PTSD
Treatment for PTSD via telehealth with Epsychiatry
Post Traumatic Stress Disorder, commonly referred to as PTSD, is a psychiatric disorder that develops in response to an extremely traumatic and often life-threatening event or situation. Traumatic events commonly associated with PTSD include things like experiencing or witnessing physical violence, serious injury, sexual assault or rape, terrorism, war/combat or a natural disaster.
Repeated exposure to trauma can also lead to prominent PTSD symptoms, as is the case for people in emergency services, domestic violence scenarios or the military. Trauma that occurs at an early age can be particularly damaging, particularly if it is associated with a parent or caregiver. Our psychiatrists and psychologists are experienced in treating PTSD and other trauma-related disorders and are here to provide caring, professional support to those in need.
What factors contribute to PTSD?
We aren’t really sure why some people develop PTSD and others don’t follow a traumatic event or experience. Research shows about 1 in 3 people who experience a traumatic event will go on to develop PTSD. Many factors are thought to interact with each other to cause a traumatic stress reaction. If you have any of the following, you may be at a higher risk for PTSD:
- Long-lasting or repeated trauma
- A history of childhood trauma or early life abuse
- Family history of mental health problems (suggesting a genetic link)
- The presence of pre-existing mental health problems, including depression, anxiety and substance misuse
- Poor social support and the presence of other stressors in your life
- Having certain personality traits, such as anxiety, neuroticism or the tendency to be risk-averse and avoid harm
What are the signs and symptoms of PTSD?
People are affected by trauma in different ways and every person’s experience of PTSD is unique to them. With that said, there are some common signs and symptoms to look out for. By its very nature, PTSD involves re-experiencing the feelings of extreme fear and panic that were felt at the time of the traumatic event/s.
Other signs and symptoms can generally be classed into 4 main categories:
- Re-experiencing the traumatic event through unwanted memories (called ‘intrusive memories’, often in the form of images or nightmares) that are recurrent, highly distressing and often accompanied by an intense physical and emotional response.
- Changes in physical and emotional reactions, such as being alert or on edge most of the time, constantly on the lookout for danger, feeling irritable and unable to concentrate, trouble sleeping, being easily startled, and strong feelings of guilt or shame.
- Avoiding triggers for your painful memories, including reminders of the traumatic event (people, places, activities), certain emotions and thoughts, and talking about the event with others.
- Negative changes in thinking and mood, including feeling emotionally numb, detached from friends and family, unable to enjoy life, and having negative views of yourself, others or the world.
PTSD can often occur alongside other mental health problems, such as depression and anxiety. Some people turn to drugs or alcohol in an attempt to cope with their PTSD symptoms and this can lead to many consequences, including problems with addiction.
How can PTSD affect you?
- Avoiding certain places and other triggers can limit someone’s activities. Say for example you live in a small town and had a serious car accident on the nearby highway, your PTSD symptoms might prevent you from driving on that stretch of road.
- Some people turn to alcohol or drugs to numb themselves and suppress their PTSD symptoms. Self-harm which comes in various forms is another means people use to poorly cope with their difficulties.
- PTSD can affect your concentration which, in turn, can impact your work. You might find it hard to pay attention, which can leave you feeling scattered and then lacking in motivation.
- Trauma might leave you feeling disconnected from your emotions. It can also make you feel guilty and blame yourself for what has happened. This in turn impacts your self-confidence and a sense of foreshortened future.
- Our emotions impact the way we think and the decisions we make. If your traumatic experiences leave you feeling guilty and not trusting, the decisions you make at work and at home will be affected.
Complex PTSD – what is it and what are some causes?
Complex PTSD, otherwise known as PTSD, occurs in response to severe, prolonged or repeated traumatic events (e.g. domestic violence, childhood abuse or being a prisoner of war). PTSD, on the other hand, generally relates to a single, isolated traumatic event (e.g. a robbery, single sexual assault, or bushfire)
People with PTSD often experience a more pronounced negative impact on their personality, identity, mood, memory and concentration and ability to regulate their own emotions. They often experience overwhelming and highly changeable emotions, which they can react to in unhelpful ways (e.g. explosive outbursts or complete detachment from emotions). People with PTSD are also more likely to have difficulties in relationships, view themselves negatively and engage in self-harm and suicidal behaviours.
