How to manage post traumatic stress disorder

A mother who meant the world to you, that little adorable sister you couldn’t live without, the big brother who would always fend for you and a loving father who held your hand when you were scared...a loving family indeed that held dreams and a future so bright, but then one day, all that was taken away from you - your loved ones got murdered brutally before your eyes and you miraculously stayed behind, alone in a cold world. How can life hold meaning? What reason would one have to keep on living? Survivors of the 1994 Genocide against the Tutsi continue to grapple with this devastating pain every single day of their lives. Sadly, this experience does not only harm one physically but can also cause enormous psychological wounds. Jules Ujeneza, 30, is one of the Rwandans who had to suffer at the merciless hands of the Interahamwe militia; his parents, two brothers and young sister were brutally murdered in cold blood and he was left for dead but narrowly survived by the grace of God. He later got another chance at life when his grandmother took him in. She loved and cared for him but, as fate would have it, Ujeneza’s grandma later passed on and no one was left for him. He was, to say the least, lost and hopeless until destiny got him to a foster home. Life has since moved on for him, but he is filled with bitter memories. “I rarely talk about what happened to me because it stirs up painful memories. However, I am trying to move on. The worst experiences come at night when I try to sleep as I always get nightmares. I once talked to a counsellor and it helped but it keeps coming back; it’s hard for one to run from their past,” Ujeneza says. The quiet personality and inability to trust anyone developed as a result of the betrayal he got. Such cases of extremely painful experiences can lead to long-term effects on an individual in form of psychological or even physical bodily trauma, leading to what health experts describe as post-traumatic stress disorder (PTSD). Expert’s view on psychological trauma Dr Jean Damascene Iyamuremeye, a psychologist at Rwanda Biomedical Centre, says that with the Genocide commemoration period, survivors remember vividly what happened to them and this stirs up mixed painful memories. People who experienced traumatic experiences are prone to getting post-traumatic stress disorder (PTSD), a disorder that develops in some people who have seen or lived through a shocking, scary or dangerous event. A Genocide survivor is given support after she breaks down during a commemoration event. (File) Signs of the condition can start after experiencing the traumatic incident or they can come later in their lives but the condition is only confirmed if the symptoms last for more than a month. Bad dreams, emotional breakdown, difficulty in sleeping, flashbacks of the trauma, frightening thoughts, are some of the signs a person with the condition faces, Dr Iyamuremye explains. “People who have been through physical or sexual assault, abuse, accidents or any other harsh event can develop post-traumatic stress disorder. They can also show such signs as getting depressed and loss of interest in activities that they used to enjoy in the past, among others,” he adds. The most common type of treatment for PTSD is psychotherapy. “People with trauma issues should try talking to a mental health professional; it can either be a one-on-one with a therapist or even talking to people you trust,” Dr Iyamuremye says. He adds that, for one to handle the patient well, you need to first understand why that person is traumatised in the first place, why and what caused the trauma, then find appropriate ways of dealing with the condition. “During this mourning period in our country, we need to be by the side of the survivors. We need to talk to them, comfort and remind them that it is all over, and that they are safe. They are vulnerable and we have to support them psychologically and socially,” Dr Iyamuremye says. Last year, there were 1,757 recorded cases of trauma during the Genocide commemoration week only. According to research by Mayo Clinic, post-traumatic stress disorder can cause significant problems in social or work situations and in relationships. The symptoms of PTSD are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in emotional reactions. Recurrent distressing memories of the traumatic event, upsetting dreams about the traumatic event, avoidance of places, activities or people that remind you of the traumatic event, negative feelings about yourself or other people, inability to experience positive emotions, being easily startled or frightened are some of the symptoms under the above four categories that a person with the disorder can experience. Care for PTSD victims The research indicates that if the stress and other problems caused by a traumatic event affect one’s life, the victims should endeavour to seek professional health care. One should try to get enough rest, eat a healthy diet, exercise and take time to relax. Also, they should avoid caffeine and nicotine as these can worsen anxiety. Turning to alcohol or drugs to numb one’s feelings isn’t healthy even though it may be a tempting way to cope as this can only lead to more problems down the road and prevent real healing. Finding a support group, an organisation or a community’s social services system can also be of assistance to the victim. Post-traumatic stress disorder can lead to extreme anxiety and emotional breakdown. (Net Photo) According to Damien Mouzoun, a counsellor and CEO of Ayina Think Tank, an organisation that helps people experiencing trauma, people who go to them for counselling on such matters get moral and emotional strength through counselling. “We use our experiences to help the victims by giving them hope and faith into their own future. We help them build a vision and goals,” Mouzoun says. “At this time when we all commemorate with the people of Rwanda and Africa the unfortunate tragedies that happened in our history, it is not an easy experience for anybody but we have to choose our path in moving forward and confront our future for the best,” he counsels. editorial@newtimes.co.rw ********************************************** The Dangers of PTSD Those who suspect that they or their loved ones are suffering from PTSD should seek help right away. People with PTSD may find themselves unable to hold a job and take care of themselves and their families. Victims of PTSD are also far more likely to attempt suicide than other members of society. Drug and alcohol addiction are also common among those who suffer from post-traumatic stress disorder, and such addiction can wreak havoc on both the PTSD sufferers and their families. In many cases, those who suffer from PTSD can be significant dangers to others, as these sufferers may find themselves unable to control their anger and aggression, leading to spousal abuse, child abuse, and other problems. Are there effective ways to treat PTSD? A number of treatment techniques, sometimes combined with one another, are being used with varying degrees of success: - Cognitive behavioral therapy, to help people recognize their ways of thinking, or “cognitive patterns,” that keep them stuck - Exposure therapy, to help people safely face what they fear, in order to learn to cope with it (virtual reality devices are often used to simulate a situation or setting in which the trauma took place) - Eye movement desensitization and reprocessing, or EMDR, which combines exposure therapy with a series of guided eye movements that help people process traumatic memories and change the way they respond to those memories. - Anti-anxiety medications and antidepressants can also ease the symptoms of PTSD; some people with PTSD whose symptoms include insomnia or recurrent nightmares find relief with a medication called prazosin that blocks the effect of adrenaline in the body. - Osanetant, a medication that has been tested in humans to treat schizophrenia, and was found to be safe but ineffective, has recently been found to block fear memories in mice shortly after exposure to a trauma. Agencies ********************************************** How best should one cope with a stressful situation? Boniface Onyango, principal and counselor at Riviera High School Boniface Onyango Identifying the problem is the first step one should take. It will then depend on the type of case; if it’s a spontaneous case, then long term help will be required. Also the affected person should be taken through the success stories of other people who had a similar experience to learn from them. Berthilde Gahongaiyire, counsellor at University of Rwanda Berthilde Gahongaiyire First and foremost, the one with the problem should be able and willing to be helped. Seeking psychological help from a professional counsellor is ideal, but the person who is giving the support should be considerate and help such people to accept their current situation. Benedict Sibomana, an evangelist at a church at Kimironko Benedict Sibomana If the person going through a stressful situation risks getting other complications, then spiritual intervention is needed. For instance, if such individual are not Born-Again, they should first accept Jesus as their saviour and be prayerful always. With faith they can be able to overcome such conditions. Dr Charles Sindabimenya, a neurologist Dr Charles Sindabimenya There are various reasons why people get stressed. If it’s due to trauma or an accident, such people need a qualified specialist to take them through medication and counselling. Besides, they should not be left in isolated places as it may worsen the situation. Compiled by Lydia Atieno

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How to manage post traumatic stress disorder