Post-operative PTSD (post traumatic stress disorder)
By Liz Lockhart
It is estimated, by a recent survey, that a quarter of medical patients with heart disease or cancer and people who have had major surgery meet the criteria for PTSD (Post Traumatic Stress Disorder). Some studies suggest that this figure is even higher. CLICK HERE FOR ONLINE PTSD HELP - FREE FOR MILITARY AND THEIR FAMILIES
Should health professionals talk to patients about this more? Or should the subject be avoided?
One clinician writing on psychcentral.com says that she always suspects that she is treating someone with PTSD when they tell her about a frightening hospital experience, without going into detail. Or, she says, that they may describe some aspect of what they experienced with their illness with the bland detail someone might use to describe a trip to the shops. In other words, emotion is often absent from the discussions of trauma in people who have PTSD until someone becomes flooded by feelings and then they cannot shut them off.
The criteria for PTSD as set out in the DSM IV (4th ed., American Psychiatric Association, text revision 2000) is:
- A traumatic event that involves actual or threatened death, or the threat of physical integrity to self or others and the person’s response to that event was intense fear, helplessness or horror
- At least one symptom of re-experiencing of the event, such as intrusive memories, nightmares, a sense of reliving the event, and/or psychological distress when reminded of the event
- Three or more symptoms of avoidance, such as avoidance of thoughts, feelings or reminders of the event, inability to recall aspects of the event, withdrawal from others, emotional numbing, sense of foreshortened future – and
- Two or more symptoms of increased arousal, such as insomnia, irritability, concentration difficulties, hypervigilance and exaggerated startle response.
From this list of symptoms we can see that avoidance is a key symptom of PTSD. It helps sufferers to function if they avoid talking about or thinking about traumatic events. It prevents them from becoming overwhelmed by their emotions.
Unfortunately avoidance carries a price.
People can feel misunderstood, lonely and isolated. The avoidance of memories can take a lot of energy. Avoidance can itself create unpleasant feelings. This could be one of the reasons why people with PTSD can sometimes drink too much or self-medicate in other ways.
Very often, people who have developed PTSD as a result of surgery or illness, appear not to want to talk about their feelings. Healthcare professionals need to recognise that injuries and operations can be very traumatic mentally as well as physically and treat the 'whole person'. PTSDsufferers need to feel in control of the situations and circumstances in which they talk about these traumatic experiences.
Avoidance perpetuates fear and as we become more and more aware of PTSD in all it's forms (not just confined to service persons), we must surely educate health professionals on how best to spot and treat it before it becomes a life long battle.
For further information or help with PTSD please see the following links