Anyone who has been diagnosed with post-traumatic stress disorder (PTSD) knows what an uphill battle it is to see a light at the end of the tunnel. Not only is the condition itself incredibly difficult to manage, but it often co-occurs with other mental health challenges.
Therefore, in order to feel like your normal self again, sufferers may need to address more than just their PTSD.
To understand what other mental health issues often coincide with a PTSD diagnosis, it is essential to fully comprehend what PTSD is.
PTSD explained
Though many people still think of PTSD as something only war veterans or those who have been through intensively traumatic experiences suffer from, this is not true.
It can affect anyone who has faced trauma, whether that is a car accident, an assault, serious health problems, childbirth, harassment or discrimination, seeing other people being hurt, or losing someone close to you.
Being sectioned or attending a mental health ward, though it is intended to improve your wellbeing, can also trigger PTSD, as can working in the emergency services and regularly witnessing distressing events.
It is diagnosed based on whether a patient is experiencing common symptoms associated with it, which include:
- Having flashbacks, nightmares, or distress when remembering events
- Feeling on edge, such as being irritable, difficulty concentrating, being easily startled, panicking, hypervigilance, and hypersensitivity
- Avoiding memories by feeling emotionally or physically numb, being unable to express affection, being self-destructive, using alcohol or drugs, keeping busy, and being unable to recall events linked with trauma
- Dealing with difficult feelings, such as not trusting anyone, blaming self, feeling unsafe and that nobody understands
Due to the similarity between symptoms of PTSD and alternative mental health disorders, it can be difficult to diagnose, particularly when it is often concurrent with other conditions.
What other mental health conditions co-occur with PTSD?
Depression
A huge number of people who suffer from PTSD also face symptoms of depression, including low mood, hopelessness, low self-esteem, feeling tearful and irritable, lack of motivation, difficulty making decisions, not being able to get enjoyment out of life, feeling anxious, and even having suicidal thoughts.
Depression also has physical symptoms, which many people may not know about. Someone who is depressed, for instance, might also start speaking more slowly than usual, or find it difficult to sleep. They may also have unexplained aches and pains, a low sex drive, a lack of energy, constipation, or lose or gain weight.
As PTSD can be so pervasive, many sufferers begin to feel hopeless, disinterested in life, and low. At the same time, depression can make PTSD worse, encouraging people to detach from their feelings further and being even more irritable and sensitive.
Substance abuse
As people who have PTSD tend to want to shut themselves off from their feelings because they find it too traumatic to deal with their past, it is no surprise that many turn to substance use.
Drinking excessive amounts of alcohol or doing drugs can disconnect them from reality, and they may find this feeling addictive, as they want to forget their past. The more they use or drink, the higher their tolerance becomes, meaning they have to continuously increase their dose to feel the same effect.
At the same time, drink and drugs can make their PTSD symptoms worse, making them more anxious, being untrusting, having difficulty concentrating, and blaming themselves for their experience.
In order to deal with their PTSD, therefore, it is essential they also talk to therapists about their substance abuse, as the two go hand in hand.
Anxiety
As PTSD increases feelings of alertness, it is understandable why lots of sufferers also have to deal with anxiety.
That is why it is often connected with panic disorder, generalised anxiety disorder, or social anxiety.
Anyone who suffers from both will know that anxiety can make their PTSD symptoms a lot worse, as their need to catastrophise means they are never able to switch off and are always on the edge.
Therefore, any therapy needs to target both, otherwise the underlying anxiety will make it difficult to ease PTSD symptoms.
Dissociative disorders
Someone who has been through prolonged trauma may also face dissociative disorders, such as dissociative identity disorder.
These are when patients distance themselves from their past experience as a defence mechanism. For instance, with dissociative identity disorder, they may experience changes to parts of their identity and these often conflict with one another.
It used to be known as multiple personality disorder (MPD) as it can appear as though one person has different characters, but it is simply that they are not aligning with all the parts of their personality.
Other dissociative disorders include derealisation disorder, where you detach yourself from the world and it feels like a dream; dissociative amnesia, which involves forgetting important information about yourself; and other specified dissociative disorder, where symptoms do not fit into a diagnosis.
The reason PTSD is linked with dissociative disorders is because people want to remove themselves from their reality. However, in order to treat one, the other needs to be diagnosed and addressed at the same time.
Bipolar
Bipolar itself is a very complex mental health disorder, but it is even more difficult to diagnose and treat when the patient has PTSD too.
“Intense lows and manic highs are hallmarks of bipolar disorder, and they can become destructive when they intersect with the emotional volatility encountered by those with PTSD,” Salon Prive Mag wrote.
Bipolar disorder is characterised by manic and depressive episodes, as well as potentially incurring incidents of psychosis. Therefore, someone with PTSD and bipolar will feel their emotions even more acutely, making them experience their trauma symptoms with greater intensity.
It can also put them at risk, as their irritability, insomnia, and anxiety can heighten during a manic episode, while their hypersensitivity, brain fog, and feeling emotionally numb can get worse when they are depressed.
In order to tackle the trauma, therapists will need to also be aware of their bipolar disorder, so they can come up with a treatment plan that complements both.
