This document discusses dealing with post-traumatic experiences during the COVID-19 pandemic. It defines trauma and outlines common trauma responses like shock, denial, unpredictable emotions, and physical symptoms. It describes acute, chronic, and complex trauma and the five stages of dealing with trauma. Signs of post-traumatic stress (PTS) and post-traumatic stress disorder (PTSD) are provided, along with the DSM-5 criteria for diagnosing PTSD. Effective therapies for PTSD, like cognitive behavioral therapy and its variants, are summarized. The document concludes with suggestions for coping with COVID-19 related trauma, like normalizing experiences, self-care, social connection, and nurturing healthy coping techniques.

1. Dealing with Post T
raumatic
Experience During COVID-19
Dr. Sojan Antony Ph.D.
Department of Psychiatric Social Work, NIMHANS, Bangalore
VIRTUAL FDP Held on 16th June 2021, organised by Sree Saraswathi
Thyagaraja College, Coimbatore, T
amil Nadu

2. COVID-19
Prolonged
Beyond our ability to cope
Fear of infection/ complications/ death
Loss of lives/job/social support…

3. T
rauma
An emotional response to a terrible event like an accident, rape
or natural disaster

4. T
rauma Features
Shock
Denial
Unpredictable emotions

5. T
rauma Features
Flashbacks (Disturbing sudden vivid memory)
Strained relationships
Physical symptoms; e.g. Headache, nausea

6. T
rauma T
ypes
Acute
Chronic
Complex

7. Five Stages
Denial
Anger
Bargaining
Depression
Acceptance

8. How do you know? Are you suffering it?
Shock, Denial, or Disbelief
Confusion, Dif
fi
culty in concentrating
Anger, irritability, mood swings

9. How do you know? Are you suffering it?
Anxiety, Fear
Guilt, Shame, Self-blame
Withdrawing from others

10. How do you know? Are you suffering it?
Feeling sad or hopeless
Feeling disconnected

11. Emotional Sufferings
Anxiety and Panic Attacks
Fear, anger, irritability
Obsessions and compulsions
Shock and disbelief

12. Emotional Sufferings
Emotional numbness and detachment
Depression, shame and guilt

13. Physical Sufferings
Irritable bowel syndrome
Chronic pain
Muscular or musculoskeletal pain with stiffens and tenderness
Chronic fatigue syndrome

14. PTSD (Post Traumatic Stress Disorder)
PTSD (post traumatic stress disorder) is a mental health problem that
some people develop after experiencing or witnessing a life-
threatening event.

15. PTS Vs PTSD
•PTS symptoms are common after a severe stressor and may
improve or resolve within a month. PTSD symptoms are more
severe, persistent, can interfere with daily functioning, and can last
for more than a month
.
•Most people with PTS do not develop PTSD.
•PTS requires no medical intervention, unless symptoms are severe.
However, person may bene
fi
t from psychological support to prevent
symptoms from worsening
.
•PTSD is a medically-diagnosed condition and should be treated by
a clinician.

16. PTS Signs
Increased heartbeats
Hand T
remors
Sweating
Bad dreams
Avoiding the triggers
Subsides in few days

17. PTSD Criteria: DSM 5
Criterion A: stressor (one required
)
The person was exposed to: death, threatened death, actual or
threatened serious injury, or actual or threatened sexual violence,
in the following way(s)
:
•Direct exposur
e
•Witnessing the traum
a
•Learning that a relative or close friend was exposed to a traum
a
•Indirect exposure to aversive details of the trauma, usually in
the course of professional duties

18. PTSD Criteria: DSM 5
Criterion B: intrusion symptoms (one required
)
The traumatic event is persistently re-experienced in the following
way(s)
:
•Unwanted upsetting memorie
s
•Nightmare
s
•Flashback
s
•Emotional distress after exposure to traumatic reminder
s
•Physical reactivity after exposure to traumatic reminders

19. PTSD Criteria: DSM 5
Criterion C: avoidance (one required
)
Avoidance of trauma-related stimuli after the trauma, in the following
way(s)
:
•Trauma-related thoughts or feeling
s
•Trauma-related external reminders

