Post-traumatic stress syndrome (PTSS) or disorder (PTSD) is a mental health condition that develops after an individual experiences or witnesses an unimaginably horrifying event. This can happen following a severe accident, natural disaster, riots, wars, genocide, or even a sexual assault.
Most individuals impacted by a catastrophe, whether as victims or witnesses, typically recover with time and self-care. However, for a few, the mental struggle lingers. Signs may comprise flashbacks, nightmares, persistent intrusive thoughts, and anxiety symptoms such as dry mouth, palpitations, and sleep disruptions. If these symptoms intensify or endure for months, the individual may be experiencing post-traumatic stress syndrome (PTSS).
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The exact cause of PTSD in certain individuals remains unknown. Previous traumatic life events, along with their intensity and frequency, could trigger PTSD. Presently, stress from work or family dynamics may also lead to symptoms. Factors like genetic predisposition to mental health disorders, a family background of anxiety or depression, the brain’s chemical and hormonal regulation in stress responses, and individual temperament are among the probable contributors.
Symptoms may develop weeks or months after the event. They may occur frequently or be present continuously. The severity of symptoms varies from person to person. It may lead to disturbances in daily work, affect focus and concentration, and even affect interpersonal relationships. One may avoid visiting the place of the accident or meeting people thought of to be involved or responsible for the tragedy.
PTSS may cause a person to develop severe depression. This manifests as sleeplessness or sleeping too much, loss of appetite, losing interest in activities that were interesting before, avoiding meeting people, and total apathy regarding surroundings. In extreme cases, one may develop suicidal thoughts or even attempt suicide. The symptoms may get aggravated by any stressful situation. The use of abusive substances also aggravates the problem.
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If the symptoms are severe or persistent over months, interfering with routine work and activities, there is a need to seek medical advice. Diagnosis is established after excluding any physical cause for the symptoms, via history and relevant investigations. Mental health issues like anxiety, depression, etc. are also excluded.
Psychotherapy remains the main cornerstone of treatment. One may opt for individual one-on-one sessions with a therapist or join a group session. Group session has the advantage that a person gets to realise they are not alone. Many others are suffering. Therefore, there is no need to feel bad or ashamed about the condition. This boosts mood slightly.
In counselling, individuals are informed about their situation, reassured that they are not alone, made aware of others facing similar challenges, and provided with support and assistance in their recovery. They are taught methods and skills to overcome symptoms and how to manage negative thoughts effectively. Individuals are guided on coping strategies for recurring symptoms.
Cognitive therapy assists in identifying thought patterns that contribute to feeling stuck, such as persistent negative thoughts. This aids in addressing flashbacks and nightmares. Behavioural therapy supports individuals in confronting and overcoming frightening situations and thoughts progressively.
Family members of the affected person are counselled about what the individual is actually suffering from. They are taught how to deal with them patiently and lovingly. All these measures help one to overcome the lasting fear, which has developed after a major stressful event. If necessary, medications like anxiolytics and anti-depressants are prescribed.
It is also useful for the affected person to connect with close ones and spend some time in their company because being in good company affects the mind positively. Engaging in creative activities and or hobbies is also useful.
Rwanda’s Ministry of Health has done a commendable job in giving due attention to the PTSS issue and providing trained mental health counsellors in all big or small healthcare units.
Dr Rachna Pande is a specialist in internal medicine.