Experiencing or witnessing a life-threatening event, natural disaster, serious accident or violent personal assault can lead to post-traumatic stress disorder but in Malta few seek help.

"Many people who go through a traumatic experience sometimes shrug off the moment and think they can work it out on their own. In Malta we see traumatic events happening, but the majority don't seek help," Edward Curmi, clinical and community psychologist, said.

"Once they realise there is help out there they find it comforting to find an explanation for their change in behaviour.

"What people need to understand is that the impact of the trauma changes our basic beliefs in life. The image we had of security and safety is shattered. A traumatic incident occurs suddenly and without warning, so it doesn't give the person time to adjust."

A traumatic incident can lead to flashbacks, irritability, anger, the loss of interest in life, the experience of distressing physical reactions such as a faster heart beat, difficulty sleeping or being easily startled, among other symptoms.

Dott. Curmi, who earned his degree in Italy, explained that though there was no definitive treatment or cure for PTSD, some treatments, especially cognitive-behavioural therapy among others, were promising.

Not everybody who endures a traumatic event will go through PTSD; it all depends on the person's coping skills.

Available data suggests that about eight per cent of men and 20 per cent of women go on to develop PTSD; and roughly 30 per cent of these individuals develop a chronic form that persists through their lifetime.

"The fact that women seem more prone to PTSD could be due to the fact that they are more in touch with their emotions, while men seem to hide their feelings," Dott. Curmi said.

There are four types of PTSD. These include:

Acute stress disorder begins within four weeks of the traumatic event and lasts at least two days.

If these same symptoms persist for more than four weeks, the diagnosis is changed to acute PTSD.

While acute stress disorder presents itself within four weeks, PTSD can begin much later, even years after the trauma, as delayed-onset PTSD.

After a period of 90 days of PTSD symptoms, the diagnosis changes again to chronic PTSD.

Dott. Curmi said that if people had faced death in the face or people had died, they tended to hold on to the memory of the trauma to ensure they never got into that situation again.

"A lot of people are wracked with the guilt that they could have done more in the situation. It is important for them to realise that these reactions are common following trauma and they are not signs of 'weakness' or 'cracking up'," he said.

Post-trauma dos and don'ts

People who have experienced a traumatic event often demonstrate changes in behaviour. These suggestions reduce the probability of long-term stress reactions.

Dos
¤ Do get enough rest

¤ Do maintain a good diet and exercise programme

¤ Do follow a familiar routine

¤ Do find time with family and friends

¤ Do take time for leisure activities

¤ Do expect the experience to bother you

Don'ts
¤ Don't increase caffeine intake

¤ Don't drink alcohol excessively

¤ Don't make unnecessary changes

¤ Don't stay away from work

¤ Don't withdraw from significant others

¤ Don't give up enjoyable hobbies or activities

¤ Don't take on new major projects

¤ Don't look for easy answers

¤ Don't pretend that everything is okay

¤ Don't use drugs or alcohol to numb feelings

¤ Don't avoid opportunities to talk or learn about post-traumatic stress

¤ Don't have unrealistic expectations for recovery

ecurmi@onvol.net