What It’s Like to Have Post-Traumatic Stress Disorder
“Never allow yourself to be manipulated by others. No one has the right to hurt you or bully you.” —the author, GMBF
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Many people who have heard of PTSD (post-traumatic stress disorder) associate it with war veterans because the media portrays them as the most common demographic affected by this condition. To be fair, the condition was first discovered in soldiers returning from war—which was responsible for PTSD’s colloquial term, ‘shell shock’ and probably the reason for the misconception.
Unfortunately, PTSD (like death and most diseases) affects all sectors of society regardless of age, religion, culture, race, geographic location, or socioeconomic status.
It is a very common affliction and no one is immune to it. There is also a phenomenon called ‘secondary trauma’ or ‘secondary traumatic stress,’ which affects caregivers of, or those living with people suffering from PTSD. Worse, there is evidence that natural disasters, including the coronavirus pandemic, can cause psychological trauma.
So we should know something about PTSD to prepare us in case it happens to us or someone we care about.
If you are psychologically affected by the pandemic and need support, reach out to your local mental health clinic or medical professional. You can also read about Covid-related mental health support here.
If you are providing support to someone with PTSD and feel overwhelmed, you can access support information here.
Real-life Scenario
To explain PTSD better and show that it happens to ordinary people and not just the armed forces, we cite a real-life case regarding a couple who divorced following years of the husband’s abuse of the wife.
In the beginning, the couple underwent mediation in the hopes of patching up their relationship. But there was a breakdown in communications and it was determined that divorce was the only solution.
Before divorce proceedings could take place, however, the lawyers from both sides ordered both husband and wife to undergo psychological evaluation. As it was the wife who was abused, it is her psychological report that we discuss here—with her permission. She and the evaluator were willing to be interviewed. The husband, however, was unavailable for comment.
The wife claims that her husband abused her verbally, physically, emotionally, and financially. He cheated on her and lied to her, took advantage of her weakness and financial status, and then abandoned her after she got sick and could not help with their finances anymore. (Before her illness, the wife had a full-time job and contributed equally to the couple’s budget.)
The abuse and abandonment left the wife devastated, affecting her life in all aspects. She lost weight and became anxious and depressed. She sought help from a psychologist, who diagnosed her condition as post-traumatic stress disorder—battered woman syndrome.
What is Post-Traumatic Stress Disorder (PTSD)?
According to the American Psychiatric Association (APA), PTSD is a psychiatric disorder resulting from witnessing or experiencing a traumatic event or from having been threatened with violence, injury, or death. The event may be an accident, war, terrorist act, sexual assault, or natural disaster.
The Mayo Clinic defines it similarly: as a mental health condition triggered by witnessing or experiencing a horrific event.
In the wife’s case, the foundation for the disease was laid out while the abuse was taking place when she and her husband were living together, but the condition manifested itself a few years after they separated.
Symptoms of PTSD—APA
The APA categorizes PTSD symptoms into four. Specific symptoms can vary in severity.
1. Intrusion—Intrusive thoughts, such as repeated, involuntary memories, distressing dreams, or flashbacks of the traumatic event. Flashbacks may be so vivid that people feel they are re-living the traumatic experience or seeing it before their eyes.
2. Avoidance—Avoiding reminders of the traumatic event may include evading people, places, activities, objects, and situations that may trigger distressing memories. Victims refrain from remembering or thinking about the traumatic event. They may resist talking about what happened or how they feel about it.
3. Alterations in cognition and mood—which include:
Inability to remember important aspects of the traumatic event
Negative thoughts and feelings leading to ongoing, distorted beliefs about oneself or others (eg, “I am weak” or “I cannot trust anyone”).
Distorted thoughts about the cause or consequences of the event leading to wrongly blaming oneself or others
Continuing fear, anger, guilt, or shame
Vastly decreased interest in previously enjoyed activities
Feeling detached or estranged from others
Unable to experience positive emotions like happiness or satisfaction
4. Alterations in arousal and reactivity—which include:
Irritability
Angry outbursts
Reckless or self-destructive behavior
Being overly suspicious and watchful of one’s surroundings
Being easily startled
Problems concentrating or sleeping
Symptoms of PTSD—DSM-V
The so-called “bible” for mental health diseases is called the Diagnostic and Statistical Manual for Mental Disorders (DSM-V). It is now in its fifth edition; hence the “V.”
The DSM-V interprets PTSD slightly differently from the APA, so it also lists symptoms differently. The former emphasizes the “flight” aspect associated with PTSD.
The “fight, flight, or freeze” syndrome refers to three ways humans historically and instinctively respond to threats: stay and fight (resist the human enemy/animal predator by using force), run away, or become paralyzed (do nothing).