20. PTSD Criteria: DSM 5
Criterion D: negative alterations in cognitions and mood (two required
)
Negative thoughts or feelings that began or worsened after the trauma,
in the following way(s)
:
•Inability to recall key features of the traum
a
•Overly negative thoughts and assumptions about oneself or the worl
d
•Exaggerated blame of self or others for causing the traum
a
•Negative affec
t
•Decreased interest in activitie
s
•Feeling isolate
d
•Dif
fi
culty experiencing positive affect

21. PTSD Criteria: DSM 5
Criterion E: alterations in arousal and reactivit
y
Trauma-related arousal and reactivity that began or worsened after
the trauma, in the following way(s)
:
•Irritability or aggressio
n
•Risky or destructive behaviou
r
•Hyper-vigilanc
e
•Heightened startle reactio
n
•Dif
fi
culty in concentratin
g
•Dif
fi
culty in sleeping

22. PTSD Criteria: DSM 5
Criterion F: duration (required
)
Symptoms last for more than 1 month.

23. PTSD Criteria: DSM 5
Criterion G: functional signi
fi
cance (required
)
Symptoms create distress or functional impairment (e.g., social,
occupational)
.
Criterion H: exclusion (required
)
Symptoms are not due to medication, substance use, or other illness
.

24. Therapy for PTSD
•Trauma-focused psychotherapy, which focuses on the memory
of the traumatic event or its meaning, is the most effective
treatment for PTSD.

25. Therapy for PTSD
Cognitive behavioral therapy (CBT) is the most effective treatment for
PTSD. There are different types of cognitive behavioural therapy.
The two most-researched types of CBT for PTSD are Cognitive
Processing Therapy (CPT) and Prolonged Exposure (PE).

26. •Cognitive Processing Therapy (CPT) where you learn skills to
understand how trauma changed your thoughts and feelings.
Changing how you think about the trauma can change how you
feel.

27. Therapy for PTSD
•Prolonged Exposure (PE) where you talk/ express your trauma
repeatedly until memories are no longer upsetting. This will help
you get more control over your thoughts and feelings about the
trauma. You also go to places or do things that are safe, but that
you have been staying away from because they remind you of the
trauma.

28. Therapy for PTSD
•Eye Movement Desensitization and Reprocessing (EMDR),
which involves focusing on sounds or hand movements while you
talk about the trauma. This helps your brain work through the
traumatic memories
.
•Medications: Selective Serotonin Reuptake Inhibitors (SSRIs)

29. What else can be done to deal COVID-19
related traumatic experience?

30. Normalize

31. Self-care

32. Ask help and give help

33. Being with nature

34. Being socially connected

35. Have healthy sleep pattern

36. Observe coping pattern

37. Unlearn unhealthy coping techniques

38. Nurture Healthy Coping T
echniques

39. Observe thoughts

40. Handle unwanted and undesirable
thoughts

41. Hatch and grow positive thoughts

42. Above all be here and now

43. Do your duties, don’t wait for results…

44. Spend time in learning

45. Think “so what?”

46. “T
ake a break and
allow others to take a break”

47. Remind us we are our masters and we
construct our reality…

48. Let us have an activity….

49. What makes you happy?

50. What makes you relaxed?

51. Who is your close friend?

52. What makes you to feel
closeness with that person?

53. What makes you
uncomfortable?

54. How do you handle your
difficult situations?

55. What do you want to tell to
your spouse?

56. What do you want to tell to
your child/children?

57. What do you want to tell to
your friends?

58. What do you want to tell to
your parents?

59. What do you want to tell to
your best friend?

60. When was the last time you
cried?

61. When did you thought about
death?

62. What makes you feel
hopeless?

63. What makes you strong?

64. What makes you special?

65. How do you handle
discouraging people?

66. What is the positive thought you
have in your mind right now?

67. In a difficult situation, what
helps you to handle it?

68. Which is your favourite place, where
you want to spend sometime?

69. Can you describe more about
that place? What else?

70. Let me conclude,
you are going to make small
and meaningful change in
many persons

71. Thank You…
Beautiful
outcome of this
summer!