Understanding and supporting people living with PTSD

June 27 is PTSD Awareness Day, a day to acknowledge a condition that affects millions of people worldwide. Post-Traumatic Stress Disorder (PTSD) is a complex mental health condition that can develop after a person experiences or witnesses a traumatic event. Despite its prevalence, PTSD is often misunderstood, and many who suffer from it do so in silence. This article details several key aspects of PTSD, aiming to increase understanding and support for those affected.

1. What is PTSD?

PTSD is a complex mental health condition triggered by experiencing or witnessing a traumatic event. Examples of traumatic events include natural disasters, accidents, personal assaults, combat, and other violent incidents. Symptoms of PTSD comprise the following:

• Intrusive memories
• Flashbacks: Reliving the traumatic event as if it were happening again
• Nightmares: Disturbing dreams related to the trauma
• Distressing memories: Unwanted and recurring memories of the traumatic event

• Avoidance behaviours
• Avoiding triggers: Staying away from places, activities, or people that remind the individual of the trauma
• Emotional numbing: Shutting down emotionally and withdrawing from activities and relationships that were once enjoyable

• Negative changes in thinking and mood
• Negative thoughts: Persistent negative beliefs about oneself, others, or the world
• Hopelessness: Feeling hopeless about the future
• Memory problems: Difficulty remembering important aspects of the traumatic event
• Loss of interest: Diminished interest in previously enjoyed activities
• Emotional detachment: Feeling detached from family and friends

• Changes in physical and emotional reactions
• Being easily startled: Heightened startle response and feeling jumpy
• Hypervigilance: Constantly feeling on edge and watching for danger
• Irritability or anger: Increased irritability or outbursts of anger
• Difficulty sleeping: Trouble falling or staying asleep, or restless sleep
• Concentration issues: Difficulty concentrating or staying focused

• Other symptoms
• Guilt or shame: Feelings of guilt or shame related to the traumatic event
• Self-destructive behaviour: Engaging in risky or self-destructive behaviours, such as alcohol and other substance abuse

While many people who experience trauma may initially have symptoms of PTSD, not everyone develops the condition. The persistence and intensity of symptoms, along with their impact on daily life, distinguish PTSD from other stress responses.

2. The Prevalence of PTSD

PTSD can affect anyone, regardless of age, gender, or background. However, certain populations are at higher risk. For instance, veterans and active-duty military personnel are particularly vulnerable due to their exposure to combat situations. According to the Department of Veterans' Affairs, it is estimated that up to 8% of Australian veterans experience PTSD.

First responders, including paramedics, police officers, and firefighters, are also at a significantly higher risk of developing PTSD due to the nature of their work. The constant exposure to traumatic incidents such as accidents, crimes, and fires, can have a profound impact on their mental health. Studies suggest that around 10% of emergency service workers in Australia are likely to experience PTSD at some point in their careers.

Civilians are not immune either. Approximately 11% of the Australian population will experience PTSD at some point in their lives. Those who have experienced sexual or physical assault are at heightened risk, as are those who have witnessed or been exposed to other acts of violence.

3. The Science Behind PTSD

Understanding the neurobiology of PTSD can help demystify the condition. Research shows that PTSD involves changes in the brain's structure and function. For example, the amygdala, the brain region responsible for fear responses, tends to be hyperactive in people with PTSD. Meanwhile, the prefrontal cortex, which helps regulate emotional responses, may be underactive. This imbalance can lead to the heightened fear and anxiety seen in PTSD.

Additionally, PTSD is associated with alterations in neurotransmitter systems, particularly those involving serotonin and dopamine. These changes can affect mood regulation, memory, and the ability to experience pleasure.

4. Comorbidities and PTSD

PTSD often co-occurs with other mental health conditions. Depression (including suicidal thoughts and behaviours), anxiety disorders, and substance use disorders are common among those with PTSD. These comorbidities can mask the underlying nature of PTSD, complicating diagnosis and treatment, and making it essential for healthcare providers to conduct comprehensive assessments.

Physical health problems are also prevalent in individuals with PTSD. Chronic pain, cardiovascular disease, blood circulation problems, gastrointestinal concerns, and skin issues are more common in this population, possibly due to the prolonged stress and inflammation associated with the condition.

5. Treatment Options for PTSD

The good news is that effective treatments for PTSD are available. Evidence-based therapies can significantly improve symptoms and quality of life for those affected. Some of the most common treatments include the following:

• Cognitive Behaviour Therapy (CBT): CBT is a widely used therapy that helps individuals identify and change negative thought patterns and behaviours. A specific type of CBT, known as Cognitive Processing Therapy (CPT), is particularly effective for PTSD. CPT focuses on helping individuals reframe negative thoughts related to their trauma.

• Eye Movement Desensitisation and Reprocessing (EMDR): EMDR is a unique therapy that involves the person recalling traumatic memories while engaging in bilateral stimulation, such as side-to-side eye movements. This process is believed to help the brain reprocess traumatic memories, reducing their emotional impact.

• Medications: Medications can help manage PTSD symptoms, particularly when used in conjunction with therapy. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed, and others like alpha-blockers, can help to alleviate specific symptoms such as nightmares.

• Emerging Treatments: Research into PTSD treatments is ongoing, and new therapies are continually being developed. For example, psychedelic-assisted therapy using substances like MDMA has shown promise in clinical trials. These treatments aim to enhance the therapeutic process and provide relief for those who have not responded to traditional treatments.

** It is important to note that the various treatment options for PTSD described here do not work equally for all individuals. Some may benefit more from one type of therapy than another.

6. The Importance of Support

Support from family, friends, and the community is essential for individuals with PTSD. Social support can provide emotional comfort, practical assistance, and a sense of belonging. It can also encourage individuals to seek treatment and stay engaged in their recovery.If you know someone with PTSD, there are several ways you can offer support:

• Listen without judgement: Allow the person to share their experiences and feelings without interrupting or offering unsolicited advice
• Educate yourself: Learn about PTSD to better understand what they are going through
• Be patient: Recovery from PTSD can be a long and challenging process - offer your support without pressuring them to "get over it”
• Encourage treatment: Gently encourage them to seek professional help if they haven't already
• Practise self-care: Supporting someone with PTSD can be emotionally taxing - make sure to take care of your own mental health as well

For more information about PTSD and resources for support, here are some useful links:

• SANE Forums
• Health Direct: Post-Traumatic Stress Disorder (PTSD)
• FearLess: Restoring control to people living with traumatic stress
• Phoenix Australia: Understanding trauma and renewing lives

PTSD Awareness Day is an opportunity to increase our understanding of this complex mental health condition and support those affected by it. By learning about the causes, symptoms, and treatments of PTSD, we can help reduce stigma and encourage more people to seek the help they need. Recovery is possible, and with the right support, those living with PTSD can lead fulfilling lives.

Dr. Carissa Coulston-Parkinson is a Clinical Psychologist with specialist knowledge in the areas of depression, bipolar disorder, anxiety, schizophrenia, intellectual disability, personality disorders, traumatic brain injury and neurological conditions.

Related Posts