PTSD: recognising the signs and getting help

Post-traumatic stress disorder (PTSD) is often misunderstood, but it is treatable.

Knowing who it can affect, how to spot the signs, and when to seek support, can help people start the path to recovery.

What is PTSD?

According to the World Health Organization (WHO), almost 4% of the world’s population will experience PTSD at some point in their lives. Yet many people still do not understand what this serious mental health condition is, who it affects, or how to identify the signs.

PTSD can develop after trauma, such as a natural disaster, serious accident, sexual assault, childhood abuse, the sudden loss of a loved one, or witnessing violence, explains Sizakele Mazibuko, a clinical psychologist at Mediclinic Crescent Mental Health Services.

“It can affect anyone who has experienced or witnessed a traumatic event – and recognising it is the first step towards healing.”

The symptoms of PTSD

“The human mind is remarkably resilient, but sometimes trauma is so overwhelming that your brain struggles to process it in a healthy way – and that’s when PTSD takes hold,” says Dr Thabo Mogotlane, a specialist psychiatrist and head of the Mediclinic Legae Mental Health Unit.

PTSD affects people in different ways, but symptoms usually fall into four main groups, he explains:

1. Intrusion symptoms: “These include unwanted flashbacks, nightmares, and intrusive memories that make a person feel as though they are reliving the traumatic event all over again.”
2. Avoidance: “People with PTSD often go to great lengths to avoid anything that reminds them of their trauma. This can mean staying away from certain places, people, conversations, or even thoughts and feelings connected to the event.”
3. Negative changes in mood and thinking: “This may present as ongoing feelings of guilt, shame, or hopelessness, distorted perception of blame, emotional numbness, or losing interest in activities once enjoyed.”
4. Hyperarousal: “Many PTSD sufferers feel constantly ‘on edge.’ They may have difficulty sleeping, experience irritability, have angry outbursts, trouble concentrating, and an exaggerated startle response.”

For a diagnosis of PTSD, symptoms must persist for more than one month and be severe enough to interfere significantly with daily life, Dr Mogotlane says.

It’s also important to understand that while PTSD symptoms typically appear within three months of a traumatic event, they may only emerge months or even years later.

“I live with PTSD”

Trauma survivor and educator Nikki was diagnosed with PTSD aged 14 after being sexually abused for years by a family friend. “It was a horrific experience that robbed me of my childhood,” she says. “At 14, a second traumatic event sent me into a downward spiral of drug and alcohol abuse and self-harm.

“PTSD, to me, is pure fear. Constant terror, racing thoughts, nightmares, panic attacks, and hypervigilance that affects every single day of my life – from going to work, dating, to simply falling asleep. Reliving the trauma daily can sometimes feel worse than the trauma itself.”

Over the years, Nikki says she’s found effective ways to cope with these feelings. “I use positive affirmations to remind myself I am worthy, valuable, and loved, take prescribed medication, and attend weekly therapy to process, understand, and manage my trauma symptoms.”

PTSD treatment options

PTSD is treatable, and many people go on to live full, meaningful lives. Evidence-based treatments include:

• Cognitive behavioural therapy (CBT). Helps identify and reframe negative thought patterns related to your trauma.
• Eye movement desensitisation and processing (EDMR). This specialised therapy uses guided eye movements to help your brain process traumatic memories.
• Medication. Antidepressants, particularly SSRIs, can help manage symptoms.
• Support groups. Connecting with others who share similar experiences can reduce feelings of isolation and foster a sense of community. Organisations like the South African Depression and Anxiety Group (SADAG) and HEAL-SA can suggest support groups online or near you.

Your healthcare professional may also recommend residential treatment at a mental healthcare facility if there is one in your area.

It helps to talk

“Too many people suffer in silence because they fear being judged or misunderstood,” says Dr Mogotlane. “Talking openly about PTSD helps dismantle that stigma one conversation at a time. If you or someone you love is struggling, please reach out to your doctor or a mental health professional. Recovery is possible. You don't have to carry the weight of the past alone.”