4 min read.Updated: 09 Jan 2020, 10:24 PM ISTVikram Zutshi
The odds are that most of us will be touched by trauma at some point, and a subset among us will experience multiple traumas. But only a fraction of sufferers receive treatment because PTSD is tough to diagnose and treat
I came across Shaili Jain while researching a condition known as post-traumatic stress disorder (PTSD) for which I had been diagnosed. I have always wanted to understand how my adult life was shaped by certain childhood experiences, and while PTSD has become part and parcel of the contemporary lexicon, it remains steeped in confusion and hearsay.
“I wrote The Unspeakable Mind: Stories Of Trauma And Healing From The Frontlines Of PTSD Science to tell the complete story of post-traumatic stress disorder, deconstructing its impact on many levels: Cellular, emotional, psychological, behavioural, societal, cultural and global," says the Stanford psychiatrist about her first book. “I wanted the reader to emerge with a precise sense of PTSD and why it is an inescapable part of all our lives and the world we live in." Today, Dr Jain is regarded as one of the world’s leading trauma scientists. “When thinking of PTSD, the most obvious image that comes to mind is the soldier back from war, but it is important to recognize that PTSD goes far beyond the horrors of war," she says. “Many traumas, such as rape, intimate partner violence, childhood sexual abuse are also closely associated with PTSD."
Humans are no strangers to trauma. The odds are that most of us will be touched by trauma at some point, and a subset among us will experience multiple traumas. While it is true that humans, by design, are naturally resilient and most will heal naturally with the passage of time, a significant minority won’t. So, at any given moment, there are millions who are suffering from active symptoms of PTSD. Of further concern is the fact that only a fraction of sufferers receive treatment because PTSD is tough to diagnose and a challenge to treat. Also, sufferers are often hard to reach. In all, this makes PTSD a pressing public health issue.
This problem is particularly acute in India, which, according to a World Health Organization-sponsored study, is the world’s most depressed country, with the highest suicide rate in Asia. Undiagnosed or untreated cases of bipolar syndrome, anxiety- and trauma-related disorders could run into hundreds of millions. There is also an extreme shortage of qualified mental health professionals in the country, with only 10% of sufferers having access to psychological care in the first place, since it is usually available only in the major cities.
What we call PTSD today has gone by various names over the centuries. Shell Shock, Irritable Heart, War Neurosis, Rape Trauma Syndrome, Battered Women syndrome are just a few of these terms. Researchers found that the human response to trauma was essentially universal and, since 1980, PTSD has been the term mental health professionals use to describe this condition regardless of the type of trauma. “PTSD is a constellation of symptoms that have been described since ancient times, yet the condition has remained elusive," says Jain. “It cuts to the heart of the life of a trauma survivor, interfering with one’s capacity to love, create, and work-incapacity brought on not by poor lifestyle choices, moral weakness, or character flaws, but by a complex interplay among biology, genes, and the environment."
In recent years, Cognitive Behavioural Therapy (CBT) has emerged as the most effective treatment for PTSD. It is a form of talk-based treatment that encompasses therapies such as Cognitive Processing and Prolonged Exposure (full recall of traumatic events). These treatments include exposure exercises, cognitive restructuring, and anxiety management skills, like breathing retraining and muscle relaxation, and learning techniques of grounding. Because it can be unbearable for many people to directly face their traumatic experiences, the dropout rate for such treatments is high. This is where gentler mind-body approaches such as mindfulness, yoga, tai chi, massage, acupuncture, hypnosis, art therapy and dance can help.
Jain warns of the toxic atmosphere created by constant negative news and opinions received via smartphones, tablets and social media that are known to trigger latent or pre-existing conditions. “It has become very apparent, in recent years, that social media, 24-hour news channels and other online forums are being used more as echo chambers to intensely amplify or reinforce preconceived ideas, as opposed to a source for unbiased data," she says. “The mental health community has certainly seen a surge in cases of addiction, depression and anxiety related to such activities."
It may be hard to imagine life without our various devices, but not being dependent on them is vital to our mental and emotional well-being. “Screen-free leisure time has never been so important as it is today," says Jain. “Spending big chunks of time in real life relationships, out in nature and engaged in restorative activities e.g. art, music or sport are the basic components of a healthy psychological life. In this stress-fuelled world, we need to stick to these fundamentals more than ever."