Treating post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a mental health problem that is triggered by either experiencing or witnessing a highly stressful event. It can occur in both children and adults. In Kenya, most people with PTSD are often dismissed as ‘attention-seekers’ and few get the psychological support and medical intervention that they need.

PTSD does not just affect soldiers

PTSD is, traditionally, thought to occur among soldiers who have experienced disturbing events in war. PTSD can occur in civilians after other life events. Some of these life events are not universally traumatic but can be challenging (in other words, different people can experience the same terrifying event but only one or two will develop PTSD). PTSD can develop a few weeks, months or even years after a disturbing event.

Events that could lead to PTSD

Childbirth: Labour and childbirth can be very traumatising. This is often the case if a mother develops complications or if she delivers a child with health problems. A woman can also develop PTSD if healthcare workers treat her inappropriately during childbirth.

Road traffic accidents: Accidents in which one nearly loses their lives or where one gets severely injured or disabled can lead to development of PTSD. It can also develop if one is involved in an accident where others lose their lives.

Robbery/Mugging: Violent robbery tends to leave one feeling violated and vulnerable. It has also been known to lead to PTSD.

Sexual assault: Rape and defilement often has a lifelong effect on the victim. In most cases, one is not able to completely put the event out of one’s mind. It is one of the most common causes of PTSD.

Child abuse: Most children are not able to voice their complaints if they are being abused. However, it is not unusual for them to develop long-term effects of this abuse.

Witnessing violent deaths: This is a common cause of PTSD among soldiers deployed for military combat. Most cannot get the violent scenes of the battlefield out of their minds (even years after they leave the military).

Unexpected loss of a loved one: The death of a loved one is very traumatising — especially if it was violent. It can be disturbing if you witness their demise.

Terrorist attacks: Events involving terrorism and being held hostage could lead to lifelong trauma. Ideally, anyone involved in a terrorist attack should undergo counselling to help deal with the emotions and long term mental effects of this situation.

Natural disasters: Earthquakes, floods, tsunamis, hurricanes etc are all terrifying events that can lead to long-term mental anguish.

Diagnosis with a life-threatening condition: Experiencing life-threatening health issues such as a heart attack can lead to PTSD. The same can occur if you are informed that you have a health condition such as cancer (especially if the news is given to you unprofessionally).

How does PTSD manifest?

Intrusive thoughts

One may experience recurrent flashbacks and memories of the event that triggered the PTSD. These are accompanied by nightmares and night terrors during which one relives the traumatising events. In addition, one may experience emotional and physical reactions to things that remind you of the traumatic event you experienced. For example, if you had a road traffic accident involving a matatu, you may find yourself shaking uncontrollably each time you see or enter a matatu.

Negative thoughts and anger

PTSD changes ones perception of themselves. You begin to have negative thoughts about yourself and even those around you. You become detached from friends and family and it becomes difficult to maintain close relationships.

One may even lose the joy of living and feel hopeless about the future. There may also be violent outbursts and irritability. These outbursts may be followed by overwhelming feelings of shame or guilt.

Anxiety

PTSD is often accompanied by anxiety, which is often triggered by unexpected events. For example, a person may go into panic mode if a child ruptures a balloon next to him.

Often, they have heightened awareness of their surrounding and are always on guard for danger.

Avoidance

The natural response to trauma is to avoid things that remind you of the traumatic event. Patients with PTSD avoid people or places that remind them of the event. In addition, they avoid talking and opening up about the event.

Poor work performance

This is usually as a result of poor concentration and memory. Some people develop a lack of interest in things that they previously enjoyed. You may also not be able to perform your job optimally because you are getting intrusive thoughts about the past traumatic event. Sleeping patterns also change — often developing insomnia, which affect performance.

Sexual changes

PTSD can lead to lack of sexual interest. In particular, women who have had a traumatic childbirth may avoid sex to ensure that they do not get pregnant again (and experience the same trauma).

Self-destructive behaviour

Coping mechanisms for PTSD are sometimes destructive including alcohol abuse, drunk driving, reckless sexual behaviour, drug abuse, gambling, eating problems (over eating or starving oneself) etc.

Suicidal thoughts and actions

It is not unusual to have people struggling with PTSD develop suicidal thoughts. Often, they are unable to voice their thoughts because suicide is considered a taboo in most communities.

What to do if you have PTSD

Seek help: Reach out to a counsellor/psychologist/psychiatrist. Most of them will help you develop a strategy to deal with your trauma.

In some cases, you may have medication prescribed if there are concerns of overwhelming anxiety or depression.

Tell your loved ones: Family and friends are your greatest support system if you have PTSD. However, they cannot help you if they do not know what you are experiencing. Reach out to them and let them know. Ask them to accompany you to counselling sessions to help them better understand what you are going through.

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