Other mental health conditions and PTSD
Comorbidity is the rule, not the exception for PTSD. Researches show that around 80% of people with PTSD have another mental health diagnosis. Co-occurring mental health diagnoses, whether they predate or follow the PTSD, have the potential to exacerbate the trauma-related symptoms and prolong recovery.
Anxiety and depression are the most common diagnoses that occur alongside PTSD. For example, research has shown around 50% of people with PTSD also meet diagnostic criteria for Major Depressive Disorder.
Alcohol and substance use disorders are also common, with people turning to these things in an attempt to self-medicate. Rates of intentional self-harm and suicidal behaviour are also higher in people with PTSD.
What is a flashback?
A flashback is a re-experiencing event that feels like the past trauma is happening at that moment. Flashback experiences can include the following:
- Experiencing emotions that you remember from the trauma
- Feeling physical sensations such as pain
- Noticing and re-experiencing sensations from the trauma. Examples of this could include seeing part images of what happened and hearing sounds from that event.
You may notice that certain people or situations trigger a flashback. Flashbacks can last minutes or even hours in duration.
PTSD self-care
- Learn what your triggers are. You may find that certain experiences trigger re-experiencing events of the past trauma. Certain people find anniversaries, smells and places quite triggering.
- Everyone’s experience of PTSD is different. Often it is not helpful to talk about experiences before you are ready to do so. Be patient and don’t judge yourself too harshly if you take longer to open up. Often people who experience PTSD find it hard to share what they are going through. That is understandable. Remember, you don’t need to talk about the traumatic event to express what you are feeling now.
- Peer support is when you have others who have had similar experiences share their knowledge, emotional and practical help. You can search locally or online for support groups. Some people who have experienced trauma find peer support invaluable.
- A lot of people who experience PTSD struggle with sleep. You might find it hard to fall asleep because of intrusive thoughts or be fearful of going to sleep due to nightmares. Good sleep hygiene practices which you learn online are often an initial step you can take to get better sleep.
- Flashbacks are very distressing and are a common occurrence in PTSD. Grounding techniques for example counting objects or focus on your breathing are some ways to foster control. Also, use ways to comfort yourself when distressed, this could include playing with a pet or listening to music.
Getting Help for PTSD
Often a good first port of call to accessing care is your GP. In Australia, your family doctor can refer you to see a psychologist or a psychiatrist. You need a referral in order to receive a Medicare rebate. You can see a psychologist or psychiatrist online or in person. They will be able to diagnose you and commence your treatment.
Talking Therapies for PTSD
There are currently two forms of therapy the National Institute of Health Care Excellence (UK) recommends. They are Trauma-focused CBT and EMDR. There are many psychologists across Australia who do both forms of therapy
- Trauma-Focused CBT – This is a type of CBT that has a trauma focus. It is an evidence-based treatment model that can be used with children and adults. It can be used with people who have experienced single or multiple traumatic events. The guidelines recommend 8-12 sessions.
- Eye movement desensitization and reprocessing (EMDR) is a popular treatment for PTSD. It involves the client moving their eyes from side to side whilst focussing on a distressing memory. These eye movements help with the processing of these memories. Also similar in some sense to the eye movements that occur at night.
- Noticing and re-experiencing sensations from the trauma. Examples of this could include seeing part images of what happened and hearing sounds from that event.
PTSD Medication
Generally, therapy is the first-line treatment for PTSD. Therapists use antidepressants most commonly as a medication for PTSD. Your doctor will prescribe you medication if therapy isn’t providing you adequate symptom relief. In the short term, we also can use sedative medication to help with PTSD.
Consider speaking with your GP regarding symptoms you experience that might suggest PTSD. They will be able to refer you to a psychologist or psychiatrist. Contact our friendly coordination team to book an appointment with one of our clinicians.
PTSD Guidelines
On 22 December 2021, the National Health and Medical Research Council updated the Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD. These guidelines provide recommendations reflecting current evidence on how to better respond to the needs and preferences of people living with these mental health issues. You can find the guideline on the Phoenix Australia website.
These Guidelines have been endorsed by each of the Royal Australian and New Zealand College of Psychiatrists, and the Australian Psychological Society.