Post-Traumatic Stress Syndrome, PTSD

It can be difficult to feel good again after experiencing scary events such as accidents, war, and sexual or physical violence. You may have symptoms such as nightmares, having difficulty concentrating and being relieved. With the right treatment, many people with post-traumatic stress disorder have good chances to feel good again.

Relative support and a safe environment also play a major role in getting rid of symptoms.

In post-traumatic stress syndrome, the symptoms of children differ from the symptoms of adults. The treatments are also partly different for adults and children.

What is Post Traumatic Stress Syndrome?

Those who have been involved in frightening, abusive or shocking events may subsequently have mental symptoms. Especially situations where you have feared for your life can evoke strong feelings of fear or fear. You may also feel mentally ill if you have witnessed unpleasant events or have experienced a difficult birth.

For some who feel mentally ill, the symptoms eventually disappear by themselves, others may suffer psychological trauma. This means that you have your symptoms and that they do not decrease without treatment.

The condition is called post-traumatic stress disorder or PTSD, which is an abbreviation of English’s “post-traumatic stress disorder”.

Here are examples of events that can lead to post-traumatic stress syndrome:

  • robbery
  • assault
  • sexual assault
  • accidents
  • natural disasters
  • torture
  • war events
  • difficult experiences during intensive care or operations
  • a difficult birth.

Symptoms of PTSD

At PTSD, it is common for you to have repeated and intrusive memories of the scary that has happened. It’s called flashbacks. Then you feel like you are in a scary situation again.

During a flashback, you can relive the impressions you experienced during the scary event. It can be sounds, detailed memories or other impressions, which make the experience feel very real. Reliving the event often causes strong anxiety and stress.

Can be triggered by something similar to the event

Flashbacks or memories can be triggered by situations or events that are reminiscent of scary experiences. It is also called trigger stimuli and can trigger your PTSD.

When you have PTSD, it is common for you to dream of nightmares that cause strong anxiety. Sometimes dreams are about what happened, sometimes they are incomprehensible.

Common symptoms of post-traumatic stress disorder

You may also have one or more of the following common symptoms of post-traumatic stress disorder:

  • You try to avoid anything reminiscent of the incident. It can cause you to isolate yourself from other people.
  • You may have memory loss that is usually limited to the time just before, during or after the event. 
  • You may feel depressed or indifferent and unable to engage in what is happening in your everyday life.
  • You may feel tense, be frightened or easily irritated. You may also have an outbreak of anger, difficulty to concentrate or difficulty sleeping. You may have difficulty learning new things.
  • You may have thoughts of suicide.

Other more unusual symptoms of post-traumatic stress disorder are feelings of unreality or a change in how you experience yourself. 

You may also have physical problems. Here are some examples of these symptoms:

It may take some time before the symptoms are noticed

The symptoms often occur within the next six months after the scary event, sometimes also later, and can be severe. But it can also take longer, up to decades after the trauma.

Several difficult events and complex PTSD

People with multiple traumas may become more sensitive to various psychological stresses. Someone who has survived several scary events, but who seems to have a functioning everyday life can suddenly feel very bad during more common setbacks.

Experiencing several shaking events such as escape and loss of close relatives at a young age can lead to a severe form of PTSD or complex PTSD.

Another common cause of a more complex form of PTSD is if you as a child have been subjected to sexual abuse or repeated abuse. It is particularly stressful if there are any relatives who are perpetrators. Being betrayed, abandoned or seriously offended as a child can also lead to a complex form of PTSD. 

When and where should I seek care?

Contact a health care center if you have experienced one or more stressful events and are not feeling well. You can contact many receptions by logging in.

Your health care provider makes an assessment of whether you need psychiatric care and, in that case, writes a referral to a psychiatric clinic.

Investigation

To get the right treatment, your doctor needs to check if you have PTSD or any other form of mental illness. Doctor and you for a call where you can tell you what trouble you have. The doctor often also uses questionnaires to make the right diagnosis. Some forms must be filled in by the doctor, while other questionnaires will be answered by you.

Your physical health is also important

In conjunction with PTSD, you may have physical problems. Therefore, to rule out that you have a physical illness, your doctor needs to examine your physical health by taking blood pressure and heart rate, weighing you, listening to your heart and lungs and taking blood tests to see if your values ​​are good. Always tell your doctor if you have any physical symptoms. Then the doctor can examine and treat you in good time.

