Getting past the trauma
Many among those evacuated from the war may go on to develop PTSD which must be timely diagnosed and treated to bring normalcy to the lives of affected persons
My cousin was doing MBBS in the war-struck parts of Ukraine and has been recently evacuated. I am worried that even though she is back home safe, she should talk to someone about all that she has been through. She has been complaining of not being able to sleep well. Is it right to see a mental health specialist or should we wait?
"War does not determine who is right, only who is left." – Bertrand Russell
The world is feeling the turbulence from the ongoing Russo-Ukrainian War.
With a war and unrest, the citizens strive for their basic needs of safety. Every citizen is undergoing stress and trauma. The soldiers who are at the fighting front are in a survival mode.
The stress and trauma that arises from such incidences can cause an aftermath of mental health issues that can range from a wide variety of symptoms, experiences, and behaviours.
Acute presentation can be in the form of Acute Traumatic Stress Disorder (ATSD) that can occur within three days and one month of the event and presents similarly to PTSD. The presentations can be:
⁕ Mood changes
⁕ Appetite changes
⁕ Difficulty in sleeping
⁕ Withdrawal from others
⁕ Changes in personality
⁕ Unable to function well
⁕ Aches and pains without any medical cause
⁕ Crying, excessive emotion response
⁕ Dissociation and numbing out
⁕ Anxiety, keyed-up energy, restlessness
It is ideal to begin taking care of your loved one's physical and mental health from the beginning after they have been through so much. It could begin at home by making small lifestyle changes, providing family support, introducing exercise and a good diet. Gradually, if the situation doesn't seem to be improving or if they are open to it, then seeing a mental health professional will open the avenue to screen them for the possibility of developing PTSD.
What is PTSD?
Not everybody reacts in the same way and there is no 'right' way to respond to a traumatic event. Traumatic events are shocking and it is normal to feel overwhelmed. Not all those who are exposed to war go on to develop post-traumatic stress disorder (PTSD).
PTSD feels like reliving the nightmare over and over again. The symptoms can include terrifying and realistic flashbacks of war scenes, intrusive memories of the trauma, panic, inability to sleep and nightmares, as well as avoidance of anything that resembles the trauma.
PTSD can occur after:
⁕ Natural disasters
⁕ Witnessing of serious accidents
⁕ Physical or sexual assault
⁕ Abuse – childhood and domestic
⁕ Terrorist attacks
⁕ Serious health problems leading to difficult ICU care
⁕ Traumatic childbirth including losing a baby
⁕ And more….
The core PTSD symptoms are:
PTSD typically develops within three months of the trauma, but may also appear years later in some cases. The population at risk of developing PTSD are those who may have had depression, anxiety and substance issues in the past, and those with a strong genetic history of mental health disorders.
Symptoms can include:
⁕ Intrusive memory: Intrusive thoughts are repetitive involuntary memories, thoughts and images that are vivid and real-like. They can present as nightmares and flashbacks. Flashbacks are so vivid that people feel they are reliving the traumatic experience or seeing it before their eyes like a movie.
⁕ Avoidance: Avoidance of external reminders that may include avoiding people, places, activities, and situations that can trigger distressing memories. Some may even actively avoid thinking about the traumatic event and resist talking about their experiences and feelings.
⁕ Negative changes in thinking, beliefs and mood: Altered anxiety state, depressive phase, distorted belief about self (feeling dirty, feeling responsible, guilty for losing loved one), unable to experience any positive emotions, feeling a sense of void.
⁕ Changes in arousal and reactivity: Hyper arousal – heightened arousal in form of being startled easily, difficulty in sleeping, concentrating, self-destructive behaviour and anger outbursts. Some may have nightmares and feel threatened in their sleep, leading to violence against their partner.
⁕ Recognising symptoms timely
⁕ Identifying the comorbid conditions
⁕ Setting up a support system
⁕ Medication: Psychiatrist may prescribe medication to help calm down the over-aroused nervous system and re-establish a balance in neurochemicals
⁕ Psychological therapy: Trauma-focused cognitive behavioural therapy
⁕ EMDR therapy: Eye movement desensitisation and reprocessing (EMDR) has shown promise in PTSD
⁕ Reintegrating and building up life again.
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