The nightmare that is PTSD

In the past few years, the term, ‘Post Traumatic Stress Disorder’ has become a household term. Mental health awareness campaigns have succeeded in educating the general public about the effects of trauma on the mind, so much so that I recently saw an article titled ‘Financial PTSD’.  Which one is Financial PTSD kuma?  You people […]

In the past few years, the term, ‘Post Traumatic Stress Disorder’ has become a household term. Mental health awareness campaigns have succeeded in educating the general public about the effects of trauma on the mind, so much so that I recently saw an article titled ‘Financial PTSD’. 

Which one is Financial PTSD kuma?  You people play too much. 

We know that life or body-threatening traumatic events like kidnapping, attacks by gunmen or flooding disasters can injure the brain, but such injuries are not like bullets ripping through organs. When bullet meets flesh injury, even death is inevitable. In contrast, traumatic events yield many outcomes. Most adapt, some thrive, but some, about 20 per cent or so, are torn apart and never recover. Many end in suicide. This relationship between traumatic growth (resilience) and a traumatic stress disorder is extraordinarily complex in aggregate, and as any clinician who works with traumatised patients will attest, more so for any individual. Of course, risk and reliance factors influence outcome, but no clear answers exist on why one person thrives while someone else suffers.

A few years ago, a young woman was referred to me. I cannot remember who and why she was referred to me, except that it was probably one of the many favours we do for friends and family. Funnily enough, I may forget a patient’s face, name or referral, but I never forget their diagnosis. And I never forget the stories.

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The twenty-four-year-old girl had the characteristic depressive facie – sad face, downcast eyes and fidgety hands. In my mind, I was already like ‘Oooo! Not today! I have a lot of work to do.’

On my face, however, was plastered a warm smile. ‘So, what brings you to the hospital today?’

I think I should try Nollywood if this medicine thing does not work.

She spoke in very low tones, depicting lack of sleep, nightmares and episodes of excessive fear. Sometimes her heartbeat was so fast that she felt it would burst out of her chest. She had severe excruciating headaches that made her body go numb. Her mouth would go dry, and diarrhoea had become the order of the day. She also had sweating episodes.

I thought of two things – a thyroid disorder or an anxiety illness.

“When did these symptoms start?” I enquired. “Six weeks prior,” she answered.

As I documented my findings, I asked offhandedly, “Was there any event that occurred in your life around that time?”

It was so slight; I could have missed the nodding of her head. Her eyes clouded with tears.

The young woman worked for an international non-governmental organisation, which typically required travelling. As a junior staff, her travel was limited to cities and local government areas. Three months prior, she travelled to Zaria for work with colleagues.

At the field, one of her superiors asked her to work on a project that had to be submitted that very day. Beating the deadline, the young woman approached her boss to show him the document, but he quickly dismissed her and asked her to return later.

Back at her hotel room, around 7pm he called and asked for the report. The naïve young woman went and knocked on his door with her laptop. After all, they had worked together for two years, and the man, who was in his forties, was like a father to her. Her boss invited her in so that he could go over the report. Then he offered her a drink.

At this point, the poor girl was crying, heavy, gut-wrenching sobs while I just sat there full of hatred for a man I have never met before.

The drink immobilised her but did not sedate her, which meant that she was aware of all he was doing to her but could not fight back. Later, he escorted her back to her room.

In the morning, after crying herself hoarse, she took the bold step to tell her line manager. The manager, a formidable woman in her fifties, swiftly set up an investigative panel and sent the girl to the hospital. There, evidence of sexual encounter was confirmed. She was also placed on medication to prevent pregnancy and sexually transmitted infections. The closed-circuit television (CCTV) in the hotel showed her entering his room and being escorted out. Further investigation later showed that he had Diazepam hidden somewhere in his bags.

One month later, the 44-year-old father of four was dismissed from the organisation. I wonder what he would tell his wife.

As is typical in these cases, the young woman decided not to press charges so as not to draw attention to herself. But then, her mind had not forgotten.

Two weeks later, her symptoms started. She was almost going crazy with fear and lack of sleep. What was worse was that she had not told her parents, fearing their reactions. A usually social person, she had completely withdrawn from her family, friends and fiancé. The poor man was worried when she stopped picking his calls.

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that an individual may develop after seeing or experiencing a dangerous event, such as physical injury or severe mental and emotional distress. In the face of imminent danger, the fear response is triggered, alerting the body to prepare for, defend or avoid the danger.  This ‘fight-or-flight’ response is a normal reaction that primes the body to protect itself from harm. Over time, however, this reaction to fear is changed or damaged in sufferers of PTSD, rendering them hypersensitive to stress and fear, even when they are no longer in danger.

Given this, it comes as no surprise that those who have experienced military combat, violent assault, natural disasters or life-threatening events are at a higher risk in developing PTSD.

What began as an ordinary consultation quickly turned into a multi-disciplinary meeting with the psychiatrist, counsellor, Obgyn and her manager in attendance. She was placed on medication and advised to confide in someone.

Over the next few months, the young woman went from bad to worse. On some days, she would come in and cry for hours, on other days, she would be mute and spend the entire day quietly shedding tears. She confessed to feeling dirty and angry with herself for her naivety.  She lost a lot of weight and became a shadow of herself. Her dreams were plagued with flashbacks of the rape and she had stopped going to work altogether. 

Finally, after almost a year without improvement, the psychiatrist admitted her for ‘depression’ as her parents were under the illusion that their daughter was possessed by evil spirits. She refused to tell them her story. As for her fiancé, the wedding had since been postponed indefinitely.  

That young woman spent four months in the hospital wards and was said to be making slow improvement, when one day, I received a call from one of the nurses – the patient had died. “Why? What happened?”

“We don’t know, doctor, but it is probably for the best; that girl was in so much pain.”

I know; but like my people say, e heavy for mouth.