DSM-V pays more attention to the behavioral symptoms that accompany PTSD and proposes four distinct diagnostic clusters:
Re-experiencing—impromptu memories of the traumatic event, flashbacks, recurrent dreams, or other intense, prolonged psychological distress related to it
Avoidance—the patient evades distressing memories, thoughts, feelings, or external reminders of the event
Negative cognitions and mood—a persistent and distorted sense of blaming oneself or others, estrangement from people, markedly diminished interest in activities, or an inability to remember key aspects of the event
Arousal—reckless, aggressive, or self-destructive behavior, sleep disorders, hyper-vigilance, or related reactions
Diagnosis of PTSD—ADAA
The Anxiety and Depression Association of America (ADAA) states that PTSD is diagnosed after a person experiences symptoms for at least one month following a traumatic event. However, symptoms may not appear until several months or even years later.
The Psychologist’s Diagnosis of the Wife
The therapist diagnosed the wife with post-traumatic stress disorder—battered woman syndrome.
According to the psych report, the wife experienced pronounced, anxious feelings and a persistently pessimistic emotional state, characterized by the presence of fear, anger, shame, and guilt.
She experienced a sense of threat in all her undertakings and this manifested as fear and nervousness. She is constantly worried about possible unknown dangers, which makes her anxious and disturbed. She feels helpless and unprotected as she thinks that something dangerous will happen to her and that she will be hurt and harmed for being inadequate and having a weak self-perception.
She is also hyper-vigilant, suspicious of other people’s motives and behavior. She views the world as harmful.
As a battered wife, she manifested learned powerlessness; fear; and loss of self-confidence, insusceptibility, and protection in response to her husband’s abusive behavior. She also experienced serious mental torture, social humiliation, and anxiety.
Clearly, the symptoms manifested were changes in cognition, moods, arousal, and reactivity.
Physical Effects of PTSD
PTSD also manifests itself through physical conditions because when we feel emotional stress, our bodies release hormones called ‘cortisol’ and ‘adrenaline’. This is when the body’s automatic ‘fight, flight, or freeze’ response kicks in.
Clinical studies report that a PTSD patient’s body continues producing these hormones even after the danger has passed. This explains symptoms like being startled easily and hyper-alertness, plus the physical indicators of anxiety: dizziness, headaches, tummy aches, and chest pains.
Who Is More Vulnerable to PTSD?
People more likely to develop regular PTSD are those who:
have minimal or no support from family, friends, or professionals
have previously experienced anxiety or depression
are currently in pain
are physically hurt
are experiencing repeated trauma
are dealing with multiple, simultaneous stressful situations, such as financial concerns, racism, bereavement, doing prison time, refugee status, or homelessness
People more likely to develop complex PTSD are those who:
experienced trauma when they were very young or who have been suffering from it for a very long time
had been harmed by a person close to them
experienced many traumatic events
have no options for escape or rescue
What Causes PTSD?
Experts from Mind UK, an organization offering mental health information and support, explain that situations viewed as traumatic vary per individual.
Harmful or life-threatening events that may lead to PTSD in the witness or victim include:
racist, sexist, or identity-related abuse, harassment, or bullying
workplace mishaps
automobile accidents
rape or sexual assault
kidnapping, hostage crisis, or any event in which one’s life is under threat
violence (includes assault, a terrorist attack, or military combat)
witnessing people being hurt or killed (as in a multiple homicide or war)
a job where one regularly experiences distressing events, such as the armed forces, first responders, caregivers, or medical staff (called secondary trauma)
natural disasters like earthquakes, floods, or typhoons
a pregnant woman’s traumatic delivery or her partner witnessing it
the death of a loved one that occurred in tormenting circumstances
admittance to a mental health medical center
diagnosis of a life-threatening illness
The Cause of the Wife’s PTSD
Many think that domestic abuse is merely physical. But, as we learn from this wife’s experience, different kinds of abuse led to her trauma:
Physical Abuse
The husband’s extreme irritability and aggressiveness manifested in physical abuse when he hit and slapped his wife around multiple times.
Emotional Abuse
The husband humiliated his wife and made her feel she was not good enough to the point that she doubted her capabilities and potential, losing her self-confidence.
The husband controlled everything, denying her the freedom to do what she wanted. He made the rules and forced her to live by them. He kept score of the positive things he did for her, making her feel that if it wasn’t for him, she wouldn’t have had a better and comfortable life… and that she wouldn’t have survived her illness.
He accused her of things she did not do or unintentionally did—even minor things. He showed a lack of empathy by being insensitive to her feelings and needs. Every time she requested supplies for her needs, like pocket money and medicine, he ignored her. He also had affairs with other women.
Verbal Abuse
The husband often said foul and hurtful words directed at the wife and her family. He did not listen to her, argued with her, and yelled at her all the time. He criticized and judged her, threatening her about withdrawing financial support.
