More than 17 million people in South Africa are dealing with depression, substance abuse, anxiety, bipolar disorder and schizophrenia — illnesses that round out the top five mental health diagnoses, according to the Mental Health Federation of South Africa.
TRAUMA AND POST TRAUMATIC STRESS
This can happen after a person experiences a traumatic event (e.g. war, assault, accident, disaster). Symptoms can include difficulty relaxing, upsetting dreams or flashbacks of the event, and avoidance of anything related to the event. PTSD is diagnosed when a person has symptoms for at least a month.
POST TRAUMATIC STRESS DISORDER (PTSD)
What is PTSD?
Post-traumatic stress disorder (PTSD) is a particular set of reactions that can develop in people who have been through a traumatic event which threatened their life or safety, or that of others around them. This could be a car or other serious accident, physical or sexual assault, war or torture, or disasters such as bushfires or floods. As a result, the person experiences feelings of intense fear, helplessness or horror.
What are the signs of PTSD?
People with PTSD often experience feelings of panic or extreme fear, similar to the fear they felt during the traumatic event. A person with PTSD experiences four main types of difficulties.
- Re-living the traumatic event – The person relives the event through unwanted and recurring memories, often in the form of vivid images and nightmares. There may be intense emotional or physical reactions, such as sweating, heart palpitations or panic when reminded of the event.
- Being overly alert or wound up – The person experiences sleeping difficulties, irritability and lack of concentration, becoming easily startled and constantly on the lookout for signs of danger.
- Avoiding reminders of the event – The person deliberately avoids activities, places, people, thoughts or feelings associated with the event because they bring back painful memories.
- Feeling emotionally numb – The person loses interest in day-to-day activities, feels cut off and detached from friends and family, or feels emotionally flat and numb.
It’s not unusual for people with PTSD to experience other mental health problems at the same time. These may have developed directly in response to the traumatic event or have followed the PTSD. These additional problems, most commonly depression, anxiety and alcohol or drug use, are more likely to occur if PTSD has persisted for a long time.
Symptoms and Effects of PTSD
Symptoms of PTSD can change over time. Some symptoms might appear within three months of a traumatic episode, or it might take years until the disorder fully comes about.
PTSD impacts the parts of the brain associated with memory and emotions. A healthy brain can tell the difference between past memories and present experiences, but PTSD interferes with this process. Someone with PTSD might react to a current environment that reminds them of past trauma. The brain responds as though the person is still in the past, triggering fear, anxiety and stress.
Suicidal thoughts are some of the most dangerous symptoms of PTSD. Abusing drugs or alcohol can intensify these thoughts.
Alcohol and drug addiction are also affected by memory. An addicted person’s brain is susceptible to triggers, or places and people associated with drug use that can lead to cravings. PTSD and addiction triggers can intertwine and intensify symptoms of both disorders.
PTSD Checklist
Have you experienced or seen something that involved death, injury, torture or abuse and felt very scared or helpless?
Have you then experienced any of the following:
- upsetting memories, flashbacks or dreams of the event?
- feeling physically and psychologically distressed when something reminds you of the event
If you answered yes to all of these questions, have you also experienced at least two of the following:
- had trouble remembering important parts of the event
- had very negative beliefs about yourself, others or the world
- persistently blamed yourself or others for what happened
- persistently felt negative, angry, guilty or ashamed
- felt less interested in doing things you used to enjoy
- feeling cut off from others
- had trouble feeling positive emotions (e.g. love or excitement)
And have you experienced at least two of the following:
- had difficulties sleeping (e.g. had bad dreams, or found it hard to fall or stay asleep)
- felt easily angered or irritated
- engaged in reckless or self-destructive behaviour
- had trouble concentrating
- felt on guard or vigilant
- been easily startled?
If all these things have been happening for a month or more, you may be experiencing post traumatic stress disorder.
How common is PTSD?
Anyone can develop PTSD following a traumatic event, but people are at greater risk if the event involved deliberate harm such as physical or sexual assault or they have had repeated traumatic experiences such as childhood sexual abuse or living in a war zone. Apart from the event itself, risk factors for developing PTSD include a past history of trauma or previous mental health problems, as well as ongoing stressful life events after the trauma and an absence of social supports.
Around 8 per cent of people will experience PTSD in their lifetime of which serious accidents are one of the leading causes of PTSD.
If you feel very distressed at any time after a traumatic event, talking to your doctor or other health professional is a good first step. If you experience symptoms of PTSD that persist beyond two weeks, a doctor or a mental health professional may recommend starting treatment for PTSD.
Many people experience some of the symptoms of PTSD in the first couple of weeks after a traumatic event, but most recover on their own or with the help of family and friends. For this reason, treatment does not usually start until about two weeks after a traumatic experience. Even though formal treatment may not commence, it is important during those first few days and weeks to get whatever help is needed.
Co-Occurring PTSD and Addiction
PTSD changes brain chemistry in much the same way substance abuse and addiction do. Often, these disorders form at the same time and feed off one another. The same trauma that caused PTSD can also trigger a substance use disorder.
Following a traumatic experience, the brain produces fewer endorphins, one of the chemicals that help us feel happy. People with PTSD may turn to alcohol and other mood-enhancing drugs, which increase endorphin levels. Over time, they may come to rely on drugs to relieve all of their feelings of depression, anxiety and irritability.
PTSD often causes people to feel disconnected from their friends and loved ones.
People with PTSD are more prone to violent outbursts and panic attacks, which can be difficult for family and friends to witness. Feelings of guilt over these outbursts can drive those with PTSD to self-medicate with drugs and alcohol. Continued use of alcohol or other drugs in this way can lead to an addiction.
Support from family and friends are very important for most people. Trying, as far as possible, to minimise other stressful life experiences allows the person to focus more on his/her recovery. If a person feels very distressed at any time after a traumatic event, he/she should talk to a doctor or other health professional. If a person experiences symptoms of PTSD that persist beyond two weeks, a doctor or a mental health professional may recommend starting treatment for PTSD.
Effective treatments are available. Most involve psychological treatment and/or medication to be prescribed in some cases in order to live a normal life.