We go about our everyday lives in two domains: the emotional and the logical. So, for example, we fall in love (emotional) and then decide to live with or marry the perosn (logical). When a relative dies we feel many emotions but manage to cope with this by allowing ourselves gradually to accept it.
Logically we know that accidents happen, but emotionally we don’t think it will happen to us. This is necessary to allow us to take risks in our daily lives. However when an accident does happen to us, a rift occurs in the barrier between emotion and logic and we lose our ‘emotional virginity’.
PTSD is a psychological injury as opposed to an illness; in exactly the same way as breaking a leg would not be called an illness). It classically occurs where the trauma (or our fear of what might happen) was very signifcant but also where we are powerless to do anything about it. Our brain finds this too much to cope with all at once and we try to push the thoughts to the back of our mind. The trauma is then experienced as thoughts, dreams, flashbacks etc despite our best efforts. As these experiences are so horrible, we continue to ry and suppress them but our stress comes out in the form of disturbed sleep, poor concentration, increased vigilance and startle response and irritability or anger.
The treatment is primarily psychological and consists of enabling the individual to relax sufficiently to allow them to process byte-sized chunks of the way in which they experience the trauma so that its intensity and effect on day to day life can gradually be reduced. Usually somewhere between 12 and 20 sessions are necessary. There are a number of different techniques and therapy may be given by a clinical psychologist or another appropriately trained therapist.
If there has been a long delay before therapy begins (more than 2 or 3 years), there are signifcant events from your past life, earlier therapy has not been successful or there are other factors such as concurrent depressive illness, then therapy may be more difficult and sometimes (even if there is no concurrent depressive illness) certain antidperessants may need to be prescribed – in this case a psychiatrist would normally need to be involved, although some GPs will do this.