Tuesday, April 23, 2019

PTSD for Writers

We just finished up a series on wounds by firearms and touched on the subject of PTSD. Over the next few posts we are going to look closer at PTSD and how it affects the characters we write. This week we will look at some of the most common symptoms of PTSD. And, in the next round, we will see how PTSD manifests in behavior.

Post Traumatic Stress Disorder (PTSD) is a mental disorder that can develop after experiencing a shocking, dangerous or terrifying event. In such events, the body is sent into "fight or flight" and releases a surge of adrenaline. In our previous posts on adrenaline, we looked at how the hormone aids the body in combatting threats as well as its negative aftereffects.

Sometimes the old gray matter gets stuck in fight or flight mode. The brain stays hyper aware, uber sensitive and demands the body to remain ready for another threat. When that happens, PTSD develops. If your character has been through any sort of trauma, these symptoms could easily be a part of their storyline. And, don't assume that trauma is only related to an incident that happens to the character. It could be that your character develops PTSD after witnessing an event.

Some Symptoms of PTSD 

anger
depression
anxiety
intrusive thoughts or memories 
flashbacks
fatigue
nightmares
loss of concentration
outbursts of anger
insomnia
increased startle
hypervigilance
avoidance
isolation
emotional numbness
guilt
loss of interest in previously enjoyed activities

PTSD Symptoms in Children and Teens

All of the above can be symptomatic of PTSD in children with the addition of bedwetting, acting out trauma during play time and separation anxiety. In adolescents there can  be destructive behavior and self bodily harm.

Physical Toll on the Body

As you might imagine, all of these mental and emotional states can take a physical toll on the body. PTSD can cause chronic fatigue, vomiting, sensory overload - meaning the lights, sounds, smells and overall physical sensations of an environment overwhelm a person -, distorted vision and hearing, and physical sensations associated with panic attacks.


What is a panic attack? We will look at that a little more closely next week as well as the difference in a panic attack and anxiety disorder. We will also look at film examples of PTSD. Until then, here's a little clip about the rise of PTSD in story telling. 




And speaking of the cinema, here's a video by Martial Club comparing fight scenes in the movies to reality. Enjoy. Until the next round at FightWrite.net, get blood on your pages.




Tuesday, April 2, 2019

Wounds by Firearms Part 3: Sensations and Trauma Video

In our first post in this three part series on firearms, we looked at some statistics regarding gun violence as well as why a bullet does damage. It's not just because it makes a hole. Promise. In part two we looked at what a "caliber" is and looked at some gross pictures. In this, the final post in the series, I spoke with a Justice of the Peace/Coroner, a paramedic and a gunshot wound victim. They all
noted a few things that could add more realism to your work in progress.

Justice of the Peace/Coroner (In the state of Texas, a Justice of the Peace acts as Coroner for a county without a Medical Examiner.)
This judicial officer said that all gunshot wounds can be fatal. There's no "safe place" to shoot a character.  So, don't assume that if your protagonist is shot in the hand that all should be just fine. She also noted that most of what she sees on TV seems fake. And, if a victim is high on drugs, they can keep fighting, even with multiple wounds, for an unbelievable amount of time.

The JoP also pointed out that gunshot wounds can be very bloody. And, the more traumatic the wound, the stronger the smell. If a bullet hits the head, brain matter can go everywhere. The bullet's trajectory is one way to determine if your character's wound to the head, or anywhere else, was self inflicted.

Paramedic
Just as the JoP said that bullet wounds can be very bloody, a paramedic said that sometimes they aren't very bloody at all. This paramedic attended to a victim recently who had five bullet wounds. A few were bandaged with only Tegaderm, a transparent medical dressing that looks like tape. He said that exit wounds were not always the huge, gaping holes as are sometimes portrayed on screen. In fact, the exit wound could be smaller than the bullet. If a bullet doesn't exit the body and is near the surface of the skin, it can be seen through the skin and felt. And, though very injured and with multiple wounds on the body, gunshot victims aren't always screaming in pain.

Gunshot Victim
This victim echoed what the paramedic said, when shot he didn't cry out pain. In fact, he told me that he didn't know he had been shot. The bullet hit him near the knee but he went to the ground from the impact.

In the ambulance he was given IV painkillers. When the painkillers ebbed his leg felt like dead weight. It was over a week before he went in for surgery to remove the bullet. While it was still lodged in his leg, he described the sensation as "screaming pain." After the bullet was removed, the pain was less intense but still excruciating. For weeks the slightest movement in the limb woke him up at night.

Sensations Noted by Other Gunshot Victims
Many victims say that upon being shot, they felt no pain. More than the breech of the bullet they felt its impact and describe it like being hit by a bat. Some looked at the wound with confusion and shock, not quite believing what they were seeing.

When the sensations of pain set it, they are noted as a deep numbness that gives way to burning. Sharp pain may follow similar to a bee sting or as intense, stabbing pain. If shot in the abdomen, internal bleeding will put pressure on internal organs and cause intense pain. The flow of blood causes a warm sensation as well as one that is cold and wet. Cleaning the wound is noted as sometimes being far more painful than the wound itself.

 What many victims reported most about their injury is something seldom seen on pages or screens: the emotional aftereffects. A friend of mine was shot during a fight. What he endured physically paled in comparison to what he suffered mentally. If your character is shot in an assault, or even in an accident, it is reasonable for them to suffer symptoms of PTSD which far exceeds physical healing time. And, it just so happens, PTSD will be the subject of our next post. Until then, enjoy these videos of  trauma team management of gunshot wounds. The first is a from single bullet that penetrated both legs and the second is gunshot wound to the neck. You will be directed to YouTube to see the first.

Until the next round at FightWrite.net, get blood on your pages. Oh, and, be sure to check out my book with Writer's Digest set to release on June 11.




https://thoughtcatalog.com/holly-riordan/2017/02/26-gunshot-survivors-explain-exactly-what-the-bullet-felt-like/
http://americanshootingjournal.com/heres-what-it-feels-like-to-get-shot/