The importance of self-care after the recent terrorist attacks

Post-Traumatic Stress Disorder (PTSD) treatment in London

The last few months have included horrendous attacks on Manchester and London and the below information is aimed at anyone who has been affected by these events. The emotional impact of the recent events will be widespread and may influence survivors, friends, bereaved families, health care workers, emergency staff and members of the general public. If you were present during one of the attacks, witnessed others getting hurt or lost someone then it is likely that this will trigger a reaction in you. Many people may experience emotional reactions after what has happened. People who were close to either of the attacks, witnessed the devastating aftermath or took part in the rescue and care of victims and survivors will most likely exhibit the strongest reaction.

Below you will find a list of common reactions that are normal and expected in the weeks after exposure to a traumatic event. These responses represent the mind’s way of dealing with and coming to terms with what it has experienced. They are a normal part of recovery, and should lessen with time.

Traumatic events may cause some or all of the following reactions:

  • Low mood or depression
  • Insomnia or disturbed sleep
  • Nightmares
  • Feelings of anger or anxiety
  • Emotional reactions that cause a sense of helplessness, confusion, disorientation, numbness, or feeling overwhelmed
  • Thoughts of a distressing nature that suddenly pop up unexpectedly
  • Difficulties trusting others and fear that others are out to cause harm
  • Avoidance of people or places

How to deal with traumatic events

There are a number of things that can help someone deal with a distressing or traumatic experience. When you have been through something traumatic, it may feel natural to withdraw and lock yourself away from others. However, seeking out contact with people who you feel close to and who you would usually spend time with is one of the most helpful ways of dealing with a traumatic event. This may include talking with friends, family members, or co-workers, and sharing how you are feeling. When sharing your experience, it can be helpful to talk at your own pace and share as much detail as you feel is necessary. Communicating with others is a two-way street, and it is important that you too are willing to listen to others who may need to talk and share their experiences and feelings. Allowing yourself to cry and taking time to grieve will help you to process what you have experienced. Bottling up feelings will prevent you from moving on and may cause further difficulties such as flashbacks later in life. Traumatic flashbacks can be understood as a re-experiencing of the traumatic event, where it feels like the event is happening again. Flashbacks could occur six months after experiencing the traumatic event itself if the traumatic event is not processed accurately at the time of the event.

Seeking out activities that provide a sense of pleasure and achievement will help improve your mood, alleviate symptoms of depression and allow you to reclaim your life. Don’t be afraid of asking friends, family members, religious or community centres for practical and emotional support. After experiencing something traumatic, it is not uncommon to have thoughts that other people are dangerous or out to hurt you. Spending time amongst other people and engaging in activities that make you feel good will help to address such negative thoughts. Returning to everyday routines and habits may help with reclaiming a state of normality in your life, and this can feel comforting and safe. Whether you are feeling depressed, angry or anxious, remember that it is important to look after yourself. You can do this by making sure you are eating and sleeping well, exercising regularly, scheduling time to relax, and practicing kindness and compassion towards yourself and others. Be patient with yourself, and accept that you will have days that are difficult and days that feel better. For many people the difficult days will reduce with time.

When to seek professional help for post-traumatic stress disorder (PTSD)

Many people who have experienced something traumatic recover naturally and do not need to seek out further support. It is therefore not recommended to seek out psychological support shortly after exposure to a traumatic event. However, for some people the negative symptoms will persist, and they may therefore need professional support. People with previous mental health difficulties or individuals who have been exposed to multiple traumatic events may be more vulnerable and be in greater need of support. It is important to recognise that subjective differences exist between people. For instance, two people who experience the same event may process and deal with this event very differently, in part due to their mental resilience. If you, or someone you know, continue to experience the symptoms below a month after the incident happened, it may be time to seek out professional help. You can read more about post-traumatic stress disorder here but symptoms to look out for include:

•    Feeling unable to enjoy life (due to the event)
•    Feeling on edge and jumpy
•    Experiencing regular nightmares
•    Experiencing flashbacks from the event where it feels like the event is happening again
•    Finding it hard not to think about the event
•    Feeling upset and fearful a lot of the time
•    Relationships falling apart
•    Increased use of alcohol or drugs to cope
•    Acting differently than before the event
•    Finding it hard to work, or look after the family and home
•    An increase in sudden emotional outbursts or feeling overwhelmed

What treatment is there for PTSD?

