POST Traumatic Stress Disorder (PTSD) was perhaps first acknowledged as a condition in troops returning from the First World War. At the time it was dubbed “Shell Shock.”

Again, it was recognised in those who had survived the horrors of World War Two, this time branded as “Combat Fatigue.”

Yet it was only really following the Vietnam War that the term Post Traumatic Stress Disorder was used.

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More importantly research was done into how to identify treat a complex range of emotions resulting from trauma.

Today we are aware that PTSD can occur following a variety of incidents, both on and off the battlefield.

Statistics show that the lifetime chance of developing PTSD in war veterans is seven per cent, yet just a percent lower in those who have never experienced military combat. Children and teenagers can also suffer PTSD.

In what may seem to be an increasingly violent world, it is diagnosed in those who have experienced terror attacks, violence on the streets and abuse in the home.

It is seen following Intimate Partner Violence (IPV). It may develop after hearing about a single shocking event. PTSD can also be the result of cumulative exposure to multiple difficult situations.

Police personnel, firemen and women and healthcare professionals have all reported PTSD due to the unusual and sometimes harrowing events that are the norms of their profession.

Most recently it has been seen as a result of the Covid pandemic, and not just in those who contracted the illness.

Four aspects are used to diagnose PTSD. The first is intrusive thoughts. This may occur as flashbacks and nightmares. Next, the sufferer tries to avoid anything that triggers these thoughts. This includes places or persons associated with the event.

Thirdly, their mood will become altered. Feelings of guilt and blame may be prominent, particularly for those who have survived sexual assault or rape.

Anxiety and depression are common as a result. Finally, the way the person acts will change. They may become overly watchful, always observing for danger even in safe circumstances.

Some go the other way, throwing caution to the wind and taking wild risks.

PTSD typically starts within three months of the events and may last for decades if untreated.

The symptoms can mimic other disorders such as Acute Stress Disorder, thought this tends to occur within a few days of the trauma and resolve within three months.

It may also be confused with an adjustment disorder, which occurs after a significant life event such as the breakdown of an intimate relationship or the loss of a close relative.

PTSD is important to diagnose and treat. Unidentified it is associated with significant ill health, both physical and mental. For parents and care-givers, it can impact on their ability to look after children, who may develop mental illness as a result.

Since the 1970s much research has been focussed on the treatment of PTSD.

Cognitive Behavioural Therapy (CBT) is an umbrella term used to describe multiple different talking therapies.

For PTSD it can be split further into three or more different treatments. Cognitive Processing Therapy aims to challenge often crippling negative thoughts such as guilt, shame, and failure.

Prolonged Exposure Therapy allows the victim to revisit the trauma in bite-sized chunks. Triggers are delivered in a safe way so that the person can cope and their emotions can change from fear and distress to resilience.

Eye Movement Desensitisation Therapy (EMDR) is perhaps the treatment that has received the greatest press coverage for the treatment of PTSD. The therapist questions the person about the trauma.

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During sessions, while revisiting the trauma, the patient watches the therapist’s fingers, which induces movements like those of REM (normal) sleep. As a result, the pain of the memory is reduced and it is perceived in a less negative manner.

Finally, group therapy allows the individual to share their experiences in a safe environment with those who have experienced the same or similar traumas. Antidepressant medications may be part of a treatment plan.

Like all illnesses, severe PTSD is unlikely to get better if left ignored, with symptoms and negative feelings getting stronger and more intense over time. However, if recognised and addressed in a timely manner, a good and lasting recovery is possible for many.