Post Traumatic Stress Disorder (PTSD) is a severe psychological reaction to a traumatic event. It involves the persistent re-experiencing of the trauma, avoidance of stimuli that remind the person of the event, increased arousal, and a numbing of emotional responses. This can affect their mood and behaviour and impact their everyday life.
For sudden cardiac arrest survivors, the loss of memory for the circumstances around the time of the event means that many are not troubled by disturbing memories. However, some develop a fear of circumstances similar to that of their event, and a small number of people have disturbing memories of the early stages of their recovery.
Approximately 80% of SCA’s occur at home and often the first on the scene and the first to attend the patient is a family member. Even if the person is familiar with CPR, performing it on a loved one can be a totally different matter and this traumatic situation is likely not prepared for. Also if family members are just witnesses to the event the shock and horror of what is happening to a loved one can be at best, deeply unsettling.
Be aware that PTSD is not routinely screened for in either the survivor or close family members and symptoms can take weeks, months or even years to surface.
Re-experiencing the event is a very typical symptom to look out for. There are a few ways it can present itself. One being as flashbacks. where you see the event in your mind and it’s perhaps triggered by something you see, something you feel or even what you hear or smell.
It can have a terrifying effect, instantly transporting you back into your memory. Not just your mind but your body too. You may find yourself acting parts of the event out like it’s happening over again.
After a cardiac arrest, possibilities are you may act out having problems breathing or start to convulse because your body is remembering when you were shocked by the defibrillator. Others may suffer with nightmares or in the opposite direction they may find it difficult to sleep.
It’s important to realise it doesn’t just affect you mentally but also physically. Pains in the body, sweating, nausea and trembling are symptoms that the person can also suffer with.
Your mood can be affected and it can make you feel like your in a heightened state of function, where your flight or fight instinct is on high alert and you perceive danger around you. Situations you used to cope well with now may make you feel anxious. People may become triggers. How they look, how they act or maybe how many of them there are.
With PTSD you view the event as negative, and to be fair it’s hard to see the good in suffering a cardiac arrest, but something distressing playing over and over in your mind isn’t useful.
You may watch it and wonder why? Had you done something different could it have been avoided?
Reactions, tears or panic when talking about the event and the effect it has had on you can also demonstrate it’s having a greater effect on you than it should do, after a certain length of time.
You may find yourself trying to avoid people, or they you if you have become upset whilst speaking to them. Places, events and activities can all have the trigger effect too. Avoidance is a way of stopping things from happening again. Some people with PTSD adopt avoidance as a coping strategy. They make themselves as busy as possible so they don’t have time to think. They try to make the memories unimportant and shut off what they feel. This tactic is called emotional numbing. Signs of a person using this coping
tactic is that they may become withdrawn and isolated.
Others may keep themselves busy, but by keeping themselves so busy they can get to the point that they just can’t stop! This is called hyperarousal. In this state, you can not relax and you look for danger constantly.
Anxiety and phobias are a hurdle to overcome with PTSD.
With Cardiac Arrest in particular you may well develop a fear of it happening again, or develop a fear of your ICD shocking you.
A person who has witnessed a cardiac arrest is perhaps likely to develop a fear of it happening again.
People can be so badly affected that they turn to drugs or alcohol to block it all out. Their relationships and work can be affected too. If it all gets too much, the risk of self-harming can not be ignored.
The condition does not just affect adults, it is a medical condition that can develop in children too. The symptoms are the same as in adults but there are three other specific symptoms to look out for. Bedwetting, separation anxiety and re-enacting of the traumatic event through play.
We all react emotionally after something unpleasant happens to us, but if there is no improvement after six weeks then a visit to your GP for a chat is advisable. Especially if the symptoms are troublesome.
Your GP can refer you to your local Mental Health Clinic or they may provide you with the details for you to refer yourself.
The treatments available are Psychotherapy and medication. Psychotherapy is the first choice of treatment. To be rid of the hold that the negative memories have over you, you have to confront them.
Before any treatment can be started you have an assessment of your symptoms. A friendly chat with a psychologist about what has happened to you, when it happened to you, how you feel and what symptoms you experience. You are given a questionnaire to answer truthfully that indicates if it is PTSD that you are suffering with.
I know the word Psychotherapy sounds scary but it’s talking! Talking to a
trained therapist whose aim is to get you to open up to them. With you they will teach you to look inside yourself, looking at your worries and problems.
They will help you deal with troublesome habits, behaviours and thought patterns. They are sessions to talk about yourself and other people. They will
listen and help you find the solution.
You will meet with the therapist on a regular basis and sessions vary may from an hour to an hour and a half.
If the therapy is provided on the NHS then be aware there is a waiting list.
There are three types of therapy that you are likely to be offered.
Cognitive Behavioural Therapy
Eye Movement Desensitisation and Reprocessing
Group therapy may be offered if anyone thinks it could be useful to them to speak about their experience with other PTSD sufferers. You can learn together how to manage your symptoms and understand the condition that you are living with.
Antidepressants are sometimes given to adults, but they are only used if trauma-focused psychotherapy treatment is refused or if no benefit has been gained from the treatment.
As heart patients though we must take care and make sure any psychology drugs are safe for us to take.
For more information and help on PTSD see the following links…