Post Traumatic Stress Syndrome

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 is the unseen victims of bullying. 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. The target of bullying may be unaware that they are being bullied, and even when they do realize (there's usually a moment of enlightenment as the person realizes 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.

The target of bullying experiences regular intrusive violent visualizations and replays of events and conversations; often, the endings of these replays are altered in favor of the target. Sleeplessness, nightmares and replays are a common feature of being bullied. 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. Fear, horror, chronic anxiety, and panic attacks are triggered by any reminder of the experience, e.g. receiving threatening letters from the bully, seeing it on the web, etc. Panic attacks, palpitations, sweating, trembling, ditto. 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. The target of bullying tries harder and harder to avoid saying or doing anything which reminds them of the horror of the bullying. 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. 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. The person becomes obsessed with resolving the bullying experience which takes over their life, eclipsing and excluding almost every other interest. Feelings of withdrawal and isolation are common; the person just wants to be on their own and solitude is sought. Emotional numbness, including inability to feel joy and deadening of loving feelings towards others are commonly reported. One fears never being able to feel love again. The target of bullying becomes very gloomy and senses a foreshortened career - usually with justification. 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. The person has an extremely short fuse and is often permanently irritated, especially by small insignificant events. The person frequently visualizes a violent solution, e.g. arranging an accident for, or murdering the bully; the resultant feelings of guilt tend to hinder progress in recovery. Concentration is impaired to the point of precluding preparation for legal action, study, work, or search for work. The person is on constant alert because their fight or flight mechanism has become permanently activated. The person has become hypersensitized and now unwittingly and inappropriately perceives almost any remark as critical.

Recovery from a bullying experience is measured in years. Some people never fully recover. 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 (feels like but is not paranoia)
• exaggerated startle response
• irritability
• sudden angry or violent outbursts
• flashbacks, nightmares, intrusive recollections, replays, violent visualizations
• triggers
• sleep disturbance
• exhaustion and chronic fatigue
• reactive depression
• guilt
• feelings of detachment
• avoidance behaviors
• nervousness, anxiety
• phobias about specific daily routines, events or objects
• irrational or impulsive behavior
• 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


Survivor guilt: survivors of disasters often experience abnormally high levels of guilt for having survived, especially when others - including family, friends or fellow passengers - have died. Survivor guilt manifests itself in a feeling of "I should have died too". In bullying, levels of guilt are also abnormally raised.
Shame, embarrassment, guilt, and fear are encouraged by the bully, for this is how all abusers - including child sex abusers - control and silence their victims.
Marital disharmony: the target of bullying becomes obsessed with understanding and resolving what is happening and the experience takes over their life; partners become confused, irritated, bewildered, frightened and angry; separation and divorce are common outcomes.

Breakdown

The word "breakdown" is often used to describe the mental collapse of someone who has been under intolerable strain. There is usually an (inappropriate) inference of "mental illness". All these are lay terms and mean different things to different people.

Two types of breakdown:
Nervous breakdown or mental breakdown is a consequence of mental illness
Stress breakdown is a psychiatric injury, which is a normal reaction to an abnormal situation

The two types of breakdown are distinct and should not be confused. A stress breakdown is a natural and normal conclusion to a period of prolonged negative stress; the body is saying "I'm not designed to operate under these conditions of prolonged negative stress so I am going to do something dramatic to ensure that you reduce or eliminate the stress otherwise your body may suffer irreparable damage; you must take action now". A stress breakdown is often predictable days - sometimes weeks - in advance as the person's fear, fragility, obsessiveness, hypervigilance and hypersensitivity combine to evolve into paranoia (as evidenced by increasingly bizarre talk of conspiracy). If this happens, a stress breakdown is only days or even hours away and the person needs urgent medical help. The risk of suicide at this point is heightened.
The person who is being bullied often thinks they are going mad, and may be encouraged in this belief by those who do not have that person's best interests at heart. They are not going mad; PTSD is an injury, not an illness.
A frequent diagnosis of stress breakdown is "brief reactive psychosis", especially if paranoia and suicidal thoughts predominate. However, a key difference between mental breakdown and stress breakdown is that a person undergoing a stress breakdown will be intermittently lucid, often alternating seamlessly between paranoia and seeking information about their paranoia and other symptoms. The person is also likely to be talking about resolving their situation (which is the cause of their problems), planning legal action against the bully, etc.

