Enquiries to the Priory about treatment for posttraumatic stress disorder have risen sharply as an increasing number of people experience the condition amid the stresses of the Covid pandemic.
There’s been a 50% increase in the number of people contacting Priory mental health services for private treatment for PTSD in 2021 compared to before the pandemic in 2019, Priory data shows.
A number of patients have experienced PTSD as a result of being referred to hospital for severe Covid – and in some cases being put on ventilators or being treated in wards where other patients have died. Others who have been working on the health frontline have also experienced symptoms; doctors have recently referred to the stress of treating unvaccinated people dying of Covid after a rapid deterioration, while concerns rise about the growing number of pregnant women with the virus needing the most serious treatment in critical care.
Priory consultant psychiatrist Dr Paul McLaren, a member of the International Society for Traumatic Stress Studies, said he had seen an increasing number of people with psychological symptoms directly related to the Covid pandemic.
‘Psychological trauma from the COVID-19 pandemic and illness is having an effect. Many have been experiencing anxiety and depression, or are struggling with substance misuse. Others are struggling with symptoms of PTSD. Many of these are people who have closely experienced the COVID-19 illness, including people who have contracted the virus and become unwell themselves, or who have lost loved ones. Those in front-line services are also faced with the trauma of losing patients under their care.’
He said people may have experienced a profound sense of anxiety and a feeling of being constantly in danger (hypervigilance). They may also re-experience the trauma, through flashbacks or nightmares. It is common for people with trauma-related symptoms to have sleeping difficulties such as insomnia as well as symptoms of generalised anxiety and depression.
Dr McLaren said he had treated patients who had suffered ‘horrific and sometimes bizarre visions’ during treatment in intensive care units for Covid. ‘It can be really distressing. They have intrusive memories of their experiences of the delirium and the traumatic things they have seen in that state. This manifests itself in nightmares and flashbacks, in which they get memories of their hallucinations which can be very upsetting.’
Dr McLaren, of the Priory’s Hayes Grove Hospital, Kent and Priory’s Wellbeing Centres in London, said hallucinations were a ‘recognisable complication of intensive care’. He had treated one patient for PTSD who had spent a month on a ventilator. ‘Intensive care unit staff have long been aware of the risk of adverse psychological reactions to ICU treatment. The high risk times are when patients are waking up in preparation for coming off ventilation, or prior to discharge from an ICU.
‘Hallucinations are caused by an acute confusional state in that brain function gets disrupted very rapidly. That can be caused by a high temperature, dehydration or even sleep deprivation, or our immune response attacking the brain. With delirium, you get disorientated, confused about where you are and have visual hallucinations of varying complexity which can be deeply traumatising.’
Priory’s statistics provide evidence to indicate the significant levels of distress experienced across some of the population during the pandemic.
PTSD is a psychiatric condition caused by trauma, occurring after a particularly distressing event, such as military combat, terrorist attacks, natural disasters, violent assaults, or serious road accidents. PTSD also occurs after rape, sexual abuse, and emotional abuse.
Living with PTSD can have a significant impact on a person’s day-to-day life. If a person is diagnosed, alongside panic attacks and related symptoms, they will frequently relive the scenes in their mind, appearing as nightmares or flashbacks, which may be accompanied by feelings of loneliness, irritability, and sometimes guilt if they feel there was something they could have done to prevent the harrowing events from unfolding. If a diagnosis is confirmed, there are a number of treatments available. There are different types of medication that can be prescribed. Typically, the prescription of this medication is initiated and monitored initially by a psychiatrist.
There are also specific psychological interventions that can be offered such as trauma-focused cognitive behavioural therapy (TF-CBT) or eye movement desensitisation and reprocessing (EMDR) therapy.
PTSD can be successfully treated, even if the symptoms appear some time after the initial trauma, with the type of treatment depending on the severity of the symptoms and how soon they have appeared after the event.
Anyone concerned about PTSD symptoms, should discuss it with their GP, who can refer them to a specialist and other services including the Priory. Priory is part of MEDIAN which is participating in the management of patients who have experienced symptoms of Covid, and/or suffered with long Covid. It is sharing its knowledge and expertise globally via its information website for medical professionals and Covid/long Covid patients.
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