Surviving trauma
suicide; violence; rape; sexual; assault; war; post-traumatic stress disorder; trauma; stress; disaster; PTSD; flashbacks;
Contents
When something happens that seriously threatens someone's life or the life of friends or family, a person may experience extreme distress in the period immediately after the stressful event. This distress is a natural response to traumatic events, and most people recover from it with the support of family and friends.
However sometimes the distress can last for a very long time and the person may need professional help to regain a sense of calmness and confidence in their life.
Traumatic events
The sort of events that can cause serious distress can include:
- personal trauma, such as violence, rape, involvement in a car or workplace accident, childhood abuse or being in combat.
- suicide, severe injury, sudden death (by accident, murder or 'natural causes') of family or friends.
- events that happen to the person's community, such as earthquake, bushfire, terrorism or war.
The same event may have little impact on one person, but cause severe distress to another person – such differences in response may be related to different past experiences, different levels of current support from family or friends, or particular mental and physical health issues that the person is dealing with.
Immediate reactions to trauma
When something happens that threatens our safety, our body reacts automatically so that we can either escape from the danger or fight it to protect ourselves. The body reactions include an increased heart rate and breathing rate, and muscle tension.
If the event is very traumatic, the reaction will be very strong. Some of the feelings people have are extreme fear, disbelief, numbness, anger, confusion, pounding heart, trembling or shaking, fast breathing, nausea (feeling like vomiting) and sweating.
After the trauma
It is common after serious trauma for people to continue to have reactions for some days, weeks or months. The sorts of feelings and reactions people experience include:
- anxiety or fear of being alone
- fear of other situations that might be dangerous
- heightened fear of danger to others
- avoiding places which remind them of the trauma
- being easily startled by loud noises or sudden movements
- flashbacks, where pictures of the event come into their mind suddenly for no obvious reason, during the day or at night, disturbing sleep
- loss of interest in normal activities
- problems thinking and concentrating
- guilt about not having prevented the event
- irritability or anger which can be directed at family or friends.
People also may experience physical symptoms, such as tight muscles, being very tired, loss of appetite or headaches.
What to do
For most people, feelings of anxiety after traumatic events will lessen over time. Sometimes the person will feel a lot better later that day or sometimes the next week. However, for a few people the distress lasts a lot longer.
Immediately after the event:
- Stay with other people – try to avoid going home if there will be no-one to talk to or help you at home.
- Talk about what happened with someone who is prepared to listen and be sympathetic – someone who will accept your fears, tears and anger. Some talking is usually helpful, but in-depth talking over and over about it is usually not.
- If the stressful event is now over, remind yourself that it is over and that you are safe or the person you care about is safe.
- Try to get some physical exercise to 'burn off' the tension and anxiety.
- Avoid things which 'dull' your feelings (such as alcohol or sleeping tablets), or which can make you feel more agitated (such as caffeine in coffee or cola drinks).
- Try to eat regular meals, even if you don't feel like eating.
- If you can't sleep, get up and do something relaxing and go back to bed only when you feel you are ready to sleep.
Many people don’t need trauma counselling immediately after a horrible event. Talking to friends or family will be valuable for most people, but some people might need professional help starting very soon after the event.
The following few days:
- Remind yourself that feeling distressed is a normal reaction to trauma, that the event is over and that the feelings will pass with time.
- Try to get back to your normal routine as soon as possible. Go back to school, study, work, sport. Resist attempts by others to get you to take time off. You need time doing normal things, not thinking about what happened over and over by yourself.
- If bad feelings overwhelm you now and then, do things like try to slow your breathing, consciously relax tight muscles, go for a brisk walk and remind yourself you are safe.
- Work on your general stress levels by eating well, exercising and relaxing.
- There may be some aspects of what happened that are difficult to forget. If it was a car accident for example, going driving for the first few times might be hard – take someone with you if possible.
Do not believe that you should be fully back to normal in a day or two. It can take longer and you may have some flashbacks or sudden anxious or irritable feelings for quite a while after a serious event.
If you find these feelings are not getting better, it could be a good idea to talk to a trauma counsellor, as it may be possible to avoid ongoing distress which could affect your life for a long time.
Post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) is a serious anxiety reaction that develops in a small number of people after overwhelmingly frightening or traumatic events. It can last for a long time after a traumatic event. In the past it has been called by other names such as 'shell shock', 'battle fatigue', 'accident neurosis' and 'rape trauma syndrome'. It can happen to people of any age, culture or gender.
