The traces of post-traumatic stress disorder in the wake of the pandemic

After experiencing or witnessing a life-threatening event, such as war, a traffic accident, an armed assault, a natural disaster or a sexual assault, It is normal to have unpleasant memories, feel nervous or have trouble sleeping and nightmares. At first it may be difficult to resume daily activities or return to a place that relives the negative situation. If the symptoms last more than a few months, it could be a post-traumatic stress disorder (PTSD).

Although this condition is associated with combatants, the United States Department of Veterans Affairs has expanded its field of action to other contemporary realities: COVID-19 survivors, victims of mass violent events (such as shootings) and family members of those experiencing PTSD. Its health and rehabilitation proposal includes sports, art, games and training programs, as well as support for those who have developed addictions as a result of the disorder.

Anyone can go through this, at any age. Some factors can increase the chance of having PTSD, such as previous exposure to a traumatic event. Y there is a key to reduce the risk: the correct management of stress after the event.

Estimates from the American Psychiatric Association state that women are twice as likely to have post-traumatic stress disorder. And minority ethnic groups in that country, such as Latinos, African-Americans and Native Americans, have higher rates than the white majority. It is a matter of vulnerability.

Fear is not the only emotion involved in reliving a bad moment. Sadness, anger, and a feeling of isolation or numbness are also common. That’s why it’s common to avoid situations and people that bring up those memories, as well as to react strongly to noise or accidental physical contact.

Also, it is not necessary for someone to have been directly involved in the adverse event. It is enough to learn of the violent death of a friend or relative or from being exposed to information that is difficult to process, as happens to police officers working on child abuse cases.

Post Traumatic Stress Disorder Symptoms

The symptoms are classified into four categories.

• Intrusion: Intrusive thoughts and involuntary memories, distressing dreams or feeling of deja vu so vivid that people actually feel like they are going through the thing they fear the most again.
• Avoidance: The person does everything possible not to meet what brings back memories. A place, certain people, objects and situations that lead them to think about what they don’t want. Too may resist talking about what happenedand his feelings.

• Changes in mood and cognition: There is difficulty remembering important facts related to the traumatic event, and also negative thoughts about oneself and others. The person will think: “It was my fault”, “I’m bad”, “I can’t trust anyone”. You may feel horror or shame about attempting activities you once enjoyed or continuing relationships with important people in your life.
• Altered reaction: These symptoms may include being irritable and having outbursts, acting recklessly or having self-destructive behaviors; live on alert, get scared easily or have trouble concentrating and sleeping.

Many people experience any of these symptoms in the days after the violent or sad event, but being diagnosed with PTSD is equivalent to spending more than a month with these discomforts in such a way that it affects your daily functions. Some people will be free of effects for months only to manifest them later. Recovery is especially long when related to other conditions such as depression, substance use, memory problems, and other physical and mental illnesses.

The UK health system recommends seeking professional help (medical or psychological) if you or your child are having problems four weeks after the traumatic experience, or if you find that you cannot manage the symptoms.

The good news is that the disorder can be successfully treated, even if it develops many years after the triggering event. Treatment depends on the severity of the symptoms and how long it has been since they started. Your practitioner may recommend:

• Active waiting, in which symptoms are monitored to see if they are getting better or worse since therapy begins.
• Antidepressant medications.
• Psychotherapy, such as cognitive behavioral therapy applied to trauma or eye movement desensitization and reprocessing (this requires a professional trained in EMDR).

Differences in trauma in children and adolescents

The US National Institute of Mental Health warns that children and adolescents can have extreme trauma-related symptoms that are quite different from adults. In children under 6 years of age, this can manifest as:

• Wetting the bed after being toilet trained.
• Having a delay in learning to speak or forgetting how to speak, if they have already done so.
• Narrate or act out the traumatic event during the game.
• Clinging to parents or some other adult more than usual.

Older children and adolescents will show signs closer to those seen in adults. But they can also develop disorderly, insolent or destructive behavior. In addition, they can develop a feeling of guilt, helplessness and a desire for revenge.

Trauma doesn’t heal on its own

It is important to treat post-traumatic stress disorder with professional help, as it is not limited to bad memories or strong emotions. A study presented in June of this year by the Harvard TH Chan School of Public Health followed more than 12,000 women with high levels of PTSD, and relates this condition to the accelerated decline in cognitive ability, specifically in the memory that we use when learning and working, as well as in psychomotor speed and attention. Cognitive decline is strongly associated with Alzheimer’s disease and other dementias.

In a world that has not yet overcome the effects of the COVID-19 pandemic, this is relevant. Curtin University, in the United Kingdom, presented a report in July this year according to which 8 out of 10 Britons who sought support from a national counseling network (National Bereavement Partnership) for having lost a loved one due to the coronavirus they had alarming symptoms of PTSD. There were also moderate and severe signs of anxiety and depression.

Lead author Professor Lauren Breen reflects on what this means for the families and friends of the more than 6 million people who have died from the virus across the planet. “This survey casts a worrying shadow of the pandemic,” she said. “Bereaved people who came to the National Bereavement Partnership also reported dysfunctional grief, death wishes to reunite with the deceased, and an inability to assume their responsibilities at home.”

According to the charity PTSD UK, 20% of global PTSD cases are due to the unexpected death of a loved one.

Breen says this creates a need for counselors to be alert to a broader range of psychological issues related to the pandemic, and to refer them to professionals who specialize in dealing with the intersection of grief and trauma.

Co-author Robert Neimeyer, director of the Portland Institute for Loss and Transition, explains that one not only loses a loved one, but also loses a sense of predictability, fairness and control about the circumstances, all crucial issues that need to be addressed during therapy. (F)