A person’s everyday activity, interpersonal interactions, and general well-being may all be significantly impacted by post-traumatic stress disorder
BY DR ROZANIZAM ZAKARIA
After a difficult day at work, Sarah was travelling home during a storm. She found the trip challenging because of the persistent rain that made the roads slick with poor visibility.
The scene from what she dreads greatest played out before her as she drove towards an intersection. A car that ran a red light brutally collided into the driver’s side of Sarah’s vehicle.
Sarah’s body was brutally shocked instantly, and terror and confusion flooded her consciousness. As the shock overwhelmed her, the once-comfortable surroundings blurred.
Sarah was physically bruised and traumatised after the accident, but the scars became more profound. Every time she considered getting behind the wheel again, she could not escape the feeling of horror that had overwhelmed her. It seemed she was reliving the horrifying moments of the collision every time she saw a car approaching an intersection.
Sarah started avoiding going to sleep. Every time she tried to fall asleep, she experienced nightmares. She broke into a cold sweat by the nightmare imagery of bent metal, smashed glass and the eerie sound of screeching brakes.
She was overcome with anxiety, which caused her hands to tremble violently and her heart beating rapidly. She withdrew from friends and family, losing her once active social life due to her inability to articulate the invisible cords that connected her to her trauma.
It was during a routine check-up that Sarah’s doctor recognised the signs. The sleepless nights, the debilitating anxiety, and the avoidance behaviour all indicated post-traumatic stress disorder (PTSD). Sarah’s life had been shattered by the car accident, and the aftermath of the trauma had left an indelible mark on her mental well-being.
Categorising post-traumatic stress disorder symptoms
Trauma is a term used to describe an emotional or psychological reaction to a profoundly upsetting or upsetting incident or experience. It is an occurrence that has a lasting effect on a person’s mental and emotional health because it exceeds their capacity to cope with or integrate the emotions involved. Traumatic incidents can entail real or threatened death, significant injury, or sexual assault, and they frequently cause the person experiencing them to feel terrified, helpless, or horrified. Natural catastrophes, accidents, physical or sexual assault, exposure to combat, childhood maltreatment, or witnessing violence are just a few of the situations that can lead to trauma.
Post-traumatic stress disorder (PTSD) is a psychological problem that affects many people who experience dreadful situations. It is a mental disorder that affects those who have been through or seen a traumatic event. Their everyday activities, interpersonal interactions, and general well-being may all be significantly impacted.
PTSD symptoms can be grouped into four categories:
1. Re-experiencing symptoms – flashbacks, nightmares, intrusive thoughts, or intense emotional distress triggered by reminders of the traumatic event.
2. Avoidance symptoms – efforts to avoid people, places, or activities associated with the trauma, as well as emotional numbing and detachment from others.
3. Negative changes in cognition and mood – persistent negative beliefs, distorted thoughts about oneself or the world, feelings of guilt or shame, and a diminished interest in activities once enjoyed.
4. Hyperarousal symptoms – hypervigilance, irritability, difficulty sleeping, exaggerated startle response and difficulty concentrating.
Multiple variables can contribute to PTSD development. In addition to the actual traumatic events, one’s chance of developing PTSD may also be increased by biological and genetic variables.
Research on twin and family studies has shown that PTSD may have a hereditary component. According to these studies, people with a family history of PTSD may be more likely to experience the illness themselves.
Additionally, twin studies have shown that identical twins have a greater concordance rate for PTSD than fraternal twins, suggesting a genetic component. Additionally, environmental and psychological elements are important. For instance, persons with a history of trauma, pre-existing mental health issues, or a lack of social support may be more susceptible to PTSD.
Impact on individuals
Studies have shown a high rate of comorbidity between PTSD and depression. The two conditions frequently co-occur, with individuals diagnosed with PTSD having an increased risk of developing depression.
Research suggests that approximately 48 per cent to 55 per cent of individuals with PTSD also experience symptoms of depression. A study published in JAMA Psychiatry found that about 46 per cent of individuals with PTSD reported having suicidal thoughts at some point in their lives. The same study reported that around 12 per cent of individuals with PTSD had attempted suicide at least once in their lifetime (Oquendo et al., 2005)
Other impacts include:
1. Emotional and psychological consequences – individuals with PTSD often experience intense fear, anxiety, anger, sadness, and a reduced sense of safety. They may also struggle with trust issues and have difficulty regulating their emotions.
2. Physical health effects – PTSD has been linked to an increased risk of various physical health conditions, including cardiovascular problems, chronic pain, and gastrointestinal issues.
3. Impairment in daily functioning – PTSD can significantly disrupt an individual’s ability to perform everyday tasks, maintain employment, and engage in social activities.
4. Relationship difficulties – PTSD can strain relationships due to emotional distance, communication problems and a lack of understanding about the disorder’s impact on the individual’s behaviour and emotions.
Evidence-based psychotherapies such as Cognitive-Behavioral Therapy (CBT), trauma-focused CBT and Eye Movement Desensitisation and Reprocessing (EMDR) effectively treat PTSD. They help individuals process traumatic memories, challenge negative beliefs, and develop coping skills.
TF-CBT is a specialised form of CBT designed for children and adolescents who have experienced trauma. It incorporates cognitive-behavioural techniques with trauma-focused interventions to address symptoms and promote healing.
Some may also require pharmacological intervention. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are often prescribed to manage PTSD symptoms. They can help alleviate depression, anxiety and sleep disturbances.
In addition, those affected will also require social support to go through the healing process from trauma. Seeking support from loved ones, joining support groups, and connecting with individuals with similar experiences can provide validation, understanding, and a sense of community. – The Health
Dr Rozanizam Zakaria is a Psychiatrist and an Assistant Professor at the Kulliyyah of Medicine, International Islamic University Malaysia (IIUM). He is also a Fellow in Child and Adolescent Psychiatry.