Anxiety and stress are symptoms of Post-Traumatic Stress Disorder PTSD in human beings and are caused by so many factors with traumatic experience being on top of the list. Stress accompanied by anxiety can be very catastrophic and may lead to hardship in coping with the situation especially when the experiences are upsetting and painful. When a person experiences the painful and upsetting conditions for prolonged periods to the point that they cannot complete daily responsibilities, then they are candidates of Post-Traumatic Stress Disorder. In some cases, victims of post-traumatic disorder tend to adjust and get better, but in others, the situation gets worse. PTSD can be defined as a psychological condition where an individual may encounter hallucinations, persistent flashbacks, or disturbing thoughts related to their upsetting occurrence. People with PTSD may indulge in harmful behavior such as disordered eating habits to deal with the experience. If the necessary measures are not implemented urgently, the condition might get worse and permanently affect the victim (Pittman et al., 2012). This paper seeks to have an in-depth discussion of what post-traumatic stress disorder is and its effects.
Clinical Definition of Post-Traumatic Stress Disorder
This mental condition may be caused by a myriad of environmental or social circumstances such as serious road accidents, upsetting birth, or elongated exposure to sexual exploitation. Other causes include military combat, terrorist attacks, horrifying assaults (mugging or robbery), being a witness or victim to violence, substance use disorder, painful childhood experiences, mental disorders, and being held hostage among others (Williamson et al., 2017). Physicians cannot accurately peg the cause of the disorder to any agent but believe PTSD could be an inherited mental health risk. They further think how the brain adjusts hormones and chemicals in response to stress, or a person’s inherited temperament could also lead to the condition.
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Signs and symptoms of the disorder could be witnessed within 30 days of the disturbing experience although most often the signs do not manifest until many years later. Victims of the condition could experience difficulty in dealing with career or private life situations. Just like there are so many reasons as to why a person may suffer from the condition so are the symptoms (Trahan et al., 2016). First, the sick person may experience intrusive memories such as having flashbacks as if reliving the haunting experience or having physical reactions when they meet with situations that remind them of the disturbing event. Furthermore, the person may exhibit habits of avoiding talk, thoughts, places, people or activities that awaken the trauma.
Secondly, the victim may experience arousal symptoms such as aggressiveness, being prepared for danger always, drinking or smoking too much overwhelming feeling of guilt or shame, or even trouble in sleeping or concentrating. Lastly, the symptoms might manifest themselves in children in the form of the children re-enacting the whole or part of the experience and having terrible nightmares (Roy et al., 2017). When any of these signs are persistent in a person for more than a month, then the person needs to seek a physician or a psychologist’s advice. Similarly, if a person experiences feelings of committing suicide, then such a person should seek professional assistance immediately. The earlier a person finds treatment the better that person is placed at avoiding worse conditions.
Five levels of Post-Traumatic Stress Disorder
An analysis of post-traumatic stress disorder reveals that the condition has five major levels which are the normal stress response, acute stress disorder, uncomplicated post-traumatic stress disorder, comorbid post-traumatic stress disorder, and complex post-traumatic stress disorder.
1. Normal stress response
Most of the victims at this stage are healthy adults who experience mild symptoms of Post-Traumatic Stress Disorder. These adults experience such symptoms as feeling secluded from relationships, emotional numbness, tension in the body, extremely severe memories, feelings of unreality, and distress. To help the victims to overcome the condition, healthcare professionals typically use group debriefings where the participants or the victims start by describing the terrifying event and how it affected them. After the description of the event, the victims move to another stage where they explain how they emotionally responded to the event after which they hold an open discussion on the symptoms that have been caused by the event. After sharing their experiences, the victims are then educated on what their emotional responses mean and how to cope with the situation (Tuepker et al., 2016).
2. Acute stress disorder (ASD)
Anxiety disorder better known as acute stress disorder takes place only weeks after the occurrence of a disturbing experience. In this level of PTSD, the sick person may avoid activities, conversations, feelings, places, thoughts, objects, or even people related to the disturbing experiences they went through as these stimuli keep reminding them of the event (Ressler et al., 2011). Moreover, they exhibit symptoms of distress, increased arousal, reliving traumatic experiences, and dissociative amnesia where they can’t recall vital things of the event. A victim of acute stress disorder can be helped to overcome the condition through medication that can help cure insomnia and anxiety, group support, and the withdrawal from the scene of the traumati c event (Dekkers, Olff, & Naring, 2010). Psychotherapy can also be used to help them overcome their condition.
