PTSD. Signs and symptoms.
PTSD signs and symptoms are a result of a flooding of the person’s mind with very intense flashbacks to the causative event(s). The memories are so vivid and involve all the senses including taste and smell, that they prevent normal perception to occur. The person becomes disassociated from what surrounds them. Their “minds eye” is focused on the intrusive memories contained in the flashback or nightmare.
Sounds, smells, surroundings and sights can all act as triggers to a flashback. As well as the flashback there is a massive surge in the FFF response that makes the person hypervigilant, aggressive, and bewildered. These episodes can last from seconds to hours.
Suppressing these episodes become the focus of the person suffering, for at the outset they think they are going mad. The experience and aftermath of the flashbacks become so frightening to the sufferer and their relatives that any form of oblivion is the natural recourse for those with PTSD. Alcohol and drugs are usual, but whilst relief may be temporary, these substances are depressive, both in terms of becoming depressed with long-term use, but also in terms of depressing or diminishing the threshold for the triggering of the dissociative flashbacks. It is usual for people who become violent – in their eyes trying to defend themselves and escape the events unfolding in their minds – and end up in the judicial system. In many cases the person may leave their families for fear of hurting their loved ones; they end up on the streets.
It may seem obvious and easy to be able to diagnose PTSD, but given the avoidance strategies the sufferer uses, often the full story becomes too distant to unravel. Equally even if members of the armed forces are taught about the effects of trauma and how to spot the early signs of PTSD in their comrades, as the British Armed Forces now do,it is not always textbook.
The presentation of PTSD varies according to the persons pre-existing personality as does any resulting PTSD.
What are the outcomes of untreated PTSD?
Outcomes of untreated PTSD are usually bad. One statistic that sticks with me is that of the 1 million US personnel who served in Vietnam, half had committed suicide within 10 years of the war ending. This occured despite the Veterans Association having put in place provision for the diagnosis and treatment of the condition. What appears to have failed was that many returning veterans isolated themselves and contact with the health services that could have helped them became impossible.
This alone shows that PTSD is a potentially lethal condition. It also carries a massive cost to the person and relatives, with family breakdown, substance abuse and early death from poor self preservation. It has been said that their are at least 20 victims for every person suffering from PTSD, they being those most closely associated with the sufferer.
What can be done?
A lot. Firstly making the general public aware of the condition and how it can present should allow for earlier pick up and diagnosis to be made. Any behavioural change noted in someone who has suffered extraordinary events and threat to life should be suspected as a sign of PTSD. This applies to children, thise who have suffered rape, RTA, life threatening surgery or ITU treatment, and anyone who has been in combat.
Treatments for the condition rely on reducing the secondary depression and self harm using antidepressants. this can help stabilise the sufferer, so that the vital Cognitive Behavioural therapy can be of use.
Present emphasis is not on exposing the full story, as that can not be changed. CBT aims at the way that the sufferer thinks and acts upon exposure to triggers and the subsequent flashbacks.
A lot of research has been done and continues to unravel how PTSD embeds itself in memory at the molecular biological level. Interesting as that may be, the prospect of new drugs to prevent, and treat PTSD is somehow, always near, but in practice remains ever so far.
Kindness, compassion, empathy and awareness are the keystones upon which PTSD can be treated. And treated it must be because the “invisible wounded” will always surround us as long as conflict and violence persist.
Combat Stress were always available to help me help others, and their work continues as a beacon for best practice.