What’s it like, keeping the secrets of trauma and PTSD? I have so much to tell you, and I can’t say a word. The trauma’s tucked away, a dirty little secret that you keep. Maybe you try to tell a friend, therapist, lover. Maybe they get it, maybe they don’t. But oh, how you want them to get it. You want their understanding words. And you want to scream, cry, run – from the fear and the pain and the sinking feeling of waking up each day and not being quite sure if it’ll stay today, today. But you don’t, you don’t do much any of that. Most of the time you . . . survive. Trauma and PTSD make keeping secrets easier, but surviving increasingly difficult.
If you can make it through one week and the next, that’s doing well. And if you can face any of that fear, and find even a touch of safety in each day, you’re doing fabulously.
All we really want, any of us – we just want it to stop: The living memories trapped in every cell. That’s what PTSD is. It’s a ghost, hanging out in your head. Therapists call them flashbacks. You’re thrown back in time without warning. Bam. So forgive us if we appear weak, at times: We’re not. We are standing naked, facing a tide that does not stop, no matter our cries, prayers, or panic.
Trauma and PTSD Symptoms
Individuals who suffer from PTSD alternate between periods of re-experiencing the trauma (in the form of flashbacks or nightmares) and periods of numbing/dissociation. This often makes treatment complicated, and is why psychotherapy sometimes takes longer than people expect.
People with PTSD cannot just “get over” the trauma. In individuals with PTSD the traumatic event still needs to be fully processed by the fear centers of the brain, and until that happens the trauma is repeatedly re-experienced in its full intensity in response to current environmental cues that are associated with it.
PTSD interferes with a person’s ability to sleep, may make them more prone to anger/irritability and makes them almost constantly alert for danger (hypervigilant). One of the hallmarks of PTSD is an unusually strong startle response – for example, to loud or unexpected noises. Anything in the current environment which is reminiscent of the emotional reaction experienced by the individual at the time of the original trauma can act as a ‘trigger’. That is, things in the here and now can put someone with PTSD back into the memory of the trauma but it is not experienced with the normal distance of an ordinary memory.
Someone with PTSD may see, hear, feel, taste or smell parts or all of the memory of the traumatic event as if it was happening again, including the same sense of fear/helplessness and terror that occurred at the time. However, the person’s reality testing capacity essentially remains intact so that they do know that the event is not really happening in the present – it ‘just’ feels like it is.
In most cases the symptoms of PTSD will dissipate in time, though that depends on a number of variables, including:-
- Initial severity of the condition;
- Intensity of the original trauma;
- Whether the individual received appropriate treatment within an adequate time frame;
- Response to medication and/or psychotherapy;
- Incidence of co-morbid mental illness or substance abuse issues;
- Number of traumatic events experienced;
- Age at which the trauma took place;
- Whether the sufferer has a reliable support system;
- Whether the trauma was repeated and/or how long it lasted; and
- Individual predisposition to a more acute stress reaction.
Treating Flashbacks, Trauma and PTSD
PTSD treatment commonly consists of a combination of psychotherapy and medications. Medications commonly used to treat PTSD include: antidepressants- typically SSRI’s, SNRI’s or NaSSS’s. If antidepressants don’t do the trick medications such as atypical antipsychotics, anticonvulsants, beta blockers and/or benzodiazepines are trialled. Their success varies pretty widely.
Understanding PTSD and Trauma: A Rough Guide
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