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Post Traumatic Stress
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What is post traumatic stress?
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A collection of reactions - feelings, thoughts and behaviours - which are experienced following a sudden distressing event which is outside the range of normal everyday human experience. It is the unexpectedness of the incident which seems to evoke the stress because it undermines one's trust in normalcy. Incidents that can sometimes lead to signs of Post Traumatic Stress include such things as burglary, an attack or an accident.

When does it occur and to whom?
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Signs of Post Traumatic Stress (PTS), such as those listed below, may not appear for days, weeks or months after the event, and can affect those not directly involved in an incident - e.g. to those who witness an accident, or to rescue workers, or to relatives of those involved.

Why does it occur?
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It is the way by which our mind and body 'processes' the event, to try to make sense of it, so that we can eventually react to it in a less distressing way. The processing is often made apparent through physical, emotional and psychological signs.


Signs and symptom
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  • recurrent intrusive recollections of the event
  • changes in sleep (e.g. not being able to sleep, or wanting to sleep all the time)
  • recurrent vivid dreams about the event
  • feeling or behaving as if the event were happening again
  • changes in behaviour (e.g. short temper)
  • changes in feelings about yourself (e.g. feeling useless)
  • numbed responses
  • changes in work effectiveness (e.g. poor concentration)
  • reduced interest in the external world (e.g. feelings of detachment and estrangement)
  • a sense of always needing to be ultra-alert
  • a sense of being vulnerable, leading to a fear of losing control
  • avoidance of activities and/or places which arouse recollections of the event
  • forgetting an important aspect of the event
  • guilt at surviving, or for things not done

Post traumatic stress is different from a bereavement reaction (in that it is about a stress reaction to a perceived threat) although the two can occur together and inter-link. It is also linked with depression, 30% of those in whom the condition is not recognised and dealt with early go on to develop depression.


How does your body help you cope?
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  • Numbness: At first you may be numb because your mind will only gradually allow you to feel the experience. So the event may feel unreal, as if it couldn't have happened to you. But as you allow your experiences to become more real in your mind, there is a need to think about the event, to talk about it, and at night to dream about it over and over again.
  • Activity: To be active, maybe through helping and giving to others may give some relief. And doing things routinely can give a sense of bringing life back to normal.

But both of these 'natural' ways of coping have inherent risks. Some people seek refuge in numbness by avoiding any reminder of the trauma - and so it is never dealt with. And over-activity is also a way of diverting attention from the fact that you might need help yourself.

How can you help yourself?
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  • Keep in touch with information about the event and any developments. This keeps the trauma 'real' and helps you come to terms with what has happened and how it has affected you.
  • It can be a relief to receive other people's physical and emotional support, even though part of you might want to reject it as part of wanting to deny what has happened. Sharing with others who have had similar experiences can feel good, barriers can break down and close relationships develop.
  • As well as being with other people, you will sometimes want to be alone in order to deal with your feelings: privacy (as opposed to isolation) is important.

Some Do's and Don'ts
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DON'T bottle up feelings
DO express your emotions
DON'T avoid talking about what happened
DO take opportunities to review the experience with yourself and others
DON'T let embarrassment stop you giving others as well as yourself the chance to talk
DO take time out to sleep, rest, think, and be with close friends and family
DON'T expect the memories to go away: the feelings will stay with you for a considerable time
DO express your needs clearly and honestly to friends, family, tutors, colleagues etc.
DO try to keep your life as normal as possible after the experience
DO be careful: accidents are more common after experiencing severe stress.


When to seek further help
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  • if you feel disturbed by intense feelings or body sensations that you can no longer tolerate
  • if you think that your emotions are not falling into place, and that you feel very tense, confused, empty, or exhausted
  • if after a month you continue to be numb and do not have appropriate feelings, or you have to keep active in order not to feel distressed
  • if you continue to have nightmares and poor sleep
  • if you have nobody with whom to share your feelings and you feel the need to do so
  • if your relationships seem to be suffering, or sexual problems develop
  • if you have accidents
  • if you smoke, drink or take medication to excess since the event
  • if your work performance suffers

Where to seek further help?
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  • At University, through your tutor or supervisor. Post traumatic stress can be associated with loss of cognitive skills such as the ability to think clearly, to conceptualise, to concentrate and to remember, so you may need to discuss how best to manage your work.
  • The NHS has specialist Post traumatic stress clinics, which can be accessed through your GP. Your GP might also discuss whether medication might help you cope with some of the symptoms.
  • The Student Psychological Services can offer you an opportunity to try to make sense of what is happening to you, and to try to think of how you want to deal with what you feel and think.

This page has been adapted from information produced by the Counselling Service at Royal Holloway, University of London and they retain copyright.
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