PTSD is not a life sentence...and it does have a silver lining

It is an unfortunate misconception that Post Traumatic Stress Disorder (PTSD) is a life sentence.  Many people who have experienced PTSD report feeling broken or fear that they are “going crazy”.   Moreover, they report feeling little hope of change or improvement in their wellbeing or quality of life.

The word ‘trauma’ literally translates to ‘wound’.  However, this name may be misleading – as with PTSD – time does not heal all wounds.  A more accurate analogy is an infection, because without proper treatment it can spread and fester causing untold distress and emotional pain to the individual, and those around them. Indeed, studies estimate that individuals with PTSD are three times more likely to suffer depression, four times more likely to abuse alcohol or use intravenous drugs, and are fifteen times more likely to commit suicide.  These statistics are shocking when we consider how effectively PTSD, like an infection, can be treated.

The good news is the vast majority of individuals report feeling significant decreases in symptoms of trauma and an increased sense of wellbeing, enjoyment, and engagement in life with treatment from a psychologist.

While it is important to remember that no two people will have the same experience of PTSD, symptoms generally include:

  • Involuntary recollection of the traumatic event (e.g. intrusive thoughts, nightmares, re-experiencing physical or emotional aspects of the event)

  • Avoidance of reminders of the event

  • Depressive symptoms

  • Negative thoughts about oneself, the world, and the future

  • Low mood

  • Lack of enjoyment from usual activities

  • Social withdrawal

  • Feeling ‘on edge’ or jumpy

  • Risky or destructive behaviour (e.g. substance abuse, anger, risky sexual behaviour)

  • Poor or interrupted sleep

PTSD can result from exposure to a range of events. In fact, a common misconception is that individuals need to be directly exposed to a life-threatening event, such as a combat situation or a physical or sexual assault in order to experience PTSD. However, we now know it can occur in response to non-life threatening events as well.  Indeed, it is not the event itself that causes PTSD, but the impact on the individual – whereby the event challenges deeply held ‘core beliefs’, which profoundly change the individual’s world view. As such, hearing about an important traumatic event such as the death of a loved one or bullying (among many other potential events) can lead to PTSD.

When something frightening occurs a special part of our brain, the amygdala, takes over. This is great in the moment as it allows us to respond immediately without being distracted by the broader context, however it effects how we store the memory. People with PTSD often experience memories of their trauma as if they are reliving the event in the present moment. This means that the memory needs to be processed so that it can become like other memories we have of every day events such as grazing our knee, or our first kiss. This means that we can view memories as events in our past, rather than having our threat system switch on and make us feel just as we did in the initial frightening moment.

Psychological treatment approaches to PTSD can include Trauma-Focused CBT and Eye Movement, Desensitisation and Reprocessing (EMDR), assist in linking fragmented aspects of the trauma memory with existing autobiographical memory.  Interestingly, it is not uncommon for individual to recall more of the actual event after treatment – as recollection of the event is far less distressing and it is recalled as something that happened in a specific context (and is therefore in the past and no longer threatening).

While individuals who have experienced PTSD do have insight into how debilitating and frightening this disorder can be, around 90% of individuals experience some post-traumatic growth following treatment. Indeed, individuals who have experienced post-traumatic growth often report a renewed appreciation of life, a greater sense of personal meaning and less reactivity with faster recovery from similarly distressing events. So, while PTSD is a life-changer, it doesn’t have to be for the worse!

Tom Morley