Amazingly, Hollywood never shows James Bond sitting in a counsellor’s office talking about his persistent anxiety after all the stressful events he goes through. Real people, though, do get impacted by terrifying events like car accidents, robberies and assaults, medical emergencies and natural disasters. Nearly everyone will be ‘jittery’ for a while; after the initial surge of adrenaline fades it is normal to be upset, anxious, tearful and to have trouble sleeping. Fortunately, most people recover steadily – the swirling thoughts and unpleasant feelings settle over days and weeks. However some people develop Post Traumatic Stress Disorder (PTSD), an Anxiety Disorder that persists for months, even years, after the event. The person may find themselves really troubled by anything that reminds them of the event, and they will spend a lot of energy avoiding those cues. When they are triggered, they find themselves experiencing the terrifying emotions of the event all over again.
After the Vietnam War it was estimated that about 250,000 American military veterans had some PTSD. They might tremble at the sound of a helicopter, throw themselves on the ground when a car backfired, and feel terrible emotions if they heard a baby cry. Some became recluses living alone in remote areas; many sought relief from drugs and alcohol.
Sexual assaults, kidnappings and warfare are particularly likely to precipitate PTSD, but it can also occur well away from battle fields and crime scenes. Heart attacks, operations, child-birth and miscarriages traumatise some people. Even events happening to loved-ones can cause PTSD; for example, parents of children diagnosed with cancer can develop PTSD. It seems psychological stress, and not just physical threats, can trigger it as well.
Sympathetic support for people after a trauma seems to help prevent PTSD, and counselling as soon as symptoms occur can help a lot. Some drugs have proved to be very helpful in relieving PTSD, though excessive benzodiazepines (like Valium) tend to make it worse. Understandably, many people seek relief from their painful emotions by self-medicating with alcohol and other drugs; sadly that tends to just create additional addiction and psychological problems. That does tend to be a thing with PTSD: it is often part of a ‘mix’ of complex psychological issues – about half of people with PTSD also meet the criteria for major depression. The only good side of that is counselling that helps people with their PTSD often seems to alleviate their other problems as well.
Good therapy, the right drugs and sympathetic support make a huge difference for people with PTSD. It can be treated. We never chose the trauma that caused it, but we can choose to actively get through it!