Download this fact sheet: Number 4.15 What is post-traumatic stress disorder? [PDF: 422 KB]
Number 4.15 June 2006
for workers
Introduction
Post-traumatic stress disorder is also referred to as PTSD. It is a psychiatric disorder that some people develop after they have experienced a traumatic event. Traumatic events include experiencing something life threatening, or witnessing injury, assault or death as a result of war, natural disaster, domestic violence or abuse. There appears to be a higher prevalence of PTSD among people, such as refugees, who have endured an extreme life experience compared to the general population.
This fact sheet provides a description of PTSD so that people working with refugees can have a better understanding of some of the problems faced by refugees who have experienced traumatic events.
The causes of PTSD
Post-traumatic stress disorder is a type of anxiety problem. It can develop after a person experiences or witnesses a traumatic event. The person's immediate response usually involves intense fear, helplessness or horror. Some examples of traumatic events are torture, a natural disaster, rape, severe car crash or fighting in a war.
Who develops PTSD?
Whether a person develops PTSD depends on the severity, intensity and duration of the trauma experienced. People who have existing anxiety, depression or other mental disorders may be more likely to develop PTSD. People who have been victims of previous trauma may also be at greater risk.
What are the symptoms of PTSD?
The symptoms of PTSD may develop directly after the trauma is experienced or may develop months, or even years, later. The symptoms of PTSD are grouped into three categories:
- re-experience of trauma: flashbacks, nightmares, intrusive memories and exaggerated emotional and physical reactions to triggers that remind the person of the trauma
- avoidance: avoiding activities, people or places that remind the person of the trauma, emotional numbing, feeling detached, lack of emotions (especially positive ones), loss of interest in activities
- increased arousal: difficulty sleeping and concentrating, increased irritability, being on guard (hypervigilance), and being easily startled.
A diagnosis of PTSD is made if a number of symptoms from each of the three categories above have lasted for a month or more and have caused the person severe problems in everyday life.
The symptoms that are associated with PTSD include:
- headaches
- depression
- anxiety attacks
- chronic pain with no medical basis (frequently gynaecological problems in women)
- stress-related conditions, such as chronic fatigue syndrome or fibromyalgia
- stomach pain or other digestive problems, such as irritable bowel syndrome or alternating bouts of diarrhoea and constipation
- eating disorders
- breathing problems or asthma
- muscle cramps or aches, such as lower back pain
- cardiovascular problems
- sleep disorders.
Post-traumatic stress disorder can lead to self-destructive behaviours, such as:
- substance misuse
- self-injury and suicide attempts
- risky sexual behaviours leading to unplanned pregnancy or sexually transmitted infections
- other high risk behaviour, for example, dangerous driving.
The social outcomes of PTSD include:
- relationship problems
- low self esteem
- alcohol and substance use problems
- employment problems
- homelessness
- trouble with the law.
How is PTSD treated?
Post-traumatic stress disorder can be treated in two ways:
- medicines for depression or anxiety
- psychotherapy or counselling.
Any alcohol and other drug use problems that are associated with PTSD should be treated before or during PTSD treatment.
How long does PTSD last?
Left untreated PTSD can last several months to many years, depending on the type of traumatic event and the person's feelings about it. However, PTSD can be treated successfully.
Relationship of PTSD to refugees
Many refugees have experienced different forms of trauma, for example, approximately seven out of 10 refugees in Australia are estimated to have been tortured. Generally, exposure to trauma increases the risk for PTSD.
Mental illness is highly prevalent among newly arrived refugees and in many instances refugees have reported symptoms associated with PTSD, such as flashbacks, nightmares, and also depression or anxiety-related symptoms.
Relationship of PTSD to drug use
The research points to a link between PTSD or trauma and substance use. For instance, a large number of clients in substance abuse clinics were found to meet criteria for the diagnosis of PTSD or to have a history of multiple traumas. As previous history of trauma and diagnosis of PTSD are more common among refugees, and increase the risk of drug use problems; this may indicate that refugees are at risk for substance use problems.
The factors that may heighten the risk of newly arrived refugees having problems with alcohol and other drug use include:
- previous experience of trauma
- diagnosis of PTSD
- cumulative stress.
While the onset of the first two is probably more relevant to the early period of the refugee experience, cumulative stress is also associated with ongoing adjustment to the new circumstances of their host country.
Support services
Early detection of these issues and provision of culturally adapted counselling may assist in preventing the onset of PTSD and substance use. Adding stress management components to programs and workshops for newly arrived refugees may help them cope with cumulative stress and may consequently reduce the likelihood for substance abuse.
The Victorian Foundation For Survivors Of Torture Inc. provides a range of services to refugees who have survived torture or war related trauma. Contact details are:
The Victorian Foundation For Survivors Of Torture Inc.
6 Gardiner Street, Brunswick, Victoria 3056
Tel. (03) 9388 0022
Email: info@foundationhouse.org.au
www.foundationhouse.org.au
More information
For more information on drugs and drug prevention contact the DrugInfo Clearinghouse on tel. 1300 85 85 84, email druginfo@adf.org.au.