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Understanding the complexities of PTSD in daily life

PTSD can be triggered by an accident or a severe health problem, not just combat. Experts help decode the condition

The physical distress symptoms of PTSD include nausea, sweating, and shivering when the trauma is triggered.(Unsplash/Joice Kelly)

By Shweta Dravid

LAST PUBLISHED 10.01.2024  |  08:00 AM IST

Among congratulatory headlines and messages that came out late November after the rescue of 41 Indian construction workers, who were trapped in a collapsed highway tunnel for 17 days, there was a tiny news detail that was probably glossed over. It was the fact that these workers would need ‘long-term support after their rescue including monitoring for post-traumatic stress disorder’. 

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In October, days after Hamas had kidnapped more than 35 young Israeli children and teenagers, a Reuters report reveals that Asher Ben-Arieh, a specialist in child trauma at Jerusalem’s Hebrew University and Haruv Institute was tapped by Israel’s Welfare Ministry to help identify the possible emotional traumas that the young hostages would have endured, and to come up with written protocols that could be used to help them cope once they were freed. 

Post-traumatic stress disorder or PTSD is a complex mental condition that can develop after an individual witnesses or experiences a traumatic or life-threatening situation. As the cases of the construction workers and kidnapped children cited here prove, it can impact anybody, irrespective of age or gender. 

Take the case of a serving combat soldier (who did not wish to be named) I spoke to. Posted in a conflict zone in Kashmir for three years, daily life was a challenge. He had to live in a 12-by 8-foot room at a height of 17,000ft in subzero temperatures guarding the borders and being responsible for his life and the men under him. Despite returning home physically unharmed, he still experiences recurrent nightmares and heightened anxiety triggered by crowded places and loud noises. Today, he leads an introverted life devoid of social interactions. This is a classic example of someone who has PTSD. 

According to The National Center for PTSD in the US, 60% of men and 50% of women suffer from at least one severe trauma in their lives, and one in three can develop PTSD. Lounge spoke to experts to understand the condition, its causes and treatments available.

Causes
Meerut-based psychiatrist, mental health expert and educator Dr Rashi Agarwal explains, “Initially, PTSD was studied in post-war soldiers and natural catastrophes as well as sexual abuse, but as time progressed, studies have shown that trauma to self and even to loved ones can provoke PTSD. Stressors can be subjective for every person." The most common causes of this mental condition tend to be accidents; sexual or physical abuse; experiences during combat in military service; experiencing continuous mental and physical torture; or severe health problems including being admitted to the ICU. 

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Symptoms of PTSD mostly occur as intrusive memories of the event(s) in the form of flashbacks and nightmares, which lead to a physical reaction or emotional outburst. You could find trouble focusing, sleeping or become easily angered, experience overwhelming guilt or shame, and have negative thoughts. “The physical distress symptoms include nausea, sweating, and shivering when the trauma is triggered," explains Dr Meghana Dikshit, founder of De Mantraa, a holistic wellness centre in Mumbai.

Different Therapies 
Navigating the tumultuous terrain of PTSD is sure but slow. With proper treatment and care, it is possible to heal completely. “Recovery from PTSD usually takes a minimum of 6 months to a year. With the right medication, psychological therapies, and support from loved ones, a person can overcome it," explains Dr. Dikshit. Dr Anjali Chhabria, noted psychiatrist and founder of Mindtemple, a counselling centre in Mumbai explains, “It’s important to note that therapy should be tailored to the individual’s specific needs and the nature of their trauma."

Chabbria, who contributes to the women's Web3 social community app coto, lists out the existing range of therapies that are tailored to the specific cause or nature of the trauma experienced by an individual. They include: Cognitive Behavioural Therapy (CBT), Prolonged exposure (PE) therapy, Eye Movement Desensitization and Reprocessing (EMDR), Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), Mindfulness-Based Therapies and Seeking Safety.  

Going back to Israel, in the interim weeks before the hostages were released, the Reuters report reveals, Ben-Arieh and a few dozen experts drafted nine (PTSD treatment) protocols for previously undreamed-of scenarios. “One was for kidnapped children. A second for children whose parents were killed. Another focuses on community-wide trauma. They include practical recommendations, what to do, in what stage," Ben-Arieh was noted as saying. Some of the recommendations were simple, such as ‘asking the child first before giving a hug, or just letting children use social media as a way to regain control over their lives.’

While there are a range of psychological treatments for the condition, Chabbria shares that medication has been found to be beneficial too. Some of the recommended options include Selective Serotonin Reuptake Inhibitors (SSRIs) to balance the brain’s serotonin levels; antidepressants to improve mood and reduce feelings of sadness; mood stabilisers to help emotionally regulate and stabilise mood swing symptoms that are not responding to SSRIs; and beta blockers to manage symptoms of acute stress and anxiety. “More explorative treatments such as MDMA-assisted psychotherapy are currently being researched, showing promising results in ongoing clinical trials," Chabbria adds. 

Signs of Recovery
“Any recovery means that the symptoms are in abeyance and the mental, physical and emotional discomfort felt by the person is at an end," explains Dikshit. For a person coming out of PTSD, it would mean better sleep as nightmares get few and far between. It would mean improved overall physical health. It would also mean diminishing anxiety and panic attacks. Eventually, the patient will experience feelings of positivity and hope.

Help at hand
Support groups in India that help navigate PTSD include: Let's Discuss the Meh (Bengaluru); Cadabam's Hospital (Bengaluru, Hyderabad); The Samaritans (Mumbai); Healing Studios (Mumbai) and Mpower – The Centre (Bengaluru). 

(With inputs from Mahalakshmi Prabhakaran)

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