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POST TRAUMATIC STRESS DISORDER (PTSD)
Paint It Black by The Rolling Stones
What is Post Traumatic Syndrome (PTSD)?
Post-traumatic Stress Disorder, or PTSD, is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person's daily life.
PTSD is marked by clear biological changes as well as psychological symptoms. PTSD is complicated by the fact that it frequently occurs in conjunction with related disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. The disorder is also associated with impairment of the person's ability to function in social or family life, including occupational instability, marital problems and divorces, family discord, and difficulties in parenting.
What Are Traumatic Events?
Traumatic events include actual or threatened death, serious injury to oneself or another person, or a threat to the personal beliefs of oneself or others. Examples include violent assaults (e.g., sexual or physical assault or mugging), torture, and severe car accidents. Refugees who are fleeing their homes because of war and political problems may suffer from stress related to trauma.
Common reactions during the days following the trauma:
It is common for people to continue to have many thoughts, images and feelings for some days, or even weeks, following the trauma. These reactions are common and are a sign that the body is recovering from a severe stress. The most commonly reported reactions include:
- Anxiety or fear of: danger to self or loved ones; being alone; being in other frightening situations; having a similar event happen again
- Avoidance of situations or thoughts that remind you of the traumatic event
- Being easily startled by loud noises or sudden movements
- Flashbacks where images of the traumatic event come into your mind suddenly for no apparent reason, or where you mentally re-experience the event
- Physical symptoms such as tense muscles, trembling or shaking, diarrhoea or constipation, nausea, headaches, sweating, tiredness
- Lack of interest in usual activities, including loss of appetite or interest in sex
- Sadness or feelings of loss or aloneness
- Shock or disbelief at what has happened; feeling numb, unreal, isolated, or detached from other people
- Sleep problems including getting to sleep, waking in the middle of the night, dreams or nightmares
- Problems with thinking, concentration, or remembering things (especially aspects of the traumatic event)
- Preoccupation with thinking about the trauma
- Guilt and self-doubt for not having acted in some other way during the trauma, or for being better off than others, or feeling `responsible' for another person's death or injury
- Anger or irritability at what has happened; at the senselessness of it all; at what caused the event to happen, often asking "Why me?" Not everyone will experience all of these reactions, or experience these reactions to the same extent. There may also be other reactions to add to the list. However, in most cases, these symptoms will disappear after a short period of time (i.e., a few hours, days, or weeks).
Immediately after the event
- Make sure you are with people. Do not go home to an empty house - ask a friend or relative to stay with you.
- Talk about the incident with others. Talking will help you get over the reactions.
- Remind yourself that the event is over and that you are now safe.
- If possible get some physical exercise. This will help to `burn off' some of your tension and anxiety.
- Avoid alcohol, sedatives, or sleeping pills (they will only dull the experience and not allow you to deal with your feelings properly).
- Restrict stimulants (such as tea, coffee, chocolate, cola, or cigarettes) because you do not want to make your body even more agitated than it already is at present.
- Try to eat something even if you do not feel like eating.
- If you cannot sleep, do not lie in bed tossing and turning - get up and do something until you feel tired.
How to handle the next few days
- Remind yourself that your reactions are a normal result of trauma and will pass in time.
- Try to get back into your normal routine as soon as possible. You may need to gradually introduce yourself to tasks that seem difficult.
- If you feel uncomfortable, scared or anxious, take some long, slow breaths and remind yourself that you are safe and that the trauma is over.
- Make sure that you are doing things that are relaxing and enjoyable - be kind to yourself.
- Continue to talk to your family, friends and colleagues about the trauma. This will help you to get over your feelings. Even if you feel a bit distant from other people, do not reject their support. Do not be afraid of your feelings.
- Work on your general stress levels by ensuring that you have adequate sleep, a good diet and regular exercise. Practise relaxation to help reduce nervous tension.
- Drive more carefully and be more careful around the home and with machinery. Accidents are more common after severe stress.
- Allow yourself time to deal with the memories. You will need commitment and patience. There may be some aspects of the experience that will be difficult to forget. If your reaction continues to seriously disrupt your life, please talk to your clinician.
Managing loss or bereavement
The experience of grief after loss is one common to human beings. The most intense grief usually follows the death of a loved person, perhaps because death is so final and we feel a great sense of loss. While what follows will concentrate mainly on bereavement, similar reactions occur in many different types of loss, e.g., breakdown of a relationship, loss of a pet, a job, a lifestyle, a limb. The intense feelings experienced after loss are a normal, healthy part of the healing process and will result eventually in learning to live with the loss. For some, however, difficulties in working through the process may result in depression.
Panic attacks are a common feature of PTSD. The symptoms are:
- Pounding Heart
- Trembling or Shaking
- Shortness of Breath
- Feeling of Choking
- Chest Pain or Discomfort
- Nausea or Abdominal Pain
- Fear of Dying
- Fear of being All Alone or That Nobody Cares
- Fear of Losing Control or Going Crazy
- Feelings of Unreality, or of Being detached of Oneself
- Hot Flashes or Chills
- Numb or Tingling Feelings
- Feeling Dizzy, Faint, Lightheaded, or Unsteady
If you are troubled by any of the symptoms of PTSD and panic, bear in mind that you're not crazy and it's treatable. See below for some resources.