Talk to your doctor if you have any other problems

Tell your doctor if you are addicted to alcohol, nicotine or other drugs. Your health care center can help you get rid of the addiction and give you advice on how to live a healthier life. You may be offered call support, training to prevent relapses and sometimes also medicines.

In some county councils, you can turn to an alcohol or addiction clinic yourself that can provide you with care and support to stop using alcohol and other drugs. Your health care center can also write a referral to a specialist hospital reception.

Always tell the health care provider if you have ever injured yourself, ie if you have cut yourself or scratched yourself on the body. Also, tell the person who treats you if you are often depressed or have anxiety.

If you have a self-harm behavior or addiction, you often need to be treated first for these disorders before you can be treated for PTSD.

Treatment at PTSD

Most people who have experienced scary events will feel good again after some time, sometimes even without treatment. But it is important that you seek treatment if the symptoms do not diminish, as it can be harmful to go for a long time with untreated PTSD. There are treatments that help.

What therapies help with PTSD?

A treatment that has shown a good effect in PTSD is a special form of cognitive-behavioral therapy, KBT,  which is called trauma-focused KBT. The treatment means that you get support in approaching the traumatic memories, slowly. You may be exposed to situations similar to the event but in a safe context. Reliving what is uncomfortable and causing anxiety occurs together with your therapist, either by visiting places or situations in reality or through thoughts.

Another form of treatment of post-traumatic stress disorder is eye movement therapy or Eye Movement Desensitization and Reprocessing, EMDR. In EMDR, eye movements are used in connection with the activation of the traumatic memory. This means that the therapist asks you to think about the scary that has happened while making a series of eye movements. The eye movements seem to help the brain process trauma memories and in this way reduce symptoms.

There are also other forms of treatment at PTSD. What treatment you can receive depends on your problems and you as a person. Other therapies that care can offer include narrative exposure therapy or psychodynamic psychotherapy. Narrative exposure therapy is about recounting the scary and getting used to the strong emotions that arise in connection with it.

Treatment can be started with so-called stabilization

Sometimes you may need preparatory conversation and relaxation before you can begin treatment. The aim is to give you greater security so that you can handle the scary events. This part of the treatment is called stabilization.

You can also get psychosocial help to create good everyday routines. The help can be about strengthening your contacts with family, friends or other relatives, getting support around the accommodation, arranging to school, getting started with good sleep routines or anything else that is needed to make life work again. You who have been subjected to sexual or physical violence can often begin the psychotherapeutic treatment with stabilization.

For some, stabilization may be sufficient for the symptoms to disappear. Stabilization is a basic therapy part that your therapist needs and you may need to return to.

The care can give you knowledge about PTSD

An important part of the stabilizing treatment is education about PTSD. It gives you knowledge of what happens in the brain and body when you are exposed to traumatizing events. You can also learn ways to reduce stress or fear when you’re not feeling well.

The training can also help you understand that symptoms of PTSD are common reactions to stressful events and that most people react the same way if they are exposed to something that is very unpleasant.

It is often possible that relatives also participate in education.

Treatment helps you to process difficult memories

When you deal with trauma, you slowly and repeatedly encounter the painful memories. This can be done using, for example, trauma-focused cognitive behavioral therapy or eye movement therapy. The purpose is to reduce the fears and fears associated with your memories. They will eventually belong to the past instead of being constantly disruptive in everyday life.

It is common at PTSD to want to avoid things that are associated with what happened. It can be a place, a word or a name. The therapist can, through so-called gradual exposure, help you to dare more and more with what creates discomfort. In this way, for example, the sound or location can be linked to new experiences. The awkward memories disappear when you stop avoiding what’s unpleasant.

Complicated forms of post-traumatic stress syndrome can usually be treated in the same way as other diagnoses, but it may take longer. A painful memory can awaken the memory of another and it can then, in turn, elicit another. The trauma treatment is then about identifying and working with the parts of the memory that are recurring and the most troublesome.

