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PTSD: What you need to know

By Kathryn Fitch

For those who haven't come into contact with it, it might be hard to picture what suffering post traumatic syndrome disorder (PTSD) would be like, making it difficult to understand why it is such a debilitating disorder. People struggling to cope with the distress and misery PTSD causes would treasure that naivety - it can be an enduring problem that turns your life into a chaotic mess. Luckily, it doesn't have to be - with treatment and support sufferers can untangle the mess and claim their lives back.

What is PTSD?

PTSD is an anxiety disorder that can occur after a person is exposed to a traumatic experience - usually within three to six months of that experience. It is characterised by a range of symptoms that can be broadly classified into three groups: re-experiencing the event, avoidance and emotional numbing, and increased arousal.

Perhaps the most stereotypical example of PTSD is seen in the angry, maladjusted Vietnam veteran, who overreacts to a car back-firing or helicopter flying over, suddenly thrown back to the jungles of Vietnam, finding himself standing in the street heart pounding, sweat pouring down his face and people staring. This isn't too far from the truth, but it isn't the exclusive domain of veterans.

Sufferers will often experience intrusive thoughts about the event and experience flash-backs, bringing on an exaggerated emotional and physical reaction. Situations that remind them of the event act as triggers. While it might be things that are easily linked - like a helicopter flying overhead for a Vietnam veteran - it could be something less obvious, like an everyday smell or sight, that PTSD sufferers unconsciously link to the event.

For example, imagine a rape survivor is in a business meeting and a colleague walks in wearing the same cologne as the rapist. She suddenly feels an uncontrollable surge of emotions and memories, and collapses in tears.

Many PTSD sufferers withdraw rather than face potentially embarrassing scenes in public. This isolation is compounded by feelings of depression, detachment and loss of interest in life. Hypervigilance, another common symptom, can exhaust their nervous system and also cause problems with sleeping. People with PTSD might also feel like they can't control their emotions, especially anger and, unfortunately, it's often their nearest and dearest that face the brunt of their outbursts.

Given this is the world PTSD sufferers inhabit, it's probably not surprising that self-medication with alcohol and drugs is a common factor with the disorder. Unfortunately this only serves to make things worse and can actually complicate treatment.

What causes it?

According to Lieutenant Colonel (LTCOL) Stephanie Hodson from the Directorate of Mental Health, at a basic level, PTSD is caused when something unpredictable and uncontrollable happens to a person that 'teaches' them that the world isn't safe.

She gives the example of a car accident at a set of traffic lights where a car runs a red light and collides with another car driving through the green light. Although both drivers are involved in the same accident, the person driving through the green light is more likely to develop PTSD. The person who ran the red light still has a sense of control in the situation, but the person driving through the green light doesn't have the same sense of control because the accident 'happened' to them.

The exposure to a 'trauma' is pivotal to PTSD. What constitutes trauma depends on the person experiencing it. Examples that Defence psychologists give of potentially traumatic events include:

• threat to one's life or bodily integrity;
• severe physical harm or injury;
• exposure to the grotesque;
• violent or sudden loss of a loved one;
• witnessing or learning of violence to a loved one;
• learning of exposure to a noxious agent; and
• causing death or severe harm to another.

But LTCOL Hodson stresses that most people are able to integrate these experiences and some people even grow emotionally when faced with trauma. However, it is important that people who do develop symptoms get treatment as soon as possible.

How do you know if you've got PTSD and what can you do about it?

Even if you've experienced a traumatic event you may not necessarily develop PTSD. According to the 1997 National Survey of Mental Health and Wellbeing only 1.33 percent of Australians suffer from PTSD.

However, if you have had a traumatic experience, symptoms to look for include:

• Persistently re-experiencing the event through dreams, intrusive thoughts/recollections, acting or feeling as if the event were recurring (hallucinations), physical reaction to reminders;
• Avoidance of thoughts, feelings, activities, and places associated with the event;
• Feeling of detachment;
• Memory loss;
• Restricted range of affect or ability to relate to others;
• Sleep difficulties;
• Anger;
• Poor concentration; and
• Hypervigilience or startle response.

If you experience any of these symptoms, consulting a health professional for an accurate diagnosis is recommended because other conditions - like anxiety, depression and substance abuse - can present with similar symptoms.

The good news is that with early identification and intervention, symptoms can usually be treated successfully, and there are resources available throughout Australia.

Further Information. A good place to start is The Australian Centre for Posttraumatic Mental Health (www.acpmh.unimelb.edu.au) which has lots of relevant information and links. The Australian Defence Force Mental Health Strategy page also contains good information about PTSD, from a Defence perspective (http://www.defence.gov.au/dpe/dhs/mentalhealth/index.htm).

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