What is it?
PTSD stands for Post-Traumatic Stress Disorder and is a specific kind of anxiety disorder caused by a traumatic event.
The psychological symptoms can include: nightmares, flashbacks, irritability, repetitive and distressing images and/or sensations, feelings of guilt, obsessing over the event and why it happened, thoughts of self-harm, and difficultly concentrating.
The physical symptoms can include: insomnia, pain, sweating, trembling and nausea.
The social symptoms can include: avoiding socialising with certain people or going to certain places that might trigger flashbacks and unpleasant feelings. Children may also re-enact the traumatic event in their play.
All these symptoms can take time to develop. Generally, they will become apparent within a month after the traumatic event but sometimes it can take months or even years.
Why might autistic people have PTSD?
The cause of PTSD can be any occurrence that is traumatic for the person who experienced it. This can include the sorts of events many people associate with PTSD like military action, being in a car accident, being sexually and/or physically assaulted or suffering abuse. But it can also include all sorts of other events like a distressing childbirth experience, the death of a family member or even pet, or a distressing health scare.
Many autistic people experience gaslighting throughout their lives, even though it may be unintentional. We may have been told we are too sensitive, that clothing is not scratchy, that noises are not too loud and that we are generally overreacting when we are actually processing input differently. Consistently being told we are ‘wrong’ can have a negative impact on our self-esteem and general mental health. When this happens over and over, the cumulative effect can be traumatic.
Complex PTSD (cPTSD) develops when someone is exposed to repeated traumatic events like abuse, neglect or violence.
There is still little research in the area of PTSD in autistic people and whether we are more likely to suffer from PTSD but there are some good reasons to think we are. You are more susceptible to PTSD if you have ever had depression or anxiety and we already know autistic people are at higher risk of both anxiety and depression. Also, unfortunately, autistic people are more likely to suffer traumatic events for a variety of reasons so we are at higher risk of experiencing something that could cause PTSD.
What can I do if I think I have PTSD?
If you do think you may have PTSD or cPTSD, the best first step is to see your GP (or another health care professional if you are already under their care, like a midwife or psychiatrist).
Your GP should assess you and talk through your treatment options, which may involve medication, some sort of therapy, or both. If the trauma was recent, they may also suggest waiting a short while to see if the symptoms diminish on their own. This is normal and does not mean you have been dismissed or ignored.
If you feel unable to tell your GP or another health care professional, try to tell someone else you trust.
What can I do myself?
Alongside the advice given by your GP (or if you want to do something to help while waiting to see a GP or while building up the courage to tell somebody) there are some things you can try yourself to help.
If you are struggling with flashbacks (a sudden re-experience of an element of the traumatic event – sometimes like a video playing it or part of it again, sometimes noticing smells/sounds/tastes relating to the trauma, sometimes feeling pain or pressure or other physical symptoms, sometimes experiencing the same emotions felt during the trauma) there are some things you can do to try to help.
During a flashback you can:
- Focus on breathing slowly and make your ‘out breaths’ (exhalation) longer than your ‘in breaths’ (inhalation).
- Try to ground yourself by listing things around you that you can see, hear, feel, smell and taste.
- Comfort yourself and take care of your sensory needs (this may mean using a weighted blanket, listening to comforting music on headphones, re-watching a series or film you like).
- Focus on an object that reminds you of the present and/or of being safe (you may wish to carry such an object with you, just in case).
When you are calm you can try to help with future flashbacks by:
- Keeping a diary of your flashbacks, including details like what you were doing/where you were/who you were with. This can help you to learn your triggers and maybe even help you to spot early warning signs that a flashback may be imminent.
- Making something to help you feel safe when you have flashbacks. This might be a recording of yourself or someone you trust telling you that you are safe, and the trauma is over. Or it could be a letter for you to read along the same lines.
As with other anxiety disorders and depression, peer support can be an invaluable source of support if you are able to find it. Online communities can be extremely useful if you are unable to find any ‘real life’ groups.
If you need support with your mental health, here are some helpful resources:
Scottish Association for Mental Health (SAMH) www.samh.org.uk 0141 530 1000
Breathing Space www.breathingspace.scot 0800 83 85 87
Samaritans www.samaritans.org 116 123