PTSD following a life-threatening diagnosis

PTSD following a life-threatening diagnosis

If you have recently been diagnosed with cancer or any other life-threatening illness, you may be feeling helpless, fearful or like your life is in danger. These are not uncommon feelings to have, and you’re not alone. For many people experiencing these kinds of emotions, there is the possibility that they may develop post-traumatic stress disorder (PTSD) as a result of this.

Medical conditions associated with an increased risk of PTSD include cancer, heart attack and stroke. Hospitalisation into intense care units, or medical procedures such as mastectomy, have also proven to create a high risk factor.

One Malaysian study found that one-fifth of cancer patients experience symptoms of PTSD, and about one-third of these continued to have consistent or worsening post-traumatic stress disorder four years after their cancer diagnosis. The reality is that anyone can get PTSD, although it is commonly triggered by a highly stressful or traumatic episode in a person’s life.

In certain situations, some people become more susceptible and it is important that if you feel you may be suffering from PTSD, the issue is identified, monitored and treated early to help you most effectively.

Symptoms of post-traumatic stress disorder don’t always happen straight away. Sometimes it can take up to a month following a traumatic event for them to become apparent. The symptoms are often characterised as experiencing an emotional numbness and avoidance of certain places, activities or people that serve as reminders of the trauma. It can also be the re-experience of the trauma of diagnosis through intrusive or distressing recollections of what has happened, including nightmares and flashbacks.

Additionally, it can come through increased arousal, which may involve difficulty sleeping or concentrating, becoming easily angered or irritable, and feeling jumpy. It can often cause an intense and prolonged feeling of psychological distress, which can also lead to physical symptoms too. PTSD may also come hand-in-hand with anxiety and depression.

You may find that after your diagnosis of cancer, or another life-threatening illness, that you are feeling more hypervigilant, aggressive, reckless or self-destructive. You may also be having difficulties concentrating, or with staying asleep or falling asleep. Your nights may involve restless, broken episodes of sleep, which can cause irritability and frustration. Additionally, you may be struggling with experiencing positive emotions, feeling detached or estranged from those around you, or be feeling less interest in participating in certain activities.

You may also find yourself feeling persistently angry, guilty, fearful or ashamed, and may find yourself blaming yourself or others for your diagnosis. This could also involve holding a sense of negativity, especially in belief systems about yourself, others, or the world around you. It may also include memory loss about certain events, trying to avoid certain memories, or flashbacks and distressing dreams. You could also find yourself being triggered by intrusive memories when you’re not expecting it.

This can all feel equally as stressful and upsetting as your diagnosis, but the good news is that you aren’t alone. You may only have one of these symptoms, or you could have many. The most important thing to understand is that this can be perfectly normal.

NICE guidance from 2005 and 2011 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).


References: BBC, ADAA“Cancer-Related Post-traumatic Stress”. National Cancer Institute. Retrieved 2017-09-16., Swartzman, Samantha; Booth, Josephine N.; Munro, Alastair; Sani, Fabio (2017-04-01). “Posttraumatic stress disorder after cancer diagnosis in adults: A meta-analysis”. Depression and Anxiety34 (4): 327–339. doi:10.1002/da.22542. ISSN 1520-6394. PMID 27466972., Cordova, Matthew J.; Riba, Michelle B.; Spiegel, David (April 2017). “Post-traumatic stress disorder and cancer”. The Lancet. Psychiatry4 (4): 330–338. doi:10.1016/S2215-0366(17)30014-7. ISSN 2215-0374. PMC 5676567. PMID 28109647;  Edmondson, Donald; Richardson, Safiya; Falzon, Louise; Davidson, Karina W.; Mills, Mary Alice; Neria, Yuval (2012). “Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review”. PLOS One7 (6): e38915. doi:10.1371/journal.pone.0038915. ISSN 1932-6203. PMC 3380054. PMID 22745687.; Edmondson, Donald; Richardson, Safiya; Fausett, Jennifer K.; Falzon, Louise; Howard, Virginia J.; Kronish, Ian M. (2013-06-19). “Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review”. PLOS One8(6): e66435. doi:10.1371/journal.pone.0066435. ISSN 1932-6203. PMC 3686746 . PMID 23840467.; Davydow, Dimitry S.; Gifford, Jeneen M.; Desai, Sanjay V.; Needham, Dale M.; Bienvenu, O. Joseph (September 2008). “Posttraumatic stress disorder in general intensive care unit survivors: a systematic review”. General Hospital Psychiatry30 (5): 421–434. doi:10.1016/j.genhosppsych.2008.05.006. ISSN 0163-8343. PMC 2572638 . PMID 18774425.; Arnaboldi, Paola; Riva, Silvia; Crico, Chiara; Pravettoni, Gabriella (2017). “A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory”. Breast Cancer: Targets and Therapy9: 473–485. doi:10.2147/BCTT.S111101. ISSN 1179-131, Liu, Chunli; Zhang, Yi; Jiang, Hong; Wu, Hui (2017-05-05). “Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model”. PLOS One12(5): e0177055. doi:10.1371/journal.pone.0177055. ISSN 1932-6203. PMC 5419605. PMID 28475593.

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.