.

•People that experience war, kidnapping, banditry, terrorism, other catastrophic

events at high risk

•Preventable, treatable with psychological First Aid

By Sola Ogundipe & Chioma Obinna

The revelation by the First Lady, Mrs Aisha Buhari, that her husband, President Muhammadu Buhari, suffered from Post Traumatic Stress Disorder, PTSD, for many years, following his involvement in Nigeria’s civil war without rehabilitation, has elicited much public interest.

The First Lady who spoke at the ground-breaking ceremony for the Armed Forces Post Traumatic Stress Disorder Centre, AFPTSDC, initiated by the Mrs Lucky Irabor-led Defence and Police Officers’ Wives Association, DEPOWA, said the incident had negative consequences on her for many years.

What Aisha Buhari said

“I want to thank DEPOWA for this foresighted vision of establishing a Post Traumatic Stress Disorder (PTSD) Centre for our soldiers. Indeed, PTSD is a mental health condition triggered by terrifying events. It is a reality that soldiers and military families have to live with, despite its negative consequences. Being a soldier’s wife or a retired soldier’s wife and a wellness expert, I understand the challenges associated with PTSD and its impact on military families and the nation.

“My husband served the Nigerian Army for 27 years before he was overthrown in a coup d’état. He fought a civil war for 30 months without rehabilitation; he ruled Nigeria for 20 months and was detained for 40 months without disclosing the nature of his offence.

“One year after he came out from detention, we were married, I clocked 19 years in his house as his wife, legitimately. I suffered the consequences of PTSD, because having gone through all these, and at the age of 19, to handle somebody, who was a former Head of State and Commander-in-Chief of Nigeria’s Armed Forces, to tell him that he is wrong is the first mistake you will make.

“So, at the age of 19, I had to figure out how to tell somebody of his calibre that he was wrong or right and that was the beginning of my offence in his house, and contesting elections in 2003 and failed, 2007, failed and 2011, the same thing – all without rehabilitation – I became a physiotherapist.

“Finally, the whole nation rose against the misuse of power and bad governance. He only succeeded when it became a movement and here we are today. He ruled Nigeria before and he is ruling Nigeria now and this is the last time and final.

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“Failing election three times was a big blow to every contestant but those that have contested for just yesterday, a simple primary election, they are still living in a traumatic condition, I tried to console them, I tried to talk to them, some of them have switched off their phones up till today, just because of a primary election.

“You can imagine me at 19 years, handling somebody that went to war, suffered a coup d’état, then lost several elections, and, finally, getting to the Villa in 2015. Also, for a woman to tell them that this is wrong or right in Nigeria and Africa is a problem.”

Medical experts speak

Experienced psychiatrists under the aegis of the Association of Psychiatrists in Nigeria, APN, who spoke to Saturday Vanguard, said PTSD is a mental health issue that should not be ignored even as incidences of the condition are on the increase in Nigeria.

A Professor of Psychiatry at the University Teaching Hospital, Jos,  Prof Taiwo James Obindo said PSTD is a mental health disorder that has a tendency to recur following a previous incidence.

Obindo, who is the APN president, said PTSD causes problems in the social and work environments and may affect relationships.

Also speaking, a Psychiatrist/Psychopharmacologist, Prof Taiwo Lateef Sheikh, noted that PTSD has a time frame, even though the symptoms could persist for a while.

Sheikh, a Professor of Psychiatry at the Ahmadu Bello University, Zaria, and the immediate past President of the APN, explained that people who have suffered PTSD in the past may suffer a re-occurrence if they faced new catastrophic experiences.

In a telephone chat, he told Saturday Vanguard that the incidence of PTSD in Nigeria was on the increase as a result of the traumatic nature of the environment being escalated by terrorism, kidnapping, rape, and domestic violence among others.

 ”I cannot say anything about what the First Lady said – whether he (Buhari) has PTSD or not. I don’t think that the wife of the president is in a position to make a diagnosis of PTSD. Maybe some health practitioners have been able to diagnose him, but I am not aware of that. However, PTSD has a time frame. It is not like you have a civil war in 1967 and you will be having PTSD in 2022. It has a time frame. It is not because you lost an election in 1999 and you are manifesting PTSD in 2022.

“It is possible that you can have PTSD shortly after the civil war and the symptoms may persist for quite a while but there is a way that it will evolve. You will not be looking at PTSD anymore; rather, you will be looking at it like some other disorders that are happening. 

“We don’t expect PTSD to remain for over 30 or 40 years. I really can’t say much about that.  However, people who have suffered from PTSD may have re-occurrence if they face new challenges or new catastrophic experiences. Such could make it appear as if it is coming back,” Sheikh remarked. 

