Understanding PTSD and C-PTSD for Healthcare Professionals
It’s estimated that 50% of people will experience a trauma at some point in their life. The majority of people exposed to traumatic events experience some short-term distress, but eventually, their trauma fades to a memory – painful, but not destructive. However, around 20% of people who experience a trauma go on to develop Post Traumatic Stress Disorder (PTSD or C-PTSD). In the UK, that’s around 6,665,000 people, yet it is still an incredibly misunderstood, often misdiagnosed and stigmatised condition.
The defining characteristic of a traumatic event is its capacity to provoke fear, helplessness, or horror in response to the threat of injury or death and therefore PTSD and C-PTSD can affect anyone.
Examples of traumatic events include
- road traffic incident
- natural disasters
- events experienced in occupations like prison staff and emergency service workers
- domestic abuse
- child abuse
- acts of terrorism
- traumatic childbirth.
Why is it important to raise awareness of PTSD?
There are huge numbers of people experiencing Post Traumatic Stress Disorder at some point in their lifetime – but it’s estimated that up to 70% of people with PTSD and C-PTSD in the UK do not receive any professional help at all.
Some people may realise they are struggling to cope after a trauma, but are unaware they have PTSD or C-PTSD. They may feel that their symptoms are just part of their life now – even if they’re debilitating and affect every part of their life.
For others who have a PTSD or C-PTSD diagnosis, they may not know that treatments to help them recover are available. Just over a decade ago, people still thought that PTSD and C-PTSD were incurable conditions, but more recent evidence and research proves it is possible for PTSD and C-PTSD to be successfully treated many years after the traumatic event occurred – but the treatment options are not as well-known as they need to be.
Additionally, people with PTSD and C-PTSD are often misdiagnosed as they can develop additional disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. These co-morbid conditions are what gets diagnosed, and the PTSD and C-PTSD is left to get worse in many cases.
For many people however, they’re simply unable to articulate how they feel, or feel able to reach out for help.
PTSD and C-PTSD can make us feel that our lives are unpredictable, that we are out of control, find it difficult to feel safe and trust other people, ourselves and our judgements. It also brings about serious, life changing symptoms which, along with physical symptoms, typically fall into 4 groups:
- reliving the traumatic event perhaps in the form of flashback, nightmares or intrusive memories (also called re-experiencing or intrusion);
- avoiding situations that are reminders of the event;
- negative changes in beliefs and feelings;
- and feeling hypervigilant and fearful of people and the world around them (also called hyperarousal).
In order to get support to the people who need it, it’s vital to raise awareness in three main areas – the causes, the symptoms to look out for, and the treatments available:
- The Causes: Many people have pre-conceived ideas of PTSD and C-PTSD, and what can cause it. There is a widespread misunderstanding that PTSD or C-PTSD only affects veterans, or those in the armed forces (likely due to it’s previous name of shell-shock) but it can in fact affect anyone, of any age. It’s vital that people are aware if they (or a friend or family member) have suffered a trauma, they should be mindful of trauma symptoms, and the possibility of PTSD or C-PTSD.
- The Symptoms: There are two areas in which knowing the symptoms are useful. The first is that people may recognise the symptoms in themselves (or a friend or family member) and reach out for help – starting their recovery process. The other is those who are suffering with PTSD or C-PTSD, can understand that what they’re thinking or feeling, or how their body is reacting, is ‘normal’ for someone with PTSD or C-PTSD – this can be of huge comfort knowing that once the PTSD or C-PTSD is resolved, those symptoms will be too. Some symptoms of PTSD and C-PTSD can feel totally unconnected to the original trauma or the condition itself, so it’s really important people can recognise just how it can affect them.
- The Treatments: PTSD and C-PTSD are misunderstood in many ways. Information about the treatments available is lacking and, at times incorrect. NICE guidelines recommend Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT) as the main options for the treatment of both PTSD and Complex PTSD (C-PTSD). There are also a variety of therapies and activities than can help ease symptoms while you wait for treatment.
As a healthcare professional, what can I do to help?
In addition to those suffering with PTSD or C-PTSD (and those around them), it’s vital that healthcare professionals are aware of all of these elements to look out for in their patients to avoid misdiagnosis, incorrect treatments and to provide the best resources for their patients.
With PTSD and C-PTSD, knowledge IS power: learning more about it is hugely important:
- Understanding what can cause PTSD or C-PTSD allows you be more mindful of any high-risk patients that you come into contact with. You may be providing physiotherapy after a traumatic accident, removing stitches after a knife crime, or providing care to someone who you know suffered child abuse. If you feel they may be at risk from PTSD, if you’re comfortable, you can suggest they speak to their GP, or visit the PTSDUK.org website for more information.
- Knowing what the symptoms are allows you to be more vigilant and watchful in the people you care for. Even joint pain, digestive issues, sleeplessness, skin problems and other physical symptoms can be a result of PTSD or C-PTSD. Understanding this can help you treat patients more quickly and effectively – treating PTSD and C-PTSD can eliminate these physical symptoms which are a result of stress and stress hormones in the body.
- You can provide real empathy in how they may be feeling. Many people with PTSD or C-PTSD suffer from exhausting hypervigilance (being on constant red alert all of the time) – and combined with their other symptoms, it can make it very difficult to leave the house, or make plans. So for example, if your patient is missing appointments, or cancelling at the last minute, perhaps consider what you can do to help: discuss alternatives with them such as a phone call, or early morning, or late afternoon appointments, or ask them to bring a friend with them.
- Understanding that treatments are available for PTSD and C-PTSD allows you to provide hope to people with the condition. PTSD and C-PTSD can make you feel very isolated, alone and fearful – you can’t understand how there can be a ‘way out’, and as a result many people see suicide as their only option. By having a knowledge of the treatments, and how they work, you can reassure your patient that things can get better – Tomorrow CAN be a New Day.
- You can share resources and tools which can help ease their symptoms while they wait for treatment. Things like acupuncture, yoga, journaling, running, and sea swimming, along with a variety of therapies such as art therapy, narrative exposure therapy, accelerated resolution therapy and hydrotherapy can all offer welcome relief from the day-to-day symptoms experienced
If you or your workplace would be willing to have a stand with/hand out leaflets and booklets about PTSD and C-PTSD – please do drop us an email with your name, address and some information about what you need.
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Treatments for PTSD
It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).
Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. You can find out more in the links below, or here.