- World Mental Health Day 2021 theme: Mental health in an unequal world
- People who have experienced or witnessed a traumatic event may get PTSD
- A combination of medicines and psychotherapy may be used to treat PTSD
New Delhi: “One of my clients is a surgeon and a convalescent COVID-19 patient. He was admitted to a hospital for the treatment of COVID-19 disease and during his stay, he saw a lot of dead bodies being taken away from the Intensive Care Unit (ICU). Though he recovered from COVID-19 and soon went back home, the visuals of the hospital and dead bodies were imprinted in his mind. As a result, he would get nightmares, shout and jump out of his bed. This is a clear case of post-traumatic stress disorder (PTSD)”, said Dr Harish Shetty, a Mumbai-based Psychiatrist while talking to NDTV about PTSD on World Mental Health Day 2021.
The United States’ Centers for Disease Control and Prevention (CDC) defines PTSD as an intense physical and emotional response to thoughts and reminders of the event that last for many weeks or months after the traumatic event.
It may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, rape, a serious accident, a terrorist act and war. Exposure to a traumatic event doesn’t always have to be first hand to have PTSD, but can also be indirect such as when one hears about the details of the traumatic incident, said Ritika Aggarwal, Consultant Psychologist at Jaslok Hospital and Research Centre in Mumbai.
PTSD And COVID-19 Pandemic
In February 2021, the Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bengaluru released an update to the manual on ‘Mental Health in the Times of COVID-19 Pandemic’, which was first released in April 2020. As per the report, hospital quarantine can be a significant life event and may result in acute stress disorder in a vulnerable population. Individuals exposed to hospital quarantine have a higher risk of later developing PTSD.
Post-COVD psychiatric conditions are brief psychotic disorder, PTSD, acute stress disorder, adjustment disorder, obsessive compulsive disorders, and depression and anxiety disorders. The Severe Acute Respiratory Disease (SARS) COVID is one of the strongest predictors for post-COVID psychiatric complications. The meta-analysis of evidence from previous coronavirus outbreaks suggested the prevalence of PTSD during the gradual recovery phase to be around 33 per cent. Nearly half of the survivors of SARS had PTSD symptoms, noted the report.
According to a survey of 234 people conducted by the Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital in Delhi during the last week of April 2020, 28.2 per cent of the participants suffered from PTSD during the lockdown in India. For 13.7 per cent of participants PTSD score was of clinical concern, while for 8.1 per cent PTSD was a probable diagnosis and for 5.4 per cent it was high enough to suppress the immune system’s functioning.
As per Dr Shetty, if 100 people are exposed to a particular trauma, seven to eight of them will experience PTSD.
Symptoms Of PTSD
Intrusive Memory And Flashbacks
When an individual experiences something, an image is captured by the brain along with the emotions. That image becomes imagery which gets converted into memory and then maybe intrusive memory as well. Intrusive memory means re-experiencing the event through flashbacks and nightmares which can result in uncontrollable shaking, chills, heart palpitations, and tension headaches, said Dr Shetty.
Avoiding reminders of the traumatic event, including talking about it – anything that may trigger memories of the event is a common symptom of PTSD, said Ms Aggarwal.
Hyper Vigilance And Hyper Arousal
Hyper vigilance means being hyper aware and vigilant of one’s surroundings and getting startled easily. Sharing an example of the same, Dr Shetty said, after experiencing a severe earthquake, when people live in temporary shelter homes, some of them get scared by the sound of a truck passing by and they rush out.
In case of a COVID-19, you see the face of a doctor and you run away as you get flashbacks of your stay in a hospital, said Dr Shetty.
As per CDC, symptoms of increased arousal include being overly alert or easily startled, difficulty in sleeping, irritability or outbursts of anger, and lack of concentration.
Antonia, Difficulty Experiencing Emotions
Antonia means difficulty in experiencing any kind of emotion – be it joy or grief. This also involves feeling detached from others and decreased interest in doing activities previously enjoyed.
Other symptoms linked with PTSD include panic attacks, depression, suicidal thoughts and feelings, drug abuse, feelings of being estranged and isolated, and not being able to complete daily tasks, states CDC’s factsheet.
Diagnosis And Treatment Of PTSD
For an individual to be diagnosed with PTSD, they must have had the above symptoms for a period lasting for more than one month, and these symptoms must have caused significant distress or difficulty in the individual’s daily functioning. Most people experience the above symptoms within 3 months of the traumatic event, but some can have symptoms starting later than that as well. PTSD can persist for months and sometimes years, which is why it is important to get treated for it at the earliest, said Ms Aggarwal.
Along with symptoms, clinical history and mental status is examined for the diagnosis of PTSD. Very rarely, psychological tests are also conducted. Following this, treatment is planned; this may either involve psychotherapy or medicines or a combination of the two.
Cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), prolonged exposure therapy (PE), and eye movement desensitization and reprocessing (EMDR) are some of the effective forms of therapy for PTSD, said Ms Aggarwal.
Dr Shetty believes that spiritual activities, mindfulness and yoga can also help in dissolving the memory. Essentially, the goal is to quarantine the memory. Here, group therapy can also help in coming out of a significant experience.
The duration of the treatment is subjective but early intervention can be helpful. It may take anywhere around four to 12 weeks to control the mental illness, said Dr Shetty.
Along with external help provided by a mental health professional, the social support that is support from family and friends is equally important for people living with PTSD to come out stronger, said experts.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
If you need support or know someone who does, please reach out to your nearest mental health specialist. Helplines:
AASRA: 91-9820466726 (24 hours)
Sneha Foundation: 91-44-24640050 (Available from 10am to 10pm)
Vandrevala Foundation for Mental Health: 9999666555 (24 hours)
iCall: 022-25521111 (Available from Monday to Saturday: 8:00am to 10:00pm)
Connecting NGO: 9922004305 | 9922001122 (Available from 12 pm – 8 pm)
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