Lit eZine Vol 7 | p-15 | INSIGHTS | Character Creation 101 – How to Write a Character with PTSD

ARTICLE

CHARACTER CREATION 101 – HOW TO WRITE A CHARACTER WITH PTSD
by Apurva

Characters can make or break a story. Writing realistic and unique characters is a daunting task for a writer. In this series of articles, we will help you write memorable characters with distinctive traits that make them real yet unique.

How to Write a Character with PTSD

What is PTSD?

Post Traumatic Stress Disorder is a mental health disorder characterised by symptoms which may develop after exposure to one or more traumatic events. These symptoms usually involve intrusive memories of the traumatic event, flashbacks, intense psychological distress when exposed to internal and external cues which serve as reminders of the trauma, behavioural changes, and a persistent negative emotional state.

What does PTSD look like?

PTSD looks different for different people diagnosed with it. Common symptoms may involve intrusive memories of the traumatic event. These are experienced as intensely distressing and are recurrent and involuntary. People may also experience flashbacks where the person feels or acts as if they are reliving the trauma all over again. In extreme cases, this may look like a cut-off from awareness of one’s surroundings in the present moment.

Severe psychological distress can be experienced in the presence of internal or external cues which remind the person or symbolise in any way any connection to the traumatic event. An individual’s reaction to these cues may lead to heightened anxiety.

Most people tend to forget important aspects of that event. They develop negative beliefs about themselves and the world. There can be self-blaming tendencies, and a persistent negative emotional state characterised by anger, fear, guilt, shame or horror. The ability to experience positive emotions declines and feelings of detachment from others creep in.

For some people, marked changes in behaviour may seem like a shift in their personality. They may become hypervigilant, self-destructive, reckless, easily irritable and angered, with frequent outbursts of these emotions. Issues with concentration, sleep may also cause disturbance in day-to-day lives of these people.

What triggers PTSD?

PTSD can develop when an individual directly experiences or witnesses one or more traumatic events. It can also develop upon learning of an accidental or violent traumatic event occurring with close family members or friends. Experiencing repetitive or severe exposure to disturbing aspects of a traumatic event may also lead to the development of PTSD.

These traumatic events may involve actual or threatened death, serious injury, or sexual violence. An individual may directly experience actual or threatened physical assault, war, robbery, torture, childhood abuse, incarceration, natural or man-made disasters, motor accidents, terrorist attacks, bullying, sexual violence or coercion, life-threatening emergencies of a medical nature like a heart attack, severe allergic reaction, events evoking catastrophic feelings like treatment of burn wounds, post-surgical experiences and such.

Witnessing events of serious injury, physical or sexual abuse, domestic violence, medical emergencies of close ones, disasters, war, or accidents and indirect exposure to grotesque aspects of war, sexual abuse, genocide, violence, murder, accidents, suicide, terrorist attacks, injury or accident may also qualify as traumatic events.

When does PTSD show up?

PTSD can occur at any age after one year of age. Symptoms usually manifest within 3 months of having experienced the traumatic event. For some people, there may be a delayed expression which may be characterised by a delay of months or years for symptoms to show up.

What are some background factors which may put an individual at risk for developing PTSD?

Risk factors may predispose individuals to trauma or intense emotional responses following an encounter with a traumatic event.

Pretraumatic factors may involve childhood emotional problems like mood disorders, anxiety disorders, OCD, genetic history, and temperament for negative affectivity. Environmental factors like low education, low socioeconomic status, adversity experienced during childhood, racism, discrimination, low intelligence and family history of psychiatric issues may also be contributory factors.

The severity of the trauma and intensity of emotional responses like panic and fear occurring during the trauma play a huge role in development and trajectory.

Posttraumatic risk factors which lead to the persistence of the disorder and exacerbation of symptoms include negative thinking patterns, unhealthy coping strategies, repetitive exposure to reminders, adverse life events, high levels of daily life stressors and other trauma-related losses.

Management of PTSD

PTSD management depends on the symptoms and needs of the affected person and is done by psychotherapy, medications, and most often a combination of both.