“ In other words, loneliness is something I've never been bothered with because I've always had this terrible itch for solitude. It's being at a party, or at a stadium full of people cheering for something, that I might feel loneliness. I'll quote Ibsen, "The strongest men are the most alone." I've never thought, "Well, some beautiful blonde will come in here and give me a fuck-job, rub my balls, and I'll feel good." No, that won't help. You know the typical crowd, "Wow, it's Friday night, what are you going to do? Just sit there?" Well, yeah. Because there's nothing out there. It's stupidity. Stupid people mingling with stupid people. Let them stupidify themselves. I've never been bothered with the need to rush out into the night”
—Charles Bukowski“Before you begin to write a sentence, imagine the scene you want to paint with your words. Imagine that you are the character and feel what the character feels. Smell what the character smells, and hear with that character’s ears. For an instant, before you begin to write, see and feel what you want the reader to see and feel.”
—Othello Bach
Post-Traumatic Stress Disorder
Also called “PTSD” and, formerly, “shell-shock”
What is it?
PTSD is a mental disorder resulting from a traumatic event such as a natural disaster, abuse, and seeing combat. While fear is a natural response to an alarming or uncontrollable situation, PTSD is fear even when that situation has stopped or been resolved.
Who gets it?
PTSD affects people of every race, age, and societal standing, but not everyone exposed to a traumatic situation contracts it. You are more likely to develop PTSD if you have a history of mental illness, few family and friends, watch someone else get hurt or killed during the event, disapprove of your actions during the event, and/or deal with extra stress afterwards like the loss of a job. Conversely, people who have a large support network and/or approve of their actions during the event.
What are the symptoms?
Re-experiencing Symptoms
- Having uncontrollable flashbacks to the traumatic event
- Bad dreams
- Uncontrollable negative or frightening thoughts (other than those about the event)
Avoidance Symptoms
- Staying away from place, objects, or situations that remind you of the event (for example, someone in a plane crash might refuse to fly)
- Feeling emotionally numb, strong guilt, depression, and chronic worry
- Hopelessness about the future
- Trouble concentrating
Hyper-arousal Symptoms
- Being easily startled
- Feeling tense or edgy
- Having difficulty sleeping and/or angry outbursts
What are the symptoms in children?
Very young children (>5 years old) temporarily forget how to talk, wet the bed, and/or attach themselves excessively to a parent or guardian. They may become extremely nervous or unreasonable if the parent/guardian is not present. Children (6-12 years old) act out the scary event during playtime, have nightmares, have difficulty making or keeping friends, and/or become more aggressive and edgy. Teenagers experience mostly the same symptoms as adults. They sometimes seek revenge for those they believe responsible.
When do the symptoms appear?
The symptoms of PTSD can occur immediately or months after the event.
What treatment is available?
There are two main types: psychotherapy (“talking” therapy) and medication. Psychotherapy attempts to remove the fear from the situation by re-experiencing it or talking about it. One method is exposure therapy, where the person is slowly acclimatized to stimuli that remind them of the event. Another is cognitive therapy, where the therapist and patient work to construct a rational reconstruction of the event (especially effective with people who feel guilt or shame about the event). The last common form of psychotherapy is teaching people how to calm their anxiety and fear; treating the emotions associated rather than attempting to puzzle through the event.
Zoloft and Paxil are the two medications most commonly prescribed to PTSD sufferers. They are anti-depressants, and come with the associated side effects (suicidal thoughts, nausea, agitation, reduced sex drive). Most people choose a combination of medication and counseling.
How do I help someone else with PTSD?
Firstly, make sure they get the right diagnosis and treatment. Make sure they are safe and do not think about self-harm or suicide, which happens frequently in PTSD sufferers. Other than that, avoid talking about anything relating to the event, unless they bring it up first. If they do, listen to what they need to say. Offer continuous support and never give up on them. Having a friend or family member with PTSD can be extremely stressful for you. They weren’t the person you knew before. Instead, they’re more irritable, isolated, frightened, and angry. You may want to build a support group around the person or find a counselor or confidant for yourself if you feel stressed.
