Information For Carers Friends And Relatives
If you are a carer, friend or relative of someone who lives with PTSD, you can get support.
How can I get support?
You can do the following.
- Speak to your GP about talking therapies and medication for yourself.
- Speak to your relatives mental health team about a carers assessment or ask for one from your local social services.
- Join a carers service. They are free and available in most areas.
- Join a carers support group for emotional and practical support. Or set up your own.
What is a carers assessment?A carers assessment is an assessment of the support that you need so that you can continue in your caring role. You might be able to get support from social services.
You can find out more about Carers assessment Under the Care Act 2014 by clicking here.
How do I get support from my peers?You can get peer support through carer support services or carers groups. You can search for local groups in your area by using a search engine such as Google. You can find all of our peer support groups here: www.rethink.org/help-in-your-area/support-groups/.
You can look on the following websites:
How can I support the person I care for?
You can do the following.
You can find out more about:
- Supporting someone with a mental illness by clicking here.
- Responding to unusual thoughts and behaviours by clicking here.
- Worried about someones mental health by clicking here.
- Stress How to cope by clicking here.
You can find out more about:
Are There Emerging Options To Prevent And Treat Ptsd
Several experimental studies provide hope that better or alternative ways to prevent and treat PTSD are on the way. Simple visuospatial tasks such as playing a computer game shortly after a traumatic experience reduce re-experiencing.55 For established PTSD, interest in using drugs to augment psychological therapy is increasing. The results of a recent RCT of the psychedelic 3,4-methylenedioxymethylamphetamine with psychotherapy for treatment resistant PTSD have been promising.5657 These approaches remain in their infancy, and further well designed clinical studies are required to determine if they will live up to their early promise.
How Should Ptsd And Comorbidity Be Managed
PTSD is associated with depression, anxiety disorders, and drug and alcohol use disorders. Little evidence exists for the effectiveness of psychological interventions for PTSD with comorbid substance use disorders. Some evidence suggests that trauma focused CBT can be effective with concomitant interventions to stabilise drug or alcohol use, but treatment effects are not as large as for PTSD in the absence of drug or alcohol misuse.54
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Avoidance And Emotional Numbing
Trying to avoid being reminded of the traumatic event is another key symptom of PTSD. This usually means avoiding certain people or places that remind you of the trauma, or avoiding talking to anyone about your experience.
Many people with PTSD try to push memories of the event out of their mind, often distracting themselves with work or hobbies.
Some people attempt to deal with their feelings by trying not to feel anything at all. This is known as emotional numbing. This can lead to the person becoming isolated and withdrawn, and they may also give up pursuing activities they used to enjoy.
Arousal And Reactivity Symptoms Include:
- Being easily startled
- Feeling tense or on edge
- Having difficulty sleeping
- Having angry outbursts
Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
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Tip : Reach Out To Others For Support
PTSD can lead to feelings of alienation from others. You may be inclined to isolate yourself from social activities and loved ones. But it is essential to maintain relationships with life and those who care about you. You are not required to discuss the trauma, but the compassionate support and company of others are essential to your healing. Reach out to someone you can connect with for an extended amount of time, someone who will listen without judging, condemning, or being frequently distracted. This someone might be your significant other, a family member, a close friend, or a licensed therapist. You might also:
Volunteering your time or reaching out to a friend in need are acts of kindness. Not only is this a terrific way to interact with people, but it may also help you regain a sense of control.
Joining a support group for PTSD. This can make you feel less alone and lonely, as well as provide essential knowledge on how to manage symptoms and work toward recovery.
How Canada Is Helping
Canada is committed to addressing PTSD. We passed the Federal Framework on Post-Traumatic Stress Disorder Act in June 2018. The Act recognizes that all Canadians can be at risk for PTSD and that a great number face higher risks because of the nature of their work.
The Act led to a National Conference on PTSD in April 2019. Experts from across the country, including people with lived experience, shared their knowledge and views. With their involvement, we have developed Canadas first Federal Framework on Posttraumatic Stress Disorder.
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Episodes With Mixed Features
As with all types of bipolar disorder, mixed episodes include both manic and depressive states, but an individual may cycle between them in the same episode or they may occur at the same time.
Some of the symptoms of PTSD are very similar to the symptoms of bipolar disorder, such as:
- increased risk of suicide attempts
- sleeping issues
Ptsd Symptoms In Children
PTSD symptoms in children, particularly very young children, may differ from those of adults and include:
- Concern over separation from their parent.
- Loss of once-gained skills .
- Sleep issues and nightmares.
- Tragic, obsessive play in which traumatic themes or characteristics are repeated.
- New fears and worries that do not appear to be tied to the experience .
- Playing out the pain through storytelling, drawings, or games.
- Without obvious reason, aches, and pains
- Irritability and hostility
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Why Do Some People Develop Ptsd And Other People Do Not
It is important to remember that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder.
