In my early thirties I decided to get involved with a local soccer team. On my first training run, confident in the knowledge of how fit I used to be, I had a cursory warm up and started kicking the ball around with my new team mates. Within 20 minutes I had torn my calf muscle. I played on for a while that day, numbed by the adrenalin, and not realizing the seriousness of the injury. Afterwards I could still walk slowly, but any sudden movements and running were out of the question. When I later consulted my physiotherapist she said my muscles may never be as strong again, but with the right rehabilitation I could get back on the field.
Post Traumatic Stress Disorder is the mental health condition most like an injury. It can result from single or multiple traumatic events, and places significant limits on normal functioning, although not always right away. Certain experiences will trigger the mental pain of anxiety and anger. Many will try to kill this pain by self-medicating with alcohol and drugs, but this does not repair the damage. The traumatized live in fear of re-injury, and avoid situations they associate with their trauma. But it’s never enough to feel safe, and their lives narrow. Depression may follow.
A debilitating mental injury is a bad break for anyone, but for highly trained members of the military, emergency services and other high-risk occupations, their being confined to the bench can be a shaming experience. We may feel only sympathy for an elite athlete who suffers a career-limiting injury, but those impacted by post-traumatic stress fear being stigmatized as weak and unworthy. Attitudes towards mental illness and injury remain negative compared to their physical counter-parts.
Rehabilitation for physical injury is a gradual process, slowly building the strength and flexibility of muscles, and psychological treatment for PTSD usually proceeds in a similar way. For trauma survivors this involves slowly building confidence – confidence that they can face the memory and reminders of their trauma without suffering harm. Jumping straight in at the deep end is often too much too soon, but to hide away at home will only result in atrophy. Gradually facing fears is necessary if they want to get back on their feet, and then one day take to the field again.
People routinely seek help from physiotherapists, doctors and other health professionals for physical injury. It is my hope that greater awareness of PTSD as a kind of mental injury will make accessing treatment for this debilitating but treatable condition just as routine.