PTSD Therapy Online
Have you experienced a traumatic situation? If you have been through a traumatic situation and are experiencing difficult symptoms or not feeling like you are your ‘old self’, like many people, you might have developed post-traumatic stress disorder (PTSD).
PTSD and c-PTSD can be really debilitating and quite frightening as we can feel a sense of loss of control over what is happening to us. Many people sadly suffer in silence, but feel as if they live haunted by what has happened. At times, in particular with complex PTSD we might not have any conscious awareness of what has happened but come to feel as if what is happening is who I am.
The information outlined below is to set out some of the common questions that people ask me in therapy or information that I help people to understand about their symptoms. I
What is Post-Traumatic Stress Disorder (PTSD)?
Post-traumatic stress disorder (PTSD) is a trauma based disorder that can arise following any event that has placed us in danger physically or psychologically, or where we have witnessed an event that has caused other people to suffer. It might even be that hearing news about an unexpected injury or death of someone close to you can lead to PTSD.
How Do I Know If I Have PTSD?
It is really normal following a difficult event to experience symptoms of shock and distress and these symptoms can naturally abate over the course of a few weeks or months. However, almost a third of people who experience such events find that the symptoms don’t lessen and at times can even worsen, this can indicate that you may have symptoms of post-traumatic stress disorder.
There are also times where PTSD symptoms can be delayed by months or even years – this is referred to as ‘delayed-onset’ PTSD. It might be that we think we have dealt with something that has happened in the past, only for it to re-emerge at a later time, perhaps being triggered by something else happening in your life.
Complex PTSD (Also referred to as Complex Trauma)
It is really normal following a difficult event to experience symptoms of shock and distress and these symptoms can naturally abate over the course of a few weeks or months. However, almost a third of people who experience such events find that the symptoms don’t lessen and at times can even worsen, this can indicate that you may have symptoms of post-traumatic stress disorder.
There are also times where PTSD symptoms can be delayed by months or even years – this is referred to as ‘delayed-onset’ PTSD. It might be that we think we have dealt with something that has happened in the past, only for it to re-emerge at a later time, perhaps being triggered by something else happening in your life.
What are the Symptoms of PTSD and c-PTSD
Symptoms to look for:
The symptoms of PTSD and c-PTSD can become quite debilitating, they are wide ranging and can lead to us making adaptions in day-to-day life to cope. However, some of the coping strategies that work in the short-term can lead to longer-term complications.
Re-Experiencing:
This can be one of the most common symptoms of PTSD and C-PTSD. This is when we literally feel as if we are involuntarily re-living something that has happened, the events play out within our minds and bodies as if we were experiencing it in the present. Different things might activate or ‘trigger’ re-experiencing symptoms. We might be aware that some of these triggers are to do with the event, but at times they can be much more subtle and we are not aware of why we then experience the flashbacks. This can be particularly distressing as it can feel as if we don’t have much control over how to manage.
- Racing heart, rapid breathing, physical sensations such as sweating, trembling, nausea.
- Images, smells, sounds and feelings associated with the trauma event
- Nightmares that might be re-occurring and related to the event
- Intrusive thoughts and images that cause distress
Avoidance:
When something has been painful, it is natural to want to ‘turn away’ from the pain so that we are not reminded of the traumatic event. This turning away from the pain is another key aspect of PTSD and C-PTSD, and can lead to further problems in our lives as it can contribute towards additional difficulties and cause us to change what we would normally want to be doing in order to manage the difficult symptoms.
- We might begin to avoid places or people or activities that remind us of the event or avoid talking about it.
- Keeping busy
- Using alcohol or substances to numb or avoid distressing memories
- Not feeling – experiencing numbness or being cut off from how we feel, which can then feel as if we are disconnected from others and isolated or alone with our distress
- Feeling disconnected from our bodies, as if we don’t belong in them
- Difficulty remembering details of what happened or feeling as if it didn’t happen
Hyper Alert and Reactivity
Feeling ‘on edge’ or jittery all the time or feeling as if there is danger constantly looming can be exhausting and can contribute towards being irritable or quick to anger.
- Feeling on edge, on guard, hyper-aware of our surroundings
- Easily startled or feeling jumpy
- Difficulty with concentrating on day to day tasks
- Difficulty with sleeping
- Sudden feelings of panic
- Irritability and anger
- Hyper-sensitivity towards sound
- Self-destructive or taking risks
Mood and Feelings:
Often with trauma events we actually change how we feel about ourselves, how we hold ourselves in mind because of what has happened to us can over time feel as if this is actually ‘who I am’.
- Difficulty with trusting others
- Not feeling as if anyone or anywhere is ‘safe’
- Feelings of shame, blame or guilt
- Overwhelming negative feelings that can feel pervasive – anger, rage, sadness, fear, shame and guilt
- Disinterest in activities you used to enjoy
- Difficulty with positive feelings such as happy, joy, or reward
Additional PTSD Symptoms
It is not uncommon for other symptoms to be experienced as well, including:
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- Anxiety and depression
- Social anxiety
- Dissociation
- Feeling emotionally unstable or dysregulated
- A sense of low self worth
- Physical symptoms – sweating, insomnia, shaking, dizziness, ‘funny’ tummy
- Self-harm
- Substance or alcohol abuse
- Overworking
Additional Symptoms of Complex Post Traumatic Stress Disorder (c-PTSD)
- Chronic and pervasive feelings of shame, guilt, worthlessness
- Chronic sense of aloneness
- Difficulty with emotional regulation
- Experiencing difficulty feeling connected with people
- Problems in relationships, having difficulty sustaining friendships or intimate relationships, feeling rejected or abandoned, feeling anxiety about being on your own
What Treatment Is Available for PTSD and c-PTSD
Eye Movement Desensitisation and Reprocessing (EMDR) is an increasingly well evidenced and effective treatment for PTSD. It is recommended by NICE and WHO’s diagnostic guidance – ICD-10 recommends it for complex post-traumatic stress disorder (c-PTSD).
Cognitive Behavioural Therapy (CBT) is also a recommended treatment for PTSD.
There are a number of therapies that are not able to receive the funding required to undergo large research trials, so the evidence base can be harder to find for some therapies. This may not in itself mean that they are ineffective, rather that they haven’t been research funded in a particular way to be able to gain recognition by NICE.
Medication – some people are prescribed medication to support with the symptoms of PTSD. Typically, consultation with a psychiatrist is required to be prescribed some of the medications that might be helpful for symptom management. Sometimes people find medications helpful to reduce symptoms meaning that they can then engage with therapeutic methods that seek to address the root of the problems.