If you’ve answered yes to any or all of the above questions, there’s a good chance that your client is suffering from undiagnosed Posttraumatic Stress Disorder, or as it is better known, PTSD. This disorder is perhaps the most misunderstood and under-recognized mental health disorder, and if not diagnosed, can persist and affect your clients for years to come. If not properly diagnosed and treated, it can easily spread so that your client’s depressive symptoms and anxiety become worse over time.
So what is PTSD exactly? Clinically, it is a phenomenon where a person’s brain becomes completely overwhelmed and unable to process information that is overloading their brain. It can occur from a single, terrifying event, or from an accumulation of seemingly non-terrifying events over time. However, in those cases, there is usually an event that is “the straw that breaks the camel’s back” - the point at which the brain ceases to be able to process or make sense of what has happened to the afflicted person.
The biggest problem with PTSD is the third group of symptoms - Dissociative symptoms. In dissociation, victims are unable to control the memories associated with their trauma. They have frequent visual flashbacks or recurring nightmares related to their trauma, or they get so locked into remembering the events that they have difficulty keeping their minds focused on their present reality. The may even feel like they are outside their own bodies, or in extreme cases, actually feel like they are more than one person (multiple personalities). If not trained to look for dissociation, doctors, psychologists, and psychiatrists often miss seeing the Dissociative Symptoms of PTSD, and will under-diagnose victims as having only anxiety or depressive disorders.
Dissociative Symptoms make it extremely difficult for people to focus and concentrate, causing them to make errors at work or at school, and causing them to doubt themselves. It may lead to them losing their jobs or failing at school, leading to a worsening of their depressive symptoms. It may make people agitated and unable to tolerate normal levels of noise, light, or activity. The recurring nightmares interfere with sleep, causing further deterioration in their cognitive functioning. Most importantly, dissociation greatly reduces a person’s ability to cope with even the smallest levels of daily stress, especially their accident injuries!
The first two groups of symptoms, Anxiety and Depression, are like the 10% of an iceberg that you see above the water. They are most visible, so psychological or psychiatric treatment is often focused only on this “tip of the iceberg”. However, the third group of symptoms - Dissociative Symptoms - are the 90% of an iceberg that lurks beneath the water. And like an iceberg, they are the symptoms that cause the most damage - just ask the passengers on the Titanic!
So by this point, you’re probably asking what the implications are for you if you are a lawyer or a physiotherapist. If you have clients who are both anxious and depressed, you should always consider arranging for psychological assessment by somebody who is trained in recognizing and treating PTSD! This is the most significant service you can possibly provide for your client.
By getting help for your clients for their PTSD, you will greatly reduce the amount of their psychological suffering. But more importantly, you will greatly increase their ability to cope with their physical injuries or pain symptoms. If you are a physiotherapist, you will make your treatments much more effective by increasing your client’s ability to participate in their own rehabilitation! And if you are a lawyer, you will be helping your clients to maximize the benefits they receive from their insurance payments and treatments!
So, my message to rehabilitation teams and personal injury lawyers is this. Learn to recognize the symptoms of PTSD and connect with a psychologist in your area who is trained to recognize, diagnose, and treat this very difficult to treat disorder. In the long run, you will have happier, healthier clients who will spread the word about your knowledge, and will help to make your practice even more successful!