In the year after my father’s death, around 10 years ago, I started to have a vivid, recurring nightmare. In the dream, I’d wake up to find him standing passively at the foot of my bed. He had this way of holding himself, with his head tipped slightly to the right. He’d then walk slowly to where I was lying, put his hands around my throat and strangle me.
“Perhaps you were suffering with something called PTSD,” said an NHS-assigned counsellor when I mentioned the nightmares – just in passing – to her earlier this year. I was seeing her after a period of strange uneasiness, which had started last year and in which I felt disconnected and sad, like my life was wrong somehow. I dreaded the future and hated myself. I felt like a poison to other people. Beyond the fact that this thinking is distracting and depressing, it also makes you dull – lots of weeping and worrying that you’ve done and said the wrong thing. Lots of sitting alone in the dark. I didn’t want that any more. I was bored of it.
Until she mentioned it, I hadn’t connected any of this to my late father or the fast-approaching anniversary of his death. Post-traumatic stress disorder. It was just a suggestion, far gentler than a diagnosis, and I quite liked that. Nothing concrete. If I’m honest, it didn’t feel like an appropriate diagnosis for me because I’m not a war veteran or a refugee or the survivor of some natural disaster. But I was interested, in a removed, anthropological way, in what she had to say.
“It’s an anxiety disorder that’s brought on by severe psychological trauma,” explains Dr Chi-Chi Obuaya, consultant psychiatrist at Nightingale Hospital. “This could be anything, but most often it relates to catastrophic events, when someone perhaps felt that their life was at risk.” In the wake of the Grenfell tragedy, for instance, it was estimated that 11,000 people might be suffering from the disorder.
It differs from other forms of anxiety in that it’s characterised by nightmares, flashbacks and intrusive thoughts that lead the sufferer to relive the incident and the overwhelming fear it may have prompted. There are other equally insidious elements, too – anger, mistrust and secrecy, all linked to the fact that the sufferer no longer feels safe. Trouble sleeping. Avoidance of anything related to the trauma. The breakdown of relationships and sense of self, and an overwhelming, irrational guilt.
According to the World Health Organization, the high prevalence of sexual violence which women experience makes us the largest single group of people to be affected by the disorder
“There’s a lot of emphasis in this country on war veterans as a group who might experience PTSD,” continues Obuaya. “And rightly so because of the things they’re exposed to in combat. But that has led to some false ideas that they are the only group who suffer.” At the end of last year, for instance, Lady Gaga explained in an interview that she had had PTSD after being raped aged 19. Piers Morgan retweeted a CNN piece headlined “Lady Gaga: ‘I have PTSD’” with his response: “No, soldiers returning from battlefields do. Enough of this vain-glorious nonsense.” It’s a neat example of a lazy assumption (though, admittedly, Piers Morgan gaffes are ten-a-penny). In fact, last year, an NHS study found that around 13 per cent of women aged 16-24 screened positive for PTSD. According to the World Health Organization, the high prevalence of sexual violence that women experience makes us the largest single group of people to be affected by the disorder.
As you might deduce from the content of my nightmares, my father and I had endured a fraught relationship. He had problems with alcohol. We don’t have to go into it now – it’s not really the point – but the last time we spoke before he died (in 2007), he’d been half out of his mind and behaved in a violent way that I realised I’d never be able to forgive. I drove away from the incident (and I liked that word – whereas family relationships seemed bloody, complex and dirty, “incident” felt clean and officious), stopped once to be sick, then kept on driving. A few months later, he was dead.
After his funeral, I went back to university and when people asked, “How’re your mum and dad?”, I’d say, “My mum’s fine, my dad died – I don’t want to talk about it.” And I just didn’t talk about it.
“People respond to trauma in different ways,” says psychotherapist Hilda Burke. “Two people might have the same experience – say, a car crash – and one may develop PTSD while the other doesn’t. A lot depends on the period following the event – how does the person deal with the trauma? Do they have people who they trust and who they can talk to?”
There are other things, now that I look back. Almost directly after the incident and with increasing frequency in the weeks after, I started to feel dread, like an uncomfortable bubble in my solar plexus. It wasn’t constant, but would come on like an attack, for half an hour at a time, and feel so acutely painful that I thought I had asthma. I went to see my GP; he told me to take some paracetamol and calm down.
“It can be difficult to diagnose if it isn’t linked to some life-threatening event,” says Burke. “In that way, it’s particularly problematic because the impact of the trauma can be felt to varying degrees for years. And the PTSD can be retriggered by other stressors.”
Even directly after his death, I actively chose not to think about my dad, but for about a year I did keep a box of sleeping tablets in my room and had this mushy, comforting sense that if it all got, you know, too much, I’d take the whole box. My relationship broke down. I can’t remember why exactly. But we split soon after his funeral and I was very unhappy.
For a while, I felt awkward about mentioning PTSD because – thanks to reactions like Morgan's – it seems like too big a response for the grubby hurts that we experience as women
I didn’t see anyone professional at the time. I didn’t think of these things as connected, really – perhaps I’ve always felt the dreads. Perhaps I wasn’t being a good girlfriend. Perhaps the stress of exams got to me. The nightmares dwindled and the dreads would come and go, but honestly, barring the garden variety ups-and-downs of life, within a few years I was fine. Throughout my twenties, I was fine. Of course, as I got slightly older, an oblique sense that everything was not fine became bigger until, as I mentioned, it was the single, overriding feeling.
Both Burke and Obuaya point out that there are a number of treatments for PTSD, from trauma-focused CBT to narrative exposure therapy, movement and art therapy and EMDR (eye-movement desensitisation and reprocessing). They can all be effective ways of allowing a person to process a traumatic experience in a way that doesn’t trigger the same overwhelming feelings of fear. Basically, they all involve an element of reliving the trauma in a safe environment, processing it so that the symptoms – anxiety, anger, mistrust, fear – aren’t liable to bubble up whenever a similar event occurs.
I’ve yet to dip my toe into any of them. When the counsellor suggested PTSD, my reaction was to shrug and forget about it. I had two more sessions with her and she offered to refer me to a specialist who’d be able to give me a more concrete “diagnosis”, but it feels somehow like I’d be pulling the loose thread on a jumper that’s likely to unravel. It’s not a very brave response, I must admit, and as she pointed out in my last session with her, “avoidance is one of the main characteristics of the condition; whether you have it or not, it’s not an effective way to deal with whatever’s bothering you".
For a while, I felt awkward about mentioning it because – thanks to reactions like Morgan's – it seems like too big a response for the grubby hurts that we experience as women and, indeed, as human beings. But the more I’ve read about PTSD, the more I’ve realised this thinking deifies a condition that is shit and hard but, much like a broken leg, treatable. One trauma is no more “real” or “valid” than another – my nightmare isn’t more terrifying than yours. I haven’t called the NHS counsellor back yet, but perhaps it’s time – perhaps I will.