This page has some great information about how bullying can lead to PTSD, or complex PTSD. I think it is mainly referring to workplace bullying, but it applies to all forms of bullying. There is also some good information on the differences between mental illness vs. psychiatric injury, and paranoia vs. hypervigilance.
http://www.bullyonline.org/stress/ptsd.htm
Mapping the health effects of bullying onto PTSD and Complex PTSD
Repeated bullying, often over a period of years, results in symptoms of Complex Post Traumatic Stress Disorder. How do the PTSD symptoms resulting from bullying meet the criteria in DSM-IV?
A. The prolonged (chronic) negative stress resulting from bullying has lead to threat of loss of job, career, health, livelihood, often also resulting in threat to marriage and family life. The family are the unseen victims of bullying.
A.1.One of the key symptoms of prolonged negative stress is reactive depression; this causes the balance of the mind to be disturbed, leading first to thoughts of, then attempts at, and ultimately, suicide.
A.2.The target of bullying may be unaware that they are being bullied, and even when they do realise (there's usually a moment of enlightenment as the person realises that the criticisms and tactics of control etc are invalid), they often cannot bring themselves to believe they are dealing with a disordered personality who lacks a conscience and does not share the same moral values as themselves. Naivety is the great enemy. The target of bullying is bewildered, confused, frightened, angry - and after enlightenment, very angry. For an answer to the question Why me? click here.
B.1. The target of bullying experiences regular intrusive violent visualisations and replays of events and conversations; often, the endings of these replays are altered in favour of the target.
B.2. Sleeplessness, nightmares and replays are a common feature of being bullied.
B.3. The events are constantly relived; night-time and sleep do not bring relief as it becomes impossible to switch the brain off. Such sleep as is achieved is non-restorative and people wake up as tired, and often more tired, than when they went to bed.
B.4. Fear, horror, chronic anxiety, and panic attacks are triggered by any reminder of the experience, eg receiving threatening letters from the bully, the employer, or personnel about disciplinary hearings etc.
B.5. Panic attacks, palpitations, sweating, trembling, ditto.
Criteria B4 and B5 manifest themselves as immediate physical and mental paralysis in response to any reminder of the bullying or prospect of having to take action against the bully.
C. Physical numbness (toes, fingertips, lips) is common, as is emotional numbness (especially inability to feel joy). Sufferers report that their spark has gone out and, even years later, find they just cannot get motivated about anything.
C.1. The target of bullying tries harder and harder to avoid saying or doing anything which reminds them of the horror of the bullying.
C.2. Work, especially in the person's chosen field becomes difficult, often impossible, to undertake; the place of work holds such horrific memories that it becomes impossible to set foot on the premises; many targets of bullying avoid the street where the workplace is located.
C.3. Almost all callers to the UK National Workplace Bullying Advice Line report impaired memory; this may be partly due to suppressing horrific memories, and partly due to damage to the hippocampus, an area of the brain linked to learning and memory (see John O'Brien's paper below)
C.4. the person becomes obsessed with resolving the bullying experience which takes over their life, eclipsing and excluding almost every other interest.
C.5. Feelings of withdrawal and isolation are common; the person just wants to be on their own and solitude is sought.
C.6. Emotional numbness, including inability to feel joy (anhedonia) and deadening of loving feelings towards others are commonly reported. One fears never being able to feel love again.
C.7. The target of bullying becomes very gloomy and senses a foreshortened career - usually with justification. Many targets of bullying ultimately give up their career; in the professions, severe psychiatric injury, severely impaired health, refusal by the bully and the employer to give a satisfactory reference, and many other reasons, conspire to bar the person from continuance in their chosen career.
D.1. Sleep becomes almost impossible, despite the constant fatigue; such sleep as is obtained tends to be unsatisfying, unrefreshing and non-restorative. On waking, the person often feels more tired than when they went to bed. Depressive feelings are worst early in the morning. Feelings of vulnerability may be heightened overnight.
D.2. The person has an extremely short fuse and is often permanently irritated, especially by small insignificant events. The person frequently visualises a violent solution, eg arranging an accident for, or murdering the bully; the resultant feelings of guilt tend to hinder progress in recovery.
D.3. Concentration is impaired to the point of precluding preparation for legal action, study, work, or search for work.
D.4. The person is on constant alert because their fight or flight mechanism has become permanently activated.
D.5. The person has become hypersensitized and now unwittingly and inappropriately perceives almost any remark as critical.
