Hong Kong has been blessed with low exposure to natural disasters. For this reason, many of us know little about Post-traumatic Stress Disorder or PTSD, and mistake that only those who had experienced catastrophes would develop trauma. In fact, any event that involves life-threatening situation, severe injury or sexual violence, is defined as traumatic. Here are 4 common causes of PTSD:

• Experiencing trauma
• Witnessing a traumatic incident
• Learning that a close relative or friend went through trauma which generally involved violence or accident
• Dealing with the abhorrent part of the trauma repeatedly, eg. workers cleaning up human remains and policemen listening to details of child abuse

Will there be a sequela of trauma?

In general, a clinical psychologist would only conduct PTSD diagnosis on a patient at least 1 month after the incident because any short-term “symptoms” could just be normal physical and mental reactions. An instant and one-off post-traumatic debriefing may not be enough to prevent PTSD. On the contrary, studies point out that it could even increase the chances of developing depression and PTSD! The clinical psychologist should make timely and careful interventions after the fact should they deem necessary.

Hence, listening to and supporting those who feel disturbed after unpleasant incidents are utmost important. It’s like comforting and spending time with a friend who is dejected in career or love, but don’t rush to offer advice. We should first listen and observe before deciding if professional intervention is needed.

Symptoms of PTSD

Unfortunately, if the following symptoms are found 1 month after the incident, one should seek professional assistance.

• Uncontrollable, repetitive thoughts about the event
• Recurring dreams of the traumatic experience
• Re-experiencing the trauma through flashbacks
• Startled or feel disturbed by an environmental or psychological stimuli
• Making an effort to stay away from people, scenarios, things and places as well as one’s feeling and thoughts that arouse recollections of the trauma
• Unable to remember some crucial details of the traumatic experience
• Exaggerated negative thoughts about oneself, others and the world
• Blaming oneself or others about the cause or consequences of the traumatic experience
• Alienating oneself, feeling guilty, scared, angry and ashamed or unable to develop positive thoughts
• Become irritable, self-mutilating, easily scared, over-sensitive, difficult to concentrate and to sleep

The cures

There are three common approaches to deal with PTSD, namely:

Cognitive Processing Therapy - to help rebuild patients’ fundamental beliefs and free them from living in the threat of the past by examining such beliefs.

Imagery Rescripting - to help patients rearrange and leave behind the trauma and traumatic feelings, and rebuild a new life.

Emotion Focused Therapy - to help patients acknowledge their emotions so as to obtain sufficient messages of self-care.

Meanwhile, we should be aware that young patients may have a distorted perception of the trauma and misunderstand the symptoms of PTSD, driving themselves into a stressed condition for an extended period of time. This affects their brain development and a more complex treatment is required.

To conclude, PTSD is one type of mental illness that is usually accompanied by depression and anxiety disorder. Since it does not heal on its own, we shouldn’t underestimate its impacts and consequences, and should ask suspected patients to seek medical advice before it’s too late.