Focus on PTSD
Since PTSD is a condition more commonly associated with combat veterans, civilians in war zones or survivors of terrorist attacks, it was a little surprising to read that glamour model and businesswoman Katie Price has been diagnosed with PTSD and prescribed a 28-day treatment at the Priory with curfew and social media ban.
Factors that may have contributed to her symptoms include a stressful divorce, knowledge that her mother has a terminal illness, severe debt problems (with talk of bankruptcy and homelessness), media revelations of continuing cocaine abuse, and a general sense of impending failure leading to high anxiety. The prospect of losing her celebrity and her ability to pay for her lifestyle could in her mind be the equivalent of a near-death experience.
Former Spice Girl Mel B praised Katie Price for revealing her diagnosis to the media. ‘I’ve openly admitted that I’ve suffered from PTSD, and it’s an ongoing thing,’ Mel B said. ‘It’s a condition you have to acknowledge and I commend her for saying that out loud. It’s hard in the public eye. I had to read about it and then I got diagnosed. Mine came in flashbacks and nightmares, and really bad anxiety, based around things that would trigger me off, or things that would make me feel so suffocated in my emotions that I couldn’t even move or talk. It’s good to be able to acknowledge it and know how you can deal with it.’
One of Addcounsel’s clinicians, Dr Mohammed Alsaidi, who is a consultant psychiatrist and clinical lead for addiction services in three London boroughs, believes that PTSD can be a useful diagnosis for some patients, but recommends caution.
‘PTSD usually arises from a near-death experience or near-death situation,’ he says. ‘However, we have lots of cases where someone has sustained a trauma – it could be a physical or emotional trauma, any form of trauma that could make them have the symptomology of PTSD, not necessarily near-death. So, for example, someone who has been frightened emotionally could have symptoms of PTSD such as flashbacks, nightmares, hypervigilance, and insomnia. Because they are emotionally sensitive, they took that trauma to heart. Usually, trauma happens when there is a loud noise associated with it. In war, it is the noise of explosions that will make them hypervigilant or with a car crash it could be the noise of impact. You might not see that much of the emotional trauma someone has suffered, but it could be there as an association of heightened anxiety. You might not have the full symptomology of PTSD, only part of it.
‘Sometimes a diagnosis of PTSD is given in order to emphasise that the patient is facing a serious crisis, not just a more simple behavioural issue. We see lots of ladies who have been raped and have been diagnosed with PTSD, because you want the patient to get proper treatment. Some women who have been raped felt they were going to die.’
Threats from people (including on social media) can also cause people to think they are going to die. ‘Fear is huge, especially for celebrities on the borderline. The anxiety is so huge that it can lead to PTSD.’
Dr Alsaidi says that great care has to be taken in giving a diagnosis of PTSD in the context of a medical assessment. ‘If the patient agrees that their symptoms are similar to those of PTSD and that the diagnosis is useful in terms of treatment, management and follow-up, then I will give them that diagnosis.’
‘Unless a diagnosis of PTSD is given, a patient will sometimes not give sufficient attention to an incident in their life which they need to address. It enables the patient to take their condition more seriously. It’s like addiction, which the medical profession used to say was a behavioural problem, but which now, because of neuro-scientific advances in America, we have started to recognise as a disease. When you say something is a disease, a patient will take it more seriously and understand that it is a long-term, chronic problem. If you don’t say it’s a disease, they might say it’s a behaviour and will disappear within weeks, and then they could continue with their addiction problem for another 20 years. It’s the same concept with PTSD: you make people vigilant about their condition. Nobody likes the diagnosis, but they would like to be helped or to help themselves, and to be aware of how much they are in trouble.
Not every patient is able to cope with a diagnosis of PTSD. The knowledge that they have a disease might be de-motivating for some because they might begin to think recovery is not possible. ‘We have to be very careful about what we say because everything we say to a patient could stay in their memory for a long time. We are much more careful than before in giving a diagnosis, because the consequences can be dire.’
‘Educating people is important in bringing them to treatment,’ says Dr Alsaidi. If a client recognises their symptoms as being those of a PTSD sufferer, as Mel B did when she read about it, or as others might do in reading about Katie Price’s predicament, then they will want to discuss it with their clinician.
As Mel B said: ‘You want to still live a fulfilled life, but you also want to recognise what you’ve experienced, and not just shut it off.’