People suffering Complex PTSD as a result of bullying report consistent symptoms which further help to characterize psychiatric injury and differentiate it from mental illness. These include:

Fatigue with symptoms of or similar to Chronic Fatigue Syndrome

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

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, victimization or possible victimization, often wrongly diagnosed as "persecution"

Occasional violent intrusive visualizations

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
• 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"

Fatigue

The fatigue is understandable when you realize that in bullying, the target's fight or flight mechanism eventually becomes activated from Sunday evening (at the thought of facing the bully at work on Monday morning) through to the following Saturday morning (phew - weekend at last!). The fight or flight mechanism is designed to be operational only briefly and intermittently; in the heightened state of alert, the body consumes abnormally high levels of energy. If this state becomes semi-permanent, the body's physical, mental and emotional batteries are drained dry. Whilst the weekend theoretically is a time for the batteries to recharge, this doesn't happen, because:
• the person is by now obsessed with the situation (or rather, resolving the situation), cannot switch off, may be unable to sleep, and probably has nightmares, flashbacks and replays;
• sleep is non-restorative and unrefreshing - one goes to sleep tired and wakes up tired
• this type of experience plays havoc with the immune system; when the fight or flight system is eventually switched off, the immune system is impaired such that the person is open to viruses which they would under normal circumstances fight off; the person then spends each weekend with a cold, cough, flu, glandular fever, laryngitis, ear infection etc so the body's batteries never have an opportunity to recharge.

When activated, the body's fight or flight response results in the digestive, immune and reproductive systems being placed on standby. It's no coincidence that people experiencing constant abuse, harassment and bullying report malfunctions related to these systems (loss of appetite, constant infections, flatulence, irritable bowel syndrome, loss of libido, impotence, etc). The body becomes awash with cortisol which in high prolonged doses is toxic to brain cells. Cortisol kills off neuroreceptors in the hippocampus, an area of the brain linked with learning and memory. The hippocampus is also the control centre for the fight or flight response, thus the ability to control the fight or flight mechanism itself becomes impaired.

Most survivors of bullying experience symptoms of Chronic Fatigue Syndrome

In law, gaining compensation for psychiatric injury is a long arduous process which can take five years or more.
Bullying causes PTSD: the legal case

Many people, especially guilty parties and their accomplices and lawyers, reject the notion that PTSD can arise from bullying. However, this research proves otherwise:
• European Journal of Work and Organizational Psychology (EJWOP), 1996, 5(2), whole issue devoted to bullying and its effects, including PTSD. Published by Psychology Press, 27 Church Road, Hove, East Sussex BN3 2FA, UK.
• The late Professor Heinz Leymann was one of the first people to identify the symptoms of injury to health caused by bullying as PTSD.
• Research from Warwick University, England, identifies bullying as a cause of PTSD
• Bullied workers suffer 'battle stress' and show the same symptoms of armed forces personnel who have been engaged in war

Few people realize that trauma and psychiatric injury can be more devastating and long-lasting than physical injury. Traumatic events strike unexpectedly turning everyday experiences upside-down and destroying the belief that ‘it could never happen to me’.

PTSD is a natural emotional reaction to a deeply shocking and disturbing experience after which it can be difficult to believe that life will ever be the same again. The symptoms are surprisingly common and include sleep problems, nightmares and waking early, flashbacks and replays, impaired memory, inability to concentrate, hypervigilance (feels like but is not paranoia), jumpiness and an exaggerated startle response, fragility and hypersensitivity, detachment and avoidance behaviors, depression, irritability, violent outbursts, joint and muscle pains, panic attacks, fatigue, low self-esteem, feelings of nervousness and undue anxiety. Survivors endure abnormal feelings of guilt, perhaps for having survived when those around them didn’t.

Untreated, PTSD symptoms can last a lifetime, impairing health, damaging relationships and preventing people achieving their potential. Sufferers often find that knowledge and treatment of PTSD (and especially Complex PTSD) is difficult to obtain. However, prospects for recovery are good when you have the right counsel and are in the company of fellow survivors and those with genuine insight, empathy and experience.

Quoted with some modifications (principally translating British to American) from http://www.bullyonline.org

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