3. Uncomplicated PTSD
Uncomplicated Post-Traumatic Stress Disorder consists of constant reliving of the disturbing experience, symptoms of numbing emotions, increased arousal, and continuous avoidance of stimuli related to the upsetting event. The uncomplicated post-traumatic disorder can be treated by group intervention, pharmacological, and psychodynamic approaches. It is also essential that intervention procedures are carried out promptly to prevent the victim from being affected even more (Dekkers et al., 2010).
4. Comorbid PTSD
At this level, the victim undergoes two chronic conditions simultaneously while also experiencing other psychiatric conditions too. Comorbid PTSD is among the most common of all the five levels of PTSD because it is usually associated with major psychiatric disorders such as alcohol and substance abuse or depression. Other related mental conditions that a sick person may experience at this stage include despair, excessive smoking or alcohol consumption, anxiety, and panic syndromes. As much as a panic syndrome is the most curable, it is also the most overwhelming of the symptoms (Ressler et al., 2011). At times they resemble severe conditions such as dire coronary conditions and the fear that grips the sick person is disabling one. These panic syndromes or disorders must not be confused with panic attacks which are a symptom of the former.
To effectively treat comorbid PTSD, it must be combined with other disorders and address them rather than dealing with them one disorder at a time. The treatment used for uncomplicated disorders are the same ones that can be used to treat comorbid PTSD. The treatment should also include those of other psychiatric problems such as alcohol and substance abuse. Comorbid PTSD has been useful in finding a new cure to many disorders like depression (Dekkers et al., 2010).
5. Complex PTSD
Diseases of the extreme stress also known as the complex Post-Traumatic Stress Disorder are common in persons who have lived in extended periods of disturbing events most probably during their childhood. Shrivastava et al. (2012) state that complex PTSD is more common in people who were victims of abuse while they were young. Examples of violations that can lead to complex PTSD include childhood sexual and physical abuse. The main symptoms portrayed by people with complex PTSD include antisocial personality disorder, aggression, alcohol and drug abuse, depression, panic, and impulsivity. Victims under this level of PTSD are generally anti-social and show signs of alcohol or drug abuse, extreme emotional problems such as aggression, panic, or depression, and self-destructive habits. At this stage, the treatment of the condition is complicated and takes a quite long time to heal than other levels of the PTSD (Ressler et al., 2011). The therapy is slower and demands a highly structured and sensitive treatment mode that should be delivered by professionals.
II. Cognitive Effects of Post-Traumatic Stress Disorder
There are many effects caused by post-traumatic stress disorder. The effects can be categorized into two major areas which are psychological aggression and emotional responses. It is crucial to note that post-traumatic stress disorder mainly affects the mental state of a person. After a person has been involved or witnessed a traumatic event, their mental state automatically changes (Tekeli-Yesil et al., 2018). Some of the mental effects caused by post-traumatic stress disorder are psychological aggression which has different emotional responses.
A. Mental behavior
1. Psychological aggression
Psychological aggression in the field of psychology has been defined as the habit that could lead to both mental and physical injury, in this case, to the victim or other persons and objects around the victim. This aggression has been cited as one of the significant symptoms of PTSD yet this symptom does not manifest itself in all the victims. Take for instance children who are suffering from the PTSD condition are mostly withdrawn and exhibit signs of increased arousal (Adamantidis et al., 2007). Furthermore, a majority of war veterans do not show any signs of physical aggression even if they were exposed to war for prolonged periods.
2. Emotional responses
Emotional aggression occurs without much planning, and spontaneous emotions determine it. The negative emotions cause emotional aggression that victims feel, and it is executed instantaneously, meaning that it is usually not planned. Even though most people believe that physical aggression is the most destructive, researchers have established that psychological aggression has worse effects (Tekeli-Yesil et al., 2018). Most victims of PTSD always strive to avoid emotions to prevent situations where they are reminded of the upsetting experiences that are bringing them the discomfort. Feelings that people with PTSD try to escape from including fear, shame, guilt, or sadness. This emotional avoidance strategy is mostly employed through the excessive use of alcohol or engagement in substance abuse (Hopwood, and Schutte, 2017). Some of the people with PTSD indulge in self-destructive behavior such as overeating. As much as these tactics provide a refuge in the short term, but in the long run, the behaviors are unhealthy and may lead to the emotions becoming stronger in the future.
