Industry Practice - PTSD Research

The patient I am designing for our visual novel, suffers from PTSD. Specifically relating to medical distress from a severe illness they had as a child. To be able to accurately portray this, I need to do a lot of research into the topic.

Medical PTSD and Medical Trauma

Medical PTSD is caused by trauma from life threatening illnesses, medical malpractice, traumatic birth, severe paediatric illnesses etc. 

Medical trauma occurs in a medical setting. It is not an official diagnosis but it can lead to conditions like PTSD, anxiety, depression or chronic pain.

Medical trauma doesn't always stem from the result of a treatment/ procedure going wrong, it can also be a response to a routine diagnosis, operation or treatment.

Symptoms

Symptoms of PTSD include:

• Fear of medical settings or medical staff
• Physical sensations, such as pain, sweating, feeling sick or discomfort
• Repetitive negative thoughts about your experience
• Avoidance or emotional numbing
• Irritability
• Feelings of depression and anxiety

Symptoms of medical trauma include:

• Numbness
• Dissociation
• Panic attacks
• Feelings of rage or shame
• Substance use
• Eating disorders
• Self harm
• Compulsive behaviours such as exercising or working all the time
• More or less sensitivity to surroundings
• Sleep problems
• Gastrointestinal issues, like nausea or indigestion
• Skin rashes
• Chronic pain

Triggers

For those who suffer from medical PTSD, triggers can include but are not limited to:

• Hospital
• Doctor's offices
• Dentist's offices
• Places with bright lights
• Being touched
• Specific smells such as disinfectant

Their own body can also be a trigger. Fear of a life threatening medical emergency or the worsening of an ongoing condition can lead to symptoms like hypochondria. 

Gabbie Nadeau, an individual who suffers from medical PTSD, comments that "I was once in a building that to everyone else didn't have a smell, but to me smelled like medical tape. I felt ill and woozy and on the verge of a panic attack" (CdLS Foundation, 2022). This shows how big of an impact the smell of a room can have on an individual suffering from PTSD.

How is it diagnosed?

There is no test to diagnose PTSD. A healthcare provider makes the diagnosis after asking about your: symptoms, medical history, mental health history and exposure to trauma. These appointments allow you to being a loved one for support as it may be difficult to talk about trauma. 

You're more likely to be offered treatment if you've had symptoms of PTSD for more than 4 weeks or your symptoms are severe. There are a number of mental health specialists you can see like a psychological therapist, psychologist, community, psychiatric nurse or psychiatrist.

PTSD in children

Children with PTSD experience similar symptoms to adults such as having trouble sleeping and upsetting nightmares.

Like adults, children with PTSD may lose interest in activities they used to enjoy and may have physical symptoms such as headaches and stomach aches.

Other symptoms include:

• Difficult behaviour
• Avoiding things related to the traumatic event
• Re - enacting the traumatic event again and again through their play

Trauma focused CBT is usually recommended for children and young people with PTSD. It normally involves a course of 6 - 12 sessions that have been adapted to suit the child's age, circumstance and level of development. The treatment could include consulting with the child's family. If CBT doesn't work, they may be offered EMDR.

Treatment

Talking therapies are likely to be recommended first. There are 3 main types of talking therapies for those who suffer with PTSD. These are:

• Cognitive Behavioural Therapy (CBT) 

This therapy is aimed to help you manage problems by changing how you think and act. Trauma focused CBT uses a range of psychological techniques to help you come to terms with the traumatic event. For example, your therapist may ask you to face your traumatic memories by describing aspects of your experience in detail. In this process, your therapist helps you cope with any distress you feel while identifying any beliefs you have about the experience that may be unhelpful such as fearing it may happen again. You could be encouraged to restart activities you have avoided since the experience.

• Eye movement desensitisation and reprocessing (EMDR)

This is a psychological treatment that involves recalling the traumatic incident in detail while making eye movements, usually by following the movement of your therapists finger. Other methods include tapping their finger or playing sounds.

• Support and advice

There are a lot of charities that provide support and advice for PTSD.

Medicine

Another method of treatment, is medicine. In adults, paroxetine and sertraline are the main types of medicines recommended. These are both antidepressants that are known as selective serotonin reuptake inhibitors (SSRIs).

These will only be used if:

• You choose not to have a trauma focused psychological treatment
• Psychological treatment would not be effective because of an ongoing threat of further trauma
• You have gained little or no benefit from a course of trauma focused psychological treatment
• You have an underlying medical condition, such as severe depression, that affects your ability to benefit from psychological treatment.

Other antidepressants like venlafaxine may be prescribed but they're not licensed to treat PTSD. These are usually not prescribed to people younger than 18 unless recommended by a specialist. If medicine for PTSD is effective, it will usually be continued for a minimum of 12 months before being gradually withdrawn over the course of 4 weeks or longer. If a medicine is not effective, the dosage may be increased.

Before prescribing medicine, the doctor must make you aware of the side effects as well as withdrawal symptoms.

For example, side effects of paroxetine:

• Feeling sick
• Blurred vision
• Constipation 
• Diarrhoea

Withdrawal symptoms include:

• Sleep disturbances
• Intense dreams
• Anxiety
• Irritability

Withdrawal symptoms are less likely if the medicine is reduced slowly.

Reference List

Anon, n.d. Medical Trauma [online]. emotion matters. Available at: https://emotionmatters.co.uk/medical-trauma/ [Accessed February 06, 2025] Anon, 2022. Treatment - Post-traumatic stress disorder [online]. NHS. Available at: https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/treatment/ [Accessed February 06, 2025] Anon, 2022. Symptoms - Post-traumatic stress disorder [online]. NHS. Available at: https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/symptoms/ [Accessed February 06, 2025] Courtney Telloian, 2021. Medical Trauma Exists, and It’s More Common Than You Might Think [online]. PsychCentra. Available at: https://psychcentral.com/ptsd/medical-trauma [Accessed February 06, 2025] Gabbie Nadeau, 2022. Medical PTSD: It’s Real and Impacts My Everyday Life [online]. CdLS Foundation. Available at: https://www.cdlsusa.org/medical-ptsd-its-real-and-impacts-my-everyday-life/ [Accessed February 06, 2025]