Imagine that it's bedtime and you're sleepy. You're in your comfortable, quiet, dimly lit bedroom, looking forward to drifting off and sleeping soundly through the night so you can face the morrow at your best. The next thing you know night has passed, it's dawn and you wake up completely refreshed. You spring from bed ready for a busy day.
Now imagine a different scenario: You ended a relationship some time ago with a hot-tempered person you were dating. One evening when you arrive home from a party, he appears out of nowhere, forces you into your home, drags you into the bedroom, and beats you severely. After being held captive for several hours, you finally manage to escape to some neighbors, who call for the police and an ambulance.
The sleep that came so naturally before the assault now is a distant memory. Falling asleep seems to take you forever and then is interrupted with frequent awakenings and nightmares. The nighttime now is never peaceful. Although your once-soothing bedroom environment is the same physically, the psychological associations are drastically different.
One of my patients recently described this history. She was robbed of the solace of her bedroom. Her physical wounds have healed, but the psychological injuries are still raw.
Survivors of traumatic events may develop posttraumatic stress disorder (PTSD). Among the more common causes of PTSD for women are physical assaults and, for men, combat experiences. Through nightmares and recurring images and memories of the event, survivors re-experience the distress they felt during the trauma.
About 90 percent of PSTD patients have disturbed sleep. They may also avoid any situation during the day that reminds them of the trauma and isolate themselves from friends and family. Many with PTSD have high anxiety levels and a heightened startle response. They are constantly vigilant for no apparent reason.
After suffering for months with the aftermath of the attack in her apartment, my patient finally was able to move out of that now-dreaded place. She's delighted, especially with her new bedroom. Both psychotherapy and an antidepressant medication have been helpful for her, and I think moving has allowed her to achieve a fuller recovery and much better sleep.
Many people experience traumatic events and are able to live normal lives. Others, however, clearly have persistent symptoms that severely impair the quality of their lives. Both medications and various types of behavior and psychotherapy treatments are helpful for people suffering with PTSD.
Remember that it is the ongoing reaction, and not the actual past trauma, that determines whether someone should seek treatment for PTSD. Unfortunately, some individuals still suffering with events from their pasts may not appreciate that they have a mental health problem and that they would benefit from professional help.
The best place to start is with a primary care provider, but often treatment with a psychiatrist, psychologist, or other type of counselor is necessary.