What is PTSD?

The psychiatrists noted that  PTSD could make the patient avoid people, become overwhelmed by the symptoms and attempt to kill themselves, resort to the use of psychoactive substances etc.

Obindo said PTSD causes problems in social and work environments and may affect relationships. On his own part, Sheikh described PTSD as a mental health condition individuals develop after experiencing or witnessing or being told about life-threatening or catastrophic events like natural disasters, combat Road Traffic Accidents, Rape etc.

Giving a detailed explanation of an account of PTSD and its clinical features, Sheikh said: “Post Traumatic Stress Disorder, as the name goes, is a medical condition that arises after someone has suffered a very stressful and traumatic experience of a catastrophic magnitude. It follows a psychological trauma and is not just mere stress of day-to-day work.

“It is more like an earthquake in which so many people died, or a collapsed building, or severe flood that wiped away a whole village, resulting in people being displaced from their homes, losing everything they own, and becoming internally displaced. They continue to live through the traumatic experience. People that can suffer from PTSD include a survivor of a deadly armed robbery attack or someone that was kidnapped for several days.

Further, he said: “A woman who was raped in a very bad manner or someone that suffered the loss of a dear one such as a husband, and a wife or a child whose death has occurred suddenly can also suffer PTSD. Also, when someone is diagnosed with a terminal disease such as cancer, it would be like a death sentence when such news is broken.”

How it affects people

According to Obindo, “PTSD may impair the ability to go about their daily activities and is associated with outbursts of anger, self-destructive behaviour like drinking or driving too fast. Individuals experience the symptoms differently and to varying degrees. It may last from a few months after the event to many years afterwards.”

In his corroboration, Sheikh noted that PTSD comes with a recognisable cluster of symptoms.

“When you have PTSD, anybody who sees you will know that you are sick. It leads to a recognisable illness that has its own recognisable cluster of symptoms that are attributable to the condition. It is a mental disorder. The patient will manifest symptoms that range from severe anxiety to agitation, and restlessness.

“Your heart is beating, you cannot eat and you cannot sleep and cannot stay in one place. You cannot focus and when anything that is related to the traumatic experience happens, it will make you agitated. You will be avoiding any situation that will remind you of that catastrophic experience. It will be coming to you like a real experience like they are playing a film of what happened to you again to the extent that you will even be running. 

“For people who went to war, whenever they hear a bomb blast, gunshot or bullet sounds, from time to time, the memories will come back to them like it is happening again. They will be running under the gutter, hiding under the bed or elsewhere as if the bullets are raining again or the bombs are coming again.

“So, those things that you were doing to keep yourself alive during that time will be coming back to you. It is like daydreaming.  Everything will come back to you again.  You will be asleep at night and you will suddenly wake up and begin shouting.”

Sheikh noted that PTSD comes with abnormal behaviour.

 ”Anyone who sees you will know that there is something wrong.  Your heart will be beating as if it wants to fall out of your chest.  You cannot eat and you cannot sleep. Your mood will go down, you will feel depressed and sad and you may even contemplate suicide. There is a high rate of suicide among people who suffer from PTSD. 

Effects on behaviour

“When your behaviour changes, it will go beyond logical reasoning because you are so overwhelmed by what is happening to you.  It will not allow you to think straight because you are so preoccupied with how to manage your situation.  I will not be able to say anything about being radical, but your logical framework of mind shifts. Anybody who sees you will know that there is a problem.”

Burden

“I don’t have the figures of the burden of PTSD in Nigeria in my head but I can say that it is becoming a common phenomenon that we are encountering.

“When we say that stress is borne out of trauma, definitely the incidence is increasing in Nigeria because of terrorism, kidnapping, and the incidence of rape, and domestic violence. As long as we still have many people who are victims of traumatic events, the numbers will continue to increase. Certainly, the number of PTSD cases is increasing in Nigeria, Sheikh argued.”

Control & prevention

In his recommendation, Obindo urged PTSD patients to see a mental health practitioner immediately after a traumatic experience.

“See the medical health practitioner as soon as the symptoms are emerging or there is thought of suicide. Debriefing after a traumatic event can help the individual. Seeing a mental health practitioner as soon as the symptoms emerge and are not abating after a month of the event can help,” he advised.

Noting that PTSD  can be prevented. Sheikh said people who go through very serious experiences like kidnapping, banditry, terrorism and catastrophic events in which they are the sole survivors can be helped.

