Essay: Understanding PTSD.

Helping Someone With Post-Traumatic Stress Disorder

Trauma is a condition that can be associated with the emotional or psychological response to a traumatic event such as sexual abuse, physical abuse, TraumaTrauma, any accident or the case of an individual caught in a natural disaster. Shock and denial are common emotions experienced immediately after a traumatic occurrence. Ongoing effects include unexpected emotions, memories, issues in a personal relationship, and sometimes physical discomfort like headaches or nausea in the long term. However, it is important to recognise that if a person experiences feelings of grief or sadness following a traumatic event, it does not necessarily mean they will develop PTSD or C-PTSD.

Anxiety disorder can have a detrimental influence on an individual’s your emotional well-being, and and can be debilitating. People who have experienced a terrible event may suffer from PTSD, which is a mental health disease that impairs their capacity to cope with the event. They mean suffer from bad dreams and have flash backs which remind them of the event. Trauma informed mental health care allows a person suffering from a mental illness to first address symptoms of the diagnosed illness such as depression, anxiety or borderline personality disorder prior to the trauma being processed.

PTSD is caused by being exposed to TraumaTrauma, which might include having a painful experience, witnessing a catastrophic event, or simply knowing about a horrific incident.

Some of the events that could lead to PTSD

• Military warfare
• Sexual or physical assault
• Abuse or neglect
• Natural calamities are all possibilities.
• Accident involving automobiles
• Traumatic birth experience  (postpartum PTSD)
• Terrorist attack

 

https://futuredays.org.uk/emdr-ptsd-trauma-therapy/

Symptoms of PTSD usually appear within three months after a traumatic event.  With many people they are less noticeable as they are able to learn to manage the symptoms and in about 15 % of people, PTSD may not manifest until years after the event.  Some people may recover within six months and this can vary.

PTSD can impact an individual with their daily living, relationships, career, and health and can result in the development of mental health disorder that is depression and anxiety.  

A diagnosis of C-PTSD includes the same symptoms of PTSD and can include difficulty regulating emotions, a feeling of worthlessness and problems with interpersonal relationships (2022 PTSD UK) 

PTSD: The Definitive Guide - The Warrior's Journey® (thewarriorsjourney.org)

A psychiatrist would carry out a mental health assessment to diagnose the individual suffering from PTSD and their your GP would carry out an initial assessment to decide on the care needed which would include sincludes your  social, physical, and mental needs and risk. From the assessment, the medical professionals would decide if the individual you needs to be referred to the Community Mental Health Team (CMHT) and if they have you have symptoms for over 4 weeks or are worse.  The guide used by doctors to help diagnose the different mental health conditions is the International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual (DSM-5).

What is Trauma?

Medical professionals recognise that some types of traumas have additional effects to PTSD and use terms such as enduring personality change after catastrophic experience (EPCACE) and in America use the term disorders of extreme stress (DESNOS).

The image below indicates how common trauma is in everyone’s life:

(https://www.ptsduk.org/14/)

Help them accept the rhythms of their daily (and often monotonous) existence and learn to live with them. If they are suffering from anxiety, it may be tempting to withdraw and avoid situations that may exacerbate their symptoms. Working around their symptoms is frequently possible and might help them manage their symptoms better. Make no apprehensions about requesting any alterations that would assist them in achieving success at school or their place of employment. It's excellent if they have supportive friends and family members that are there to support them. Their friends and family members are likely glad to help them, so let them know what they require, whether it's transportation to appointments, monthly coffee dates to get them out of the house, or simply an understanding ear to listen to them out loud. Make them well aware, drinking themself to oblivion with a bottle of whiskey is not a sustainable option in the long run. Yes, taking medications to escape the painful features of PTSD may seem enticing. Alcoholism and drug addiction, on the other hand, can be damaging and make their recovery more difficult in the long run.

