-Ibrahim Suleiman, Ph.D
“I was over the whole situation but something worse came. I could not sleep most nights, I had nightmares and I lived in fear that I might be abducted again.” –Yagana Mustapha.
“I didn’t want to continue studying because I was feeling unsafe in a schooling environment.” –Joy Bishara.
These were the words of survivors of the Dapchi and Chibok abductions, Yagana Mustapha and Joy Bishara respectively. Their words narrate the distress resulting from their traumatic “Boko haram” encounter. If such traumatic feelings are not addressed, they can eventually lead to severe illnesses such as depression, anxiety and post-traumatic stress disorder (PTSD). It can also lead to low self-esteem, poor performance, and suicidal tendencies.
Nigeria has been experiencing an unprecedented rise in incessant terrorist attacks, insurgency, kidnapping, and banditry. PTSD is a common psychological consequence of experiencing or witnessing such traumatic events.
Post-traumatic stress disorder can occur at any point in an individual’s life. It is commonly caused by exposure to or witnessing severe life-threatening or traumatic events during childhood or adulthood. These traumatic events may include the act of terrorism, banditry, road travel accidents, physical assault, political and ethno-religious violence, sexual or emotional abuse, debilitating illness and death of a loved one.
PTSD is a global mental health concern whose severity is influenced by the magnitude and frequency of traumatic events. In addition, an individual’s sensitivity to impeding stressors could determine the severity of the disorder. Some people present with acute and intermittent symptoms while others present with chronic and persistent symptoms of PTSD.
Not everyone exposed to trauma will develop PTSD. Adjusting and coping with traumatic experiences could be difficult sometime. Most people often get better with time and good self-care. If the symptoms progress, and last for months or even years or interfere with your normal day-to-day functioning, it implies that someone is likely having PTSD.
Symptoms can vary over time or vary from person to person. Symptoms of PTSD could include unwanted distressing memories of a past traumatic event, having flashbacks (as if it is all happening again), nightmares, trouble sleeping, depression, severe anxiety, becoming emotionally distressed by anything that reminds you of your previous traumatic experience, as well as uncontrollable thoughts about past events.
People with PTSD may embrace the act of avoidance, they avoid thinking or talking about a past traumatic event, and they avoid places, activities or people that remind them of the traumatic event. Although avoidance may keep someone away from triggers of PTSD, it does not rule out the chances of having emotional distress and absurd physical reaction when exposed to memories of past traumatic experiences.
In some cases, negative thought encroaches. Victims of some traumatic events develop the feeling of hopelessness about the future, detachment from family and friends, disliking previously enjoyed activities, finding it difficult to experience positive emotions, becoming easily startled or frightened, developing aggressive behaviour, often getting angry and persistently being on the guard for danger even when in a very peaceful environment. Some people may adopt self-destructive lifestyles like heavy alcohol intoxication, overspeeding when driving, and hard drug abuse.
Certain risk factors increase one’s chances of developing PTSD after a traumatic event. Some of these factors include age, gender, marital status, educational level, religious belief, ethnicity, occupation, and average monthly income.
The risk of PTSD is highest among middle-aged women, while older adults who survived catastrophic events are considered to be particularly susceptible to developing PTSD.
Other risk factors include previous traumatic experience, family history of psychiatric disorder(s), nature of the impeding trauma, availability of someone to talk with following a traumatic incidence, access to healthcare, social response to victims of traumatic events (e.g. social stigmatization of rape victims).
The prevalence of PTSD due to man-made disaster-induced (such as banditry) is placed at around 27%. A study on PSTD among internally displaced persons (IDPs) in Nigeria has identified low monthly income and non-availability of someone to talk to about life-threatening experiences from “Boko Haram insurgency” as the strongest influencers of PTSD among the IDPs.
There is no direct or inverse relationship between marital status and PTSD. The role of marital status in the development of PTSD has been inconsistent.
After surviving a traumatic event, it is common for victims to develop PTSD-like symptoms at first. These include continuously thinking about the traumatic event, fear of reoccurrence, anxiety, anger, depression, and sometimes guilt. However, these feelings are usually short-lived normal stress reactions.
To prevent these normal stress reactions from getting worse and developing into PTSD, it is advisable to seek help early enough. The simple courtesy of listening and provision of comfort by family and friends will make a big difference. For some people turning to their faith community could also prove helpful.
It is recommended that you see a physician, psychologist or mental health professional if you are having trouble getting your life back under control or experiencing symptoms and disturbing thoughts about a traumatic event for more than a month. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
Our culture and tradition are yet to fully recognize the existence of some mental health abnormalities including PTSD. This calls for increased awareness, victim sensitization, screening, and early identification of PTSD which may otherwise go undiagnosed and untreated.
Ibrahim Suleiman Ph.D is a Senior Lecturer of the Faculty of Medical Sciences, University of The West Indies, Barbados
ibrahim.sulaiman@cavehill.uwi.edu
