We are all familiar with the moment our favourite lead character is shown to have a memory back to a horrifying moment from their past, or from earlier on in the series equating to their psychological state and unravelling storyline.

This is PTSD, known as post-traumatic stress disorder. There are increasing media representations of PTSD, but what exactly is it?

PTSD is an after effect of a traumatic event that has the potential to last months or years, often associated with soldiers, the rest of us are not exempt.

Traumatic events are overwhelming and frightening experiences, like being involved in an assault, witnessing an accident or attack. For some life carries on unaffected, whilst others are subject to psychological symptoms of grief, depression, guilt, shame and blame and specific to PTSD flashbacks and nightmares; avoidance and numbing; and hypervigilance, being constantly on alert.

Physical effects of irregular heartbeats, diarrhoea and pains are often occurrent with PTSD as a result of the continued activation of the fight, flight response.

A flashback of the traumatic memory will induce the same physiological responses as at the time of the traumatic experience itself.

Then the less commonly known complex-PTSD (cPTSD) is suffered when individuals suffer repeated severe neglect or abuse.

In addition to PTSD symptoms, cPTSD has symptoms of difficulties with regulating emotions; distrust towards the world; feelings of hopelessness, worthlessness as if they are damaged goods; feeling alienated; avoiding interpersonal relationships; suicidality and dissociative symptoms.

Dissociation is literally ‘ignorance is bliss’ in psychology terms with your brain disconnecting from the trauma and associated memories, feelings and identity, acting in self-preservation from the psychological turmoil.

This further creates difficulties with symptoms of amnesia, detachment to yourself and your emotions with a loss of self, a distorted perception of those and the world around you.

For some it’s a natural response to trauma, others decide to tune-out (this is often found with children) and for those with schizophrenia, bipolar and borderline personality disorder it’s a symptom of their disorder.

Trauma fundamental changes us, from the hardwiring of our brain to the bodies responses, operating from an instinctive drive in the face of trauma.

We are familiar with the four Fs- fighting, fleeing, feeding and f(love)-ing; fighting and fleeing are geared up in trauma and freezing can also occur. The reptilian brain, a drive in our survival, activates shutting down non-essential processes to conserve energy, the nervous system releases a flood of stress hormones to prepare the body in particular cortisol.

Cortisol prepares the body for its chosen method of survival, the vagus nerve sending signals to the heart, lungs and stomach, creating that feeling we get when we are in the grips of fear (for those who fear nothing, let me know how, for others with acrophobia or ophidiophobia (an evolutionary rationalised fear) will be all too familiar with this feeling.)

Generally, we sense danger, and no it’s not a sixth sense or the Illuminati (associated with the reptilian brain), its an innate instinct and further taught to us by our caregivers, aiding the development of part of our autonomic nervous system.

Mirror neurons aid this learning process with mimicry and in the development of empathy (if you are on the Autistic Disorder spectrum this may be more difficult), these handy neurons guide our perception and action.

Its mirror neurons that enable us to interpret individuals’ intentions or make us wince when someone gets hurt (unless it’s our sibling or best mate falling over, then we malfunction and laugh).

Consider walking home at night and a large, conspicuous hooded hulk of an individual approaches, alarm bells go off, you cross the road or your heart rate increases, and you hope to pass them unbothered, with wallet and limbs intact.

When someone approaches you in a bar we can sense their intentions and that niggle of your partners infidelity, this particular one is a paradox as we generally trust the person we love and therefore what they say, yet our instinct is flagging up something else putting us into conflict.

This conflict is particularly difficult in differentiating for individuals who have been abused by their care giver and by partners, the very people we look for love and security, are the very people who risk that safety and neglect us.

The potentiation of this can result in the dysregulated response occurrent with PTSD; overactivated amygdala, resulting in hypervigilance, underactive hippocampus, restricting consolidation of what has happened to put it as a past event resulting in the continued heightened preparation of flight or fight and finally the continued elevation of stress hormones.

There are a number of therapies that aid PTSD for some medication aids the turning down of heightened responses, likely the combination of medication and therapeutic techniques may be suitable.

Therapies include eye-movement desensitisation and reprocessing, cognitive processing therapy and other cognitive therapeutic frameworks providing individuals with an opportunity to rationalise what has happened and gain skills to thrive and move out of survival mode.

Other holistic techniques engaging writing therapy to come to terms with what has happened; art therapy as an alternative expression; and yoga to get back into your body, effective for individuals who have experienced sexual and physical abuse and have disconnected with their bodies.

Trauma is attributable to the development of mental health difficulties and physical ill-health, finding individuals who experienced traumas in childhood, known as adverse childhood effects (ACEs) have increased mortality from heart disease, chronic lung disease and other health management.

Individuals working in professions dealing with traumatic events (paramedics, police and emergency services) or those dealing with disturbing details of forensic cases all are susceptible.

The outing of trauma can often result in a post-truth wake and can incur in mental health, especially in light of the shame and blame associated, particularly in the #metoo movement and clergy sexual abuse causes.

This is the tip of an iceberg that may explain and be a precursor in the development of mental health difficulties and physical health.

For further reading check out Dr van de Kolk, who articulates trauma beautifully, advocating building trust with patients and the holistic alternatives from a one pill fix, find it here.

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