Understanding PTSD

Post-traumatic Stress Disorder (PTSD) is a normal human response to a very traumatic experience, which is likely to cause emotional distress. 

It is estimated that as many as 1 in 3 people who have experienced trauma will develop PTSD. Certain predisposing factors may increase the risk of developing the disorder, such as any pre-existing underlying mental health issues and the possible influence of personality traits. Other mental health issues may be experienced alongside PTSD, such as panic attacks, depression and anxiety disorders. 

What is it like to experience PTSD?

For some people with PTSD, everyday life can be very exhausting and distressing, at times even debilitating. This is especially so when a person may experience overwhelming psychological reactions triggered by certain things which remind them of the past event. 

People are most likely to develop PTSD symptoms between 1-6 months following a traumatic incident, such symptoms include:

Intrusive thoughts, sensations and flash-backs:

• Having a major traumatic experience, which may involve real or perceived threat, physical or psychological injury or near-death experience.
• Recollections of intrusive thoughts- flash backs, nightmares, intrusive thoughts linking to the traumatic experience
• Feeling a sense of numbness; this is sometimes developed to deter intense feelings relating to the person’s trauma
• A greater sense of arousal or hypervigilance- Increased sensitivity to surroundings, enhanced startle reaction and insomnia
• The traumatic event becomes persistently re-experienced- recurrent, intrusive, negative and or disturbing recollections through thoughts or dreams.
• Suddenly feeling or acting as if the traumatic event was happening again, this may include a sense of reliving the experience through hallucinations, dissociations and delusions.

Changes in cognition and mood:

• Negative thoughts about oneself 
• Feelings of guilt, anxiety and self-blaming 
• Attempting to avoid thoughts and feelings relating to a traumatic event
• Avoidance of situations that provoke unpleasant memory 
• Psychogenic amnesia- inability to remember key aspects of the trauma
• Lack of motivation and loss of interest in activities/hobbies
• Feeling alienated from others
• Sense of hopelessness & unable to see the future in a positive way 

Usually, an individual with PTSD would present at least two of the below symptoms:

• Increased arousal- hypersensitivity 
• Trouble falling asleep or staying asleep
• Irritability or outbursts of anger
• Difficulty in concentrating
• Hypervigilance
• Excessive reaction of fright
• Physiological reactions on exposure to events that resemble or symbolize the traumatic event 

A cognitive understanding of PTSD

The cognitive model of PTSD devised by Ehlers and Clark (2005), illustrates how an individual processes their trauma and the extent to which memory becomes affected (linking to autobiographical memory of the event). This way of processing can lead to a current sense of threat. The model highlights certain types of appraisals (mental assessments) that may be developed: 

Overgeneralisation

Here, individuals typically perceive normal activities as more dangerous and threatening than they in fact are. It is this that can sometimes cause individuals to resort to hypervigilant and linked behaviours.

Catastrophising

Catastrophising occurs when an individual exaggerates the probability of bad things happening to them. In the longer term, this can evolve into developing negative beliefs and paranoid thoughts such as ‘I attract disaster’ or ‘bad things will happen to me’ 

Negative Appraisals

Consistently appraising situations negatively can lead to distressing emotional experiences of depression, aggression and anxiety these, in turn, contribute to unhealthy coping mechanisms, such as avoidance behaviours and thought suppression.

Treatment options for PTSD can vary according to the severity and the type of issues experienced. The interactions of different symptoms and their causes can be incredibly complex which is why treatment should always be performed by someone with the proper qualifications, such as a licensed clinical psychologist.