What do you think when you hear the term PTSD or Post Traumatic Stress Disorder? Most people think of war veterans, people who have seen friends and comrades die or have been exposed to extreme horrors. We’ve heard about PTSD in the context of war for centuries, using terms such as shellshock, soldier's heart, combat fatigue or war neurosis. We see this depicted in films and on TV all the time, even recently I was watching ‘The Ranch’ on Netflix one of the characters has PTSD from his term in the US- Iraq war.
But what if I told you PTSD is almost as common in civilians as veterans? That the ‘traumatic’ event doesn’t have to be a war? In counselling we talk about ‘Big T’s’ and ‘Little T’s’ in relation to trauma. A big T could be something like experiencing terrorist attack, physical or sexual assault, domestic abuse and of course combat. A small T could be something like divorce, ongoing financial hardship, or job loss. Officially PTSD comes from experiencing a ‘Big T’ trauma, however this is a wide and varied net of experiences.
Having said that, the cumulative effect of multiple ‘Little T’ traumas cannot be overlooked, for example, if one experienced divorce, financial hardship AND job loss all in a short space of time, it could lead to PTSD. This is harder to pick up on for sufferers as it’s not a single specific event, rather an ongoing experience of multiple ‘smaller’ traumas.
PTSD is not a one size fits all diagnosis. Much like there are many variants of depression or anxiety, there are also different kinds of PTSD, such as:
· Delayed-onset (symptoms appear 6+ months after the event).
· Complex (from trauma experienced at an early age)
· Birth (from childbirth)
· Secondary (from supporting someone close to you through a trauma)
COVID19 and the subsequent stressors have caused an increase in PTSD over the past 12-18 months. People are still experiencing traumas, but now they are being held against the backdrop of border closures, isolation from family and community, financial hardship as a direct result of COVID, job loss as a direct result of COVID and so forth.
For example, a woman who has suffered a miscarriage (Big T - One in six women who lose a baby in early pregnancy experiences long-term symptoms of PTSD), is now experiencing that alongside the potential additional traumas of isolation from support networks, financial distress and anxiety being in public spaces due to risk of catching COVID. This will hugely increase her chances of developing PTSD.
Another example would be someone experiencing divorce (Little T), but set against the backdrop of isolation, financial hardship and anxiety for personal safety, this ‘Little T’ could turn into PTSD due to the number of issues compounding.
Our brain stores traumatic memories (of all kinds) differently to normal ones. As a trauma is often too difficult to process in one go, we store them in such a way that they get revisited and processed slowly in smaller chunks. In PTSD this can look like flashbacks and nightmares. This is our brains way of trying to protect us in the moment and trying to prevent overwhelm. Remember, our brains and their automatic response systems still live in caveman times. Back then, we couldn’t take time to process traumatic events as our main priority was survival. So, we shelved them to revisit when it was safer.
Having PTSD doesn’t mean there’s anything wrong with you or that you’re weak, it means you experienced a trauma, and your brain is trying to protect you the only way it knows how.
Symptoms of PTSD include (but are not limited to):
· Reliving aspects of what happened e.g., flashbacks, nightmares, intrusive thoughts.
· Alertness or feeling on edge e.g., trouble sleeping, impaired concentration, being easily triggered.
· Avoiding feelings or memories e.g., blocking out details of the event, feeling emotionally numb, feeling a need to be constantly busy, using drugs and alcohol to avoid memories.
· Difficult beliefs or feelings e.g., feeling like you can’t trust anyone, blaming yourself for what happened, overwhelming feelings of anger, sadness, guilt and shame.
People who are experiencing PTSD often struggle in other areas of life, for example:
· looking after yourself
· holding down a job