Although the term “post-traumatic stress disorder” is a relatively new one, the condition which it describes has been recorded as far back as ancient times.
The eponymous main character in The Epic of Gilgamesh, widely regarded as the earliest surviving great work of literature, is plagued by constant nightmares and flashbacks to the death of his closest friend Enkidu which he witnessed. The Ancient Greek historian Herodotus recorded how a participant in the Battle of Marathon was struck down with blindness after he too witnessed a close comrade’s death while in battle.
Following the end of the American Civil War, Dr. Jacob Mendez Da Costa conducted tests on surviving personnel who had seen combat and reported that many of them appeared to be suffering from ailments unrelated to war wounds, including palpitations and constricted breathing.
Without the benefit of modern psychological services, these traits were assumed to originate from an overstimulation of the heart’s nervous system, thereby giving birth to the informal nickname of “soldier’s heart” and later “Da Costa’s syndrome”.
The condition first came to prominence during the First World War, where many soldiers returned from the front lines blind, deaf or mute and with seemingly no convincing medical explanation as to why. The early theory that the malady was caused by prolonged exposure to shell fire gave rise to the name “shell shock”. Its sufferers were often unable to even eat or sleep, much less perform their soldierly duties.
Into old age, many veterans of the First World War still relived their horrifying experiences with alarming clarity. One, David Ireland, spent seventy-seven years in a psychiatric hospital in Scotland before his death in 2001. Even as he approached his centenary Harry Patch, the last surviving soldier to have fought in the trenches, recalled being transported back to the front lines with the constantly exploding shells as a result of a light flickering outside his bedroom door.
In 1980, PTSD was officially recognised by the American Psychiatric Association as a mental health disorder. Three years later, the U.S. Department of Veterans Affairs conducted a study of the prevalence of PTSD and other similar issues among veterans of the Vietnam War.
Its findings were disturbing. As many as fifteen per cent of all personnel who had served in that war now had PTSD. A similar study conducted in 2013 revealed that, almost forty years after the end of the war, 11% of male Vietnam-era veterans and 7% of female veterans still had PTSD.
What exactly is post-traumatic stress disorder?
PTSD is classified as an anxiety disorder which sufferers develop after either being involved in or witnessing traumatic events. This means it is entirely possible to develop it outside a combat zone, although the disorder is typically associated with wars and battle. It is characterised by vivid nightmares and flashbacks and possible feelings of guilt and irritability. Fr most sufferers, the symptoms will manifest within a month of the trauma. For others however, it can be months and sometimes even years before they begin to feel the effects. This is known as delayed PTSD or delayed-onset PTSD.
Those who experience trauma at an early age or are subjected to prolonged trauma are likely to be diagnosed with complex PTSD, which has some additional symptoms such as constant feelings of emptiness or hopelessness, feeling as if they are permanently damaged, feeling completely different to others and dissociative symptoms such as depersonalisation.
As already mentioned, PTSD can occur for a variety of reasons, not all of which are related to military service. Other causes of PTSD include being kidnapped, being involved in a car accident, being raped, seeing other people killed or hurt, surviving a natural disaster and being diagnosed with a life-threatening condition.
Numerous treatments exist for PTSD, the most common of which are therapy-based. Trauma-focused cognitive behavioural therapy is a specialist form of CBT that has been modified to address the specific emotional and psychological needs of those who struggle with trauma.
This form of therapy is commonly offered to those with PTSD. A range of techniques ae employed to help the sufferer come to terms with their trauma and change the negative ways in which they feel about it. This may include thinking about the traumatic event in detail and identifying unhelpful thoughts and feelings that arise.
The National Institute for Health and Care Excellence recommends that a course of 8-12 sessions, each lasting between 60-90 minutes at least once a week. Alternatively, eye movement desensitisation and reprocessing (EMDR) is designed to reduce the symptoms of PTSD by making eye movements while recalling the trauma they have suffered.
Research is currently being conducted into additional forms of treatment for PTSD. Group therapy is another option and some people find sharing their experience with others that suffer from PTSD and working together to find ways of managing the symptoms to be beneficial. Medication for PTSD is less common, with paroxetine and sertraline being the only antidepressants licensed specifically for treating it. Medication is generally used as a last resort or when the risk of ongoing trauma is high, thereby reducing the efficiency of therapy.
PTSD can be a debilitating and frightening malady to live with, but with the right treatment it can be overcome. It is not something to be ashamed of – it can occur to anyone who has experienced trauma in the past. If you suspect you are beginning to suffer from the effects of it, do not delay and consult your GP at once.
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