E. Recovery from a bullying experience is measured in years. Some people never fully recover.
F. For many, social life ceases and work becomes impossible; the overwhelming need to earn a living combined with the inability to work deepens the trauma.
Common symptoms of PTSD and Complex PTSD that sufferers report experiencing
•hypervigilance (may feel like paranoia, but see HERE for key differences between paranoia and hypervigilance)
•exaggerated startle response
•irritability
•sudden angry or violent outbursts
•flashbacks, nightmares, intrusive recollections, replays, violent visualisations
•triggers
•sleep disturbance
•exhaustion and chronic fatigue
•reactive depression
•guilt
•feelings of detachment
•avoidance behaviours
•nervousness, anxiety
•phobias about specific daily routines, events or objects
•irrational or impulsive behaviour
•loss of interest
•loss of ambition
•anhedonia (inability to feel joy and pleasure)
•poor concentration
•impaired memory
•joint pains, muscle pains
•emotional numbness
•physical numbness
•low self-esteem
•an overwhelming sense of injustice and a strong desire to do something about it
Common features of Complex PTSD from bullying
People suffering Complex PTSD as a result of bullying report consistent symptoms which further help to characterise psychiatric injury and differentiate it from mental illness. These include:
Fatigue with symptoms of or similar to Chronic Fatigue Syndrome (formerly ME)
An anger of injustice stimulated to an excessive degree (sometimes but improperly attracting the words "manic" instead of motivated, "obsessive" instead of focused, and "angry" instead of "passionate", especially from those with something to fear)
An overwhelming desire for acknowledgement, understanding, recognition and validation of their experience
A simultaneous and paradoxical unwillingness to talk about the bullying (click here to see why) or abuse (click here to see why)
A lack of desire for revenge, but a strong motivation for justice
A tendency to oscillate between conciliation (forgiveness) and anger (revenge) with objectivity being the main casualty
Extreme fragility, where formerly the person was of a strong, stable character
Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy)
Clumsiness
Forgetfulness
Hyperawareness and an acute sense of time passing, seasons changing, and distances travelled
An enhanced environmental awareness, often on a planetary scale
An appreciation of the need to adopt a healthier diet, possibly reducing or eliminating meat - especially red meat
Willingness to try complementary medicine and alternative, holistic therapies, etc
A constant feeling that one has to justify everything one says and does
A constant need to prove oneself, even when surrounded by good, positive people
An unusually strong sense of vulnerability, victimisation or possible victimisation, often wrongly diagnosed as "persecution"
Occasional violent intrusive visualisations
Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovable
A feeling of being small, insignificant, and invisible
An overwhelming sense of betrayal, and a consequent inability and unwillingness to trust anyone, even those close to you
In contrast to the chronic fatigue, depression etc, occasional false dawns with sudden bursts of energy accompanied by a feeling of "I'm better!", only to be followed by a full resurgence of symptoms a day or two later
Excessive guilt - when the cause of PTSD is bullying, the guilt expresses itself in forms distinct from "survivor guilt"; it comes out as:
•an initial reluctance to take action against the bully and report him/her knowing that he/she could lose his/her job
•later, this reluctance gives way to a strong urge to take action against the bully so that others, especially successors, don't have to suffer a similar fate
•reluctance to feel happiness and joy because one's sense of other people's suffering throughout the world is heightened
•a proneness to identifying with other people's suffering
•a heightened sense of unworthiness, undeservingness and non-entitlement (some might call this shame)
•a heightened sense of indebtedness, beholdenness and undue obligation
•a reluctance to earn or accept money because one's sense of poverty and injustice throughout the world is heightened
•an unwillingness to take ill-health retirement because the person doesn't want to believe they are sufficiently unwell to merit it
•an unwillingness to draw sickness, incapacity or unemployment benefit to which the person is entitled
•an unusually strong desire to educate the employer and help the employer introduce an anti-bullying ethos, usually proportional to the employer's lack of interest in anti-bullying measures
•a desire to help others, often overwhelming and bordering on obsession, and to be available for others at any time regardless of the cost to oneself
•an unusually high inclination to feel sorry for other people who are under stress, including those in a position of authority, even those who are not fulfilling the duties and obligations of their position (which may include the bully) but who are continuing to enjoy salary for remaining in post [hint: to overcome this tendency, every time you start to feel sorry for someone, say to yourself "sometimes, when you jump in and rescue someone, you deny them the opportunity to learn and grow"]
17 Mar 2015, 2:55 pm
