Dear Doc

I have had some problems in my life and lost a lot of loved ones. For the past few years I have felt depressed and even been self-harming myself. Also at times I just can't control myself, I'm always yelling or something. I have looked up a few things about self-harm and stress problems and they say it may be a sign of PTSD, but how do I know for sure and tell my mom.

Laina, 15

When you lose a loved one it can be a traumatic experience. The pain can seem unbearable and it can take a long time to get over it. That’s especially true when you’re going through puberty and trying to come to terms with who you are.

It certainly sounds as if you’re having difficulty coping. But you have realised that getting angry, losing control, yelling and harming yourself is not the answer.

You’ve shown great maturity by writing to me. The next thing to do is to tell your mum – this is not something you should deal with alone. If you find it difficult to tell her, try speaking to another adult you trust or your doctor. Your doctor will be able to refer you to a therapist or counsellor.

PTSD

Post-traumatic stress disorder (PTSD) is a very strong anxiety reaction to a traumatic event – any experience that is overwhelming, frightening, out of our control and possibly life threatening.

For example, PTSD can be triggered by seeing a car crash or being the victim of an act of violence.

You don’t even have to be hurt by the experience; in some cases even hearing about the event may be enough to trigger PTSD.

Symptoms

When someone is suffering PTSD they usually experience some or all of the following symptoms, usually within three months of the traumatic event. The symptoms may continue for long after:

• Reliving the event through nightmares and/or flashbacks (these are memories of the event that feel like it’s happening again right now), and thoughts or images that seem to come out of nowhere.
• Avoiding reminders of the event by not talking about what happened and avoiding people, places, or activities that remind them of it
• Being emotionally numb; feeling detached and/or feeling differently about themselves or other people than they did before the event
• Being tense and nervous and getting easily startled and irritated – they may have difficulty concentrating and sleeping

These symptoms can be very distressing and can even make people worry that they might be ‘going mad’. It is important to know that you aren’t. And remember that treatment for PTSD is very successful.

Helping yourself

Whether or not you have these symptoms, it sounds like you are struggling with strong emotions. There is a lot you can do to help yourself.

To start, it would be good to try and understand what triggers your anger and self-harming. You could try writing down answers to questions like: When did they happen? Who were you with? How did it make you feel before and after?

Doing this will help you understand the triggers, which you can watch for in future. Then you can ask for help when you spot them happening.

And if you ever feel the urge to self-harm, imagine it was someone else about to harm you – you wouldn’t let them. So don’t let yourself do it. Instead, call a friend and talk it through. Always try to be gentle with yourself.

Appropriate reactions

Obviously there will be times when you feel angry or frustrated. These are reasonable and valid emotions. But they shouldn’t be expressed in a way that is harmful to yourself or others.

When you feel yourself getting triggered you could try any of these things until you feel the emotion go:

• Take lots of long, slow, deep breaths
• Count slowly from ten to zero
• Go for a walk
• Think of something you like
• Excuse yourself and get away
• Phone a friend and talk it through

Lift your mood

Whenever you feel sad, low or down you could try getting a pen and paper and finishing the sentence ‘I’m glad I’m not…’ five times.

It could help to take some time to think about the things that are good in your life. At the end of every day write a list of all the good things that have happened.

If that feels too much like homework you could try just thinking about the good things last thing at night.

Of course, life can be tough. It tests us. It’s how we deal with the challenges and difficulties that we encounter that shapes us and make us who we are. Just remember that there is no problem that is too big to overcome.

For more help and information...

• ChildLine are there to listen to any problems you have and will try to help you sort them out. They run a confidential 24-hour helpline for children and young people. Call 0800 1111 or visit their website.
• For more help and advice on coping with PTSD ask your doctor or visit some of the factsheets and information on the website of the Royal College of Psychiatrists.
• The National Self-Harm Network has lots of very useful information on their website.

Last reviewed by Great Ormond Street Hospital: 24 November 2008

What are these?Bookmark with:
Delicious   |   Digg   |   Facebook   |   reddit   |   StumbleUpon

Copyright © Great Ormond Street Hospital