The main treatments for PTSD include medication and psychological therapies as follows:

• Trauma-focused cognitive behavioural therapies (TF-CBT) which help individuals accept and talk about what has happened by making them think differently about the event.
• Eye movement desensitisation and reprocessing (EMDR) which uses eye movement while thinking of the event by helping your brain reprocess the event.
• Talking therapies can be used to target specific things such as difficulty sleeping.
• Medication can be offered if therapy has not worked which is reviewed regularly and can help with symptoms of depression and anxiety.
• In cases of complex PTSD, care needs to be taken on therapy used as some treatments , if not used correctly, can worsen the situation if not used correctly..
• People can manage PTSD through self-care which includes learning to relax, practice mindfulness and mediation, exercise, follow routines and by eating a balanced diet.

• A person suffering from PTSD may find it necessary to talk about the painful experience over and over again. Remember that this is a normal part of the healing process, and resist the urge to advise their loved one to stop rehashing the past and move on. Instead, offer to speak with them as many times as they require.
• Help them maintaining their composure in the face of an emotional outburst is essential. This will indicate to their loved one that they are "safe," which will help to avoid the situation from developing further.
• Allow the individual some room. Avoid encircling or grasping the individual. A traumatized individual may feel endangered as a result of this.

• Mind's helplines (https://www.mind.org.uk/information-support/helplines/)
• Local Minds (https://www.mind.org.uk/about-us/local-minds/)
• Side by Side

(https://sidebyside.mind.org.uk/?_adal_ca=cg%3DOrganic.1647453388070&_adal_cw=1647430866341.1647453388070)

This leaflet provides information to professionals including families and gives them a better understanding of PTSD, (sometimes described as an ‘acute stress reaction’) and provides an insight into how PTSD can develop when a loved one has been subjected to a traumatic event. There is a misconception that when an individual experiences trauma, they will develop PTSD and although trauma does have a significant impact, it does not always lead to mental illness.

Anxiety disorder, often known as PTSD, arises when a person has been subjected to a stressful experience of some kind. The event has to be experienced in one of five described ways on a regular basis, the individual must avoid stimuli associated with the event in three of seven defined ways, and the person must display at least two symptoms of hyperarousal that were not present prior to the event (Greene et al., 2021).

In the treatment of PTSD, a number of approaches are often used, including key event stress debriefing, cognitive behavioural therapy, and eye movement desensitisation and reprocessing. It is believed that up to 3 out of every 100 persons may suffer from PTSD at some point in their lives (Knott, 2017). According to military research undertaken all around the world, there is a wide range in the prevalence of PTSD.

Anxiety Due to Trauma

Anxiety disorders such as post-traumatic stress disorder (PTSD) can develop following exposure to traumatic events such as physical or sexual assault, injury, combat-related trauma, natural disaster, or death. The neurological foundation of post-traumatic stress disorder (PTSD) has been clarified by an increasing number of neurobiological investigations carried out over the past 20 years, although the neuronal alterations behind PTSD are still not understood (Boccia et al., 2015). According to the findings of a recent study (Miragoli et al., 2017), age was a significant factor in building narrative coherence and predicted the level of orientation, the sequence of events, and the level of evaluation of the event participants had during the event. Instead, narrative coherence and cohesion were found to be associated with posttraumatic stress disorder (PTSD). As a result, narrative fragmentation may prove to be an effective diagnostic tool for understanding the impact of post-traumatic stress disorder (PTSD) in children. Furthermore, in a court situation, the traumatic consequences of post-traumatic stress disorder (PTSD) on the narrative coherence and cohesion of a child's testimony could be crucial indicators in the appraisal of the child's testimony. It was discovered in the research of Atwoli and colleagues (2014) that there are significant differences in the distribution of trauma and post-traumatic stress disorder (PTSD) among orphaned and separated children in different domestic care environments, with street youth suffering more than those in CCIs or households. Bullying and sexual abuse must be addressed, particularly in extended family settings, and interventions are required. Street youth, a hitherto unserved and underserved demographic, are in desperate need of specialised mental health care and assistance.

