PTSD – Post Traumatic Stress Disorder

The recent events in New Zealand, I am sure, have brought memories flooding back to many who have been involved in similar mass casualty events.

The ongoing damage to those who are exposed to this   kind of trauma, either as part of their work commitment, or as someone that has been thrown into an unfortunate circumstance by fate, is often unseen, but the effects no less devastating.

I recently spoke to an old friend who I remember as being such a wonderfully positive and happy person. She was the smile on a cloudy day, the life of the party. That was until she became a 911 operator, and after 5 years of service found herself thrown into the depths of PTSD to the point that she could not function…let alone smile.


Diagnosis of PTSD requires exposure to an event that involved the actual or possible threat of death, violence or serious injury. Your exposure can happen in one or more of these ways:

  • You directly experienced the traumatic event
  • You witnessed, in person, the traumatic event occurring to others
  • You learned someone close to you experienced or was threatened by the traumatic event
  • You are repeatedly exposed to graphic details of  traumatic events (for example, if you are a first responder to the scene of traumatic events)

You may have PTSD if the problems you experience after this exposure continue for more than a month and cause significant problems in your ability to function in social and work settings and negatively impact relationships.



Post-traumatic stress disorder treatment can help you regain a sense of control over your life. The primary treatment is psychotherapy, but can also include medication.

Combining these treatments can help improve your symptoms by:

  • Teaching you skills to address your symptoms
  • Helping you think better about yourself, others and the world
  • Learning ways to cope if any symptoms arise again
  • Treating other problems often related to traumatic experiences, such as depression, anxiety, or misuse of alcohol or drugs

You don’t have to try to handle the burden of PTSD on your own.



Several types of psychotherapy, also called talk therapy, may be used to treat children and adults with PTSD.

Cognitive therapy. This type of talk therapy helps you   recognize the ways of thinking (cognitive patterns) that are keeping you stuck – for example, negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy.

Exposure therapy. This behavioral therapy helps you   safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma.

Eye movement desensitization and reprocessing (EMDR).EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them. You may try individual therapy, group therapy or both. Group therapy can offer a way to connect with others going through similar experiences.



Several types of medications can help improve symptoms of PTSD:

Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration.

Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. You and your doctor can work together to figure out the best medication, with the fewest side effects, for your symptoms and situation.



If stress and other problems caused by a traumatic  event affect your life, see your doctor or mental health         professional. You can also take these actions as you continue with treatment for post-traumatic stress disorder:

Follow your treatment plan. Although it may take a while to feel benefits from therapy or medications, treatment can be effective, and most people do recover. Remind yourself that it takes time.

Learn about PTSD. This knowledge can help you understand what you’re feeling, and then you can develop coping strategies to help you respond effectively.

Take care of yourself. Get enough rest, eat a healthy diet, exercise and take time to relax. Try to reduce or avoid caffeine and nicotine, which can worsen anxiety.

Don’t self-medicate. Turning to alcohol or drugs to numb your feelings isn’t healthy, even though it may be a tempting way to cope. It can lead to more problems down the road, interfere with effective treatments and prevent real healing.

Break the cycle. When you feel anxious, take a brisk walk or jump into a hobby to re-focus.

Stay connected. Spend time with supportive and caring people – family, friends, faith leaders or others.

Consider a support group. Ask your mental health professional for help finding a support group, or contact veterans’ organizations or your community’s social services system.



The person you love may seem like a different person than you knew before the trauma – angry and irritable, for  example, or withdrawn and depressed. PTSD can significantly strain the emotional and mental health of loved ones and friends.

Remember that you can’t change someone. However, you can:

Learn about PTSD. This can help you understand what your loved one is going through.

Recognize that avoidance and withdrawal are part of the disorder. If your loved one resists your help, allow space and let your loved one know that you’re available when he or she is ready to accept your help.

Offer to attend medical appointments. If your loved one is willing, attending appointments can help you understand and assist with treatment.

Be willing to listen. Let your loved one know you’re willing to listen, but you understand if he or she doesn’t want to talk. Try not to force your loved one to talk about the trauma until he or she is ready.

Encourage participation. Plan opportunities for activities with family and friends. Celebrate good events.

Make your own health a priority. Take care of yourself by eating healthy, being physically active and getting enough rest. Take time alone or with friends, doing activities that help you recharge.

Seek help if you need it. If you have difficulty coping, talk with your doctor. He or she may refer you to a therapist who can help you work through your stress.

Stay safe. Plan a safe place for yourself and your children if your loved one becomes violent or abusive.

There are now some excellent private mental health services on the Island which I would be happy to share with you via email –


Kim Patra is a qualified Midwife & Nurse Practioner who has been living and working in Bali for over 30 years. She now runs her own Private Practice & Mothers & Babies center at her Community Health Care office in Sanur.

Kim is happy to discuss any health concerns that you have and may be contacted via email at, or office phone 085105-775666 or

Copyright © 2019 Kim Patra

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