A traumatic neurosis is also called a post-traumatic stress disorder. Oppenheim already described this syndrome in 1889. In 2001 it was discussed in detail in the DSM IV. The cause can be found in a stressful event that is experienced as life-threatening. This includes violence against oneself, partner or children, destruction of the home or experiencing an accident in which someone is seriously injured or killed. Symptoms of traumatic neurosis do not appear for several days to several weeks. This is followed by a delayed startle response. Treatment is often necessary. In a number of cases the complaints do not disappear.
What is a traumatic neurosis?
Hermann Oppenheim first discussed traumatic neurosis in 1889. Oppenheim was a German neurologist who lived from 1857 to 1919. He attributed the symptoms of traumatic neurosis to a traumatic experience. He also stated that traumatic neurosis should be seen as an independent disease with a traumatic experience as its cause.
But what do the words trauma and neurosis actually mean? Trauma means ‘injury’. We are often talking about a physical injury, damage to tissue. But we also know about psychological injury or damage. This is called psychotrauma. Psychotrauma stands for psychological injury that occurs after a traumatic event. The word neurosis means ‘disorder of the nervous system’. With a neurosis there is no psychosis or psychological damage. There is also no physical cause. A neurosis arises from emotional problems.
The term traumatic neurosis was later replaced by the term posttraumatic stress disorder . In 2001 it was described in the DSM IV-TR (text version). DSM stands for Diagnostic and Statistical Manual of Mental Disorders and is an American medical manual used in psychiatric diagnosis. An important characteristic described was ‘intense fear, helplessness or horror’ in the patient, who witnessed or was a victim of a life-threatening situation.
Causes
A traumatic neurosis does not just arise. Often it concerns a life-threatening event that occurs, and from which people are shocked. In many cases, after a serious situation, the person has to recover from the shock. This is accompanied by trembling and sweating, but also by palpitations. This quickly goes away when we can talk about it or process it. In the case of a traumatic neurosis, the cause is not only the life-threatening or very traumatic event, but also the inability or inability to cope with it.
Symptoms
The first symptoms occur a few days to a few weeks after the event. It is therefore not the case that trembling or perspiring immediately after the event is a traumatic neurosis, but a normal reaction of the body. No, with a traumatic neurosis the symptoms do not occur for several days before they occur. To the outside world the entire incident seems forgotten, but for the patient the misery only begins.
A delayed startle response occurs. This manifests itself through perspiration (sweating), shaking and reliving the event. This time a strong fear is felt while reliving. The re-experience is also compulsively undergone: it cannot be stopped. The thoughts arise involuntarily.
Other symptoms include being startled by sounds that normally do not frighten or frighten. This makes people feel rushed and anxious. This concerns sounds that occur unexpectedly, such as a car honking or a door closing.
Many patients experience sleep disorders. They have trouble falling asleep or wake up often. Nightmares about the event also occur repeatedly. This causes exhaustion, loss of concentration and fatigue during the day. This only fuels the feeling of being rushed.
Attacks of anxiety can also occur. There is great fear here without there being a threatening situation. On the other hand, panic attacks can also occur. These are accompanied by rapid and shallow breathing, palpitations and anxiety. Patients in panic no longer have an eye for reality. In some patients, attacks of aggression occur. These can occur suddenly.
Therapy
The symptoms wear off again after some time, eventually disappearing completely. Sometimes psychotherapy is necessary. The main thing is that the patient tells what happened. Feelings and thoughts are relived and discussed. The message is to talk a lot. This is done under the guidance of a psychotherapist.
For a number of patients, approximately one third, psychotherapy does not work sufficiently. The traumatic event was so serious or left such an impact that the patient has difficulty coping with it. The symptoms then remain present for years, sometimes even for life. This ensures that the patient can no longer function normally within society. It is therefore important to process a traumatic event as quickly as possible. This sometimes prevents a traumatic neurosis or post-traumatic stress disorder. In the Netherlands, victim assistance is therefore offered when a serious event occurs. Victims are given the opportunity to talk about the event and can always turn to them for help later.
