Survivors’ dilemma in face of post-traumatic stress syndrome

Post-traumatic stress syndrome (PTTS) refers to symptoms and signs which develop following any disaster. It is a delayed and protracted response to a stressful event of shattering nature, being outside the range of everyday human experience and which would cause distress to almost everyone. Such events include natural disasters, terrorist attacks, major accidents or human tragedies such as genocides. Signs of PTSS often develop within a few weeks to months after the tragedy. The typical symptoms are night mares, difficulty in sleeping, recurrent night mares or unpleasant memories of the event, difficulty in concentration, among others. Depression due to loss of loved ones in the tragedy or financial losses add on to the tense situation. All relevant tests done exclude any physical disease in these people and then they are finally labeled as suffering from PTSS. Affected person can be of any age or gender. Some of these individuals resort to alcohol, drugs or other addictions to find a respite. A few may even indulge in crime for supposed vengeance or as a diversion for the mental stress they undergo. Further complications can occur due to medicines being taken. Painkillers when taken for long cause gastritis. Medicines like haloperidol or chlorpromazine, prescribed for depression and anxiety lead to apathy and stiffness of limbs and body parts as side effects. Diazepam when given regularly to treat insomnia tends to cause addiction and dependence. The course of PTSS tends to be variable, depending on the mental make up and circumstances of the individual. Some strong-willed individuals, after realising the situation, divert their emotions in to some kind of work or prayers and recover fully. Others recover partly but tend to suffer from symptoms intermittently say around the time, when they are reminded of their dear ones lost in the tragedy. Weak-minded persons lose hopelessly to the situation. These are the people needing maximum attention to help them cope with the loss. Good counseling is the first and foremost need for these individuals which should be reinforced intermittently. Group counseling sessions are very beneficial. They help an individual to understand that he is not the only one to suffer due to the tragedy. There are many others like him or her or even worse affected. They should be made to understand that life is a precious gift and cannot be wasted like this in suffering. What has happened cannot be undone but one should try to improve the future in the present time. Group activities like prayers, community work, among others, are advantageous as they bring the survivors close and help in better understanding of their own problems and those of others. Rehabilitation in the form of providing education, vocational training and change of job or place of living proves to be very useful for these persons. It reduces the over all impact of the tragedy on the individual. Medicines prescribed should be kept to minimum and that too whenever necessary. Good measures have been adopted by the Government to rehabilitate genocide suvivors and minimise PTSS. Every concerned individual can contribute to reducing PTSS in affected persons.This can be achieved by having a good understanding with that person, helping them in necessary need without being undue prying or sympathetic. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital