THE HEALTH | JULY , 2023

MINDTALK

BY DR ROZANIZAM ZAKARIA

The scene from what she dreads greatest played out before her as she drove towards an intersection . A car that ran a red light brutally collided into the driver ’ s side of Sarah ’ s vehicle .

Sarah ’ s body was brutally shocked instantly , and terror and confusion flooded her consciousness . As the shock overwhelmed her , the oncecomfortable surroundings blurred .

Sarah was physically bruised and traumatised after the accident , but the scars became more profound . Every time she considered getting behind the wheel again , she could not escape the feeling of horror that had overwhelmed her . It seemed she was reliving the horrifying moments of the collision every time she saw a car approaching an intersection .

Sarah started avoiding going to sleep . Every time she tried to fall asleep , she experienced nightmares . She broke into a cold sweat by the nightmare imagery of bent metal , smashed glass and the eerie sound of screeching brakes .

She was overcome with anxiety , which caused her hands to tremble violently and her heart beating rapidly . She withdrew from friends and family , losing her once active social life due to her inability to articulate the invisible cords that connected her to her trauma .

It was during a routine check-up that Sarah ’ s doctor recognised the signs . The sleepless nights , the debilitating anxiety , and the avoidance behaviour all indicated post-traumatic stress disorder ( PTSD ). Sarah ’ s life had been shattered by the car accident , and the aftermath of the trauma had left an indelible mark on her mental well-being .

CATEGORISING POST-TRAUMATIC STRESS DISORDER SYMPTOMS

Trauma is a term used to describe an emotional or psychological reaction to a profoundly upsetting or upsetting incident or experience . It is an occurrence that has a lasting effect on a person ’ s mental and emotional health because it exceeds their capacity to cope with or integrate the emotions involved . Traumatic incidents can entail real or threatened death , significant injury , or sexual assault , and they frequently cause the person experiencing them to feel terrified , helpless , or horrified . Natural catastrophes , accidents , physical or sexual assault , exposure to

combat , childhood maltreatment , or witnessing violence are just a few of the situations that can lead to trauma .

Post-traumatic stress disorder ( PTSD ) is a psychological problem that affects many people who experience dreadful situations . It is a mental disorder that affects those who have been through or seen a traumatic event . Their everyday activities , interpersonal interactions , and general well-being may all be significantly impacted .

PTSD symptoms can be grouped into four categories : 1 . Re-experiencing symptoms - flashbacks , nightmares , intrusive thoughts , or intense emotional distress triggered by reminders of the traumatic event .

2 . Avoidance symptoms - efforts to avoid people , places , or activities associated with the trauma , as well as emotional numbing and detachment from others .

3 . Negative changes in cognition and mood - persistent negative beliefs , distorted thoughts about oneself or the world , feelings of guilt or shame , and a diminished interest in activities once enjoyed .

4 . Hyperarousal symptoms - hypervigilance , irritability , difficulty sleeping , exaggerated startle response and difficulty concentrating . Multiple variables can contribute to PTSD development . In addition to the actual traumatic events , one ’ s chance of developing PTSD may also be increased by biological and genetic variables .

Research on twin and family studies has shown that PTSD may have a hereditary component . According to these studies , people with a family history of PTSD may be more likely to experience the illness themselves .

Additionally , twin studies have shown that identical twins have a greater concordance rate for PTSD than fraternal twins , suggesting a genetic component . Additionally , environmental and psychological elements are important . For instance , persons with a history of trauma , pre-existing mental health issues , or a lack of social support may be more susceptible to PTSD .

IMPACT ON INDIVIDUALS

Studies have shown a high rate of comorbidity between PTSD and depression . The two conditions frequently co-occur , with individuals diagnosed with PTSD having an increased risk of developing depression .

Research suggests that approximately 48 per cent to 55 per cent of individuals with PTSD also experience symptoms of depression . A study published in JAMA Psychiatry found that about 46 per cent of individuals with PTSD reported having suicidal thoughts at some point in their lives . The same study reported that around 12 per cent of individuals with PTSD had attempted suicide at least once in their lifetime ( Oquendo et al ., 2005 )

Other impacts include :

1 . Emotional and psychological consequences - individuals with PTSD often experience intense fear , anxiety , anger , sadness , and a reduced sense of safety . They may also struggle with trust issues and have difficulty regulating their emotions .

2 . Physical health effects - PTSD has been linked to an

Dr Rozanizam Zakaria is a Psychiatrist and an Assistant Professor at the Kulliyyah of Medicine , International Islamic University Malaysia ( IIUM ). He is also a Fellow in Child and Adolescent Psychiatry . increased risk of various physical health conditions , including cardiovascular problems , chronic pain , and gastrointestinal issues . 3 . Impairment in daily functioning - PTSD can significantly disrupt an individual ’ s ability to perform everyday tasks , maintain employment , and engage in social activities .

4 . Relationship difficulties - PTSD can strain relationships due to emotional distance , communication problems and a lack of understanding about the disorder ’ s impact on the individual ’ s behaviour and emotions .

TREATMENT APPROACHES

Evidence-based psychotherapies such as Cognitive-Behavioral Therapy ( CBT ), trauma-focused CBT and Eye Movement Desensitisation and Reprocessing ( EMDR ) effectively treat PTSD . They help individuals process traumatic memories , challenge negative beliefs , and develop coping skills .

TF-CBT is a specialised form of CBT designed for children and adolescents who have experienced trauma . It incorporates cognitive-behavioural techniques with trauma-focused interventions to address symptoms and promote healing .

Some may also require pharmacological intervention . Antidepressants , particularly selective serotonin reuptake inhibitors ( SSRIs ), are often prescribed to manage PTSD symptoms . They can help alleviate depression , anxiety and sleep disturbances .

In addition , those affected will also require social support to go through the healing process from trauma . Seeking support from loved ones , joining support groups , and connecting with individuals with similar experiences can provide validation , understanding , and a sense of community . – The Health