Friday, 3 January 2014

12 Days of Mental Health : Day 8 - PTSD

Well in theory, this should be day nine, but I got a bit caught up and forgot to get a blog post for yesterday... apologies! Lucky for you, there are two blog posts coming your way to compensate.

Today's blog is from Charlotte, a lady I have recently got to know through Mark who did a guest post earlier this week on addiction. She's really lovely and I'm so chuffed she could put together such an amazing blog post in such a short space of time, so thank you!

Please note that this blog post may be extremely triggering for some. It is VITAL to look after yourself. If you're affected by this post, please do call the Samaritans on 08457 90 90 90. 

What is PTSD?

Post-traumatic stress disorder (often known as PTSD) comes under the umbrella of anxiety disorders, and can develop after a distressing or traumatic event (this does not include things like a job loss or exams, for example). In some, the symptoms may develop very quickly after the actual event, but for others, it may be weeks, months or even years before they start to experience symptoms of PTSD. For some, these experiences can cause PTSD - it's not completely clear why some people experience PTSD symptoms whilst others in the same situation do not. Some research suggests it is genetic, so if your parents have a mental health diagnosis, you may be more susceptible, alongside if you already have a pre-existing mental health diagnosis yourself. Other factors include the whether or not it was a natural disaster (terrorist attacks, violence and exploitation appear to increase the likelihood of someone developing PTSD rather than a natural disaster), whether or not you feared for your life, and whether you were conscious at the time of the event.

It's believed that PTSD could be linked to a natural coping mechanism to help you be prepared for if the traumatic event was to happen again.Studies have shown that the adrenaline/stress hormones in those with PTSD are still being produced a lot more than normal, even when there is no imminent danger, and it is the adrenaline that fuels our fight or flight response. The symptoms of this disorder can be extremely debilitating though, and it can really affect the quality of life in some individuals.

The types of event that make individuals vulnerable to PTSD include violent attacks, sexual abuse, military combat, witnessing violent deaths, road accidents, and natural disasters, amongst others. According to the NHS Choices website, around one in every three people who experience a traumatic event are likely to experience symptoms of PTSD.

What are the signs and symptoms of PTSD? 

It is not uncommon to feel no emotion at all immediately after a traumatic experience, or feel "numb". For some, PTSD symptoms may follow, and they can include:

  • Reliving the distressing event - this can come in the form of flashbacks, nightmares, or intrusive thoughts/images, or being triggered by certain things that remind of of the event. 
  • Feelings of guilt 
  • Avoidance - not wanting to talk about the experience, or avoiding certain places/people
  • Experience symptoms of anxiety and feeling "on the edge" 
  • Insomnia and difficulty in concentrating
  • Becoming easily upset or angry
  • Feeling emotionally unattached or disassociating
  • Difficulty in maintaining close relationships
  • Experiencing symptoms of depression, and maybe thoughts about harming yourself
In the first instance, always visit your GP for a diagnosis. Depending on how recently you experience a distressing event, they may take a watchful waiting approach to see if symptoms subside or if they worsen. Otherwise, your GP may make a referral to your local mental health team for treatment. 

What treatments are available? 

They are various treatment options for PTSD, and they can vary in suitability depending on how long ago the traumatic event was, or the type it was.  

CBT is often used, and can be targeted specifically. There are event age-appropriate CBT sessions for children. Trauma-focused CBT has been specifically formulated for those who have experience a traumatic event, and can be incredibly effective, teaching individuals how to replace negative ways of thinking into more positive ones. 

You may also be offered EMDR (eye movement desensitisation and reprocessing) which has more recently been used to help those suffering with PTSD. It involves recalling the incident whilst moving your eyes side-to-side following the direction of your therapist. (There's more information online about EMDR). 

There is also the option of medication for some, whether that is in the form of antidepressants, anti anxiety tablets, or something similar. 

The support of friends and family is always recommended as well, so open up to them if you can. If you know someone with PTSD, let them talk about their experiences and just listen - it's free to do as well. 

Charlotte's Story

I've never worried about writing a blog post before, have never struggled over an article - I am a writer by trade, you see. People have described my ability to write as a talent, as my gift but sitting here trying to find how to write about my PTSD leaves me speechless and unclear on where to start.

I hear so many people talking about the moment that changed their lives, the moment that made their lives, the moment they are waiting for, they moment they will know - a whole world made of moments and yet mine is dominated by just one. I spend most days plotting and planning how I might escape my moment, hoping I might wake up with out it in my mind, there altering my perceptions of reality and opinions of myself.

My moment, which is defined by the two 38 ton lorries smashing into the coach my friends and I were traveling on, caused my 13 year battle with Post Traumatic Stress Disorder. When first diagnosed, at 16, I thought I would at worst, wake up in cold sweats after nightmares, perhaps struggle with concentration and cry often about the event, the papers, the court case and of course, the funeral of my friends.

I was wrong and it didn't take me long to face the harsh realities of PTSD consuming my life, my thoughts and my thinking. My moment did more than crop up every now and again. Every time it flashed through my brain, appeared in my nightmares and flooded my thoughts, my knees weakened, my stomach turned and my heart shattered just a little more.

That tiny little moment, over time poisoned my brain - like a mouldy piece of fruit turning everything else in the bowl to mush. I lost my self respect, I hated myself, I destroyed anything that might be positive in my life. I was unable to build or maintain any normal relationships. I became obsessed in trying to undo the past, bargaining with whoever created that moment, pleading with them to undo it. I drank, I ate too much, I didn't sleep, I couldn't concentrate, I had no pride in anything and whilst the world was collapsing around me the only thing that existed in my brain was my `moment'.

Just after I turned 26, and I realised eleven years had passed whilst I had been in a dark and painful haze, I tried to take my own life. It was New Years Eve and whilst others celebrated , loved, thanked and looked to the future, I hoped for freedom. 

Thankfully, I woke up and found myself in the care of a mental health team who were able to get me on some medication that gave my brain a volume switch and allowed me to press pause whilst I, initially, just slept peacefully for a few days. In the weeks that followed, I worked hard to address my past - pulling some of it out my brain and finding ways of simply file other parts of it away. I had the support of psychiatrists, care workers and my GP but also created my own tools and methods for coping. 

For example, I wrote myself a 'mind diet', listing activities, food and people that had a positive impact on my mental well being and those that had a detrimental effect. I kept a mind diary, noting what I had been up to and how it had made me feel. I had long and painful conversations with people around me, being painfully honest whilst giving them the opportunity to support me in my recovery. I drew mind maps, linking the details of the coach crash and the surrounding events and my fears, anxieties, ambitions so that I understood and objectified them and I forced my brain to accept and explore the most painful and tragic experiences I will ever face.

Yet somewhere, towards the beginning of Spring, I felt better and I found that hours and then days and eventually weeks passed without nightmares, panic attacks or destructive thoughts. I found motivation, aspiration. I began to have fun, I experienced freedom and have slowly but surely began to like myself and realise that life is made of many moments and with the right medication, the right people around you and lots of hard work and bravery, you can control the impact moments have on your life. I have learnt that pain can be transient rather than permanent but most, when you and your brain have a tough time, you must be kind to yourself. You must be honest with those around you so that they can understand and help and you need to accept that there will be good and bad days. I couldn't have done it without the medication to support me and certainly needed expert help and am eternally thankful to everyone that fought my stubborness, accepted my anger and cared when I cried.

I hope that from my journey, those stuck in their moment will find the strength to keep walking rather than giving in.

Further Information

If you require immediate support, please call the Samaritans on 08457 90 90 90. They're open 24 hours a day, 7 days a week, 365 days of the year.