Healing mental scars

By Lin Kan Hsuan Source:Global Times Published: 2014-3-11 18:53:01

PTSD patients who seek help immediately after a traumatic experience have a greater chance of recovering from their disorder sooner. Photo: Li Hao/GT

Nearly two weeks have passed since the March 1 Kunming Railway Station terrorist attack that left 33 people dead and 143 others injured, but the horror is still fresh in Patricia Xia's (pseudonym) mind. The university student was waiting in line at the station to buy a train ticket to her hometown of Wuhan, Hubei Province, when a gang of up to 10 knife-wielding assailants stormed the station and randomly stabbed commuters.

Xia was separated from her friend during the frenzy as she fled the station, running three blocks away. Xia remained paralyzed by fear even after police shot dead five of the terrorists, but forced herself to return to the station to search for her friend.

It wasn't until the following morning that Xia discovered her friend had also thankfully survived. Although both were physically unscathed, Xia and her friend continue to suffer mental anguish like many survivors.

Need for early intervention

Experts warn that some survivors of the Kunming terrorist attack are likely to suffer post-traumatic stress disorder (PTSD), a debilitating mental condition that follows experiencing or witnessing a terrifying event. A team of mental health professionals from the Yunnan Provincial Psychological Society began assessing survivors shortly after the attack for early symptoms of PTSD, including increased anxiety, nightmares and hyper vigilance.

Zheng Yi, vice president of the Beijing Anding Hospital in Xicheng district, dispatched a team of four psychiatrists to Kunming on March 2.

"Doctors help PTSD patients to relax through progressive muscle relaxation, eye movement desensitization and reprocessing, and stress-coping mechanisms. They will prescribe medication if necessary, but only as a subsidiary treatment," he added.

In China, PTSD first gained widespread recognition after the 2008 Wenchuan earthquake in Sichuan Province that left more than 85,000 dead or missing. Zheng, 56, led a team of 30 mental health specialists sent to the disaster zone after the quake.

One of the most publicized PTSD cases after the Wenchuan earthquake was the suicide of Dong Yufei, a local agriculture commission director who hanged himself in a farmhouse five months after the disaster.

Dong, 40, lost his 12-year-old son and other relatives in the quake. Even though he seemed unburdened by personal grief while helping soldiers recover bodies from the rubble, he was in a fragile mental state. "No one discovered that he had sunk into a state of numbness, which is a psychological mechanism to avoid crumbling after experiencing trauma," Zheng said.

Rob Blinn, director of the Psychological Health Center at Beijing United Family Hospital, noted China has made "huge advances in treatment of PTSD" since the Wenchuan earthquake.

"Most Chinese mental health professionals I know are very much aware of the need for intervention. The response after Wenchuan and Yushu [landslide in 2010] was huge," he said. "The vast majority of people impacted by trauma don't develop PTSD, but there is a human need to grieve that crosses every culture and belief system."

PTSD patients who shun treatment and seek comfort by drinking alcohol only worsen their condition. Photo: IC

Long road to recovery

Women are more vulnerable to PTSD not only because "men tend to conceal their feelings more," but because women are more often victims of domestic violence and sexual assault, said Zheng. "However, the odds of men suffering PTSD are almost equal to women based on clinical cases," he said, adding it was a condition that "can't be neglected or underestimated."

Song Zhenzhu, a psychiatrist at Qiqihar Hospital in Northeast China's Heilongjiang Province, said besides natural disasters and human-inflicted trauma, there are other factors that can cause PTSD. "Incidences of PTSD vary among individuals, but the diagnostic basis is a sudden event that traumatizes people who lack adequate time or support to adjust themselves before resuming normal life," said Song.

Younger people are among the most at-risk group for PTSD, said Song, who has treated two 14-year-old girls for the condition.

"The first girl witnessed her grandfather's death in a car accident. She suffered speech and writing defects for several months," Song said. "The second girl had been raped by her neighbor. Her family noticed something odd in her behavior, and the girl was able to indirectly describe what happened and eventually receive treatment."

Timely diagnosis and treatment are crucial to put victims on the path to recovery as soon as possible. Even though it can feel natural to suppress painful memories, Song said it is important to communicate and confront negative emotions.

"A positive prognosis can be achieved if patients are able to express how they feel soon after their traumatic experience. Around 90 percent of these patients successfully recover," said Song.

Women are about twice as likely as men to experience PTSD. Photo: IC

Living with PTSD

All doctors interviewed by Metropolitan declined to refer PTSD victims for this story, citing the possible negative impact it could have on their recovery.

"Most [PTSD patients] recover from their mental torture, but asking them to recall their traumatic experience can reopen old wounds," said Zheng.

Former PTSD patient Kate Lam (pseudonym) agreed to speak to Metropolitan about her struggle with the condition in the hope that "more people suffering mental anguish will seek help sooner."

During her childhood, Lam witnessed regular arguments between her parents that often turned violent.

"Each day I returned home from school I would sit on the porch wondering if there would be another fight that night," Lam, 30, told Metropolitan in a phone interview from her native Hong Kong. "I shared my bedroom with my younger brother. I felt responsible for comforting him because our parents were incapable of caring for us."

Lam said her grades at school suffered due to her traumatic home life that left her feeling "overwhelmed with anxiety."

She was never physically abused, but memories of her parents' dysfunctional relationship have influenced Lam's own ability to maintain intimate relationships.

"Sometimes when my father was out of his mind he would threaten to stab himself," she recalled. "Although I've taken medication regularly and spent a lot of money on therapy, I still feel vigilant about even trivial matters."

Lam was diagnosed with PTSD at 19 by a psychiatrist she saw after suffering sleep problems and flashbacks of her father threatening to stab himself. Lam refuses to cook at home, citing her fear of holding knives. Her nervous temperament has turned her life into an emotional roller coaster, with mood swings a common occurrence.

"My traumatic past is deeply rooted in my mind. I still have a long way to go [in recovery]," she said. 

Low public awareness

There are no statistics about PTSD in China available from health authorities, but the US Department of Veteran Affairs puts the estimated prevalence of lifetime PTSD at 7.8 percent of the general population.

"There are factors that make some people more likely than others to develop PTSD after experiencing trauma. Those who have a family history of mental disorders are more likely to suffer PTSD," said Song.

However, there are some positives for people who beat the condition. Zheng noted that those who conquer the disorder are often more resilient for their experience.

"When patients are able to overcome difficulties, they grow to be more adaptable to various situations and better at communicating negative feelings," he said.

Even though survivors are still coming to grips with trauma of the Kunming terrorist attack, Xia holds hope for a brighter future and plans to visit the city again in future.

"I hope my friend [who survived the Kunming attack] can regain her inner peace as soon as possible," Xia posted on her Weibo account on March 3.

Meanwhile, a fresh tragedy has put mental health specialists in China on high alert. The Beijing-bound Malaysia Airlines jet with 154 Chinese passengers that went missing on March 8 has thrust PTSD in the spotlight again. Relatives of those missing aren't the only ones traumatized by the news, but Blinn warned too much exposure to media coverage of the disaster can "exacerbate reactions."

"It is good to recognize that most people experience some level of increased anxiety after something like this, but if we aren't immediately involved we need to take breaks from media coverage," he said.

Posted in: Metro Beijing

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