Shining a light on trauma

Post-traumatic stress disorder (PTSD) is a significant problem. It affects approximately one in 20 Australians and is worse among veterans, with 20 to 35 per cent experiencing the disorder.

We’ve come a long way towards understanding the causes and treatment of PTSD. As older veterans would know, it has a name now for starters, and it is steadily gaining the recognition it deserves as a legitimate and devastating illness.

But understanding an illness is only half the battle. The important question is what can be done about it?

In partnership with RSL Queensland, the Gallipoli Medical Research Foundation (GMRF) has significantly contributed to increased understanding of PTSD and its consequences. GMRF’s Associate Director of Mental Health Research, Dr Maddy Romaniuk, is working on the frontline of PTSD treatment as both a clinician and researcher.

“The more we understand the mechanisms of PTSD, the more we appreciate just how complex it is,” Dr Romaniuk says.

“It is a true ‘Biopsychosocial’ condition, which is a fancy way of saying it is influenced by your environment and impacts your mind, body and your day-to-day life with family and friends.”

HOW TO RECOGNISE THE WARNING SIGNS OF PTSD

PTSD can present in several ways, but there are certain behaviours and actions to look out for:

• Disturbing memories or nightmares about past traumatic experiences
• Avoiding thoughts, feelings or reminders of past traumatic experiences
• Changes in mood including increased anger, lack of interest in activities and emotional numbness
• Hypervigilance, concentration difficulties and sleep disturbance
• Long-term physical health problems including gastric complaints and sleep disorders
• Heavy alcohol consumption.

Dr Romaniuk has seen these warning signs play out in veterans she has treated as a clinician, and she’s also seen the impact PTSD has on sufferers and those around them.

“Veterans don’t come into my office and say, “Oh I’ve been feeling emotional numbness” or “I’m hypervigilant”. That’s just the way the symptoms are described under the medical model.

“Instead they’ll tell me… ‘I know I must have loved my wife once, because I proposed to her, but I feel nothing now…’ or they’ll say ‘I never sit with my back to the door – I’ve got to keep an eye on the exits at all times. I’m constantly on the lookout. It’s exhausting, and most days I’d just rather not leave the house’.

“These are the types of things I hear, and these experiences of PTSD can have a devastating impact on someone’s life.”

WHAT YOU CAN DO

If PTSD is affecting your life, there are two important points to remember:

1. Treatment is available

   There are several treatments available. These are classified in terms of ‘first- line’ treatments, (those with the most evidence demonstrating they work), and ‘second-line’ treatments, (those that do not address the condition directly, but may be helpful in reducing some symptoms or improving general wellbeing).

   Combining first-line and second- line treatments over time is often the best approach in an overall treatment regime of PTSD.

   The first-line treatments for PTSD recommended in the National Guidelines include Trauma-focussed Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR), two forms of talking therapies.

   The second-line options include adjunct treatments such as medication and psychosocial support therapies, including peer-to-peer support.

   “If you would like to access first- line PTSD treatment, it is important that you speak to your GP and seek a referral for a clinician (usually a clinical psychologist), who is actually trained in delivering these treatments. Not all mental health providers have this training, so it’s important to check before making an appointment,” Dr Romaniuk says.

1. Treatment is helpful

It may seem obvious, but it is important to recognise the crucial role treatment plays in the road to recovery. As clinicians like Dr Romaniuk will tell you, PTSD is rarely alleviated without treatment or intervention; in fact, it is only likely to worsen.

“If you had a serious physical injury, like a broken leg, and you just ignored it and kept walking on it for months and years, it would certainly worsen, fester, and get more and more complicated to treat,” Dr Romaniuk says.

“PTSD is the same. Just like a broken leg, it’s important to seek treatment early to stabilise the injury and follow advice to promote healing.”

Open Arms – Veterans and Families Counselling is a national service all veterans can access for PTSD treatment, with clinicians trained in first-line therapies as well as many options for second-line treatments, including peer-supporters. Call them 24 hours a day on 1800 011 046.

Mates4Mates is also an organisation that provides first-line therapies via their psychology team, as well as second-line adjunct treatments including peer support, equine and adventure therapies. Their centres are based in Brisbane, Townsville and Hobart. Call 1300 4 MATES (1300 4 62837).

FOR LOVED ONES OF A PTSD SUFFERER

For many veterans with PTSD, a close friend or family member might recognise the warning signs before they do. So, what do you do if you’ve talked to somebody you suspect may have PTSD, but who refuses to get help?

1. Try to take away the stigma of PTSD

   Explain that the symptoms and reactions are common among veterans. Normalising their reactions and experience can help reduce feelings of isolation and frustration over the impact PTSD is having on them.

2. Demystify treatment

   Veterans may have misconceptions about what therapy is like and are reluctant to seek out the unknown. Try to explain some of the options outlined above and inform them about the range of services available.

3. Encourage them to keep trying They may have sought out treatment and had a bad experience, discouraging further action.

Acknowledge that treatment isn’t a ‘one size fits all’ approach and encourage them to try something else.

WHAT MORE CAN BE DONE?

Medical research is constantly expanding our understanding of, and treatment for, PTSD. GMRF is committed to enhancing the health and wellbeing of veterans and their families, and we can continue this work thanks to our committed partner RSL Queensland.

We have current and upcoming studies that will be recruiting participants and we need your help. The veterans and family members who give of their time are contributing to vital research that will make an impact for years to come. Get involved.