Many factors play a part in whether a person will develop PTSD. Some examples are listed below. Risk factors make a person more likely to develop PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder.
Some factors that increase risk for PTSD include:
- Living through dangerous events and traumas
- Feeling horror, helplessness, or extreme fear
- Having little or no social support after the event
- Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
- Having a history of mental illness or substance abuse
Some factors that may promote recovery after trauma include:
- Seeking out support from other people, such as friends and family
- Finding a support group after a traumatic event
- Learning to feel good about ones own actions in the face of danger
- Having a positive coping strategy, or a way of getting through the bad event and learning from it
- Being able to act and respond effectively despite feeling fear
Researchers are studying the importance of these and other risk and resilience factors, including genetics and neurobiology. With more research, someday it may be possible to predict who is likely to develop PTSD and to prevent it.
What Risks Are Associated With Ptsd
Alcohol and drug use
Some people who live with PTSD use drugs or alcohol to help manage the symptoms.
Drug or alcohol misuse can make you more unwell, especially is it is excessive. It can make you more likely to try and harm yourself or take your own life.
You can find out more about Drugs, alcohol and mental health by clicking here.
Mental health conditions
Most people who live with PTSD will have at least 1 other mental health condition. The most common conditions are:
- substance use, and
- anxiety disorders.
Other mental health conditions have some of the same symptoms as PTSD. This may be why PTSD can sometimes be hard to diagnose.
If you think you may be experiencing PTSD, you can tell your healthcare professional. You can explain that youve been through a trauma, and you think your symptoms might be related to PTSD.
You can find out more about:
Sometimes PTSD symptoms can be long-lasting and can have a significant impact on day-to-day life. This can sometimes lead to suicidal thoughts.
You can find out more about Suicidal thoughts How to cope by clicking here.
There is a link between PTSD and psychosis. But it isnt known if psychosis is sometimes a symptom of PTSD. Or if it is a separate mental health condition, that can be developed alongside PTSD.
You can find out more about Psychosis by clicking here.
Physical health issues
You can find more information about:
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What Are The Implications Of The Dsm
Changes in the diagnostic criteria have minimal impact on prevalence. National estimates of PTSD prevalence suggest that DSM-5 rates were only slightly lower than DSM-IV for both lifetime and past-12 month . When cases met criteria for DSM-IV, but not DSM-5, this was primarily due the revision excluding sudden unexpected death of a loved one from Criterion A in the DSM-5. The other reason was a failure to have one avoidance symptom. When cases met criteria for DSM-5, but not DSM-IV, this was primarily due to not meeting DSM-IV avoidance/numbing and/or arousal criteria . Research also suggests that similarly to DSM-IV, prevalence of PTSD for DSM-5 was higher among women than men, and increased with multiple traumatic event exposure .
Eye Movement Desensitisation And Reprocessing
Eye movement desensitisation and reprocessing is a relatively new treatment which has been found to reduce the symptoms of PTSD.
It involves making side-to-side eye movements, usually by following the movement of your therapist’s finger, while recalling the traumatic incident. Other methods may include the therapist tapping their finger or playing a tone.
It’s not clear exactly how EMDR works but it may help you to change the negative way you think about a traumatic experience.
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What Are The Symptoms Of Ptsd
The main symptoms and behaviours associated with PTSD and complex PTSD include:
- Reliving the experience through flashbacks, intrusive memories, or nightmares
- Overwhelming emotions with the flashbacks, memories, or nightmares
- Not being able to feel emotions or feeling numb
- Dissociation, that can include disconnecting from yourself or other people
- Avoidance. This could mean that you try to distract yourself from thinking about the trauma. Or you avoid people and situations that remind you of the trauma.
Other symptoms and behaviours associated with PTSD and complex PTSD include:
- Negative mood and thinking.
You can also try self-help techniques.
How can the NHS help me?
If you have symptoms that are causing you a lot of distress or are affecting your daily life, you can see your GP.
Your GP should carry out an initial assessment using screening tools to decide what care you need.
Your assessment should include information about:
- your physical needs,
- your social needs, and
- any risk to yourself or others.
Your GP will be able to talk to you about treatment options and coping strategies. You’re likely to be offered treatment if you’ve had symptoms of PTSD for more than 4 weeks or your symptoms are severe.
You can choose whether to have treatment and decide about the options your GP offers you. If youre unsure of anything, like the benefits of treatment, then ask your GP.
You can find out more information about NHS mental health teams by clicking here.
Who Can Get C
- People who have survived living in concentration camps.
- People who have survived prisoner of war camps.
- Survivors of long-term childhood physical and/or sexual abuse.
- Anyone who has been part of a prositution brothel.
- Survivors of long-term domestic violence.
