General Overview
The first principle is to learn to help yourself in a positive way by:
- Keeping life as normal and free of other stresses as possible.
- Getting back to some kind of routine even if different from before.
- Talking about what happened to someone you trust when you want to.
- Trying relaxation exercises and times for meditation or being peaceful.
- Going back to work unless this increases stress.
- Eating and exercising regularly.
- Taking time to be with family and friends - unless this increases stress.
- Being more careful generally - accidents are more likely at this time.
- Speaking to professionals who can help, e.g. doctors, solicitors, counsellors.
- Talking to spiritual advisors if they understand trauma.
- Expecting to get better, reading stories about previous survivors.
- Contacting survivor groups such as Disaster Action or local groups.
Try to avoid negative reactions such as:
- Blaming yourself for what is a normal reaction to a terrifying experience.
- Bottling up your feelings.
- Avoiding talking or thinking about it at all.
- Expecting the memories to go away immediately, they may be with you for quite some time.
- Expecting too much of yourself too soon. The trauma and appointments will demand a lot of your energy for a while.
- Being isolated while still having enough time on your own to think.
- Drinking excessive amounts of alcohol or coffee or smoking more.
- Missing meals.
Other people might obstruct your processing of the trauma and this can either be intentional or unintentional. Be aware of people who will not let you talk about what happened, avoid you, are angry with you, think of you as weak or even hold you responsible for what happened.
Treatment
Just as there are both physical and psychological aspects to PTSD, so there are both physical and psychological treatments for it.
Medication
Antidepressants will reduce the intensity of PTSD symptoms and relieve any depression that is also present. They will need to be prescribed by your doctor or a psychiatrist.
Sedatives will help to reduce high levels of arousal.
Sleeping tablets can be of help in the short term.
Psychotherapy
These are 'talking therapies' of which there are many varieties. All effective forms of psychotherapy after trauma focus on the traumatic experience that has produced your symptoms rather than on your past life, unless a previous problem has been reactivated by the new event and is feeding the trauma. The aim is not to forget what has happened but to think differently about it, about the world, and about your life. Talking about trauma can be difficult because at the time it can seem unreal and put you into a trance-like state. Time should be taken to build rapport and feelings of safety before dealing with the traumatic story. It is harder to deal with if you can't remember what happened, can't put it into words, or can't make sense of it.
Cognitive-Behavioural therapy is a way of helping you to think differently about your memories so that they become less distressing and more manageable. It will usually also involve some relaxation work to help you tolerate the discomfort of thinking about the traumatic events, and regular homework. CBT is usually short term, offering 6-12 sessions. Other therapies may include CBT methods.
EMDR (Eye Movement Desensitisation & Reprocessing) is a technique which uses eye movements to help the brain to absorb flashbacks and to make sense of the traumatic experience. It should only be used as part of an ongoing therapy. It is one of several 'power therapies' which reduce specific trauma reactions.
Group therapy involves meeting with a group of other people who have been through the same or a similar traumatic event. The fact that other people in the group do have some idea of what you have been through can make it much easier to talk about what has happened, and has a major influence in confirming that the symptoms are normal and part of a universal reaction to surviving a traumatic experience.
Body-focused therapies help to control the distress of PTSD by putting the 'brakes' on hyperarousal and include physiotherapy, osteopathy, massage, acupuncture, reflexology, yoga, meditation and tai chi. They all tend to help you develop ways of managing stress and relaxing and are particularly effective if you find it difficult or impossible to put the impact of the trauma into words.