He undermined her capacity by making her feel like a weakling, ordering her about, and blaming her and her family for his misfortune.
He lied and deceived her about the lifestyle he maintained outside the marriage. He made her feel worthless by discouraging her from going back to work, telling her that she will just be a liability to the company she wanted to join.
Financial/Economic Abuse
The husband depleted the wife’s savings and used up her credit card, but he did not give his wife financial support, saying he did not have any money. But upon investigation, the wife discovered that he spent it on expensive hobbies, posh restaurants, out-of-town/overseas trips, expensive gadgets, and a car.
He spent more time with his friends and other women than with his wife. He also borrowed money from his wife’s friends and relatives, then didn’t pay them back, leaving his responsibility to his wife. He also avoided paying the bills, making her worry about them.
All these greatly affected the wife, which resulted in PTSD. The wife lost her self-esteem and trust in others, especially men. For quite some time, the wife went through a lot of trauma, stress, anxiety, and depression, which affected how she dealt with life and other people.
How to Overcome PTSD
These are tips from the wife, based on her experience:
Give yourself some time until you are ready to talk about your traumatic experience.
Also reserve time to think, reflect, and look into the things you should have done—but without judging yourself. Try to find out the factor that triggers your PTSD, so you can avoid it in the future.
When you are ready, confide in someone. Talk to family members, friends, and religious/community support staff (clergy, school/neighborhood counselors). Surround yourself with supportive people you can trust.
Watch inspirational videos, listen to encouraging podcasts, attend self-help seminars/webinars, and engage in self-healing meditation programs.
Keep yourself busy by starting new hobbies, do household chores, and other productive activities.
Spend time with your loved ones, pets, and plants. You can tell them how you feel without being judged. Gardening, doing craftwork, and playing with pets lessen stress and entertain you—extremely helpful in forgetting trauma.
Take care of yourself physically and psychologically. Eat a balanced diet and engage in exercise, sports, or any positive physical activity.
It’s also helpful to get a regular medical check-up.
Avoid alcohol, illicit drugs, and some legal prescription medicine that can be potentially addictive.
Make some physical self-improvements, such as a hairstyle change and other forms of self-care, like going to the spa, where you can avail of spirit-boosting hydrotherapy, aromatherapy, massages, and facials.
Socialize. Go out with family, friends, and colleagues.
Divert attention away from your troubles by helping a charitable institution.
Join a support group. Listening to people with the same problem as yours will make you realize that you are not alone.
Seek help from medical specialists: counselors, psychologists, psychiatrists, or therapists.
For those practicing religion: Turn to God (or the Supreme Being, the Universe, or deities) and spend more time praying for strength and hope.
For Catholics: Join Bible study groups, attend daily masses (online during the pandemic), and pray the rosary often.
Change your life by telling yourself you can surpass this ordeal. Turn negative thoughts and energy into positive ones and move on.
Treatments for PTSD
The National Institute for Health and Care Excellence (NICE), the organization that issues guidelines on health care best practices, recommends two types of talking treatment for PTSD:
Trauma-focused cognitive-behavioral therapy (TF-CBT)—a type of cognitive-behavioral therapy especially for PTSD sufferers. It helps patients by changing their behavioral patterns and teaching them coping strategies and problem-solving skills. NICE recommends 8-12 regular sessions of approximately 60-90 minutes, plus sessions with the same therapist once weekly.
Eye movement desensitization and reprocessing (EMDR)—a revolutionary new treatment similar to hypnosis that reduces PTSD symptoms.
In an EMDR session, the therapist asks the patient to make rhythmic eye movements while recalling the traumatic event. These eye movements are meant to replicate the same kind we make while sleeping, which is when the brain processes memories and experiences. We will discuss EMDR in detail in a future post.
Final Thoughts
Everyone will experience a form of trauma at some point in their lives. We all have different methods of dealing with it. As we’ve mentioned in this article, there are many ways to heal, especially anchoring ourselves to God. There are moments when we just have to condition ourselves to fight it, do mind over matter, or seek professional help.
Ultimately though, it is an individual decision for any person with PTSD. What will you choose: Create a positive life or dwell on the negative? Get over your PTSD or be imprisoned by it forever?
Regardless of how bleak you see the future, there will come a time when you will say, “Enough is enough!” That is when you are certain you can really move on and start anew.
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Sources:
Photo Credits:
Thumbnail of a despondent figure made of copper—Marisa04
Globes—Lars Nissen
Soldier and bullet—Pixabay
Couple fighting—Mart Production
Screaming man shackled by barbed wire—Martin Redlin
Hand on door—Rabia
Counseling session—Gerd Altmann
EMDR (eye close-up)—Harry Quan
Enough is enough!—Duané Viljoen
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