies that an individual can do for themselves, there is one thing that everyone with PTSD should do as soon as possible, and that is seeking out a counsellor/therapist.

8. In what ways can others help an individual with PTSD to manage their condition?

People who have a loved one with PTSD can help them to manage their condition by, firstly, educating themselves on what PTSD is. Knowing what the early warning signs to look out for are, as well as being able to identify symptoms and treatment that can be accessed for the condition, can make people better equipped to offer support that could be of immense help to their loved one with PTSD.

After researching into PTSD, people should be aware of the types of things that can trigger it, one of those things being stress.

To help an employee at work, employers should ensure that the individual feels able to talk about their mental health without worrying about the consequences of speaking truthfully. They should be made aware that they have the employers total respect and understanding, and that if they need to discuss anything, they can do so in confidence knowing that their job will not be at risk, and nor will their hours/pay etc. If the stress of work is thought to be contributing to an individual’s PTSD, both the business and the individual can work together to create a schedule with greater flexibility and less responsibility.

Regardless of whether you are a family member, employer, or friend of an individual with PTSD, the same thing should be shown in all contexts- patience. People with PTSD often find it very difficult to say how they are feeling. This can be frustrating for their loved ones who just want to help them, but it is important not to push them, as this can lead to them experiencing greater feelings of distress, especially if they feel guilty or like a burden. Instead, they should be made aware that you are there to listen when they feel ready, and that you are on hand to offer them support.

It can be understandably hard to see a loved one with PTSD distancing themselves from you, but it is important to remember that it is not a personal attack on you, in fact it is not them at all, but their illness. It can be helpful to show your commitment to the relationship in these situations, so that the individual knows that you are there for them no matter what, helping them to feel loved and supported.

Though others will want to help and support their loved ones in anyway they can, there might come a stage when your help is not enough. In this instance, you should suggest therapy to them, being sure to do your research first so that you can propose the benefits of professional treatment to them. Your encouragement, either for them to join therapy or a support group (or even both) can be all it takes for them to decide to make that phone call, or send that email, that could ultimately put them on the ‘road to recovery.’

9. What local resources and treatments are available to someone experiencing PTSD?

  • TRS (The Trauma and Resilience Service.)

Located in the neighbouring South Yorkshire town of Rotherham, the TRS offers trauma survivors who present with PTSD, individualised support based on their assessed needs.

The overarching aim of the service is to develop effective pathways of support for individuals with PTSD and their families, educating them on PTSD along the way, and supporting referrals to other locally available resources, if appropriate.

  • IAPT (Improving Access to Psychological Therapies.)

IAPT is a free service for adults in Doncaster who are experiencing common mental health problems, including PTSD. They offer different types of support, including therapy (group, individual, and online), as well as specialist groups and counselling. People with symptoms of PTSD can massively benefit from this service which is made up of a team of professionals.

  • EMDR (Eye Movement Desensitisation Reprocessing.)

EMDR is a psychotherapy technique used primarily to help those suffering with PTSD by relieving stress. It aims to reprocess memories and reduce distressing emotions that are associated with those traumatic memories, so that the symptoms can be better managed in the future. During EMDR sessions, traumatic experiences are relived in brief doses while a therapist directs their eye movements.

  • CBT (Cognitive Behavioural Therapy.)

CBT for the treatment of PTSD is trauma focused, making use of a range of psychological techniques to help people come to terms with the trauma of their past. This requires the individual to revisit the trauma they experienced, something which is often avoided by people with PTSD. The aim of doing this is not to distress the individual, but to help them identify their beliefs around the situation that is impacting upon their mental health, doing so in a controlled environment with the presence of a fully trained therapist.

Over the average 8-12 weeks spent engaging in weekly therapy, the individual will be gradually encouraged to face up to their fears. They will be prompted to gradually start reintroducing activities into their life that they have been avoiding due to negative associations.

CBT therefore works to help people living with PTSD reclaim control over their life again, helping them to move on from their trauma and look forward to the future.

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