Post-Traumatic Stress Disorder Chooses You

Post-traumatic Stress Disorder (PTSD) is often oversimplified to a summoning of ‘bad memories’- yet its severity has much more at stake for victims. 

This could be you, tomorrow You do not need a certain quality of life, a family history of mental illness, or to partake in any lifestyle to experience a traumatic event. Trauma constitutes any actual or threatened event of injury, assault or death. Although this list is not all-encompassing, traumatic events can include physical assault, sexual abuse, witness of death or injury, combat, and natural disasters. 

PTSD is caused by an alteration of the the psychophysiological system: programming fear conditioning mechanisms as the body’s first responder. In simpler terms, a PTSD sufferer operates on the hypervigilance of of the reptilian brain’s fight-or-flight instinct. Any trigger that mimics similarity to the event, causes a re-experiencing of it, accompanied by intense emotional and physical reactions before the mind is even aware. A song you heard, place you went, or an outfit you wore on the day of the traumatic event, can be especially problematic when it is ubiquitous in daily life. Common symptoms include: 

• Vivid hallucinations and flashbacks 
• Nightmares and insomnia 
• Panic attacks 
• Hyper alertness and inability to focus 
• Loss of belief systems 
• Anxiety and/or depression 

While these symptoms seem to go hand-in-hand with acute stress disorders alike, these do not include the darker long-term costs of PTSD. 

What more is at stake? With no surprise, the symptoms of PTSD can  come at the expense of one’s career, relationships, passions and lifestyle. But moreover, the body may develop chronic conditions that further worsen the quality of life. PTSD does not manifest itself immediately after trauma. Oftentimes, the onset of PTSD is delayed and and discovered through the psychological symptoms accompanied by physical morbidities. The ‘wear and tear of the body’ (allostatic load) due to the hyperactivity in the brain does not just affect the mind, but also the body. Disorders of this part of the brain responsible for regulating stress levels are correlated with these symptoms: 

• Fibromyalgia 
• Irritable bowel syndrome 
• Chronic fatigue 
• Musculoskeletal symptoms 
• Hormonal imbalances 
• Hypertension, often leading to cardiovascular/coronary heart disease 

It’s easy to mistake physical symptoms as just co-existent with PTSD or as crocodile tears to garner sympathy. Yet the physical manifestations are very real and directly relate to the condition. When these problems are not taken seriously by peers and doctors, the social isolation furthers the suffering. 

Lack of support and visibility in Aotearoa While a cure is difficult to achieve, symptoms can be partially managed with medication, counselling and psychotherapy. Recent research also shows that neuroplasticity can be a game-changer as a holistic approach for managing this condition. Hypnotherapy, havening and EMDR are now also being more closely reviewed as alternative methods to traditional therapies. However, these are expensive and often difficult to access. Whether the issue is access or social stigma in finding help, alcohol and drug uptake is a common solution to temporarily relax the brain which can be problematic. 

ACC has very specific requirements in order to qualify for service. Funded counselling is provided for victims of sexual abuse, ‘covered’ physical injuries, work-related traumatic incidents, and treatment injuries. The scope of coverage is evidently limited. Even within these cases, the complexity of PTSD can lead to problems with eligibility for support. For example, PTSD can arise out of multiple events or reoccur from another traumatic event. These situations are few of the many that ACC does not cover. Only 6 of the 29 claims filed by NZ Police in the last 5 years were accepted, showing that the current criteria for eligibility is simply not cutting it. Notably, PTSD cannot be managed with a one-size-fits-all approach. While counselling is the go-to option, it is easy to imagine how this can be difficult and triggering. In the ACC context, PTSD is still treated as a psychosocial condition rather than a somatic one. 

Victims have said that more work is needed in exploring holistic and physical approaches which do not demand a return to traumatic memories, but rather address the cumulative effects of stress on the body. ACC has a good foot in this door by offering yoga to certain victims. Down this track, ACC could and should include more physical modalities such as craniosacral therapy and flinchlock release therapy. More awareness to affirm the productivity and long-term affordability of these methods is required so that they can become more accessible as healing tools. 

What next? The Christchurch Mosque Attacks have brought many unaddressed issues in Aotearoa to light –  one of them being the complexity of trauma and its lack of support. This had led to more public awareness and critical engagement with the issue of underfunding support services. While not a lot may be happening, the visibility of this issue is a first step to voicing a need for funding and policy implementation. 

In Auckland, PTSD Help NZ, a volunteer-based grassroots community, holds monthly meetup sessions to support victims of PTSD. They are currently seeking more resources that can be made available to underserved victims and are actively engaging in ways to educate their community about additional methods of therapy. 

What can you do to support victims? PTSD may seem abstract to someone who has never experienced it, making it difficult to empathise with trauma victims. Here are some things you can do to help: 

Support, listen to, accept and validate victims without expiration 

Educate yourself on what people are experiencing 

Be sensitive around dates, places, words and things that might be triggering 

Stop saying “That gave me PTSD” Unless it actually did. Using mental illnesses as adjectives discounts the severity of conditions that are associated to real, suffering people who are already isolated from society. I don’t believe that this is done with maligned intention. This attitude is only one that reflects a lack of knowledge and visibility. We need awareness, so that there can there be compassion, respect and understanding for this debilitating condition. 

Dreaver, C. 2018, October 16. Most claims for police PTSD rejected. Radio New Zealand. Retrieved from https://radionz.co.nz Grogan, S., & Murphy, K. P. (2011). Anticipatory Stress Response in PTSD: Extreme Stress in Children. Journal of Child and Adolescent Psychiatric Nursing, 24(1), 58-71. doi:10.1111/j.1744-6171.2010.00266.x Mcfarlane, A. C. (2010). The long-term costs of traumatic stress: Intertwined physical and psychological consequences. World Psychiatry, 9(1), 3-10. doi:10.1002/j.2051-5545.2010.tb00254.x Mental Injury Assessments for ACC. (n.d.). Retrieved from https://www.acc.co.nz/assets/provider/mental-injury-assessment -guide.pdf Wahbeh, H., Senders, A., Neuendorf, R., Cayton, J., & Oken, B. (2014). Complementary and Alternative Medicine for Post-Traumatic Stress Disorder Symptoms: A Systematic Review. The Journal of Alternative and Complementary Medicine, 20(5). doi:10.1089/acm.2014.5199.abstract