B. Physical behavior
1. Aggression
Anger is associated with the arousal symptoms of PTSD, and if not managed in time could affect the adverse relationships of the victim and the people surrounding them. It should be noted that anger is just, but one of the signs of PTSD and is not present in all the victims. The few people who exhibit this symptom show it intensely to the point that it looks like they are out of control (Lindqvist et al., 2017). In cases where it is not manageable, the victims tend to cause harm either to themselves, people or objects around them. For those who try to hide their anger by suppressing it or hiding it from others, the condition could lead to them adopting self-destructive habits.
Physical aggression is the type of aggression that involves physically causing harm to other people. Physical aggression is caused by psychological processes which act as an outlet of emotions and frustrations for people who are psychologically affected. Some of the most common forms of physical aggression include hitting, shooting, or kicking other people (O’hare, & Sherrer, 2013). Urgent intervention measures must be undertaken to prevent physical aggression and protect other people from harm.
2. Isolation/avoidance
Avoidance or isolation in PTSD is the situation where the victims dissociate themselves from activities, people, places, songs, and other circumstances that could expose them to body-level grief. Similar to those experiencing emotional avoidance, these people tend to engage in self-destructive habits and some even practice escapism where they had behind the mask of drugs and substance abuse. A practical example is when a young girl is raped in a dry-cleaning shop on her way home from work (Hoskins et al., 2015). This girl may avoid using all cleaning products, and in case she gets a wafting smell of a cleaning product she may experience a panic attack. With time, she may pick up an avoidance behavior by drinking alcohol and later avoid dry cleaning shops because they remind her of the site where she was assaulted.
Isolation involves the withdrawal of a person who has post-traumatic stress disorder from people. The victim might maintain solitude by avoiding other people or making conversations as brief as possible. It is also essential to identify people who isolate themselves from others to find out what might be the cause.
C. Relationships with PTSD
Human beings are social animals who cannot exist on their own for longer periods because they are programmed to relate with other people and share their experience to live a fulfilling life. If a person is isolated from their community for a long period, they are likely to suffer from depression and even die as a result of the separation. It is therefore evident how relationships that exist among human beings are important. Since birth, human beings are surrounded by other people whom they depend upon for various purposes. Most human relationships serve the purpose of developing and nurturing other people thus leading to personal growth and development (Trahan et al., 2016). There are however other relationships that harm or affect individuals and may impede their journeys to personal growth and development. Even though there are many causes of bad relationships, Post Traumatic disorder is one of the major factors that affect relationships between the victims and the people around them such as close family members and spouses.
It is now clear that people who have witnessed or experienced various types of trauma mostly have post-traumatic stress disorder (PTSD). PTSD has many effects on the victims and the people who are close to the victims. One of the most well-known effects of Post-Traumatic Stress Disorder is its ability to destroy relationships between two or more people. Individuals that suffer from Post Traumatic Disorder find it hard to thrive within personal relationships which involve close family members, spouses, children, or friends (Tekeli-Yesil et al., 2018). The deterioration in the quality of friendship is most common among individuals who have just begun experiencing trauma and those that have experienced it for a long period. Post-traumatic stress disorder can affect the quality of relationships in many different ways. Some of them include the hampering of effective communication, trust, responsive assertiveness, and cooperative problem-solving. People with post-traumatic stress disorder have challenges that sometimes prompt other people who do not suffer from trauma to react in certain ways that may affect the victims even more, further worsening their situation.
Shrivastava et al. note that most of the survivors of physical abuse, terrorism, rape, or childhood sexual abuse report that they regularly have a reoccurring sense of horror and terror which makes it difficult for them to trust other people, even those that they are intimate with leading to strained relationships. The feeling of trust or sexual intimacy makes a person living with post-traumatic stress disorder feel like they are letting down their guard. Even though emotional support and strong gestures of love may improve and alleviate the fears held by most victims, their past experiences always make it difficult for them to maintain relationships (2017).
Tuepker et al. argue that most people who have experienced or witnessed traumatic events in the past often struggle with anger issues and impulses. They tend to be easily irritated and can quickly react even to incidences that may seem small. For the purposes of maintaining positive relationships with other people, the victims of PTSD suppress their emotions and feelings to enable them to fit into particular social groups. The challenge, however, is maintaining the suppression of anger as in no time, they will be forced to let it out (2018). Additionally, most survivors avoid intimate relationships or closeness to other people by assuming an attitude of dissatisfaction or constant criticism to push away loved ones and friends. Incidences of physical and verbal abuse characterize most intimate relationships held by survivors.
