Post-Traumatic Stress Disorder

What is post-traumatic stress disorder?

Around 2.3 per cent of people in Germany suffer from post-traumatic stress disorder. But what is mental/psychological trauma?

"A state of intense fear we experience when confronted with a sudden, unexpected, possibly life-threatening event over which we have no control and to which we cannot respond in an effective way, no matter how hard we try." (Flannery, 1999)

There are different types of trauma - one-off, repeated, man-made, caused by (natural) disasters or accidents.

Not all people who have been exposed to trauma develop post-traumatic stress disorder (PTSD). There seem to be different protective factors (sense of meaning, social support, coping mechanisms) and risk factors (e.g. young age, previous illnesses, family stress factors).

Causes

So-called traumatic events to which the person concerned has been exposed or which he/she has witnessed are regarded as causal.

What symptoms can post-traumatic stress disorder trigger?

Often, the symptoms appear with a delay of a few weeks to several months. In some cases it takes many years until the typical symptoms appear:

• Persistent ("intrusive") memories of the trauma or re-experiencing the trauma in the form of "flashbacks" or dreams; internal distress in situations similar to or related to the trauma
• Circumstances similar to or related to the trauma are avoided
• Partial or complete inability to remember important aspects of the trauma OR persistent symptoms of increased psychological hyperexcitability, which may manifest themselves as sleep disturbances, irritability, difficulty concentrating, hyper-vigilance or increased jumpiness.

If traumatic events have occurred repeatedly and over a long period of time, a condition known as complex PTSD may also be present. This is characterised by a massive disturbance in the regulation of feelings and behaviour, by disturbances in perception and consciousness (e.g. dissociation, amnesias), disturbances in self-perception, in social relationships, by the development of physical complaints without clear organ reference or fears of physical illnesses, and by a change in attitudes to life.

How is post-traumatic stress disorder diagnosed?

The diagnosis of PTSD is made through consultations and, if necessary, with the help of questionnaires.

How is post-traumatic stress disorder treated?

Inpatient therapy may become necessary if treatment in the home environment is not practical or possible due to everyday demands (e.g. due to the care of children or other relatives). Hospital treatment may also be necessary due to the severity of the illness. The wide range of therapies on offer and the availability of therapists and nurses create a supportive and protective atmosphere in which many patients are able to address their stressful memories and symptoms and work out a helpful way of dealing with them.

Our treatment includes therapies that take into account the physical, psychological and spiritual dimensions.

Physical dimension: Here, the use of various medications can be considered. However, the treatment of PTSD with medication is always a supportive treatment to alleviate the often agonising accompanying symptoms such as inner restlessness, sleep disturbances, dejection or drive disorders; its use is always assessed on a case-by-case basis. Primarily, antidepressants are used for this purpose, in rare cases also neuroleptics. With the help of anthroposophic medicines, the individual's self-healing powers are stimulated. External applications, compresses, rubs and oil dispersion baths support the healing process. Sports and physiotherapy complement the therapy offer in terms of the physical dimension.

Psychological dimension: Imparting knowledge (psycho-education), therapeutic painting, music therapy, therapeutic eurythmy, therapeutic modelling and sculpting, garden therapy.

Spiritual dimension: The spiritual dimension is taken into account within the framework of psychotherapy. Individual and group discussions take place. Trauma-specific psychotherapy is cross-method, i.e. it combines elements of behavioural therapy, depth psychology, schema therapy and anthroposophic psychotherapy. We pursue the following goals:

• Building a new sense of security
• Finding a good way to deal with difficult feelings and with stressful memories
• Building coping skills for problematic everyday situations
• Placing the experience in the biography

These goals are pursued with the help of different methods. In the individual sessions, in addition to the therapeutic consultation - e.g. imagination methods or the so-called chair technique from schema therapy - mindfulness exercises are used and/or the patients are encouraged to try out certain new behaviours. Observation tasks or independent behavioural experiments can be arranged between sessions. In the groups there is the opportunity to try out new ways of behaving (e.g. setting boundaries) with the help of role plays.

Various meditation options also complement what is available in terms of the spiritual dimension.

Prospects: living with the disease

PTSD is well treatable, and most patients respond positively to therapy. However, if left untreated, the disorder can take a chronic course and in some cases turn into a permanent personality change.