Post-Traumatic Stress Disorder Explained

Did you know that around 12% of Australians will experience PTSD in their lifetime? (Beyond Blue 2019; Sane Australia 2018).

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is the term given to a specific set of reactions and health complications that follow the experience of an event that threatened a person’s life or safety, or the safety of those around them (Beyond Blue 2019; Better Health Channel 2017).

The term PTSD is often used to describe post-war mental health complications, but you don’t have to have experienced combat to have PTSD. PTSD can relate to a range of traumatic events, which in many cases have severe effects on the person.

Knowledge of post-traumatic stress disorder is essential to all healthcare workers and related to Standard 5 of the National Safety and Quality Health Service Standards: Comprehensive Care, as well as Standard 3 of the Aged Care Quality Standards: Personal Care and Clinical Care.

Note that PTSD is distinct from PTS (post-traumatic stress). PTS is a normal and adaptive response to trauma, it is not a mental illness. The side effects of PTS should resolve over the space of a month (Bender 2018).

PTSD Causes

Situations that may trigger PTSD include:

• Physical or sexual assault;
• A car accident or other road accident;
• A traumatic birth experience;
• War and torture;
• Experiencing an act of terror;
• Natural disasters;
• A friend or family member experiences a traumatic event.

(Beyond Blue 2019; Phoenix Australia n.d.a; Better Health Channel 2017; American Psychiatric Association 2017; Your Health In Mind 2016)

PTSD Facts

PTSD can affect anyone; 25% of people who experience trauma will develop PTSD (Sane Australia 2018).

PTSD is more common in women than men (Sane Australia 2018; Your Health in Mind 2016).

While serious car accidents are the leading cause of PTSD in Australia, people who have experienced repeated, deliberate harm–such as sexual or physical abuse–are more likely to develop PTSD (Sane Australia 2018; Beyond Blue 2019).

War veterans and emergency service workers generally have high rates of PTSD (Your Health in Mind 2016).

PTSD and Comorbid Conditions

It is well documented that people with post-traumatic stress disorder often present with additional psychological disorders (American Psychiatric Association 2017; Mayo Clinic 2018; Phoenix Australia n.d.b). A recent study into the prevalence of PTSD in Aboriginal and Torres Strait Islander People in custody in Australia found that PTSD often corresponded with anxiety (31.2%), depression (32.8%), psychosis (24.6%) and suicidal ideation (50.1%) (Heffernan et al 2015).

PTSD Symptoms

• Repeated thoughts related to the event that are intrusive, intense, disturbing, or all of these.
• Vivid flashbacks of the event.
• Panic attacks.
• Feeling physically and psychologically distressed.
• Negative thoughts and feelings about one’s self including guilt, depression, anxiety, fear or shame.
• Avoidant behaviours, such as avoiding places, people or objects related to the event.
• Sleeping and concentration difficulties.
• Being easily angered, irritated, wound-up or alert.
• Feeling emotionally numb, experiencing dissociation or general feelings of detachment.
• Being constantly on guard for danger.
• Experiencing a sense of hopelessness.

(American Psychiatric Association 2017; Beyond Blue 2019, Better Health Channel 2019; Mayo Clinic 2019; Donohue 2019; Phoenix n.d.b.)

The prevalence of substance abuse is also widely understood to co-occur with people living with PTSD (American Psychiatric Association 2017; Heffernan et al. 2015; Beyond Blue 2019).

PTSD Symptoms in Children

Children and teenagers can have extreme responses to trauma, but the symptoms they display are often different to those expressed by adults (National Institute of Mental Health 2019).

Be alert to symptoms such as:

• Bedwetting;
• Reluctance or sudden inability to talk;
• Acting out the event during play; and
• Being particularly clingy.

(National Institute of Mental Health 2019; Sane Australia 2018).

The complications of PTSD can not be overstated. As well as the severe symptoms of PTSD in adults and children, PTSD can have ongoing negative effects on a person’s day-to-day life (Mayo Clinic 2018; Your Health in Mind 2016).

PTSD can impact all facets of life including work, relationships, health and over-all quality of life (Mayo Clinic 2018; Your Health in Mind 2016).

Risk Factors that Increase the Chance of Developing PTSD

• Being injured;
• Childhood trauma;
• Having little or no support after the event;
• Genetic factors and/or having a history of mental illness;
• Substance abuse;
• Having additional stresses after the event; and
• Seeing another person get injured, or killed.

