The Sydney Siege isn’t over, and won’t be for years for many of the hostages, emergency responders co-workers and even people not at the scene and as we found after 9/11 even with some people just watching the events unfold on TV. The spectre of PTSD or Post-Traumatic Stress Disorder will have a long-term life changing effect on many people.
PTSD or Post-traumatic Stress disorder is really an illness of a sudden and traumatic loss of innocence.
In effect any event which is outside of that individuals normal or previous experience, and is sudden and traumatic can spark off PTSD. Basically PTSD occurs when the shock is so overwhelming that the mind and body can’t process it properly and the system goes into a series of reactions to the shock. PTSD in effect changes the life of the sufferer, often for years.
You don’t even have to be at the scene or actually have had anything happen directly to you to suffer. A Danish study just published just last week showed we can get PTSD even before on event in what is termed Pre-Traumatic Stress Disorder. The researchers kept close contact with soldiers before their first posting into a war zone (Afghanistan) and found soldiers suffering from similar symptoms to PTSD even before they had arrived in theatre and that Pre-Traumatic Stress was a reliable predictor of full blown PTSD symptoms.
Usually to be diagnosed with PTSD you have to suffer from some or all of the following symptoms for 3 moths or more.
There are 4 types of symptoms of PTSD:
Hyper-arousal is being hyper sensitive to all sorts of things like sudden noises, dangerous situations and even things like perceived criticism. Hyper-arousal also results in difficulty sleeping and concentrating, being easily startled, and increasing anger even to people and situations that would previously not evoked any response, agitation, and hyper vigilance or being super alert to the potential of danger in situations you wouldn’t normally even notice. People suffering from hyper-arousal will often see danger or react to things even when there is no real danger present. Imagination often plays a large part here.
The symptoms of re-living includes intrusive memories, flashbacks, exaggerated reactions to even small reminders of the event, and actually reliving the events at random times. This is particularly common for the emergency services.
A typical and symptomatic response to anxiety and trauma is growing avoidance, including avoidance of the scene, other people, daily tasks etc. The feeling like you want to avoid things is usually accompanied by feelings of being overwhelmed even with every day things like making phone calls or going out.
Disassociation is a feeling that you are o longer in your own body. People feel like they are distanced from events. It is often described as taking a step (or many steps) back from your eyes. It is like observing things and feeling no connection to them even though you are or should be. People tend to feel robotic, disconnected from their feelings, and others and can also result in a lack of energy, hopelessness, and isolation. As sufferers start feeling more and more detached, they often start to withdraw from others and can also often suffer from depression. This can lead to people, as we see with war veterans, withdrawing to the extent that they become homeless and outcast.
The trouble is the sufferer is rarely in a place to self-diagnose and because of behaviours like anger, irritability, a lack of interest and withdrawal they can easily end up alone and undiagnosed. As this all happens over a period of time and can often happen months or even years after an event, it can be difficult to associate the symptoms with the event and diagnose it. Indeed studies have found that PTSD sufferers can in some situations have no memory of the event which started the illness.
From our work with the emergency services we have found that emotional resilience training can reduce the incidence of stress related illnesses by about 60%.
PTSD is very treatable if the correct diagnosis is made and the right treatment is obtained. The diagnosis is often the hard part.
The human trail of the Sydney Siege and similar incidents will stretch out for years to come. It is really only the vigilance of loved ones that will detect many of the aftershocks.
Berntsen, D & Rubin, D.C. Pretraumatic Stress Reactions in Soldiers Deployed to Afghanistan. Journal of Clinical Psychological Science. 1-12 Nov 2014. DOI: 10.1177/2167702614551766
Poulos, A.M. et al (2014) Amnesia for Early Life Stress Does Not Preclude the Adult Development of Posttraumatic Stress Disorder Symptoms in Rats. Biological Psychiatry
, 2014; 76 (4): 306 DOI: 10.1016/j.biopsych.2013.10.007