29/07/2013 07:57 BST | Updated 25/09/2013 06:12 BST

What Causes Post-Traumatic Stress Disorder (PTSD)?


As we struggle to absorb shocking incidents like the recent train crash in Galicia, along with sympathy for the grieving families our thoughts also turn to the survivors. And psychologists who specialise in helping people recover from incidents like this know that while some of the surviving passengers will eventually get over their shock and trauma, sadly others will be unable to do so. If they are still suffering from disabling symptoms one month after the event, they will be diagnosed with post-traumatic stress disorder, or PTSD. But what exactly is PTSD and what causes it?

Although it is a term often bandied about in the media, the term 'PTSD' - like 'depression' - is frequently misused. It does not mean simply being upset after a traumatic incident. If you are suffering from post-traumatic stress, you will experience extremely powerful and unpleasant symptoms which may include flashbacks (where you suddenly re-experience the traumatic incident, as if it is happening in the present moment); nightmares; hyper-arousal (being easily startled, tense and on edge); feeling emotionally numb, guilty or excessively worried; and avoiding places, people or events that remind you of the traumatic event.

We can suffer from PTSD after experiencing what is known as a 'Type I' trauma - a single, shocking event like a car or train crash, violent crime or assault. Essentially, your brain just gets overwhelmed by the shock of this experience, and so shuts down - it can also do this as a self-protective mechanism to allow you to deal with the incident. This explains why people can seem strangely calm and unemotional immediately after, say, a car crash, but then get extremely upset when they are safely back home.

When the brain shuts down like this, it cannot properly 'process' the traumatic event and integrate it into the normal flow of what's called 'autobiographical memory'. So flashbacks are in part your brain's attempt to process the experience, file away the upsetting memories and allow you to get on with living your life. That's why the treatment for PTSD involves helping the person re-experience the event - in a completely safe, unhurried way - so they can process it, accept that it has happened, is in the past and that they are now safe, and so begin to move on.

This cognitive-behavioural treatment - known as 'reliving' - has been proven to be extremely effective for problems related to Type I trauma, so the good news is that we now understand a great deal about PTSD and how to treat it.

Please note: PTSD is a serious condition that can completely dominate someone's life, so if you or someone you know is suffering from it speak to your GP or a mental health professional trained to deal with this disorder. Please do not see a counsellor or therapist who has not had specific training in treating PTSD, as just talking about a trauma can actually make it worse - make sure they are a CBT therapist, clinical psychologist or psychiatrist.

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