Post - traumatic stress disorder
Studies show that the impact of HIV/AIDS on the psychological characteristics of a person can be significant. The effects include higher rates of depression and anxiety, increased substance use, social isolation and cognitive impairments. Recently there has been a focus on Post-Traumatic Stress Disorders (PTSD) in Long Term Survivors (LTS). The origins of PTSD in LTS are the traumas associated with an HIV/AIDS diagnosis when there were no treatments and therefore the diagnosis was a “death-sentence”. These LTS also faced losses of entire networks of friends. They woke up each day waiting for a treatment to forestall the collapse of their immune system. Add to those stresses the rejection by family and friends and the toxic impact of being painted as a social outcast driven by homophobia and fear of a poorly understood sexually transmitted disease HIV.
The diagnosis of the syndrome is reliant on a series of criteria. Its diagnosis can only be done by a professional, although there are screens for PTSD symptoms. Here are some of the PTSD characteristics:
- Re-experiencing the traumatic event(s): These may include sudden resurrection of memories, visual memories, that recall the trauma underlying PTSD. They can be very unwelcoming, and some have described them like nightmares or flashbacks. This can take many forms and are often very very upsetting.
- Avoiding the triggers that underly the trauma(s) to be recalled: Often the person with PTSD will try to avoid at all costs those triggers that recall the trauma. People with PTSD will stay away from any memories that cause them to recall and relive the traumas. They will avoid in conversation or day to day activities the thought and emotional reactions that are associated with the traumatic events. These avoidance behaviors cause stress and anxiety as well as social isolation.
- Negative thoughts and moods. PTSD causes many to no longer be able to recall events and especially event details. Their thinking processes are often invaded by thoughts of worthlessness together with frequent emotional states of anger, fear and shame.
PTSD should be diagnosed by a mental health professional especially those who are experienced with the disorder and the interventions that exist.
Most treatments are short in duration and must be provided by those skilled in their use. They include:
- Cognitive behavioral therapy (CBT) and cognitive processing therapy (CPT): CBT must be provided by a skilled clinician. It aims to change the patterns of thinking or related behaviors which then change the feelings that occur.
- Prolonged exposure therapy: This therapy involves confronting and re-experiencing the trauma. This must occur in a safe environment with a highly trained professional. This process causes the person to confront rather than avoid the trauma.
- Eye movement desensitization and reprocessing (EMDR): This approach tries to assist how the brain categorizes the traumatic memories in such a manner that the emotions that erupt when the trauma is recalled are so that the emotions associated with the trauma are not reawakened.
The lives of Long-Term Survivors were shaped by events that happened almost 30 years ago. Many remain locked if not captured by those events which cause painful and deviating emotional states today. Be aware and seek professional help. And be supportive of those who you might observe who are going through the continued traumas that underlie PTSD.