Studies conducted in the United Kingdom have discovered that the prevalence of PTSD does not increase or only slightly increases with time following the completion of a prior tour of duty; however, some researchers have discovered that the incidence of PTSD increases with time following the completion of a prior tour of duty (Rona et al., 2016). In some circumstances, researchers have observed that delayed presentation can occur in as many as 70% of post-traumatic stress disorder patients over a three-year period in some cases. Military soldiers who had previously had some symptoms but subsequently acquired full-blown cases of PTSD as a result of their war experiences account for 20% of all cases of delayed PTSD found by the Department of Defense (Rona et al., 2012).

Based on the study's findings (Karatzias et al., 2017), it was established that theoretical and experimental research should be conducted in a progressive manner to design an intervention programme for persons who are suffering from  PTSD. It was specifically intended to increase the treatment potential of the Disturbances in Self-Organisation (DSO) cluster by lowering the number of symptoms present in the cluster, which is particularly important for patients with Alzheimer's disease. A reduction in the number of DSO items is being contemplated to better align with the overarching objectives of the International Classification of Diseases (ICD)-11.

Causes of PTSD

An investigation by Garcia et al. (2018) revealed that sexual assault has the potential to cause major emotional consequences for its victims, but that there is a great deal of variation in the symptoms described by various victims. The identification of risk variables related with symptoms displayed by victims of sexual abuse is therefore crucial to provide effective treatment. The severity of the sexual abuse was found to be a negative predictor of self-efficacy, while self-efficacy was found to be a positive predictor of active coping and a negative correlate of symptomatology. At the end of the day, the sense of family support was positively associated with self-efficacy and adversely associated with symptomatology.

According to the findings of a study conducted by Runyon et al. (2014), youth referred for treatment in the aftermath of child sexual, physical, or both sexual and physical abuse presented with a variety of profiles of PTSD symptom clusters, indicating the need for individualised tailoring of evidence-based treatments. According to the findings of the study conducted by (McNally et al., 2017), the network approach to mental diseases provides a fresh paradigm for conceiving post-traumatic stress disorder (PTSD) as a causal system of interacting symptoms. PTSD is swiftly becoming an important subject for network analytic approaches to psychopathology, and it is expected to become even more so. The mapping of the structure of links among PTSD symptoms, particularly across different trauma types, is a vital first step in the treatment of PTSD. According to the findings of a study conducted by Aakvaag et al. (2016), there is growing interest in trauma-related shame and guilt in general. However, there is still much to learn about the relationship between these emotions and the sort of event, gender, and mental health. The greater the number of different types of violence that were recorded, the greater the degrees of shame and guilt. Clinicians should be aware of the feelings of shame and guilt that can accompany a range of violent incidents, including non-sexual violence, in both men and women, and should be particularly mindful of whether an individual has had repeated violent encounters in his or her lifetimeIn their research (O'Driscoll & Flanagan, 2015), they discovered that difficulties with sex are common after sexual trauma, but that they are rarely addressed as part of the therapy of PTSD. Whenever outcomes related to sexual function are included, they are considered as a secondary measure to other measures. While it is impossible to draw definitive conclusions from the existing information, it appears that psychiatric treatment for PTSD has no influence on sexual issues. Despite some improvement over the course of treatment, pre-post effects imply that treatment was effective. This finding may be improved if treatment specifically targeted sexual difficulties. In light of the paucity of data in this area, it appears that there is a significant need for additional research in order to develop a set of evidence-based guidelines for practitioners conducting treatment in this area. It was discovered by Raabe et al. (2015) that Imagery Rescripting as a standalone treatment is possible and beneficial in an outpatient population with CA-related PTSD without the need for prior stabilisation in a research conducted in the United Kingdom.

Diagnosis, Severity and Duration

Researchers have been looking at mental health issues that Veterans are experiencing all around the world for the past ten years, as shown by the findings of research done by Murphy et al. (2017). The number of Veterans seeking treatment for mental health problems has increased fourfold in recent years, according to a new study done in the United Kingdom, among other things. Nonetheless, despite the fact that the vast majority of those who requested assistance were married, experts discovered that less attention had been paid to the needs of Veterans' close companions than they would have liked (Loucks et al., 2019). People all across the world have been adversely affected by the limitations on social engagement imposed in response to the Covid-19 outbreak, according to the conclusions of a study carried out by (Olding et al., 2020).