Psychological interventions are recommended as the primary treatment approach for trauma. At present, Cognitive Behaviour Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) are the two recommended treatment approach outlined in the national treatment guidelines. Although psychological interventions may vary in style and length, their primary aim is to help you deal with difficult emotions and strengthen your way of coping. Medications are not currently recommended as the first line of treatment, but some medications may help to alleviate some symptoms of depression and anxiety. Some medications can therefore be used alongside psychological support.

Treatment for PTSD in London

City and West Psychology have experienced professionals who are trained in both CBT and EMDR, and who regularly work with trauma. For further information you can read more about post-traumatic stress disorder on our site. If you would like to hear more about how we might be able to help, please get in contact by giving us a call or you can book an appointment to tackle your PTSD online.

Breaking out of the depression prison

Finding the lightIn today’s society, depression is a common issue but what is it really like to experience depression? People who have gone through depression will often tell me that their world turned grey and that they experienced a sense of loneliness so strong that it could be felt in the most inner parts of their bones. They describe being in a prison of gloom and suffering, a prison whose walls are invisible, but still quite impenetrable.

In the prison of depression, the mind often travels to a place of darkness, and it becomes preoccupied with our sins, our inadequacies and the futility of our existence. Each day starts to merge into the next, and the focus of our attention becomes more and more on the issues of life and death, more specifically – what we have done with our life, our place in the world, and our feelings of anger, guilt, shame, jealousy, revenge, fear, hate, courage, forgiveness and love. Sometimes we feel imprisoned for years.

What comes out of this period of painful turmoil will vary from person to person. For some it will be an ongoing sense of confusion and sorrow, whilst for others it can result in growth, compassion and ultimately a sense of peace.
During my time as a psychologist I have had many conversations with people who have gone through depression. Some of them have had treatment with other health care professionals on multiple occasions and yet their symptoms of depression have persisted. I have also had many conversations with individuals who have been through horrible and life changing situations, but who nevertheless have somehow coped. The current literature on depression suggests that despite our life circumstances, we ourselves build the prison of depression. This is good news! If we built the walls that keep us trapped, then we also have the ability to find the key that will allow us to unlock the door and let us out.

Breaking free from the prison of depression can sometimes happen in as little as five or six sessions if you follow a few simple steps. Firstly, adopting a position of curiosity and willingness to try something new will put you in a great position from the outset. When entering therapy, you will be faced with two paths. The first represents a path that you have been down before, it’s the path of no change, and it includes holding on to your old thoughts, feelings and behaviours. The second path will be unknown to you, and might therefore at first bring up a sense of fear. However, should you decided to take a leap of faith and chose this second path, then in return it may offer you the possibility of change and hope. When breaking out of the prison of depression, hope is important and nurturing hope in any way that works for you will be vital. This could for instance be done by seeking out support from others, reading inspirational stories about others who have broken out of the prison of depression, or acting as your own cheerleader.

Secondly, working towards meeting your emotional needs, will over time allow you to find enjoyment in life again. In the prison of depression, it is common to lose ones’ sense of meaning and purpose in life, and this often results in reduced experiences of pleasure and a sense of achievement. Identifying activities that may provide an increased sense of pleasure and achievement and then embarking on these activities usually has a positive impact on mood.

Thirdly, identifying what beliefs, opinions and assumptions maintain the depression can be key to understanding what changes to make in the future. Identifying unhelpful thinking patterns and considering alternatives views will put you one step closer to finding the key and unlocking that door.

Finally, learning to show compassion towards yourself. Being self-compassionate involves acting the same way towards yourself as you would towards a friend or loved one if they were going through a difficult time. It includes purposefully comforting yourself when life is hard, and focusing on how you can best take care of yourself in that moment.
Although the journey out of the prison of depression will be different for every individual who embarks on it, the four points above will put you in a good position to finally finding that key and living the life that you want and deserve.

Author: Dr Torstein Stapley
Read more about the author here