Zooming in on Post-Traumatic Stress Disorder (PTSD)

Post-traumatic Stress Disorder falls under the psychiatric diagnoses and is generally considered an indication of serious psychosocial problems that can develop after a stressful situation (war or peace mission). Both my father and mother had to deal with this PTSD because of what they experienced in WWII. However, in the 1950s and 1960s, this term was not yet known.

Biopsychosocial health

If people manage to survive stressful situations for years, an important question is whether and to what extent such people have suffered psychological damage as a result of that stressful period. Assessing any health damage is far from simple. This is all the more difficult in times when people were not yet familiar with the possible psychological consequences of wars and no term had yet been coined under which all kinds of strange – related – symptoms could be classified. Later research into PTSD showed that the assessment of any health damage is only possible when the symptoms of PTSD are examined in conjunction with a person’s bio-psychosocial (physical, psychological and social) health.

Other health problems

The difficulty in assessing possible health damage as a result of PTSD lies in the fact that – in the same way as with other psychiatric disorders – it also applies to Post-Traumatic Stress Disorder that people are able to function adequately, despite the fact that they are hindered by the condition. . I personally noticed that this adequate functioning of my parents became less and less successful after other health problems developed in them.

Father

After his capture as a KNIL soldier in the former Dutch East Indies, my father was transported to Burma and deployed in the construction of the infamous ‘Burma railway’. The gratitude and joy about his safe return from Burma was spoiled after a few years – back in the Netherlands – when it turned out that he had contracted amoebic dysentery (amoebiasis) during this captivity. Amoebic dysentery is a serious and exotic tropical disease, a disorder of the large intestine. Later it turned out that this condition not only increasingly eroded his resistance, but it also became clear that he was increasingly unable to suppress his tantrums. Tantrums associated with and resulting from the severity of the traumatic experiences, such as feeling powerless and loss of control.

Remark

Follow-up studies in sufferers of this disorder showed:

  • that a poorer physical condition results in more PTSD symptoms and then leads to more and more serious physical symptoms;
  • it also became clear that violence occurs in approximately 13% of families of veterans without PTSD, but that this percentage rises to above 30% in families of veterans with PTSD;
  • that only 29 – 40% of veterans with serious mental health problems seek help. An important reason for refraining from treatment is not only fear of stigmatization (being perceived as weak), but also fear of loss of status within the unit.

 

Mother

My mother – pregnant for the first time in her life at the time – was placed in a so-called Japanese camp as a Dutch prisoner of war in the former Dutch East Indies, where she worked as a tea leaf picker on the plantations. This means working for hours in the scorching sun without enough food and drink and under appalling conditions. After the Japanese capitulation, my parents – although traumatized by the war conditions, but deeply grateful – were reunited. My mother’s later declining health due to, among other things, thyroid problems increased the risk of the continuation of PTSD in my father and, conversely, the failing health of my father increased the persistence of PTSD in my mother, with the result that she became increasingly anxious and became more uncertain.

Non-professional support

Recent research has shown that support from partners and the social network is essential for preventing or limiting PTSD. In the case of my parents, both were traumatized and both had suffered health damage. Neither of them mentioned the traumatic situations they had endured, neither of them was able to set up a social network in which their problems could be discussed confidentially. They were unable to support each other, had no friends or acquaintances who were able to do so. If we pay attention to the fact that the mental health of the PTSD sufferer is in line with the mental health of his partner, it becomes crystal clear that both were in urgent need of professional support. However, there was no professional support – aimed at Post-Traumatic Stress Disorder – in the first decades after WWII. Even today, it appears that – despite the demonstrated importance of non-professional care by partners and others – this important source of care is still largely ignored when setting up and developing aftercare for persons who have undergone stressful circumstances.

Relationship between PTSD and other bio-psychosocial health aspects

Research has shown that PTSD symptoms are strongly linked to other aspects of health. That is why PTSD cannot be seen separately from the overall health condition.

Predictors of PTSD symptoms

There are two background data that have a significant predictive value for both PTSD symptoms and bio-psychosocial health. This background information is:

  • 1. life’s problems;
  • 2. the presence of domestic problems during deployment or captivity.

 

Remark

When the partner relationship was also included as a predictor in the study, it turned out that – as far as domestic problems were concerned – this relationship functioned better as a ‘predictor’ than the presence of domestic problems. In fact, the contribution of home circumstances was no longer significant, while the partner relationship turned out to be the strongest predictor.

Personal experiences

In the post-war years, the years of reconstruction, it was not easy for our family to make ends meet financially. That put pressure on the quality of the relationship between both my parents and on the relationships between the children and our parents. It also affected the health status of father and mother. This influence on health and therefore on the more frequent occurrence of PTSD symptoms was also evident from studies that showed that the partners of deployed soldiers had more health problems than among the soldiers themselves.
My father’s tantrums and the related growing anxiety and insecurity associated with my mother’s declining health were recognized by me in the findings of research into the connection between physical, psychological and relationship scales of military personnel and partners. The research showed that the PTSD index is related to the partner’s aggression. The highest scores on the aggression scale were found among interviewed soldiers with a high PTSD score. There appear to be strong connections between the life events experienced by the soldier (father) and the aggression experienced by the soldier’s partner (mother).

Conclusions from the research

In relation to my personal experiences as a result of PTSD in both my parents, I mainly recognize the conclusions from the research:

  • 1. the finding that the presence of more PTSD symptoms is associated with a clearly increased risk of physical, psychological, social and relational problems;
  • 2. the distinction that needs to be made between the four clusters of PTSD symptoms, namely: reexperiencing, avoidance, dysphoria and hyper-arousal.

Note :
Dysphoria = loss of interest or pleasure in all or almost all activities, accompanied by depression, sadness, sadness, dejection, hopelessness, feeling down, not being cheerful;
Hyper-arousal = excessive reaction to unexpected events, feelings of being threatened, difficulty or inability to sleep, irritability, fits of anger, difficulty concentrating, feeling constantly on guard or having the feeling of being constantly threatened from all sides.

  • 3. the fact that previous life events and domestic problems contribute to the presence of PTSD symptoms and poorer health after these experiences;
  • 4. the relatively poor health status of the partners of deployed soldiers. The percentage of high scores on the PTSD scales for the partner turned out to be twice as high as for the soldier himself.

 

Recommendations from UB4M

Finally, related to what my parents experienced, I would like to end with some of these recommendations.

  • Guidance and support are more appropriate than trauma treatment for the PTSD symptoms observed. An important part of this guidance/support is to gain timely insight into the risk of PTSD symptoms or the fact that they already exist;
  • More guidance and support should be offered to the partners of soldiers, perhaps even more than to the soldiers themselves.
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