A traumatic injury can be caused by a variety of circumstances, with interpersonal violence and self-harm being the two most common types of traumatic injuries that can be seen in most healthcare centre(Jones et al., 2018). Inequalities in access to justice disproportionately affect the most disadvantaged, and the government's efforts to reduce crime, particularly in the capital, have gotten a lot of attention recently. Being that there is the prospect of an extended time of restrictions as a result of the ongoing pandemic, it is critical to identify those who are most at risk and to put in place measures to aid those individuals and groups of people as soon as possible (Palmer et al., 2019).

According to researchers (Murphy and Turgoose, 2019), many war veterans in the United Kingdom are still unable to access psychiatric treatment for PTSD. Those seeking treatment must first overcome several practical obstacles, such as balancing employment and other obligations with attendance at residential or outpatient sessions, before they can make significant progress. Mental treatment for veterans needs more accessible and flexible means of delivery, and research is now being conducted in this field.

According to the findings of a recent study (Ashwick et al., 2019), veterans suffering from mental health illnesses are hesitant to seek treatment because of several practical and psychological difficulties they must face before receiving treatment. Here are a few illustrations: Teletherapy has been recommended as an alternative method of delivering care to ensure that patients who are difficult with the treatment they need. Twenty-six persons who had engaged in teletherapy for PTSD  were followed up by the researchers after their treatment had concluded, including those who had not completed the whole course of therapy.

Living with PTSD

According to Jones et al.,  (2018), the trainers were tested within six pre-existing training teams that were randomly allocated to provide either a resilience-based intervention (SPEAR) or standard training (control) to applicants during the recruiting process. Twenty-three trainers delivered SPEAR instruction throughout the programme, while eighteen instructors delivered control instruction. Many mental ailments, including PTSD, common mental disorders (CMD), alcoholism, homesickness, and mental health stigmatisation, were investigated at the outset of this study, with the findings used to influence the course of the remainder of the examination.  Although potential confounders were taken into consideration in the analysis, there were no statistically significant differences between the groups when it came to levels of PTSD, chronic medical distress (CMD), alcohol use, and help-seeking behaviour, and homesickness at any of the assessment points.

There are various signs and symptoms connected with  PTSD, including sleepiness, irritability, poor concentration, hypervigilance, and increased startle response, to name a few (Possemato et al., 2017). If the symptoms persist for more than a month and damage one's capacity to function at the job, in social situations, or one's personal life at the time of diagnosis, the condition is classified as severe. In the treatment of PTSD, a variety of therapies have been studied and assessed, with some proving to be more effective than others in certain instances. Even though Critical Incident Stress Debriefing (CISD) is the most often employed strategy, it is not necessarily the most effective one that may be employed (CISD). Known as cognitive behavioural therapy (CBT), this type of psychological intervention for trauma sufferers entails them participating in a one-to-three-hour "debriefing" session as soon as possible after the Trauma occurs (Rothbaum et al., 2014). A debriefing session follows the encounter, during which the participants are invited to express their thoughts and feelings about the traumatic event, and the group leader tells them about the potential trauma symptoms that may appear as a result of the experience (Dalton et al., 2018).

 Most individuals are fully aware of the long-term consequences of neglecting to seek treatment for mental diseases as soon as they manifest themselves, and they understand the need of acting when they do. It is critical to educate oneself about the reasons that contribute to the failure of service members suffering from mental health difficulties in the United Kingdom to receive treatment, as this will enable support personnel to seek help more promptly in the future (Murphy and Busuttil, 2014). Murphrey et al., (2014) revealed that individuals willingness to seek mental health treatment was influenced by a range of variables. A number of internal stigma-fighting components, such as encouraging individuals to develop an internal locus of control, have been shown to be particularly effective in encouraging individuals to engage in assistance-seeking behaviour, as evidenced by a study.

