Post-traumatic stress disorder (PTSD)

Summary

Post-traumatic stress disorder (PTSD) is a mental health problem that can develop in people who have experienced or witnessed an event that threatens their life or safety, or that of those around them. This can be a car or other serious accident, physical or sexual assault, war-related events or torture, or natural disasters such as bushfires or floods. Effective treatments are available for PTSD.

Post-traumatic stress disorder (PTSD) is a mental health problem that can develop in people who have experienced or witnessed a traumatic event that threatens their life or safety (or others around them). This could be a car or other serious accident, physical or sexual assault, war-related events or torture, or a natural disaster such as bushfire or flood.

Other life-changing situations such as being retrenched, getting divorced, or the death of an ill family member are very distressing, and may cause mental health problems, but are not considered traumatic events that can cause PTSD.

Anyone can develop PTSD following a traumatic event, but people are at greater risk if:

• the event involved physical or sexual assault
• they have had repeated traumatic experiences such as sexual abuse or living in a war zone
• they have suffered from PTSD in the past.

Symptoms of PTSD

A person with PTSD has four main types of difficulties, being:

• re-experiencing the traumatic event – through unwanted and recurring memories and vivid nightmares. There may be intense emotional or physical reactions when reminded of the event. These can include sweating, heart palpitations or panic
• avoiding reminders of the event, such as thoughts, feelings, people, activities or situations that bring back memories of the event
• negative changes in feelings and thoughts, such as feeling afraid, guilty, flat or numb, developing beliefs such as ‘I’m bad’ or ‘The world’s unsafe’, and feeling cut off from others
• being overly alert or ‘wound up’ – sleeping difficulties, irritability, lack of concentration, becoming easily startled and constantly being on the lookout for signs of danger.

People with PTSD can also have what are termed ‘dissociative experiences’, which are frequently described as:

• ‘It was as though I wasn’t even there.’
• ‘Time was standing still.’
• ‘I felt like I was watching things happen from above.’

A health practitioner may diagnose PTSD if a person has symptoms in each of the four areas for a month or more, which lead to significant distress, or impact on their ability to work and study, their relationships and day-to-day life.

It is not unusual for people with PTSD to experience other mental health problems at the same time.
Up to 80 per cent of people who have long-standing PTSD develop additional problems, most commonly depression, anxiety, and alcohol or other substance misuse. These may have developed directly in response to the traumatic event or have developed sometime after the onset of PTSD. 

Impact of PTSD on relationships and day-to-day life

PTSD can affect a person’s ability to work, perform day-to-day activities or relate to their family and friends. A person with PTSD can often seem disinterested or distant as they try not to think or feel in order to block out painful memories. They may stop them from participating in family life or ignore offers of help. This can lead to loved ones feeling shut out. 

It is important to remember that these behaviours are part of the problem. People with PTSD need the support of family and friends, but may not think that they need help. There are many ways you can help someone with PTSD. 

Risky alcohol and drug use with PTSD

People commonly use alcohol or other drugs to blunt the emotional pain that they are experiencing. Alcohol and drugs may help block out painful memories in the short term, but they can get in the way of a successful recovery. 

When to seek help for PTSD

A person who has experienced a traumatic event should seek professional help if they:

• don’t feel any better after two weeks
• feel highly anxious or distressed
• have reactions to the traumatic event that are interfering with home, work and relationships
• are thinking of harming themselves or someone else.

Some of the signs that a problem may be developing are:

• being constantly on edge or irritable
• having difficulty performing tasks at home or at work
• being unable to respond emotionally to others
• being unusually busy to avoid issues
• using alcohol, drugs or gambling to cope
• having severe sleeping difficulties.

Support is important for recovery

Many people experience some of the symptoms of PTSD in the first couple of weeks after a traumatic event, but most recover on their own or with the help of family and friends. For this reason, formal treatment for PTSD does not usually start for at least two weeks or longer following a traumatic experience. 

It is important during those first few days and weeks after a traumatic event to get whatever help is needed. This may include information and access to people and resources that can help you to recover. Support from family and friends may be all that is needed. Otherwise, a doctor is the best place to start, to get further help. 

Treatment for PTSD

If problems persist after two weeks, a doctor or a mental health professional may discuss starting treatment. Effective treatments are available. Most involve psychological treatment, but medication can also be very helpful. Generally, it’s best to start with psychological treatment rather than use medication as the first and only solution to the problem. 

The cornerstone of treatment for PTSD involves confronting the traumatic memory and working through thoughts and beliefs associated with the experience. Trauma-focussed treatments can:

• reduce PTSD symptoms
• lessen anxiety and depression
• improve a person’s quality of life
• be effective for people who have experienced prolonged or repeated traumatic events, but treatment may be required for a longer period.

Things to remember

• PTSD develops in some people after they experience or witness an event that threatens their life or safety, or that of others around them.
• Symptoms include vivid memories, feeling constantly on edge and avoiding reminders of the event.
• It is common for people to have some of the symptoms of PTSD in the first few days after the traumatic event. Most will recover by themselves or with the support of family and friends. Others may need professional help.