Post Traumatic Stress Disorder or PTSD (F43.1) is usually associated with the armed forces and the difficulties faced by those who have seen and experienced near death situations in the front line. There are however, a myriad of other situations which can lead to the development of this disorder. Any traumatic event that involves the threat of death can result in symptoms of PTSD such as intrusive thoughts and nightmares about the trauma.
In addition to events such as sexual or physical assaults, road traffic accidents or being a part of a natural disaster, the occurrence of a stroke or a heart attack can also lead to PTSD. Research undertaken by the Columbia University Medical Centre found that not only is PTSD common among heart attack and stroke victims, with one in four developing PTSD symptoms within a year, but it also increases their risk of additional strokes or cardiovascular events.
Sufferers can be affected by feelings of panic and fear following their trauma and often use the avoidance response or are hypervigilant. For example, a person who was attacked by a dog would feel extreme panic on hearing a dog bark and may avoid any open spaces where dogs might be present, such as parks or woods. War veterans speak of becoming exhausted by simple outings, such as going to a shopping centre, due to constantly watching the actions of the hundreds of people around them alert for anything out of the ordinary, in response to their time on patrol in hostile areas.
Living in constant fear can have an effect on blood pressure and heart rate, which can lead to additional health problems, particularly in those whose traumatic event involved the cardiovascular system. Sleeping and concentration can also become difficult and it has been well documented that PTSD sufferers can turn to alcohol and illegal drugs in an attempt to alleviate their symptoms. It can also precipitate major depressive disorder.
All these factors indicate the need for treatment as soon as possible after the traumatic event takes place. The longer PTSD is left undiagnosed and untreated, the lower the chance of a full recovery. Treatment usually takes the form of a combination of psychological treatments and medication.
Eye Movement Desensitisation and Reprocessing (EMDR) has been shown to be particularly effective in treating PTSD. It involves making repetitive left to right eye movements, while recalling the traumatic event, which helps to reduce the influence of the event in the mind. Trauma-focused Cognitive Behavioural Therapy (CBT) is also used to help patients come to terms with the traumatic event by replacing negative thoughts with positive ones.
Medication is usually only recommended if psychological treatments have not been effective. NICE (the National Institute of Clinical Excellence) suggest the use of the antidepressants but while they may help with feelings of depression and anxiety, they do not treat the causes of PTSD.
As a result of their treatment for PTSD, the sufferer should gain the skills to address the symptoms of PTSD in the future, helping them to think better about themselves, others and the world about them, and teaching them coping skills if the symptoms should arise again.
Dr Adrian Winbow is an experienced consultant psychiatrist and an advanced EMDR therapist and has successfully used EMDR in the treatment of PTSD. To make an appointment with Dr Winbow, please contact us at Private Psychiatry.