Traumatic Stress & Post Traumatic Stress Disorder

Definition

Traumatic stress is the name given to reactions after seeing or being affected by a very frightening event. These can be things such as road accidents or the sudden death of a friend or relative etc. These reactions often follow unexpectedly terrible events in our lives or communities.

Traumatic stress is a natural reaction to these events. Whilst we can normally cope with some stress and emotional pain in our lives, such events overwhelm us and are difficult to deal with. These events can leave people feeling unsafe and less secure than they were and fearful about life in general. The terrorist attack on the twin towers in New York and the following psychological effects on entire communities, is a good example of a community wide traumatic stress reaction. So was the death of Princess Diana.

Post traumatic stress disorder is the name given when people cannot easily get over these events and become severely psychologically affected over a long period of time.

Causes

The closer people are to terrible events, the more they tend to be affected. Children are generally more vulnerable than adults. For them, the security of a loving home and life in general, may be shattered after a robbery, an assault on their parents, or involvement in a car crash etc. Like many other things in life, people vary in their response to situations and events. Some factors that make people more likely to develop traumatic stress are:

• The event itself (how shocking or severe).

• The situation of the person to the event (e.g. whether they were there or saw it on TV.).

• The persons' past psychological history (previous traumas or emotionally upsetting experiences).

• The quality of psychological support after the event (e.g. whether there is someone to talk to and to share the event with).

Signs Of Traumatic Stress Disorder

The effects of a traumatic event can be viewed in terms of short-term and longer-term effects. The severity of long-term effects can be lessened if appropriate help is provided soon after the event.

What are the signs of traumatic stress?

• Having mental "flashbacks" to the event. Sometimes it is difficult for people to get the event out of their mind and this can cause difficulty in sleeping. There may be associated nightmares.

• Becoming anxious and fearful about facing situations or in going places.

• Children can have "regressive" behaviour (acting in a younger way) such as being very clingy, thumb sucking, bed wetting or being very demanding - emotionally and behaviourally. This may come at a time when parents are also feeling vulnerable too.

• There may be psychosomatic symptoms (physical signs of emotional distress) such as headaches and stomach upsets and other general aches and pains.

• These effects normally disappear down after a few weeks and the child or adult makes a proper "adjustment" to these events. This does not mean they will forget about them. Occasionally, the horror may be re-lived briefly such as on anniversaries or when there are other reminders. Generally, the affected person can maintain a full and proper life.

Complications

Longer-Term Effects

For some people the effects do not pass. They cannot make a proper "adjustment" to what has happened. They have developed post traumatic stress disorder - which is a serious psychological condition.

What to look out for:

• Fears that are centred around the event. For instance after the twin towers terrorist attack many people were worried about flying. Most of them got over this fear after a few weeks, but for some people, the thought of ever flying on an aeroplane again will be too much. They may avoid airports or block out the noise of aeroplanes passing overhead in an effort to avoid anything that reminds them of the event. Such reminders can produce extreme anxiety.

• After a house robbery, children or adults may become obsessive about checking locks, or become extremely anxious about noises in the night. Over time, these fears should subside, but for the person with post traumatic stress disorder they persist.

• Re-living the experience. Flashbacks to the event may become very real and frightening, as if the event were happening again. This can lead to panicky feelings and high anxiety levels. For children and adults these can be very frightening and debilitating.

• Anxiety. These reactions can raise people's anxiety levels to a point where even small events or changes in their lives can produce fear and edginess. This can make leading a normal life impossible.

• For children, there may be difficulties in separating from their parents, leading a normal social life and managing academically and socially at school. In a similar way, adults may withdraw socially and find work difficult to attend or manage.

Treatment

What can be done to help manage traumatic events?

How well people cope with trauma is down to their own psychological adjustment and the support they receive after the event. After a traumatic event, people need someone to be there for them. Someone to listen to them and to acknowledge the distress they are feeling in a sympathetic, non-judgmental way.

Talking about such events and sharing experiences and feelings, helps people adjust. Children and adults can be helped to talk by speaking through to their feelings. For instance you might say, "That was such a horrible thing that happened, you must be feeling upset, frightened and confused by it" etc. This helps the person connect to and make sense of their feelings.

Don't avoid talking about the event thinking it is better not to bring unpleasant memories back. If you are going to talk, find a point in your day when you and the traumatised person have enough time to talk and without interruption. It is not fair on the person, or yourself, if you have to rush the discussion. If you have feelings connected with the same event, try to be open about these too - sharing the experience together.

If you are a parent of a child, or a friend or colleagues of someone who has suffered a traumatic experience that you were also involved in, try to ensure you are getting support for yourself too. It will be difficult to help others if you are traumatised yourself.

If the symptoms of post traumatic stress get worse over time and last over 4-6 weeks, get some professional help for yourself, your child or friend. This can be through your GP who may refer you onto a psychological or psychiatric service. These services will have trained counsellors and other therapists to help families and individuals to cope with the effects of the trauma. Some employers provide counselling services that you may be able to use too.

After major traumatic events, the authorities often set-up special centres for people to attend. These can be useful for support, advice and treatment.

As should be the case with any psychological illness, always contact your doctor for advice and information should you be worried for yourself or others.

Dennis Neill

Family Therapist

Family Therapy UK

1st May 2008