Post Traumatic Stress Disorder (PTSD)
Following a traumatic event that results in real or perceived danger to oneself or the lives of significant others, it is normal to experience symptoms of anxiety. In some cases these symptoms of anxiety resolves over a few weeks/months. In others the anxiety symptoms persist and cause significant disruption to their day to day activities. In the context of pregnancy it is now understood that PTSD can occur as a result of traumatic childbirth. Experience of previous traumatic events (e.g. violence, miscarriages) may come back to haunt them during pregnancy or experiences of trauma during pregnancy or childbirth may result in symptoms of PTSD.
Symptoms of PTSD include:
1. Re-experiencing symptoms:
- Flashbacks—reliving the trauma of childbirth or previous traumatic event over and over, including physical symptoms like sweating and trembling in response to any memory of the traumatic event
- Bad dreams/nightmares of something bad happening to the infant
- Frightening thoughts that the child is in danger of some sort.
- Safety behaviors- staying away from places, people, events, or objects that are reminders of the experience or perceived dangers
- Feeling emotionally numb
- Having trouble remembering the traumatic event.
3. Hyper-arousal symptoms:
- Being easily startled
- Feeling tense or “on edge”
- Having difficulty sleeping, becoming irritable and/or having angry outbursts
- Sweating, increased heart beats, trembling, feeling “out of control”
What causes PTSD?
It is normal to experience a range of emotional reactions following any traumatic event (e.g. childbirth) where one perceives significant threat to self and/or significant others (in this context, one’s child). While some people are able to overcome the emotional setback with time, others who may be vulnerable (e.g. those who are anxious by nature, have inadequate family support, or those who may be pregnant and overwhelmed by changing hormone levels, stressful life circumstances are more likely to develop PTSD.
Treatment for PTSD
A combination of pharmacotherapy and psychotherapy is usually recommended for PTSD. Pharmacotherapy is indicated as both bodily symptoms of PTSD (sweating, trembling, increased heart beats) and emotional symptoms of PTSD (reliving the trauma through flashbacks, nightmares etc and the emotional reactions of anger, grief etc) can often be very disabling for the woman, particularly during pregnancy or immediately following delivery. Medications often helps in gaining some control over these symptoms and helps the woman engage in psychotherapy where she can discuss her concerns without feeling very overwhelmed.