How to Support Individuals with PTSD

 Meiser-Stedman et al.,  (2016) conducted the study and discovered that psychological counselling and medication are the most effective treatments for PTSD that an individual may use to help in their rehabilitation. Despite the fact that dealing with traumatic situations can be extremely difficult, expressing their thoughts and obtaining professional assistance is sometimes the only way to fully heal from PTSD and other forms of anxiety. The technique of eye movement desensitisation and reprocessing (EMDR) will be discussed in further detail in the next section. This treatment is intended to specifically address the condition of PTSD. It is recommended that persons suffering from severe PTSD get treatment within one month after the occurrence. The patient is encouraged to make rhythmic eye movements during the course of the treatment in order to keep the information processing system in the brain active while receiving this therapy.

In conclusion, families and healthcare worker who is working with a patient suffering from PTSD must be aware of the disease and know where to get extra resources for the patient. It is also critical for the nurse to establish a trustworthy connection with the patient via effective communication and empathy. Therapeutic or healing touch should be used by the nurse in order to build trust between the patient and the nurse. In addition, the nurse should be knowledgeable about the signs and symptoms of drug or alcohol misuse, as many patients may use these substances to alleviate the symptoms of PTSD. It is critical for the nurse to monitor the patient for indicators of PTSD, such as avoidant behaviour and disassociation. As a result, the nurse should be aware that the patient may have difficulty sleeping as a result of dreams associated with the traumatic occurrence. Suggest to the patient that he or she practise relaxation methods before going to bed. If the nurse is around throughout the night, she or he might give the patient a back massage to help them relax and go asleep. It is important for the nurse to ensure that the patient's treatment centre is as peaceful as possible during the nighttime hours. PTSD is a serious anxiety illness that can significantly impair a person's ability to function in daily life for a prolonged length of time. It is critical that the patient get treatment as soon as possible because the disorder has the potential to have major consequences on the person's health and well-being. Psychotherapy treatments are the most effective approach to treating people suffering from PTSD.

Useful Contacts

References

Ashwick, R., Turgoose, D., & Murphy, D. (2019). Exploring the acceptability of delivering Cognitive Processing Therapy (CPT) to UK veterans with PTSD over Skype: a qualitative study. European Journal of Psychotraumatology, 10(1), 1573128. https://doi.org/10.1080/20008198.2019.1573128

Dalton, J. E., Thomas, E. W. S., Melton, H. A., Eastwood, A. J., & Harden, M. (2018). The provision of services in the UK for UK armed forces veterans with PTSD: a rapid evidence synthesis. Health Services and Delivery Research. https://eprints.whiterose.ac.uk/133790/

Dr Laurence Knott. (2017, August 9). Post-traumatic Stress Disorder. Patient.info. https://patient.info/mental-health/post-traumatic-stress-disorder-leaflet

Greene, T., Harju-Seppänen, J., Adeniji, M., Steel, C., Grey, N., Brewin, C. R., Bloomfield, M. A., & Billings, J. (2021). Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19. European Journal of Psychotraumatology, 12(1), 1882781. https://doi.org/10.1080/20008198.2021.1882781

Jones, N., Whelan, C., Harden, L., Macfarlane, A., Burdett, H., & Greenberg, N. (2018). Resilience-based intervention for UK military recruits: a randomized controlled trial. Occupational and Environmental Medicine, 76(2), 90–96. https://doi.org/10.1136/oemed-2018-105503

Karatzias, T., Cloitre, M., Maercker, A., Kazlauskas, E., Shevlin, M., Hyland, P., Bisson, J. I., Roberts, N. P., & Brewin, C. R. (2017). PTSD and Complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania. European Journal of Psychotraumatology, 8(sup7), 1418103. https://doi.org/10.1080/20008198.2017.1418103

