Çocuklarda Deprem Korkusu
10 Şubat 2023
Ölüm Kaygısı
17 Şubat 2023
Travma Sonrası Stres Bozukluğu
Travma, kişide büyük bir çaresizlik ve korku duygusu uyandıran, aynı zamanda kişinin yaşamını beklenmedik bir şekilde tehdit eden, stres ve sıkıntı yaratan, olağandışı durumların meydana getirdiği etkilerdir
Yakın çevreden birinin ani kaybı, doğal afetler (deprem, yangın, sel), taciz veya tecavüz saldırıları, kaza yaşamak, ağır bir hastalığa yakalanmış olmak, patlamalar, savaşlar, şiddet veya işkence görmek, kişi üzerinde ruhsal travma yaratabilecek olaylardır. Kişi travmayı bizzat kendisi yaşayabilir veya travmatik bir ana şahitlik edebilir. Bu tür travmatik olaylar yaşayan veya bu olaylara şahit olan bireylerden bazıları bir yas süreci geçirebilir ve zamanla iyileşir, hayata yeniden adapte olabilir. Fakat bazı bireyler, yıllar geçse de önceki yaşamındaki iyilik haline dönemeyebilir.
Yaşamış oldukları kaygı ve stres ile birlikte travma sonrası stres bozukluğu veya depresyon geliştirebilir. Bir travmanın ne kadar şiddetli ve tehlikeli olduğu, zaman olarak ne kadar uzun sürdüğü gibi etkenler travma sonrası stres bozukluğu gelişimini etkilemektedir. Özellikle insan eli tarafından gerçekleştirilen travmatik olaylar doğal yollarla oluşan olaylara göre kişileri çok daha olumsuz bir şekilde etkilemektedir.
Travma sonrası kişilerde ortaya çıkan en sık rahatsızlıklar travma sonrası stres bozukluğu ve depresyondur. Ruhsal bir travma sonrası ortaya çıkan depresyonda, kişiler yoğun olarak moral bozukluğu, isteksizlik, uyku bozukluğu, iştah eksikliği, hareket kısıtlılığı gibi belirtiler yaşamaktadır.
Travma sonrası stres bozukluğu geliştiren kişilerde ise uykusuzluk, iştah problemleri, kabuslar görmek, olayla ilgili anıların devamlı olarak zihinde canlanması, her an tedirgin ve tetikte hissetmek, çok çabuk irkilmek, geleceğe yönelik planlar yapamamak, sosyal hayatın kısıtlanması, kolay bir şekilde sinirlenmek ve huzursuz hissetmek, olayı hatırlatan durumlardan, konuşmalardan, kişilerden kaçınmak, çevresine karşı yabancılaşmak ve duygusal olarak körelmek, olayın tekrar olacağına dair yoğun düşüncelere sahip olmak gibi belirtiler ortaya çıkmaktadır. Bu belirtiler kimi insanlarda birkaç hafta sonra ortadan kaybolabilirken, kimi insanlarda uzun süreler boyunca kalabilmektedir. 2. Dünya savaşı sonrası askerler ve gazilerde uzun süre belirtilerin yaşanması da travma sonrası stres bozukluğuna bir örnek olarak gösterilebilir.
Travma sonrası stres bozukluğu yaşayan kişilerde, belirgin olarak olayı yeniden hatırlamak, olayı hatırlatacak durumlardan kaçınmak ve aşırı uyarılmışlık hali gibi belirtiler ortaya çıkmaktadır.
1.Olayı yeniden hatırlamak: Kişi olayları sürekli olarak bir döngüde hatırlamaktadır. Anımsamak istemediği duygular, imgeler, düşünceler ve sesler devamlı olarak aklına gelmektedir. Örneğin o an şahit olduğu sesler, haykırışlar zihninde belirmektedir. Bununla birlikte kişide terleme, titreme, kalp çarpıntısı, nefes almakta zorluk, iç sıkıntısı gibi fizyolojik tepkiler meydana gelmektedir. Kişi hatırlağı anı gerçekten yaşıyormuş gibi tepkiler verebilmektedir. Örneğin yaşamış olduğu bir travma depremle ilgili ise sallanıyormuş gibi hissetmek ve buna uygun davranmak, kaçmaya çalışmak şeklinde davranışlar sergileyebilir.
2. Kaçınma: Kişi, travma yaratan durumu hatırlatan kişilerden, seslerden, mekanlardan, diyaloglardan, anılardan kaçınmaktadır. Travmatik anı hatırlamak kişi üzerinde büyük bir sıkıntı, üzgünlük hali, kaygı, stres, korku duygusu uyandırmaktadır. Bu sebeple kişi, olumsuz duygulardan uzaklaşabilmek için o anı hatırlatan durumlar içerisine girmemektedir. Olaya ait duygu-düşüncelerini ve anıya ait detayları bastırmaktadır ve bu şekilde olayın en acı verici kısımlarını unutabilmektedir. Bazen kişi bu anı hatırlamak istese dahi anımsamakta zorluk yaşayabilir.
3.Aşırı Uyarılma: Yaşadığı ruhsal travma sonrası bireyler hayatlarını aşırı tetikte bir halde geçirebilmektedir. Travmatik anın tekrar olacağına dair büyük bir endişe, korku hissederler ve her an bir tehlike içindeymiş gibi tedbirler almaya çalışırlar. Travmadan kaynaklı aşırı uyarılmışlık halinde olan ve diken üstünde bekleyen kişiler yüksek seslerde, beklenemedik hareketlerde kolay bir şekilde sıçrama, ürkme, bunalma, terleme, titreme, nefes darlığı gibi belirtiler yaşayabilmektedir. Aşırı uyarılmışlık haliyle birlikte kişinin uyku düzeni de büyük oranda etkilenmektedir. Ufak bir seste uyanmak, uykuya dalmakta zorluk yaşamak sık yaşanan belirtiler arasındadır.
Yaşanan olayın büyük bir felaket, her şeyin kaybı, gelecekte yaşamanın anlamsızlığı gibi gösterilmemesi önemlidir. Deprem öncesi günlük yaşantısına bir an önce dönebileceği uygun ortamlar oluşturulmalıdır. Örneğin, top oynamayı seven ve büyüyünce futbolcu olmak isteyen bir çocuk için kağıttan bir top yapıp oynaması sağlanabilir.
Çocuklar, yetişkinlere göre daha kırılgan olarak düşünülse de aslında psikolojik olarak daha sağlam ve esnek bir yapıya sahiptir. Travmatik tetikleyicilerden sıyrılıp günlük rutinlere uyum sağlama ne kadar hızlı gerçekleşirse psikolojik olarak iyilik hali de o kadar artacaktır.
Tedavi
Travma sonrası stres bozukluğunun tedavi yöntemleri arasında psikoterapi desteği veya ilaç tedavisi almak mümkündür. Travmatik stres bozukluğu belirtilerini gösterme derecesine göre kişilere uygun tedavi planlamaları yapılmalıdır. Bilişsel Davranışçı Terapi ve EMDR terapisi travma sonrası stres bozukluğu için kullanılan etkili tedavi yöntemleri arasındadır.
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