Post-traumatic stress disorder (PTSD)
What is PTSD?
Post-traumatic stress disorder (PTSD) is a mental illness. It comes after an event where a person is exposed to actual or threatened death, serious injury or sexual violence.
The event could be something that has happened to you, or something you have seen.
- a natural disaster such as an earthquake, flood or bushfire
- a major car crash or other serious accident
- severe physical injury
- rape or sexual assault
- domestic violence
- war or other attack
- witnessing murder or violent death
- a traumatic birth experience.
People with PTSD have intrusive memories of the event. The memories affect their physical and mental health, relationships, work and daily activities.
PTSD affects about 4% of adults in Australia and New Zealand. It is diagnosed more in women than in men. War veterans and emergency services workers generally have higher rates of PTSD.
There are effective treatments available for PTSD. With the right help, you have a good chance of recovery.
What causes PTSD?
Psychiatrists think that PTSD is caused by the brain laying down memories in the wrong place. During the traumatic event it’s as if the brain gets overwhelmed. The memories get filed in the ‘immediate action’ part of the brain, instead of the normal place.
Not everyone who experiences a traumatic event gets PTSD. In people who don't, it’s thought that the brain gradually comes to terms with the memories and they are no longer as vivid.
For people with PTSD, these memories are as distressing and immediate as when the event first happened.
After a traumatic event
It’s normal to feel upset or distressed for a couple of weeks after a traumatic event.
Emotional support and practical help with meals, clothing or housing are most helpful during this time. It’s important to stay connected with people who care about you.
If you still aren’t coping a number of weeks, months or even years after the trauma, PTSD may be diagnosed.
Signs and symptoms of PTSD
Everyone who has PTSD will experience it differently.
Some people with PTSD have suicidal feelings and want to self harm. Often people with PTSD also have depression or anxiety, or abuse alcohol or drugs.
You might notice:
- intrusive memories of the event that you have no control over
- distress when you come across things that remind you of the event
- physical symptoms like sweating or heart palpitations
- feeling watchful or ‘on guard‘
- trouble sleeping
- angry or emotional outbursts
- blaming yourself for the events
- feeling like there is nothing to look forward to.
If you notice any of these symptoms, and they are affecting your daily life, it’s important to seek help.
If you think you may have PTSD, the first step is to see your GP (family doctor) to discuss your concerns.
Your GP can assess your symptoms and refer you to a psychiatrist if you need it.
How is PTSD treated?
Psychological treatment (talking therapy) designed for trauma is the most effective treatment for PTSD.
If psychological treatment isn’t an option for you, or if it’s not working, you might be offered antidepressant medication.
Trauma-focused cognitive behavioural therapy (CBT)
Trauma-focused CBT is a type of psychological treatment. The aim is to help you deal with the trauma you experienced. You will recall and work through the emotions and sensations that you felt during the original event until they cause much less distress.
Psychiatrists and other therapists are trained to be sensitive to what you can handle and how fast you can go through treatment. If it’s too much, tell your therapist rather than leaving treatment.
Eye-movement desensitisation and reprocessing (EMDR)
During EMDR, your therapist will ask you to do a series of eye movements (moving eyes from side to side). At the same time, you focus on a disturbing memory. While it may sound strange, this therapy is thought to ‘reprocess’ the memories so that they move into the normal memory system. You can read more about EMDR here.
EMDR is a specialist treatment that is only offered by some therapists.
The most common type of medication used for PTSD is an antidepressant. This is usually a selective serotonin reuptake inhibitor (SSRI). An example of an SSRI is fluoxetine.
Sedatives (sometimes called ‘sleeping tablets’) might be prescribed for a short time to help you sleep.
What doesn’t help?
Things that don't help people with PTSD recover are:
- psychological treatments other than those listed in this fact sheet
- ‘debriefing’ a traumatic event in detail in the immediate hours or days after the event
- pretending nothing is wrong or hoping symptoms will go away by themselves
- drinking alcohol or using drugs
- isolating yourself from other people.
What can a psychiatrist do for PTSD?
Psychiatrists are crucial to the effective treatment of PTSD.
There are also psychiatrists who have a special interest in treating people with PTSD.
A psychiatrist can help with:
- diagnosing PTSD
- treating PTSD with psychological treatments
- treating any depression or anxiety
- treating alcohol or drug issues
- prescribing medication
- keeping track of your physical health and any side effects of medication
- admitting you to hospital if required
- connecting you to community supports
- referrals to other health professionals.
Recovery from PTSD
With proper treatment, about half of people diagnosed with PTSD will feel like they are back to normal within 3 months. Others may have symptoms for a year or more. A smaller group will live with some symptoms for the rest of their lives.
Relapse of PTSD
PTSD symptoms can come back. Sometimes particular places, people or other reminders of the event can trigger PTSD.
Make a recovery plan with help from your therapist. A plan will make it easier to cope with a relapse and continue on your recovery.
Living with PTSD
- Learn about your condition and talk to those close to you about your PTSD.
- Keep track of changes in your sleeping and eating patterns.
- Ask for help when you need it – talk to your GP, therapist or call a helpline.
- Join a support group in Australia or New Zealand.
- Be aware of the signs of depression
’Learning about my condition helped me to understand what was going on. I appreciate my life now and realise that PTSD is not a handicap, just another bump in the road of life.’
Norm, South Australia
‘For me, PTSD is permanent but very manageable. Learn where your own capabilities end. If you are unable to help yourself, pick up the phone. Call up a service to help.’
Graham, New Zealand
Helping someone with PTSD
Helping someone with PTSD can be difficult. They may be withdrawn, have angry or emotional outbursts, or be using drugs or alcohol to cope with their condition.
You can help by:
- supporting and encouraging them to get psychological treatment
- providing emotional and practical support
- encouraging them to get extra help if they are not coping
✔ PTSD is a mental illness and there are effective treatments available.
✔ Find a psychiatrist who specialises in treating PTSD.
✔ Most people with PTSD will recover with the right treatment.