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What is PTSD?

What is PTSD?

Magazine illustration, containing a brain and titled PTSD and the Brain
Blue label, containing an explanation of The Command Centre part of the brain
Green label, containing an explanation of The Guard Hut part of the brain
Orange label, containing an explanation of The Records Office part of the brain
Magazine illustration of a brain, with sections labelled one to three

What is PTSD?

PTSD stands for post-traumatic stress disorder and it’s the most common mental health issue we treat. It’s one of a few mental health conditions where you have to have gone through a specific type of traumatic event to get it – you must have thought your life or someone’s else’s life was in danger, at risk of serious injury or attack.

Warning signs

As a result of going through this event, you develop a certain set of symptoms:

Re-experiencing symptoms

This is when the memory of what happened to you has not been stored correctly and consequently it keeps popping into your mind uncontrollably. This could happen as a nightmare or as a flashback (when you actually feel like your body is back in the horrible event). 

Hyperarousal symptoms

These can include panic attacks, being easily upset or angry, disturbed sleep or a lack of sleep, irritability or aggressive behaviour, and extreme alertness – you are always on the lookout for danger.

Avoidance symptoms

Because the memories are so unpleasant and the feelings associated with them so awful, you avoid anything that is going to cause that memory to come into your head more readily. Triggers come in all shapes and sizes – it might be crowds, loud sounds or anniversaries such as Remembrance Day.

Negative mood symptoms

You might have thought you were a good person, believe other people are generally kind and trustworthy and the world is a safe place. But after going through a traumatic event, you can be left thinking you’re not a good person, you didn’t do enough, the world is unpredictable and dangerous. It can leave you with a negative and bleak way of thinking.

Many veterans we help are confused about what’s wrong with them and question if they are mad. Why them? Does it say something about their character? The answer is no. Whilst most people recover from traumatic events, a small but significant proportion continue to experience problems and it is a recognised medical condition.

There are three parts of the brain key to understanding PTSD - we've given them our own names to help explain:

What happens to the brain during a traumatic event?

During a traumatic event, the brain takes the decision not to waste resources filing memories, so the connection between the guard hut and the records office (see above) is lost. All resources are focused on reacting to the danger.

For some people who haven't had the opportunity to think about what's happened, the link between the guard hut and the records office never comes back online and the memories are not filed properly. When the command centre comes back in action, it can start criticising the actions you took, creating feelings of guilt.

PTSD is not just about what happened to you but how you are left thinking about it.

There is effective treatment available for PTSD. NHS NICE guidelines currently recommend two evidence-based forms of treatment: trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR). Both the trauma-focused CBT and EMDR allow the individual to process the traumatic memories, nightmares and flashbacks by helping to confront what has happened in a measured, safe way. At Combat Stress we provide trauma-focused therapies. People can talk through the event to change their view on what happened. This can help them process the memory and file it away properly.