The concept of post-traumatic stress disorder (PTSD), as we know it today, was defined in 1980 in the wake of the devastating effects observed among American Vietnam War veterans.
It can affect those who have experienced traumatic events such as combat, attacks, natural disasters, hostage-taking, the announcement of a violent or unexpected death, or who have witnessed serious accidents.
What all of these people have in common is that they experienced these events as sources of intense stress or terror, and a feeling of helplessness in the face of the situation.
In France, surveys conducted with Inserm evaluated the consequences of the January 2015 attacks (Charlie Hebdo, Hyper Cacher, Montrouge, Dammartin-en-Joel). After 6 to 18 months, 18% of witnesses showed symptoms of post-traumatic stress, with a prevalence ranging from 3% among those in close proximity to up to 31% among those directly threatened (Impact Surveys). 3% of participants (police officers, caregivers, etc.) were also affected by anxiety and depression disorders.
Disturbed memory
Post-traumatic stress disorder is a malfunction, memory distortionAs Francis Eustache (neuropsychologist, Inserm-EPHE)* reminds us, he explains: Certain aspects of the traumatic event are poorly encoded in memory, which can resemble amnesia.
This can lead to memory problems later on. In addition, the state of stress resulting from trauma can cause a form of hypermemory (an involuntary and intense return of memories, in this case traumatic): intrusive thoughts and images impose themselves on the individual. These images give the impression of an experience in the present through the subject.
How do you recognize PTSD?
The diagnosis combines recovery, avoidance, and neurovegetative activity. What does that mean?
People recall traumatic events through Memories of the pastIntrusive images or thoughts, recurring nightmares, hypersensitivity to stimuli associated with the trauma (sound, smells, etc.). This is accompanied by physical reactions such as sweating, pallor, increased heart rate, etc.
– People avoid anything that reminds them of the trauma (thoughts, discussions, etc.) to avoid emotional pain. They often try in vain to suppress intrusive thoughts about the trauma. However, these attempts only reinforce their initial anxiety.
– People often experience mood disturbances and decreased emotional responsiveness and interest in usual activities. They may also show signs of neurovegetative activity: hypervigilance, irritability, concentration problems, and sleep disturbances.
20% of people are chronically affected.
Most people recover within three months of the event, but 20% develop a chronic form of the syndrome.
Contributing factors may be pre-existing such as previous traumatic experiences, sensitivity to fear, personality, and physical and mental health.
Genetic or epigenetic factors (which modify gene expression) can influence brain plasticity by reorganizing neural connections and networks.
The traumatic event itself (its intensity, emotional impact, and physical consequences) is taken into account, as well as the post-traumatic context (psychological, social, and family support, and the presence of stress or chronic pain).
The effectiveness of medications, especially specific serotonin reuptake inhibitors, in the treatment of psychiatric disorders has been recognized.
However, it should always be combined with psychotherapy. Among the effective methods, we find cognitive behavioral therapies (CBT), EMDR (Eye Movement Desensitization and Reprocessing), and psychodynamic psychotherapies in particular.