PTSD and C-PTSD share many of the same symptoms, but literature has pointed to three symptoms exclusive to C-PTSD
- Problems with emotional regulation.You might have a lessned sense of emotional sensitivity. You may lack the ability to respond to situations appropriately or feel you are unable to control your emotions.
- Problems with interpersonal relationships. You may have difficulty feeling close to another person feel disconnected or distant from other people. It may be hard for you to maintain close relationships with family, significant others, or friends.
- Negative self-concept. You may have a poor perception of oneself. You might feel worthless, helpless, shame, guilt, and other problems related to self-esteem.
C-PTSD can be treated with the same evidence-based treatments that are effective for treating PTSD. However, some research suggests that therapy with a focus on reestablishing a sense of control and power for the traumatized person can be especially beneficial.
Some examples of how to treat anxiety include:
While there is no one simple answer, people do recover with a combination of supports. It can take some time to find out what works best for you, but it does get better.
Cognition And Mood Symptoms Include:
- Trouble remembering key features of the traumatic event
- Negative thoughts about oneself or the world
- Distorted feelings like guilt or blame
- Loss of interest in enjoyable activities
Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.
It is natural to have some of these symptoms for a few weeks after a dangerous event. When the symptoms last more than a month, seriously affect ones ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD dont show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.
Signs You Or Someone You Know Has Bpd
The same review finds that, while these two conditions are distinct diagnoses, some researchers have observed that one condition may exacerbate the symptoms of the other. For instance, PTSD can intensify the affective instability of someone who has BPD. It may also serve as a trigger for self-injury among people who have BPD.
BPD is often found in people who have suffered from childhood abuse of any kind, and the authors of this paper cite that out of 547 people who had both conditions, 36 percent had experienced childhood sexual abuse. Broken down by gender, 43.43 percent of women who had both PTSD and BPD had childhood sexual abuse in their backgrounds compared with 19.14 percent of men in this same group.
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Helping Someone With Ptsd
If someone you love is living with PTSD, its normal to want to reach out and help. But when it comes to PTSD, it can be difficult to know how to support them.
If you think a loved one could be experiencing PTSD, there are ways you can offer support. The National Alliance on Mental Illness offers some helpful guides:
- PTSD e-learning module
- Veterans & Active Duty offers more information about veteran mental health
- NAMI Homefront offers free, six-session educational program for families, caregivers, and friends of military service members and veterans
Be sure to fill your own cup and seek out the support of a trusted friend or therapist.
For more information, tips, and general support, download the PTSD Family Coach app.
Prevention After Large Scale Traumatic Events
Evidence to support routine intervention after traumatic events involving many people is lacking. However, some evidence suggests that high levels of social support are perceived as protective.27 Consensus guidelines recommend supportive, practical, and pragmatic input but avoidance of formal clinical interventions unless indicated.282930
Statistical Methods And Measurement Caveats
National Comorbidity Survey Replication
Diagnostic Assessment and Population:
- The NCS-R is a nationally representative, face-to-face, household survey conducted between February 2001 and April 2003 with a response rate of 70.9%. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview , a fully structured lay-administered diagnostic interview that generates both International Classification of Diseases, 10th Revision, and DSM-IV diagnoses. The DSM-IV criteria were used here. The Sheehan Disability Scale assessed disability in work role performance, household maintenance, social life, and intimate relationships on a 010 scale. Participants for the main interview totaled 9,282 English-speaking, non-institutionalized, civilian respondents. Post-traumatic stress disorder was assessed in a subsample of 5,692 adults. The NCS-R was led by Harvard University.
- Unlike the DSM-IV criteria used in the NCS-R and NCS-A, the current DSM-5 no longer places PTSD in the anxiety disorder category. It is listed in a new DSM-5 category, Trauma- and Stressor-Related Disorders.
National Comorbidity Survey Adolescent Supplement
Diagnostic Assessment and Population:
Box 1 Traumatic Event Required For Diagnosis Of Ptsd
- Exposure to actual or threatened death, serious injury, or sexual violation, in one or more of the following ways:
- Directly experiencing the traumatic event
- Witnessing traumatic event in others
- Learning that the traumatic event occurred to a close family member or close friend cases of actual or threatened death must have been violent or unintentional
- Experiencing repeated or extreme exposure to aversive details of the traumatic event this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related
Proposed ICD-11 criterion
- Exposure to an extremely threatening or horrific event or series of events
DSM-5 lists the 20 symptoms required for PTSD to be diagnosed,14 separated into four groups . All symptoms must be associated with the traumatic event. In the proposed criteria by ICD-11,17 PTSD will be diagnosed according to six criteria . To reflect the heterogeneity of PTSD, ICD-11 will introduce a new complex PTSD diagnosis . This requires satisfaction of the criteria for PTSD plus symptoms of mood dysregulation, negative self concept, and persistent difficulty in sustaining relationships and feeling close to others. Service users may meet the diagnostic criteria in one system but not in the other owing to the differences.19
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