Stress is a normal human response and something we all experience to some degree from time to time. Just think of an occasion when you were running late for work or for an important appointment, you were probably feeling the effects of stress then. In circumstances like these, the stress usually fades away fairly quickly and has no lasting effects.
However, other life events such as losing a job, a relationship breaking down, being diagnosed with a medical condition or a loved one dying can cause more significant stress and impact on our health and wellbeing. Even the things we consider good like getting married, going on holiday, changing jobs or moving home can be stressful.
Most people, given appropriate time and with support from family and friends, will get through these difficulties. Occasionally, people can get stuck in their distress and develop stress, trauma or post traumatic stress disorder symptoms. When this happens some help from a trained professional may be appropriate.
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Trauma can be caused by any event that you perceive as being potentially threatening to your life or safety. This may be a one off event such as having a car accident, being physically attacked or being involved in a natural disaster. Or it can result from persistent stress such as living with domestic violence or sexual abuse, living with a terminal or debilitating illness, or living in a war zone.
An event does not actually have to be life-threatening or involve bodily harm to be traumatising, it is your perception of it that matters. In some cases you may not even feel frightened but your body may unconsciously perceive things like accidents, illnesses or surgery to be threatening. Conversely, no matter how frightening an event may seem, not everyone will be traumatised by it.
You are more likely to be traumatised by a stressful event if it happened unexpectedly, you felt helpless to stop it, it happened more than once, someone was intentionally cruel or it happened during your childhood.
In some cases there may be no memory of a traumatic experience. However, if you are experiencing trauma symptoms it is likely that something traumatising has happened.
Post Traumatic Stress
The most serious form of stress is traumatic stress which results from experiencing a traumatic situation. Post Traumatic Stress is stress that continues long after (usually six months or more) a traumatic event has occurred. Post Traumatic Stress usually causes a problem in one area of your life associated with the original traumatic event. For example, someone who has developed Post Traumatic Stress following a car accident may become overwhelming fearful of being in a car or may even avoid using a car altogether, but will otherwise be unaffected in other aspects of their life.
Symptoms of post traumatic stress
The trauma symptoms described below are a normal response to a traumatic event, which everyone will experience to some degree. Usually, these symptoms get better by themselves and fade away over time. However, when they happen together over a long period of time (six months or more), it is almost certainly an indication of unresolved trauma.
Physical symptoms of post traumatic stress
- Rapid heartbeat and breathing
- Increased sweating
- Cold or clammy skin
- Muscle tension
- Difficulty sleeping
- Exaggerated startle response (jumpiness)
- Unexplained aches and pains
Emotional symptoms of post traumatic stress
- Shock, anger or denial
- Guilt, shame and self-blame
- Feeling helpless or inadequate
- Feeling sad or tearful
- Feeling anxious or fearful or even having a panic attack
- Feeling emotionally numb
Other symptoms of post traumatic stress
- Nightmares or flashbacks
- Feeling unreal or disconnected in some way
- Forgetfulness and difficulty concentrating
- Avoidance of anything associated with the trauma
- Withdrawal from others
If you are concerned that you suffering from post traumatic stress and it is impacting on your life, please contact your doctor who will be able to help assess your symptoms and give you a proper diagnosis.
Post Traumatic Stress Disorder or PTSD
Post Traumatic Stress Disorder or PTSD is an anxiety disorder which occurs when stress escalates to such an extent that it affects your ability to function on a daily basis and impacts on most aspects of your life. People with Post Traumatic Stress Disorder often have survivor guilt, relive the trauma through nightmares or as flashbacks, feel frequently on edge and alert to danger, feel emotionally numb and disconnected from reality, have persistent distressing thoughts or images and are likely to have problems trusting people.
Symptoms of Post Traumatic Stress Disorder or PTSD
If the above trauma symptoms are not resolved, other symptoms may appear and develop into Post Traumatic Stress Disorder or PTSD. Symptoms may develop days, weeks, months or even years after the traumatic event.
Physical symptoms of Post Traumatic Stress Disorder or PTSD
- Hypervigilance – always being on “red alert”
- Exaggerated startle response (jumpiness)
- Increased sensitivity to light and sound
- Sleep problems
- Unexplained aches, pains and illnesses
- Panic attacks and anxiety
Emotional symptoms of Post Traumatic Stress Disorder or PTSD
- Abrupt mood swings
- Difficulty dealing with stress (always feeling stressed out)
- Frequent crying
- Emotional numbness
- Depression and feelings of impending doom
- Feelings of detachment, alienation and isolation
- Loss of interest in life and suicidal feelings
- Feelings of being helpless
- Inability to love or trust
- Fear of dying or going crazy
Other symptoms of Post Traumatic Stress Disorder or PTSD
- Intrusive memories or flashbacks
- Nightmares and night terrors
- Mental blankness
- Forgetfulness or amnesia
- Difficulty concentrating
- Limiting life choices (never going on dates, applying for jobs, etc.)
