Post-traumatic stress

These experiences can be so overwhelming and frightening that individuals experience post-traumatic reactions, also called post-traumatic stress. This describes symptoms in adults and children, looks at what can help and where to go if the symptoms persist.

Adult’s normal response to trauma

Immediately after the trauma you may feel:

• shocked or stunned
• numb/ cut off from feelings or what is going on around you
• denial – unable to accept what has happened
• After a few days you may feel …Emotional reactions
• scared
• angry
• relieved
• guilty
• helpless
• sad
• (and/or) have other symptoms
• sleep disturbances
• flashbacks and/or nightmares
• poor concentration
• poor appetite
• being constantly alert
• palpitations
• panic attacks
• headaches/ stomach aches
• changes in sex drive or libido
• constantly tired

Individuals react differently and take different amounts of time to come to terms with what has happened. After a trauma nearly everyone will have some of these symptoms in the first few months.  Although the symptoms can be distressing, they can help you understand what has happened and should gradually improve and disappear.

What can help?

It has been found that talking about how you are feeling to a trusted person can be helpful.  Whilst you are in hospital, counsellors, a psychologist or chaplains are available for you to talk to. You can ask a member of staff to refer you, but often a counsellor will be on the unit during the day.

Practical things you can do include:

• taking regular breaks, making sure you eat and drink
• helping with your child’s care where possible
• writing a journal – either about your thoughts and feelings or for your child about their time on PICU
• nominating a trusted person to be your communicator with friends and relatives at home

When you are home Do…

• try and get back to your normal routine
• talk to someone you trust
• keep life as normal and stress free as possible
• try relaxation exercise to deal with any symptoms of anxiety
• take care of yourself – find time to do things that help you
• have time with family/friends
• ensure that you try to eat regularly and healthily and drink water

Do not…

• bottle up your feelings
• take on too much
• drink excess alcohol or use non-prescription drugs
• make any major life changes or decisions

When should I seek further help?

• If your symptoms persist for more than six weeks, or develop at
• anytime in the future after the trauma and you are experiencing any
• of the following, contact your GP to discuss the situation.

Flashbacks and nightmares

You may find yourself reliving the event such as seeing the accident, trauma, event or your child in intensive care. During the day this can happen as a flashback and at night as a nightmare. You may feel that the flashback is so vivid that it brings back the emotions and physical sensations you first experienced. You may even be able to recall smells and sounds which can be triggered by normal everyday things.

Avoidance

You may find that thinking about the event is so distressing that you try and avoid thoughts, reminders and even places associated with the trauma. For example, you may avoid driving near the accident site. You may try not to talk about it to try and stop the strong emotions you feel.

Being constantly alert

You may find that you are constantly anxious and unable to relax. You may be more alert to dangers and unable to switch off from these. This also means that you find it hard to sleep.  Other symptoms include low mood, headaches and stomach aches, drinking more, anxiety/panic attacks, sleep disturbances, palpitations or poor concentration.

It may be helpful for your GP to refer you to a psychologist or counsellor who can help you.

Children

Children’s normal response to trauma

• After a very frightening experience children are likely to be distressed, tearful, frightened and in shock. This may also happen to siblings of the child in hospital. They may show any of the following:
• Young children may have upsetting dreams about the event that traumatised them or they may have nightmares about monsters or other scary things.
• Younger children may be generally anxious and fearful of separating from their parents.
• They may re-enact the traumatic event in their play over and over again.
• They may lose interest in things that they used to really enjoy.
• They may have other symptoms such as tummy aches and headaches.
• They may find it hard to concentrate at school.
• They may be unwilling to talk about what has happened.
• Teenagers may become more aggressive and may have symptoms similar to adult.  Some research has shown that children who have reported strange experiences like hallucinations whilst on PICU have a greater chance of experiencing post-traumatic stress after three months.

What can help while in hospital?

• When children have experienced a trauma they need to be close to their family. You are the best person to provide them with the love, comfort and support they need at this time.
• Talk to your child about feelings. For younger children you can help them understand what feelings they may be having.
• Helping with their care where possible is important.
• Writing a journal to help them understand what happened to them (fill in the gaps if they were unconscious).
• As children feel safer with familiar things it is a good idea to bring things in from home to put on their bed or room. A favourite toy, book, blanket, story tapes or listening to favourite music.
• Using play, when they are able to, is a good way to help your child express their feelings. Using puppets and dolls and thinking about how they may be feeling about what has happened, or about being in hospital allows children to explore their feelings in a safe way. Role playing doctors and nurses also helps them work through feelings about their experiences in hospital.
• For older children you may want to provide them with a diary to write in themselves and encourage them to talk about their feelings.
• As children’s emotions are affected by their parents it is important to control your own fears and anxieties. If your child sees that you are calm he or she will feel safer and be more willing to share feelings with you.
• There are play specialists and a clinical psychologist available for your child if you feel that would be helpful whilst you are in hospital.

If your child’s symptoms persist… and are not improving after six weeks, please contact your GP. They can refer you to your local child and adolescent mental health team who will have child psychologists or counsellors who will be able to help your child.

In summary

People do get over their experiences in time, but for some people their traumatic experiences can set off a number of symptoms that can last.  Whilst this can be a normal reaction, remember to look after yourself and your family and seek help when needed.

Other support

RCPysch (opens in a new tab) - This useful website offers more information about PTSD and other leaflets on depression and anxiety.

Further help can be sought from:

Assist (Assistance Support and Self-Help in Surviving Trauma)

Helpline: 01788 560800. This is a support organisation for people suffering from PTSD.

While on the ward at Addenbrooke’s please ask a member of staff if you feel that it would be helpful to talk. Counsellors and a clinical psychologist are available during normal working hours.