It is with great shock & deep sorrow that we have witnessed the unfolding of horrific events since Easter Sunday in Sri Lanka. Along with the rest of our country, we too believed that the days of waking up to news of attacks were long past us. However, due to the cowardly actions of a few, we have been sprung back into a history we thought we had long left behind.
Despite the senseless cruelty that inspired these actions, with each day that passes we are reminded of the bravery of our armed forces, the kindness of our people when united- forever ready to help a neighbor in trouble - and the resilience that helped us persevere through a 30 year long civil war. We are not a nation that is terrified easily.
We cannot imagine the pain of those that lost loved ones nor the injured. It is a long road ahead. Historically, Sri Lanka has not placed enough emphasis on the role of the emotional impact of such attacks on a person's psyche. Our system lacks sufficient psychological & psychiatric support. To that end, we have compiled a short primer on one of the most prevalent disorders that arise out of such events in the hope that it will prove of worth to help a loved one or your own self.
What is PTSD?
Post Traumatic Stress Disorder (PTSD) is defined as an anxiety disorder that is characterized by a set of symptoms that develop in people who have undergone a traumatic event. It has previously been described as "shell shock" or "combat fatigue" for armed forces. Women are twice as likely to suffer from it as men.
What are the signs & symptoms of PTSD?
Not everyone who has undergone a traumatic event is likely to suffer from PTSD - some may have strong feelings of anxiety, stress & sadness. People may experience feelings of intense fear, horror, guilt, irritability or helplessness. However as much as a headache does not signify a meningitis, these particular experiences may not signify PTSD. If you suspect your loved one maybe suffering from PTSD, it is important to visit a health professional and receive a diagnosis & treatment.
A person who maybe suffering from PTSD may have four main types of difficulties:
1.Re-living the traumatic event – The person relives the event through unwanted and recurring memories, often in the form of vivid images and nightmares. There may be intense emotional or physical reactions, such as sweating, heart palpitations or panic.
2. Being overly alert or wound up – The person experiences sleeping difficulties, irritability and lack of concentration, becoming easily startled and constantly on the lookout for signs of danger.
3.Avoiding reminders of the event – The person deliberately avoids activities, places, people, thoughts or feelings associated with the event because they bring back painful memories.
4. Feeling emotionally numb – The person loses interest in day-to-day activities, feels cut off and detached from friends and family, or feels emotionally flat and numb.
If these symptoms persist for longer than a month and are not due to medication, substance use or other illness, it is likely that the person is suffering from PTSD.
When to see a professional
Many people struggling with PTSD may turn to unhealthy coping mechanisms such as substance abuse or self harm. As such, it is important to seek out a qualified professional to speak with – this may help bring back hope through the sharing of experience and helping learn healthy & effective ways of coping.
My friend or loved one suffers from PTSD, what can I do to help?
Encourage & raise awareness on healthy coping strategies such as:
Educate: People with PTSD struggle in isolation – finding it hard to reach out. Encourage them to seek out safe people to connect with those who can support them in their recovery journey. By learning about the condition, they have words to more clearly explain what is happening to them and ask for what they need from others.
Support Network: Despite the lack of a wide range of physical options for support in Sri Lanka, there is a number of online support groups (links below). Connecting with others going through this similar experience breaks down walls and helps the person understand they are not alone.
Spend Time with People: Though the inclination is to shy away and withdraw from people due to feelings of fear, anger, anxiety and being overwhelmed, it is best for them to spend time with others as it will have a significant difference in the person’s mood or outlook. You – as the loved one – may be afraid of reaching out as you don’t know what to say and are afraid of making things worse – but even quiet time together or going for a walk may be better than isolation.
Be aware of triggers: Help them become aware of their triggers. Internal triggers include anger, sadness, feeling vulnerable whilst external triggers include news programmes, anniversaries, holidays – though it makes sense to avoid triggers, it has been shown to be more helpful to find healthy coping mechanisms in event of a trigger.
Mindfulness: Time of prayer, meditation & other mindfulness activities may help calm the body & mind. The goal of the time is to stay present without any fear of threat or judgement. Learning slowly, a few minutes per day – using an app such as Happiful – may help.
Exercise: Calming the mind works alongside getting the body moving. Physical exercise helps our body cope with stress. Even a 10 minute walk per day has been shown to help.
To this end, Barressential offers all fitness or rehab classes free of charge to anyone who has been a direct victim of these attacks. Please get in touch at hello@barressential.com
My employee suffers from PTSD, what can we do?
Due to trouble concentrating & problems sleeping it may make it harder for those with PTSD to stay focused and productive at work. As a result, rates of unemployment are high amongst those with PTSD.
Though it may be the hardest thing to do, it is important they continue working. Encourage the employee to communicate clearly their needs so that you and other colleagues can work with them. Remain flexible with scheduling, help to minimise distractions, allow them moments to regroup if they are feeling overwhelmed and rearrange the workspace in a way they feel safe.
What treatments are available for PTSD?
Medications: No medications are specifically designed to help PTSD but other medications that are currently used to treat anxiety and mood disorders have been found helpful.
Psychotherapy: Speaking to a therapist & sharing experiences is an important part of the recovery process.
Alternative therapies: Yoga or acupuncture has been shown to offer healing benefits and studies have shown to significantly reduce PTSD symptoms in participants.
PTSD in children
Adults are not the only ones to suffer from PTSD and given the high number of child victims in the recent attacks, we believe it is best to be aware of the appearance of PTSD in children. Symptoms vary depending on age as described below:
Preschool
Cry or scream a lot
Eat poorly or lose weight due to loss of appetite
Experience nightmares or night terrors
Extraordinary fear of being separated from their parent or caregiver
School Age
Have a hard time concentrating at school
Difficulty sleeping—insomnia or nightmares
Feelings of guilt or shame
Anxious or fearful in a variety of situations
Teens
Eating disordered behaviors
Self-harm
Feeling depressed or alone
Begin abusing alcohol or drugs
Engage in risky sexual behavior
Make impulsive dangerous decisions
Tips for parents in helping a child with PTSD
Try to keep child’s schedules and lives as similar as possible to before the event.
Let them talk about the traumatic event when and if they feel ready: if not words through pictures and journalling. Praise them for being strong when they do talk about it, but don't force them if they don't feel like sharing their thoughts.
Reassure them that their feelings are normal. Support and understanding from parents can help with handling difficult feelings.
Some children and teens find it helpful to get involved in a support group for trauma survivors.
Get professional help immediately if you have any concern that a child has thoughts of self-harm. Thoughts of suicide are serious at any age and should be treated right away.
Help build self-confidence by encouraging children to make everyday decisions where appropriate. PTSD can make kids feel powerless, so parents can help by showing their children that they have control over some parts of their lives.
Tell them that the traumatic event is not their fault. Encourage children to talk about any feelings of guilt, but don't let them blame themselves for what happened.
Stay in touch with caregivers. It's important to talk to teachers, babysitters, and other people who are involved in your child's life.
Resources & References
Sri Lankan Resources
http://www.pulse.lk/everythingelse/psychological-support-sri-lanka/
http://marcelderoos.com
http://www.themorning.lk/the-ohana-project-leaving-no-one-behind/
Information
https://www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/ptsd
https://kidshealth.org/en/parents/ptsd.html
Online Support Groups
https://www.reddit.com/r/ptsd
https://www.myptsd.com
https://www.7cups.com
https://www.betterhelp.com
PTSD Blogs
http://www.healmyptsd.com
https://psychcentral.com/disorders/ptsd/
https://ptsdblogger.com
Mindfulness Apps
https://www.developgoodhabits.com/best-mindfulness-apps/