Post-traumatic stress. “We can detect the first clinical signs, particularly a change in behavior.”

Elodie Pi-Leroy, head of the psychiatry department at the Robert-Piquet Army Teaching Hospital in Bordeaux, works closely with Athos. A place designed and funded by the Ministry of Armed Forces to support mentally injured servicemen in the process of psychosocial rehabilitation. It is an opportunity to discuss with him this evil that often develops quietly… and can have serious psychological consequences and even destroy lives.

Madame Figaro. – Can you give us the definition of post-traumatic stress?
Elodie P-Leroy.– It’s a syndrome that’s been known in armies since ancient times, even if it’s called something else. During Napoleon’s reign, there was talk of cannonball syndrome. Today, it is defined as an organized and lasting condition caused by a situation in which the subject may be exposed to a stressful, catastrophic or inhumane event. In the case of the military, it can be situations of direct or indirect confrontation with combat or death. This stress often manifests itself at a distance from the event. At this moment, either there is no direct manifestation, or there may be an acute stress state. Most often, the so-called latent phase occurs, symptoms are absent or develop quietly. Then the first symptoms appear, in particular, the resuscitation syndrome. People see the images of the event again, relive it and experience the same emotional charge, it can be day flashes or nightmares. Symptoms of hypervigilance, startle from noise, oculophobia (fear of crowds, Editor’s Note), avoidance behavior may be accompanied by withdrawal, behavioral changes, mood swings, anxiety or anger attacks, cravings, etc.

Are there warning signs, and can they be avoided?
The only way to avoid this would be to resist these events. However, we cannot know in advance what is traumatic for this or that person. In a group of people, the same event may cause injury to one or two people, but not to the whole group. And we don’t know it in advance. On the other hand, we can identify events with high traumatic potential and try to detect the first clinical signs in the days and months that follow, particularly a change in behavior.

Can we recover from PTSD?
Psychotherapies recognized by the highest health authority are mainly EMDR (eye movement psychotherapy that targets traumatic memories) and CBT (cognitive and behavioral therapy). But each individual will choose the tools that suit them best. At our hospital, we also offer occupational therapy, psychomotor therapy, wellness care, discussion groups, and more. The main thing is to be able to treat early enough, and therefore do not hesitate to consult your doctor as soon as the first symptoms appear. So the first step is to restore sleep and refine the diagnosis to offer the most appropriate primary treatment. There may be progression to a stable form, most often with a continuance of sleep disturbances, hypervigilance, or even social isolation that are quite disabling. This is why it is necessary to have this support for psychosocial rehabilitation and training or to return to work, possibly in an adapted position. It’s a long-term, networking job.