Dr Michael Bott | Consultant Psychiatrist UK

More about trauma

Why do my memories of the traumatic event not seem to fade?
What is PTSD?
How is PTSD treated?
I've heard that it can be harmful to relive the traumatic incident so soon after the event - is this true?
Aside from therapy, is there anything else I could do to alleviate the symptoms of PTSD?

Why do my memories of the traumatic event not seem to fade?
Our brains have systems which are programmed to recognise dangerous situations and warn us to take care by producing physical symptoms like sweating, churning in the stomach or rapid heartbeats. After accidents these protective warning signs can occur when no real danger exists.

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What is PTSD?
PTSD stands for Post-Traumatic Stress Disorder. It is categorised according to when symptoms occur and how long they last. There are three types of PTSD:

Acute: symptoms last between one and three months after the event

Chronic: symptoms last more than three months after the event

Delayed onset: symptoms don’t appear until at least six months after the event

Diagnosis of PTSD is usually based on the following:

Initial assessment – Your health care provider will ask you about your symptoms and medical history. This could be done by a structured interview and/or questionnaire. You will be given a psychological assessment and asked about past trauma. PTSD will be diagnosed if you have the specified symptoms, they last for more than one month, and they result in both emotional distress and disturbed functioning (problems at school, work, and/or in family and peer relationships).

Diagnosis is often based on the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which include the following:

- Exposure to a traumatic event
- Repeated vivid and uncontrollable memories
- Dreams and recollections of the event
- Emotional numbness
- Physical symptoms of fear triggered by cues in the environment or other physical sensations that dredge up the traumatic event
- Interference with work, school, and/or relationships

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How is PTSD treated?
Treatments for PTSD include:
- EMDR (Eye Movement Densitisation and Reprocessing)
- Exposure (live and imagined - which aims to evoke anxiety and promote habitation)
- Cognitive restructuring which aims to modify dysfunctional thoughts, beliefs and assumptions
- Anxiety management techniques, including stress inoculation training (SIT) which aims to teach the patient a variety of coping skills in order to manage anxiety and other symptoms.

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I've heard it can be harmful to relive the traumatic incident so soon after the event - is this true?
The reason EMDR works where counselling fails is due to the fact that the human brain treats memories of traumatic incidents in a different way to memories of everyday life. Counselling, or what can be called an 'insight-oriented' treatment can sometimes help to override automatic physiological responses to traumatic memories, while EMDR seeks to abolish them. Following 9/11 studies showed that survivors who benefited from early intervention with EMDR treatment had significantly decreased levels of distress.

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Aside from therapy, is there anything else I could do to alleviate the symptoms of PTSD?
- Talk about what happened to you, how you feel and what you remember.
- Talk about the experience with others who shared it with you if you have contact with them.
- Write about your experience whether this is for yourself only or to share with others.
- Cry.
- Eat sensibly and try to rest.
Watch your alcohol, tobacco, drug use and don't allow it to increase from your usual use.
- Take up exercise and/or relaxation-meditation on a regular basis.

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