Post-Traumatic Stress Disorder (PTSD)

Evidence  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713115/ 

Reem Malouf, Sian Harrison, Hollie A.L Burton, Chris Gale, Alan Stein, Linda S. Franck and Fiona Alderdice 

Parents of babies admitted to neonatal units (NICU/SCN) are exposed to a range of potentially distressing experiences, which can lead to mental health symptoms such as increased anxiety and post-traumatic stress.

Education  

Post-traumatic stress disorder (PTSD) refers to a range of symptoms or reactions that you can develop if you have personally experienced or witnessed a traumatic event. 

The experience of having a child born premature or sick can have profound and long-lasting effects on parents, including the development of post-traumatic stress disorder (PTSD). While the immediate focus was on the health and well-being of your child, it's crucial to recognize and address the emotional toll on parents in the months and years that follow. 

Emotional Impact: Parents of premature or sick children often experience intense emotional distress, including fear, anxiety, guilt, and helplessness. Witnessing their child's struggle for survival in the neonatal intensive care unit (NICU) can be traumatic and overwhelming, leading to the development of PTSD symptoms. 

Persistent Re-Experiencing: Parents may find themselves re-living traumatic moments from the NICU experience, such as the baby's birth, medical procedures, moments of crisis, or feelings of uncertainty about the future. Intrusive thoughts, flashbacks, and nightmares can disrupt daily life and trigger intense emotional reactions. Sometimes this can continue years after the child is born and be triggered by birthdays or the anniversary of when the child was released from hospital.  

Avoidance and Numbing: To cope with the overwhelming emotions associated with their child's medical journey, some parents may engage in avoidance behaviours, such as avoiding reminders of the NICU experience, distancing themselves from discussions about the child's health, or numbing their emotions through substance use or other means. 

Hyperarousal and Hypervigilance: Parents with PTSD may experience heightened levels of anxiety, irritability, and hypervigilance, constantly scanning their environment for signs of danger or distress. Sleep disturbances, difficulty concentrating, and an exaggerated startle response are common symptoms of hyperarousal. Parents may experience extreme anxiety if their child needs to visit a hospital or have a medical procedure.  

Impact on Parenting and Relationships: PTSD can strain relationships between partners and affect parenting dynamics. The stress of caring for a child with higher medical needs, coupled with the emotional toll of PTSD, can lead to conflicts, communication breakdowns, and feelings of isolation within the family unit. 

Long-Term Health Consequences: Untreated PTSD can have significant long-term health consequences for parents, including increased risk of depression, anxiety disorders, chronic pain, cardiovascular disease, and substance abuse. Addressing PTSD symptoms early can help mitigate these risks and promote overall well-being. 

Treatment  

Parents who have a premature or sick child should seek support to help them navigate the challenging emotions and experiences which have occurred. It is important to recognise that you have experienced a traumatic event, and it is normal to experience a range of different emotions. 

It's essential for parents experiencing PTSD symptoms to seek professional help and support. Trauma-informed therapy, counselling, and support groups can provide a safe space to process emotions, develop coping strategies, and regain a sense of control over their lives.  

There are a number of effective treatments for PTSD that may be recommended for you by your health professionals. These may include: 

Trauma-focused cognitive behavioural therapy (CBT) – this is where you identify and challenge negative thoughts in relation to the traumatic experience, process memories and reduce unhelpful strategies or coping behaviours. 

Eye movement desensitisation and reprocessing (EMDR) – this is a type of therapy where you are guided to move your eyes in a certain way which supports the processing of trauma memories. 

Antidepressant medication – this is medication you may be prescribed to help with depression or anxiety symptoms. 

Practicing self-care and implementing healthy coping strategies are essential for parents navigating the challenges of PTSD. Engaging in activities that promote relaxation, mindfulness, and connection with others can help reduce stress and improve overall mental well-being. 

Empowerment   

The long-term effects of PTSD in parents of premature or sick newborns can be profound and far-reaching. Every parent will have a unique experience and response to the events that happened to their child when they were in the NICU, but by recognizing the signs and symptoms of PTSD, seeking professional help and support, prioritizing self-care, and implementing healthy coping strategies, parents can embark on a journey of healing and resilience. 

Useful links 

The Australasian Birth Trauma Association (ABTA) 

https://birthtrauma.org.au/postpartum-trauma-disorders-e-g-ptsd/ 

Health Direct, Australia  

https://www.healthdirect.gov.au/post-traumatic-stress-disorder-ptsd 

The Royal Australian and New Zealand College of Psychiatrists 

https://www.yourhealthinmind.org/mental-illnesses-disorders/ptsd 

Pregnancy, Birth and Baby, Australia 

https://www.pregnancybirthbaby.org.au/birth-trauma-emotional 

Panda – Perinatal Mental Health 

https://panda.org.au/articles/childbirth-trauma-and-recovery/ 

COPE – Centre for Perinatal Excellence 

www.cope.org.au 

Miracle Babies Foundation 

https://www.miraclebabies.org.au/content/birth-trauma/gmc0l4 

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