You get to practice the techniques you have learned

After the processing, a final treatment part remains, which is also called the consolidation phase. Here you should make use of what you and the therapist have been working on to get rid of trauma symptoms and avoid any problems in the future.

Drug treatment can help with PTSD

You may also be offered drug treatment. It is mainly drugs for depression used in the treatment of PTSD. Drugs are often prescribed in combination with psychotherapy. In addition to feeling less depressed, many feel that the drug makes them less sensitive to unpleasant impressions.

What do I do if the trouble does not decrease?

Ask your health care center to write a referral to a psychiatric outpatient clinic if you find that your problems do not decrease even though you have received treatment or if the problems are very severe. For some people with PTSD, the symptoms tend to be alleviated after six to twelve months of treatment. Others may be completely free of symptoms after a few months of treatment. You may sometimes need to be admitted to a psychiatric ward if you have severe problems.

You can get support and help if you are exposed to violence

The health care provider may ask you if you are subject to violence. The reason is that they want to find out if there is a current threat in your life that requires you to help. If you are exposed to violence in close relationships, health care can ensure that you come into contact with the social service that can support and help you in different ways. For example, social services can arrange sheltered accommodation for you if necessary. There is also help for perpetrators of violence who are prepared to receive support to change their lives. It is the county council or the home municipality that has information about which local organizations are in your vicinity.

What can I do for myself?

The recovery from PTSD works differently from person to person. Some have an easy time talking to friends or other relatives and feel better about it. Others need support to put words into what has happened. Try to be patient with yourself and your emotions if it takes time to get rid of the hassles that you experience as stressful.

Physical activity can relieve

Use your experience from past difficult situations. Do things that you know you are doing well.  For example, physical activity is something that can relieve the symptoms of mental illness. It can be good to move around or work out with others.

Take care of yourself

When you notice that the mental and physical tension is increasing, it is good to try to relax with the help of calm and deep breaths. It is important to breathe into the abdomen so that the lower abdomen moves outward and to avoid superficial and rapid breathing in the upper chest. Eat regularly and a balanced diet. Good sleeping habits facilitate recovery.

Avoid alcohol and other drugs

It is important that you avoid alcohol and other drugs after one or more traumatizing events. You may get addicted and may then need to be treated for both PTSD and addiction. Then the treatment takes longer. Being affected also makes it more difficult to process the trauma even if you can temporarily feel better.

Meeting others can provide positive experiences

Remember not to shy away from social situations as it can make the trouble worse. Wanting to avoid social contexts that create discomfort is natural when you have been exposed to trauma. But it also reduces the chance of positive experiences and can lead to you not getting rid of the symptoms.

Being close to someone with PTSD

Take the time and show that you care when someone has PTSD and is feeling bad. Listen when they are ready to talk about their experiences, even if the story is repeated a number of times.

Someone who has experienced one or more traumas can easily be irritated. Do not take it personally and be as calm as possible. Avoid pushing someone to tell them about difficult memories if they themselves are not ready for it.

You can advise the person to seek help at a health care center. You can help book times if needed and if you like. You may need to encourage the person to seek help several times. Another way to provide support is to attend the reception if the person seeking care wants it. It may be good for someone to follow and hear what is being said and can act as support afterward.

Seek help yourself if you are not well

Contact your healthcare provider if you who support someone with PTSD need help yourself. If the person who is ill has had contact with the care, you can sometimes get support from the health care staff as a close relative.

Own time is important

Take your own time if you feel your needs come completely in the dark. For example, you can stick to activities you like, such as taking a walk or meeting your own friends. Creating your own space does not mean that you are less involved in the person who is feeling bad.

If you want to get in touch with others in similar situations, you can contact a  support organization.

Influence and participate in your care

You can seek care at any healthcare center you want throughout the country. This also applies if you want to seek care at open specialist clinics. Sometimes a referral is required. Being able to influence and participate in their care is a right that is regulated by the Patient Act.

Ask if you do not understand

In order for you to be involved in your health care, it is important that you understand what the health care provider says. Ask questions if you don’t understand. Once you have received information about your treatment you can give your consent or express a yes in another way. You can also refuse treatment.

Fixed care contact and interpreter can be a good support

You are entitled to permanent care contact if you have contact with many different persons in connection with your care. It is a person who among other things helps to coordinate your care.

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