What is Post Traumatic Stress Disorder

What is PTSD? Georgia Mills talks to Oxford University clinical psychologist Jennifer Wild...

Jennifer - PTSD is a severe stress reaction. It develops after exposure to extreme trauma and it has a number of symptoms. The main symptoms that are quite disabling and troubling are what we call the “re-experiencing symptoms.” These are unwanted memories that come back to mind very frequently and are very distressing and take up a lot of attention and disrupt somebody’s day. There are also flashbacks, and when flashbacks occur it can make someone feel as though they’re back at the time of the trauma and it happening all over again. Nightmares are another form of re-experiencing symptoms and memories that wake people up in the middle of the night and are distressing, and usually people can’t get back to sleep afterwards. The next set of symptoms are the avoidance symptoms. This is avoiding reminders of the trauma. And the next category of symptoms are what we call negative alterations and cognition and mood. And what that really means are that after trauma, people either develop quite negative beliefs about  themselves, or they may have had negative beliefs early but these get quite a lot stronger afterwards so they may feel and believe that they’re very worthless, for example. Then the final category of symptoms are the hyperarousal symptoms. So feeling hyper aroused, difficulty concentrating, difficulty sleeping, feeling very very on edge.

Georgia - What kind of a trauma could bring PTSD on?

Jennifer - Quite a broad range of trauma can trigger PTSD. A trauma such as a sexual assault, a physical assault, military trauma, bombing, terrorist attacks, the loss of a loved one by traumatic means.

Georgia - When someone develops PTSD, does a change happen in the brain that we can kind of "see"?

Jennifer - We know that, with trauma, stress hormones are released and they may affect the brain. They may make it difficult for the amygdala, which is our emotion centre in the brain, to dampen down an emotional response. So, in PTSD, we see this over-generalised sense of danger so lots of things feel very dangerous. And this could be because the amygdala, the emotion centre of the brain, isn’t well dampened-down in PTSD. So, after trauma, for some people, they’ll have a hypersensitive amygdala, which will make it very difficult to feel calm in response to a trauma reminder.

Georgia - How common is PTSD?

Jennifer - It’s quite a common disorder and what we call the “lifetime prevalence” is between seven and eight percent. So, seven or eight percent of people will have PTSD at some point in their life...

Some studies have estimated the lifetime risk for PTSD of up to 30% in veterans of certain wars. It can make transition from the military into what’s commonly dubbed "civvy street" much more challenging. Malcolm Iliffe, was a sergeant who served with the Coldstream Guards, a regiment that played a key part in the proceedings at the Battle of Waterloo...

Malcolm - Sometimes to be an ex-forces you think you’re alone a bit. We all seem to have slight problems. I mean I know I’ve got PTSD. It’s not the nicest of thing. It plays havoc with your life. I still can’t even hold hands with my wife, for instance, because I can’t let my guard down. It is horrible at times.

Sometimes to an ex forces it’s a lonely life after you leave. There’s ex-forces on the streets, there’s ex-forces in prisons, they’re in mental homes. And for somebody like myself I can go months without actually talking to anybody or going out. I feel safe in my own environment.

But I feel like now I want to go out and tell people. The experience I’ve had here it’s so hard to explain when you’ve actually found something from the period. The history of my regiment it like give you… it’s like an injection. It’s pumping something back into you. But just to come to Hougoumont for me is a big honour because I’m ex-Coldstream Guards.

My battalion was the gate; one of our sargeants shut the door and I think for any Coldstream to come here. It was such a big battle for us. I mean it must have been a hell of a feeling for them. They were surrounded on three sides, there was a fire fight going on, but you’re doing your job. They’ll have all been doing their job yeah, but everybody’s frightened. If anybody says to you in any interviews they weren’t frightened in any conflict, they’re lying.

You are frightened but you’re doing a job. You’ve been trained to do a job. They’d have been trained to put their musket balls in the barrels. They’d have been trained to fire back. No different than us changing a magazine on the rifles that I used when I was in. You’re doing a job.

Your colleague drops next to you; if he’s badly injured you try to do someert, if not, you just carry on. He’s another dead person; you’ve got to carry on. And there’s always that saying stand, stand, stand your ground, stand. Even in today’s warfare they stand.

The lads that were here in 1815 would have been exactly the same. They’d have been no different from me...