Most of the PTSD survivors are heavily dependent on their spouses. Research has also established that they are in most cases overprotective of their partners, friends, or family members. Overprotectiveness strains relationships as people feel like they are restricted from practicing their own will. Most overprotective partners become violent due to various trivial factors further destroying many relationships between PTSD victims and those close to them (Williamson et al., 2017). Additionally, most victims engage in alcohol and drug abuse to deal with the effects of PTSD. Alcohol and substance abuse negatively affect and also destroy friendships or partner relationships.
Shou et al. state that most people who have undergone through traumatic experiences or witnessed traumatic events in the first weeks or months experience feelings of anger, anxiety, and detachment, especially when it comes to relationships with other people. The experiences make it difficult for the victims to return to the same level of intimacy that they had before the traumatic events. It is estimated that approximately 5 to 10 percent of the people who have experienced or witnessed traumatic events experience problems associated with intimacy (2017). The problems may last for years or even until the victim's demise unless intervention measures are adapted to assist in the situation. It is, however, important to note that not all the people who experience traumatic experiences suffer from PTSD. Many couples and families have people suffering from PTSD among them but do not experience relationship problems.
Shou et al. also explain about the different ways that PTSD can affect the relationship between victims and their close family members, friends, and even spouses. PTSD makes it difficult for victims to regulate their emotions which come in the form of suicidal thoughts, sadness, and severe anger. Such emotions, if not controlled can affect the way victims interact with other people who are close to them. Severe anger increases the frequency of conflicts within a relationship while sadness might affect communication between people. Communication is important, especially in people with PTSD as it enables them to share and let out what may be bothering them. Through communication, one can be assessed and referred to further help by a professional (2017). PTSD also results in issues of self-perception where the victim experiences strong feelings of shame, helplessness, and guilt. Such feelings make them over dependent and overprotective to other people who are close to them thus making it difficult to maintain strong and healthy relationships. It was further argued that PTSD affects interpersonal relationships due to the effects that it has on its victims especially interruptions in consciousness which results in poor memory and increased periods of dissociation.
Even though it has been established that PTSD affects relationships between the victims and other people, it is also important to look at the various ways that can be used to overcome the emotional challenges caused by PTSD. It is vital to note that a lot of effort and work must be continually put in to ensure that people suffering from PTSD can maintain relationships successfully. Most health professionals recommend that helping a person improve their communication skills can help in improving relationships as improved communication skills enable the victims of PTSD to communicate whatever is in their mind and prevent them from suppressing their feelings.
According to Roy et al. , several studies have also found out that people suffering from PTSD find the creation or the expansion of personal support networks helpful. A large people support network is effective in improving and maintaining relationships because it provides the victims with alternatives of who to share their plight with whenever they are overcome with different feelings. It is usually a hard task to maintain or rebuild family and friend relationships as it sometimes takes years of hard work and dedication (2017). It is therefore important for other people to appreciate the efforts put in by the victims and also support them in their initiatives to create stronger relationships.
Healthcare professionals also play a huge role in helping victims of PTSD to build and improve their relationships with other people. Psychiatrists, for example, may offer to counsel to patients with PTSD, enabling them to share their feelings and experiences thus resulting in the treatment of PTSD. Healthcare professionals may also recommend various measures that can be adopted by patients to deal with the various effects of post-traumatic stress disorder. It is therefore recommended that people who suffer from PTSD make an initiative of visiting a health care professional who may help to do away with the disorder and improve a victim's ability to build and maintain strong and healthy relationships (Williamson et al., 2017).
According to Hoskins et al. there are several types of professional help that might help the victims to build and maintain healthy relationships. The most commonly used types of professional help include individual or couples counseling. There are times when counseling may require group therapy, but the type of counseling is usually determined by the situation and the needs of the victim. Some of the most commonly discussed topics in counseling are communication skills, stress management, parenting skills, and anger management. Since the victims vary from one another, the therapist must choose the most suitable topic depending on the response of the victims (2015).