Symptoms of PTSD
There are 3 main groups of problems experienced by people with PTSD:
Intrusive symptoms: Memories and images of the traumatic events may intrude as vivid daytime memories, dreams and 'flashback' experiences. These occur suddenly and without an obvious cause. People often have intense feelings at the same time, such as grief, guilt, fear or anger. They may be so vivid that the person thinks the event is happening again.
Avoidance symptoms: People may avoid situations, people or events which remind them of the experience. They may withdraw into themselves in an attempt to shut out the painful feelings and memories. They may feel unable to relate emotionally even to people they are very close to – this may affect relationships, as others feel rejected by the person with PTSD.
Arousal symptoms: People with PTSD may feel jumpy or constantly on guard. They may have problems getting off to sleep, and have disturbed sleep. They may feel irritable and angry with themselves, others around them and the world in general. They often report memory and concentration problems.
Also:
- People with PTSD often develop problems at work and in relationships with family and friends.
- Depression is a common problem for people with PTSD.
- Many people with PTSD develop harmful patterns of alcohol and other drug use.
Treatment of PTSD
There are many types of treatment for PTSD but most include:
- education to understand reactions to trauma
- stress management techniques
- dealing with the memories (cognitive behaviour therapy)
- use of medication (mostly antidepressants).
One of the important parts of recovery is getting to know that others have had the same reactions and feelings after severe trauma. Meeting other people as part of a group of people with similar experience (eg war veterans) has proven useful in helping them deal with the trauma.
Supporting someone with PTSD
- Offer general support. The person will need to feel safe and cared for. It can be helpful to offer to share everyday tasks.
- Be willing to listen. It is really important for the person to be able to talk about what happened and to try to make sense of it. But not all people can do this easily and it might be very hard to listen to. Encourage the person to get professional help if you find you cannot manage listening or he is not able to talk.
- Recognise that PTSD can affect people in different ways and in different ways on different days.
- Get support for yourself if you have a close relationship with someone who has PTSD, as it can be very difficult to persist with supporting a person who is changeable, sometimes angry, irritable and even rejecting.
Someone with PTSD in your family
- If one of your parents or someone else in the family suffers from PTSD, it can affect your life in different ways. It is important to remember that it is nothing you have done or brought about.
- The person with PTSD may find it hard to express emotions or may be withdrawn from the family. This can make other members of the family feel pushed away.
- If one parent is left with most of the job of ‘running the family’, this parent can begin to suffer due to this added burden.
- If the person with PTSD is worried about perceived dangers, they can become controlling. Other family members can feel trapped by their over-protective behaviour.
- Sometimes the person suffering PTSD can think the way they are acting is normal. Other members of the family can be confused by this and not get a chance to discuss their fears or problems.
Resources
South Australia
- The Second Story Youth Health Service (TSS)
- Central: 57 Hyde St, Adelaide
- South: 50a Beach Rd, Christies Beach
- North: 6 Gillingham Rd, Elizabeth
- West: 51 Bower St, Woodville
Contact TSS is via the Youth Healthline on 1300 13 17 19, or for mobile phone callers (08) 8303 1691 (normal rates apply).
- Child Adolescent Mental Health Service (CAMHS)
Northern Services
c/- Women's & Children's Hospital
72 King William Rd, North Adelaide 5006
Tel: 8161 7389, 1800 819 089
Fax: 8161 7371
- Child Adolescent Mental Health Service (CAMHS)
Southern Services
c/- Flinders Medical Centre
Bedford Park 5042
Tel. 8204 5412
Fax 8204 5465
- Vietnam Veterans Counselling Service
'Sons and Daughters' is a free service for children of Vietnam veterans.
telephone: (08) 8290 0300 or (country callers) 1800 011 046
For information about this group, go to:
http://www.dva.gov.au/factsheets/default.htm
General
References
Australian Centre for Posttraumatic Mental Health - publications:
http://www.ncptsd.unimelb.edu.au/resources/index.html
Leslie-Adams, A. 'I thought it was just me…'. Information for the children of Vietnam veterans about PTSD and the family, 1999. From the Vietnam Veterans Counselling Service.
Janice A. Sabin, J. et al. 'Primary Care Utilization and Detection of Emotional Distress After Adolescent Traumatic Injury: Identifying an Unmet Need' Pediatrics, Jan 2006; 117: 130 - 138.
National Institute for Health and Clinical Excellence 'Post-traumatic stress disorder (PTSD): the treatment of PTSD in adults and children' March 2005
http://www.nice.org.uk/
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Youth Healthline on 1300 13 17 19 (local call cost from anywhere in South Australia).