(National Institute of Mental Health 2019; Tull 2019)

Treatment

Most people will recover well within two weeks to three months of a traumatic event, those who do not should seek treatment (Your Health in Mind 2016; Beyond Blue 2019; Better Health Channel 2017). Many effective treatments are available.

Treatment may include:

• Counselling/psychological treatment (talking therapy):
  • Cognitive behaviour therapy (CBT);
  • Group therapy.
• Trauma-focussed treatment:
• Prolonged exposure therapy (PE).
• Medication;
• A combination of these.

(Better Health Channel 2017; American Psychiatric Association 2017; National Institute of Mental Health 2019; Phoenix Australia n.d.c.)

For children, trauma-focussed cognitive behaviour therapy is the recommended treatment (Better Health Channel 2017).

PTSD Relapse

Revisiting places or reuniting with certain people can reignite PTSD in some people. It is recommended that patients make a recovery plan with their therapist (Your Health in Mind 2016). Remind patients that in some cases, PTSD has been known to intensify over time (Mayo Clinic 2018).

Additional Resources

• The Aged Care Quality Standards: https://agedcare.health.gov.au/quality/aged-care-quality-standards
• Beyond Blue: https://www.beyondblue.org.au/
• Lifeline: https://www.lifeline.org.au/
• Phoenix Australia: https://www.phoenixaustralia.org/

References

• American Psychiatric Association 2017, What Is Posttraumatic Stress Disorder?, American Psychiatric Association, viewed 18 September 2019, https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
• Better Health Channel 2017, Post-traumatic Stress Disorder (PTSD), Better Health Channel, viewed 18 September 2019, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/post-traumatic-stress-disorder-ptsd
• Beyond Blue 2019, What is PTSD?, Beyond Blue, viewed 18 September 2019, https://www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/ptsd
• Beyond Blue 2019b, Statistics, Beyond Blue, viewed 18 September 2019, https://www.beyondblue.org.au/media/statistics
• Bender, J 2018, ‘What Are the Differences Between PTS and PTSD?’, Brainline, viewed 20 September 2019, https://www.brainline.org/article/what-are-differences-between-pts-and-ptsd
• Donohue, M 2019, ‘Post-Traumatic Stress Disorder’, Healthline, viewed 18 September 2019, https://www.healthline.com/health/post-traumatic-stress-disorder#treatment
• Heffernan, E, Andersen, K, Davidson, F and Kinner, SA 2015, 'PTSD Among Aboriginal and Torres Strait Islander People in Custody in Australia: Prevalence and Correlates', Journal of Traumatic Stress, 28, pp. 523-530.
• Mayo Clinic 2018, Post-traumatic Stress Disorder (PTSD), Mayo Clinic, viewed 18 September 2019, https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
• National Institute of Mental Health 2019, Post-Traumatic Stress Disorder, National Institute of Mental Health, viewed 18 September 2019, https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
• Phoenix Australia n.d.a., What Are Traumatic Events?, Phoenix Australia, viewed 18 September 2019, https://www.phoenixaustralia.org/recovery/what-are-traumatic-events/
• Phoenix Australia n.d.b., Effects of Trauma: PTSD, Phoenix Australia, viewed 18 September 2019, https://www.phoenixaustralia.org/recovery/effects-of-trauma/ptsd/
• Phoenix Australia n.d.c., Treatment for Posttraumatic Stress Disorder, Phoenix Australia, fact sheet, viewed 18 September 2019, https://www.phoenixaustralia.org/wp-content/uploads/2015/03/Phoenix-PTSD-Treatment.pdf
• Sane Australia 2018, Post-traumatic Stress Disorder (PTSD), Sane Australia, viewed 18 September 2019, https://www.sane.org/information-stories/facts-and-guides/post-traumatic-stress-disorder
• Tull, M 2019, ‘Causes and Risk Factors of PTSD’, Very Well Mind, viewed 18 September 2019, https://www.verywellmind.com/ptsd-causes-and-risk-factors-2797397
• Your Health in Mind 2016, Post-traumatic Stress Disorder, Your Health in Mind, viewed 18 September 2019, https://www.yourhealthinmind.org/mental-illnesses-disorders/ptsd

(Answers: a, b, d)