“You need to seek psychological support from your immediate and extended family, friends, and other relatives and then from medical practitioners. There is what we call psychological First Aid. People will call you on the phone, talk to you and make you feel that they share in your problem and that you are not alone.

“They render all these as psychological First Aid and it has a way of preventing PTSD from developing. If you suffer sleep deprivation and your appetite is down, you can also meet professionals to help manage your sleep, appetite, mood, depression, and anxiety.  So all these things have a way of preventing the occurrence of PTSD. 

“We usually don’t want it to happen, that is why when disasters occur when people suffer catastrophic experiences, we ask them to come for counselling, and for psychological First Aid so as to prevent the occurrence of PTSD. Persons with initial symptoms should see mental health professionals who will guide them to avoid PTSD.”

Recommendation for war returnees

Sheikh further disclosed that PTSD was first discovered among soldiers who returned from the Vietnam War in America.

 ”They were the first set of people that were observed to be having certain specific clusters of symptoms that now came down to the development of criteria for the diagnosis of the condition that is called PTSD.

 Since then, we do know that when soldiers come back from war, a few of them are likely to come down with PTSD.   You have also to understand that as human beings, we are resilient.

“Our body has a way of absolving shocks as a result of disasters, or catastrophic experiences that happen to us, but a few of us may not have that resilience to prevent PTSD.  But it is not every soldier that partakes in the war will come down with PTSD. 

“It is only a few have some missing links that are not allowing them to absolve the shock the way other people will absolve it.   There is a programme in place for military men who retire from the war that is supposed to be looked after in a particular manner and also to prevent PTSD.  But whether we have that for our soldiers, I am not too sure.   Even if we have the programme that we are implementing for soldiers coming back from war that I don’t know.”

Sheikh stated that generally in the military, there is a programme for soldiers who come back from war to be assessed and assisted in a psychological manner so that they will not develop PTSD because it is a very serious condition, especially in the fatality rate.

Famous people with PTSD

Oprah Winfrey –   Oprah Winfrey suffered a lot of trauma as a child, including beatings that left her bloody to bear witness to extreme violence between her grandfather and grandmother.

Mick Jagger –   Mick Jagger was paralyzed with grief after his long-term girlfriend, fashion designer L’Wren Scott, took her own life in their apartment in March 2014.

Lady Gaga – Mega-pop star   Lady Gaga revealed that she suffered from PTSD after being repeatedly raped when she was 19 years old by someone that she knew.

Chris Brown – Poor impulse control and violent outbursts have plagued Chris Brown ever since he appeared in the public eye. While in a court-mandated rehab for substance abuse, Brown was diagnosed with both bipolar disorder and PTSD.

Ariana Grande – Pop star Ariana Grande has been diagnosed very open about the trauma caused by a terrorist attack at her concert in Manchester, England, in 2017 that claimed the lives of 23 people. She says that the incident is still so heavy on her heart every single day.

Tracy Morgan – Comic and actor Tracy Morgan were involved in a 2014 car accident when his van was rear-ended by a Walmart tractor-trailer at high speeds. The crash not only left him with broken bones, but also with traumatic brain injury and PTSD, and the accident claimed the life of a dear friend. He struggles with survivor’s guilt, flashbacks, and anxiety every time he got into another car. Whoopi Goldberg – In 1978,   Whoopi Goldberg, the famed comedian said she witnessed a mid-air collision between two planes, a tragedy that significantly impacted her life. She has battled a fear of flying since then, even growing emotional and experiencing flashbacks to that moment when she was on an aeroplane, and continues to receive therapy.

Shia LaBeouf – While shooting a movie in Georgia in 2017, Shia LaBeouf was arrested and sentenced to court-ordered rehab. It was the first time he was told that he had PTSD. Prior to that incident, he assumed that he was an alcoholic.

Monica Seles – Monica Seles rose to become the youngest professional tennis player to garner a number-one ranking at the age of 13. In 1993, she was attacked on the court, during a match in Germany against Steffi Graf. She took a two-year break while receiving treatment for PTSD.

Charlize Theron – Award-winning producer and actor, Charlize Theron one of the most successful talents in show business, suffered a traumatic event while a teenager living in South Africa. In self-defence, her mother shot and killed her father who’d come up drunk, armed, and abusive.

Clint Malarchuk – During a nationally televised hockey game in 1989, Clint Malarchuk, a then goaltender for the Buffalo Sabres, had his jugular vein severed by the skate of an opposing player. Malarchuk later suffered anxiety, depression, and flashbacks, and more than a decade later was drinking heavily and attempted suicide. He went 20 years with undiagnosed PTSD which almost ended his life 20 years later.