- Avoiding situations associated with the trauma
- Avoiding social contact
- Attraction to dangerous situations
- Exaggerated or diminished sexual activity
- Using alchohol or drugs to self-medicate
According to the National Institute for Health and Clinical Excellence (NICE), approximately 80-90% of sufferers of Post Traumatic Stress Disorder go on to develop other problems such as anxiety or depression.
If you think you are suffering from Post Traumatic Stress Disorder or PTSD it is important to see your doctor as soon as possible so that your symptoms can be properly assessed, diagnosed and treated.
Self-help for Post Traumatic Stress and Post Traumatic Stress Disorder
Some of the self-help suggestions below involve physical activity, therefore, if you have any physical injuries or a history of physical problems, you should consult your doctor before you start on any exercise programme.
Seeing your GP is the best place to start if you think you may be suffering from post traumatic stress or post traumatic stress disorder. Your GP will be able to assess your symptoms, make a diagnosis and discuss a treatment plan with you.
Talking about the trauma with family or friends can help you to make sense of the event and how it has impacted on your life. You may prefer not to talk with those close to you for fear of upsetting or burdening them or because you feel you should be over it by now. If this is the case, you may find that counselling, psychotherapy or hypnotherapy will help.
Writing about the trauma can also be a helpful way of making sense of what happened and how it has affected your view of yourself, other people or the world.
Drawing or painting any intrusive images or flashbacks can be a helpful way of releasing them from your mind onto paper so that they have a less powerful effect on you and gradually begin to fade away.
Visualisation techniques can help to replace frightening flashbacks and unwanted images. One visualisation that might help is to think of a time and place when you felt calm and content. Perhaps you were on holiday, visiting a favourite place or just chilling out at home. Next relax, breathe slowly and deeply and bring this image to mind as if you are there now. As you recall this image, what do you notice about yourself and your surroundings? What can you see, hear, taste and smell? What can you physically feel on your skin? Are you warm or cold? Can you feel that sense of contentment and calm? Where do you feel this in your body? Hold this image and feeling for a minute or two. It will help to improve your mood. This technique works best if you practice it regularly so that you can call on it easily when you need help. If you are struggling to remember a pleasant memory you could always make one up, a fantasy will help just as well!
Breathing techniques can help have a calming effect by slowing your breathing down and reducing your symptoms. Sit upright on a comfortable chair with your feet flat on the floor. Take a deep breath in through your nose for 4 seconds (hold your hand flat on your stomach, you should see it rise as you breathe in). Hold your breath for 2 seconds and exhale through your nose for 6 seconds. (Breathe through your mouth if it is difficult to breathe through your nose). If you struggle at first to slow your breathing to the above rate, you could try 3 in, 1 hold and 4 out to begin with. Practice this technique 2 or 3 times a day and it will help you to develop a more relaxed breathing style.
Mental Distraction can help to take the edge off your symptoms. A simple way of doing this would be to work backwards in your head from 100 deducting 3 each time, e.g. 100, 97, 94… and so on. Alternatively having a small puzzle, one that will fit into a pocket, and requires concentration and manipulation (like those ball and maze games where you have to get the ball into the centre without dropping it down a hole) can help.
Exercise such as swimming, aerobics, jogging, going for a brisk walk, skipping or competitive sports can help relieve physical and emotional tension and can give a sense of achievement.
Progressive Muscle Relaxation can help reduce the tension, irritability and anger that often accompanies post traumatic stress. This technique requires that you tense each muscle group in sequence, holding for 5 seconds, then relaxing for 10 seconds before moving onto the next muscle group. When you tense each muscle group you should feel it but not so much so that it causes pain. This technique works best if you practice it regularly to help you become more aware of where you hold tension in your body and how to release it. The relaxation sequence is:
- Right hand and forearm – Make a fist.
- Right upper arm – Bend your arm to make a muscle.
- Left hand and forearm – Make a fist.
- Left upper arm – Bend your arm to make a muscle.
- Forehead – Raise your eyebrows as high as you can.
- Eyes and cheeks – Squeeze your eyes shut.
- Mouth and jaw – Open your mouth as wide as you can.
- Neck – Face forward and raise your head to look at the ceiling. Note: Be very careful not to over tense your neck!
- Shoulders – Bring your shoulders up to your ears.
- Shoulder blades and back – Bring your shoulder blades together as far as you can and push your chest out.
- Chest and stomach – Breathe in deeply filling your chest and lungs with air.
- Hips and bottom – Tighten your bottom muscles together.
- Right upper leg – Tighten your thigh.
- Right lower leg – Pull your toes towards you. Beware over tightening your calf muscle and causing cramp.
- Right foot – Clench your toes downwards.
- Left upper leg – Tighten your thigh.
- Left lower leg – Pull your toes towards you. Beware over-tightening your calf muscle and causing cramp.
- Left foot – Clench your toes downwards.