Post Traumatic Stress Disorder (PTSD)
Post traumatic stress disorder is severe anxiety after psychological trauma, this is a mental disorder that belongs to the group of disorders related to trauma and stress factors.
It is characterized by the appearance of specific symptoms after exposure to a stressful, extremely traumatic event, which involves physical harm or is of an extraordinarily threatening or catastrophic nature for the individual.
By definition, post-traumatic stress disorder is preceded by one or more stressful events of exceptional or catastrophic proportions (psychological trauma). The threat does not necessarily have to affect yourself directly, but can also have been observed and experienced by others (e.g. as a witness to a serious accident, act of violence, sexual assault, warfare, traffic collisions, child abuse, domestic violence or other threats on a person’s life).
This fear is accompanied by a strong physical reaction due to the secretion of adrenaline, the hormone that enables the body to react quickly to danger. Fear and the physical reaction that accompanies it are part of a natural defense mechanism designed to ensure survival. These reactions are therefore normal and usually go away a few hours after the event.
However, in people with post-traumatic stress disorder, these reactions do not go away completely. The person continues to relive them with the same intensity as the first time, in the form of dreams or flashbacks. Flashbacks are mental images that bring the traumatic situation to life for the person. The person may also relive these reactions when exposed to a situation similar to the one that caused the trauma.
The affected person can then try to avoid situations or conditions that remind them of the trauma. The need to avoid any threatening situation can have serious consequences on personal, family and social activities.
POST-TRAUMATIC STRESS SYNDROME IN CHILDREN
Children are more predisposed to PTSD because they find it hard to put what they are going through into perspective. In them, apart from the usual causes, a state of post-traumatic stress can appear a few weeks after an imaginary or fictional event – a particularly violent film, for example. Like adults, children with PTSD relive stressful events and have nightmares. They are afraid for no apparent reason and tend to withdraw into themselves. Often these are restless and angry children who have difficulty concentrating and suffer from sleep disturbances. Treatments are effective in treating children with PTSD as well as adults.
WHAT ARE THE CAUSES OF POST-TRAUMATIC STRESS?
The traumatic events that cause PTSD have some common characteristics. Most of the time, they actually resulted in death or irreversible damage. Sometimes they were simply seen as carrying such consequences. The person with PTSD may be the victim, or simply the witness, to the traumatic scene. These events provoked an intense reaction mixing fear, distress and horror. They vary from sexual assault or transport accidents, to war, hostage-taking, physical or mental violence, natural disaster or terrorist attack.
More than the actual severity of traumatic events, it is the perceived severity that seems to determine the onset of PTSD. When trauma has been inflicted by a person, it is perceived more intensely than that due to chance or technical failure.
Faced with a traumatic event, some people show more predisposition to develop PTSD: those who have retained, because of their personal history, a great sensitivity to bereavement or an anxious temperament; those, endowed with a naive disposition, who thought the world was harmonious; those who suffer from emotional isolation and cannot rely on a network of friends or family. Finally, the elderly and children are particularly vulnerable.
Symptoms of post-traumatic stress disorder usually start within the first 3 months after a trauma. However, it can sometimes take several months or even years for symptoms to appear.
The characteristic signs of post-traumatic stress disorder are:
a feeling of intense fear, horror and helplessness accompanied by one or more of the following symptoms:
heart palpitations (heart beating abnormally fast),
thoughts that force themselves into the mind and run out of control. Because of these thoughts, the affected person experiences distress, which manifests as anxiety and depression;
difficulty in feeling certain emotions, for example tenderness and sexual desire;
difficulty falling asleep;
a need to be on constant alert, ready to respond.
CAN WE AVOID THE DEVELOPMENT OF A STATE OF POSTTRAUMATIC STRESS?
During the stressful period following a traumatic event, certain measures appear to help prevent the progression to chronic mode.
If necessary, it is essential to discuss the event with friends, family, GP, psychotherapist or others who have had the same experience, etc. But some people prefer not to talk about what they went through. In this case, it is best not to force them to describe their experience. Recent studies have shown that forcing someone to relive the traumatic event through speech can interfere with natural recovery. This observation also tends to call into question the working methods of the psychiatric teams dispatched to support people who are victims of a collective tragedy.
To prevent stress from setting in permanently, it is also important for the traumatized person to accept their own reactions and distress, without being offended by the incomprehension of those around them about the feelings expressed. Better to let time do its thing, without being too impatient to regain your well-being. Taking care of yourself, practicing relaxation and relaxation activities, are all elements that will contribute to healing.
Finally, it is preferable not to consume alcohol, drugs or anxiolytic drugs (tranquilizers) or hypnotic drugs (sleeping pills), apart from those possibly prescribed by the attending physician.
HOW TO HELP PEOPLE SUFFERING FROM ACUTE STRESS?
When a loved one has recently suffered a trauma, it is possible to help them recover without progressing to post-traumatic stress disorder.
Advise him to see a doctor quickly, who will help him get over the course and intervene early if there is a risk of progressing to a chronic mode.
Listen without ever judging. Ask her open-ended questions to help her express herself. Do not force him to relive the trauma, but encourage him to express what he is feeling during the discussion.
If you feel up to it, talk to him about how he can try to integrate trauma and its consequences into his beliefs, values, and outlook on life in general.
Advise him to find out about acute stress and PTSD, for example from a patient association or victim support (legal aid). Understanding the symptoms you are experiencing is a first step towards recovery.
Help him relax, unwind and take his mind off things. Make sure he feels safe at all times. Identify with him his sources of stress and help him neutralize them.
Post-traumatic stress disorder is a treatable illness. There are recognized treatments to treat it. Treatments allow people with the disease to regain control over their lives and daily activities. The earlier the sufferer consults, the better their chances of recovery.
In the majority of cases, post-traumatic stress disorder is effectively treated with psychotherapy, medication, or a combination of these 2 treatments.
PTSD experts generally recommend one of the following 3 therapies:
cognitive behavioral therapy, which aims to modify the person’s problematic thoughts and behaviors and replace them with thoughts and reactions appropriate to reality. It helps to understand the origin of the problem and to find solutions;
EMDR technique (EyeMovement Desensitization and Reprocessing). This technique combines the movements of the person’s eyes with mental images that remind them of the traumatic experience. It aims to decrease the person’s sensitivity to traumatic images and memories.
Some antidepressant drugs also have a beneficial effect, shown in clinical studies, even if the person is not depressed. Paroxetine (Déroxat, Divarius and generics) and sertraline (Zoloft and generics) are the only molecules with an official indication in the treatment of post-traumatic stress. If this fails, another antidepressant may be prescribed by the psychiatrist. If the sleep problems are significant, hypnotic treatment may be offered.
Treatments can be started as soon as the stress becomes unusually persistent (more than a month after the traumatic event). Usually, their positive effects are felt after three to four months.