Meiser-Stedman, R., Smith, P., McKinnon, A., Dixon, C., Trickey, D., Ehlers, A., Clark, D. M., Boyle, A., Watson, P., Goodyer, I., & Dalgleish, T. (2016). Cognitive therapy as an early treatment for post-traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action. Journal of Child Psychology and Psychiatry, 58(5), 623–633. https://doi.org/10.1111/jcpp.12673

Murphy, D., & Busuttil, W. (2014). PTSD, stigma and barriers to help-seeking within the UK Armed Forces. Journal of the Royal Army Medical Corps, 161(4), 322–326. https://doi.org/10.1136/jramc-2014-000344

Murphy, D., Hunt, E., Luzon, O., & Greenberg, N. (2014). Exploring positive pathways to care for members of the UK Armed Forces receiving treatment for PTSD: a qualitative study. European Journal of Psychotraumatology, 5(1), 21759. https://doi.org/10.3402/ejpt.v5.21759

Murphy, D., Palmer, E., Hill, K., Ashwick, R., & Busuttil, W. (2017). Living alongside military PTSD: a qualitative study of female partners’ experiences with UK Veterans. Journal of Military, Veteran and Family Health, 3(1), 52–61. https://doi.org/10.3138/jmvfh.4011

Murphy, D., Spencer-Harper, L., Carson, C., Palmer, E., Hill, K., Sorfleet, N., Wessely, S., & Busuttil, W. (2016). Long-term responses to treatment in UK veterans with military-related PTSD: an observational study. BMJ Open, 6(9), e011667. https://doi.org/10.1136/bmjopen-2016-011667

Murphy, D., & Turgoose, D. (2019). Evaluating an Internet-based video cognitive processing therapy intervention for veterans with PTSD: A pilot study. Journal of Telemedicine and Telecare, 1357633X1985039. https://doi.org/10.1177/1357633x19850393

Olding, J., Zisman, S., Olding, C., & Fan, K. (2020). Penetrating TraumaTrauma during a global pandemic: Changing patterns in interpersonal violence, self-harm and domestic violence in the Covid-19 outbreak. The Surgeon. https://doi.org/10.1016/j.surge.2020.07.004

Palmer, L., Thandi, G., Norton, S., Jones, M., Fear, N. T., Wessely, S., & Rona, R. J. (2019). Fourteen-year trajectories of post-traumatic stress disorder (PTSD) symptoms in UK military personnel, and associated risk factors. Journal of Psychiatric Research, 109, 156–163. https://doi.org/10.1016/j.jpsychires.2018.11.023

Possemato, K., Kuhn, E., Johnson, E. M., Hoffman, J. E., & Brooks, E. (2017). Development and refinement of a clinician intervention to facilitate primary care patient use of the PTSD Coach app. Translational Behavioral Medicine, 7(1), 116–126. https://doi.org/10.1007/s13142-016-0393-9

Rona, R. J., Burdett, H., Bull, S., Jones, M., Jones, N., Greenberg, N., Wessely, S., & Fear, N. T. (2016). Prevalence of PTSD and other mental disorders in UK service personnel by time since the end of deployment: a meta-analysis. BMC Psychiatry, 16(1). https://doi.org/10.1186/s12888-016-1038-8

Rona, R. J., Jones, M., Sundin, J., Goodwin, L., Hull, L., Wessely, S., & Fear, N. T. (2012). Predicting persistent post-traumatic stress disorder (PTSD) in UK military personnel who served in Iraq: A longitudinal study. Journal of Psychiatric Research, 46(9), 1191–1198. https://doi.org/10.1016/j.jpsychires.2012.05.009

Rothbaum, B. O., Kearns, M. C., Reiser, E., Davis, J. S., Kerley, K. A., Rothbaum, A. O., Mercer, K. B., Price, M., Houry, D., & Ressler, K. J. (2014). Early Intervention Following Trauma May Mitigate Genetic Risk for PTSD in Civilians. The Journal of Clinical Psychiatry, 75(12), 1380–1387. https://doi.org/10.4088/jcp.13m08715