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In most cases , those who suffer from PTSD will recover , but the condition may also become chronic . In the worst cases it may cause enduring changes of personality .
Enduring personality changes after a catastrophic experience
The effects of a catastrophic experience may endure for years . Acute stress symptoms may no longer be evident , but the survivor is permanently in a state of desperation and depression . According to the WHO , a person having this disorder is characterised by : “ a hostile or distrustful attitude toward the world , social withdrawal , feelings of emptiness or hopelessness , a chronic feeling of being on edge as if constantly threatened , and estrangement . Post-traumatic stress disorder may precede this type of personality change .” This state of mind might be described as a ‘ burnt-out ’ form of PTSD .
PART III : THEORY
Stressors are likely to be catastrophic events , which characteristically last for a long time :
• Experience of concentration camps .
• Natural disasters .
• Prolonged captivity or exposure to life-threatening situations , with imminent risk of being killed ( for example , victims of abduction or terrorism ).
• Torture .
Symptoms related to severe stress or stress disorders
It is possible to identify several categories of trauma symptoms . These are symptoms that must be present if a severe reaction is to be characterised as a trauma-related disorder ( notably PTSD ). Most symptoms fall within three clusters .
Intrusions : symptoms associated with re-experiencing a trauma
In a life-threatening situation the human brain does not behave in a normal way . Everything happens too fast to store events properly in the memory , so survivors often suffer partial memory loss because the traumatising event remains present in the unconsciousness .
• Flashbacks . One relives the trauma over and over . Invasive memories of the event trigger physical symptoms ( rapid heartbeat , sweating ). Because the body is still in a state of alert , it prepares over and over again to fight or flee the traumatising event ( see hyper arousal ).
• Bad dreams , nightmares . These cause severe sleeping problems . A survivor may also be disoriented when waking up .
• Frightening thoughts . These may surge up automatically , and cannot be stopped .
• Trauma-related stimuli . Words , objects , sounds , smells , and also inner stimuli trigger recollections of the traumatic event ( in the form of flashbacks , nightmares , frightening thoughts ), to which the body responds as if the event is recurring in reality .
All of the above cause severe problems in the survivor ’ s everyday life .
Avoidance symptoms
A traumatised person naturally tries to avoid anything that might recall memories of the traumatic event . She employs cognitive , emotional and behavioural strategies to avoid exposure to such stimuli , and also tries to avoid all forms of traumatic memory and emotion . This can lead to numbness , and problems of recall ( see ‘ dissociation ’).
This too creates serious problems in daily life because , for example , survivors will :
• Avoid places , events , or objects that remind them of their experience , and as a result may become isolated and solitary .