From the analysis of the effects of PTSD on relationships, it is clear that the disorder negatively impacts relationships that exist between victims of PTSD and the people close to them. Human beings are social animals who cannot exist on their own for longer periods as they are programmed to relate with other people and share their feelings and life to live a fulfilling life. If a person is isolated from the community for a long period, they are likely to suffer from depression and even die as a result of the separation. Most of the survivors of physical abuse, terrorism, rape, or childhood sexual abuse report to having a reoccurring sense of horror and terror which makes it difficult for them to trust other people, even those that they are intimate with leading to strained relationships. PTSD victims often struggle with anger issues and impulses. They tend to be easily irritated and can quickly react even to incidences that may seem small. To maintain positive relationships with other people, the victims of PTSD suppress their emotions and feelings to enable them to fit into particular social groups. To help people living with PTSD create strong and quality relationships, it is important that they are urged to visit healthcare professionals who might be able to offer them remedies to their condition.
III. The eating habits and patterns of people suffering from PTSD
A. Diet
As discussed earlier, many people with PTSD practice avoidance. That is to say; they avoid people, places, or even events to name but a few. Due to the pressure mounted on their selves to suppress the anger in them or just for the simple reason of avoiding certain things that evoke memories of the traumatic event, these people at times practice self-destructive behavior such as overeating (Williamson et al., 2017). Overeating is a poor practice of unhealthy diet and has its demerits such as obesity and consequent health-related disorders as exemplified by coronary heart disease, arteriosclerosis, and high blood pressure. Hence, excessive eating should be moderated to avoid further endangering of the lives of these victims.
In most cases, people who have experienced traumatic events in their lives have concerns over their images, and they also suffer from low self-esteem. Tuepker et al. (2016) state that the prevalence of eating disorders among PTSD patients is about 24.3 percent a testament to the correlation that exists between PTSD and eating disorders. As part of their coping mechanism, PTSD patients avoid eating enough food, purge, or adopt binge eating. However, adopting such eating behaviors only makes them feel worse about themselves. More efficient coping strategies should be used to help PTSD patients overcome their conditions without affecting their eating habits.
A balanced diet has in recent times been identified as one of the treatments for PTSD. Since most people with mental health, disorders are believed to have a diet that is not optimal, and PTSD is a mental disorder, it is, therefore, logical that victims of this condition have a poor diet. Furthermore, anxiety and depression are two conditions also associated with poor dietary patterns (Lindqvist et al., 2017). Hence, a well-balanced diet will go a long way into rehabilitating these two conditions and indirectly alleviate PTSD since these two are prime symptoms of the situation. All though researchers have identified no specific dietary regime as the best for the treatment of this condition, but also dieticians are working on solving the same issue soon.
IV. Sleep/Insomnia patterns
Post-traumatic stress disorder affects the pattern of sleep of a victim due to the memories that a person keeps from the traumatic experience. According to O’hare, & Sherrer (2013), about 70 percent of the people who have PTSD complain of insomnia and nightmares. The sleep disorders are usually as a result of paranoia due to the traumatic events. Furthermore, PTSD causes nightmares and flashbacks as the victims regularly revisit the traumatic experiences in their mind. The most effective treatment for sleep disorders among PTSD patients includes medication and therapy.
A. Hours of sleep
It has been documented heavily on the relationship between lack of sleep and PTSD. One of the hyperarousal symptoms of PTSD is sighted as restlessness and lack of sleep. Victims find it hard to sleep or to stay asleep with some of them being more scared of the nightmares than sleep itself (Matsakis, 2014). Since when they sleep, they will relive their harrowing experience through nightmares the victims prefer to stay awake.
The reason for lack of sleep in PTSD conditions has not been positively identified even though hyper-arousal is associated with the state. People with Post-Traumatic Stress Disorder are always on guard and very tense at times (Matsakis, 2014). Due to this hyper-arousal condition, these people fail to sleep properly, and they will remain sensitive to whatever is taking place around them even when they sleep. Furthermore, people with PTSD have been associated with sleep apnea and loss of control. Loss of control is mainly due to the victims having the feeling that when they sleep, they will lose control of themselves.
B. Rem sleep
Rem sleep is a condition where the people with PTSD undergo a type of rest where they sleep at intervals and have rapid eye movements, and faster breathing and heartbeat. Different studies carried out on war veterans show that most people with PTSD also experienced this sleep disorder (Shou et al., 2017). Therefore, REM sleep is brought about by hyper-arousal hence denying the victim the opportunity to have a rest.
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