PTSD in Peshawar: The long road back

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Soldiers stand guard as APS students leave. —AFP
Soldiers stand guard as APS students leave. —AFP

It was during our morning report on the Inpatient Psychiatric Unit when we heard his screams.

We all ran to his room and found him standing there, his hands tightly clenched into fists, ready to fight. I caught glimpses of anger and fear simultaneously flash across his face as he stared at the empty space in front of him.

He did not respond to us, he did not even turn to look at us when we called his name.

My Attending quickly asked the nursing staff to bring in his medication. Later, he explained to us, the inexperienced interns, that our patient was having a flashback, a severe symptom of Post Traumatic Stress Disorder.

In other words, he was re-living his emotional trauma, unaware of his surroundings and the people around him. He was simply at a time back in his life where he had suffered a distressing ordeal.

This is just one of the diagnostic criteria of PTSD — a disorder where one is exposed to a situation that was life threatening or caused serious injury; symptoms can include flashbacks, nightmares, panic attacks, hyper vigilance and sleep disturbances.

After the APS tragedy, a lot of my colleagues in the US either went to Peshawar or provided Psychiatric services through tele-psychiatry.

Three months since the Peshawar attack, it is with a sense of failure, I realise that despite my more than seven years of experience in psychiatry, I still do not have the emotional strength needed to reach out to the children of APS.

I lack the courage, the self-control required to remain compassionate yet composed, while listening to the events that unfolded in front of their eyes in the very school they grew up in; learning, playing and protected from the harsh realities of the world.

Also read: Most victims shot in the head

I fear, even if I tried, they may see an adult, a professional who has heard countless tales of torture and pain, at a complete loss for words, somewhat broken and unable to hold back her tears.

I cannot as once I, too, was a child just like them, growing up in Peshawar, surrounded by friends, trying to bunk classes, playing sports and frantically cramming for my exams at the last minute. I can, however, relate to their life before December 16th. Therefore, I can also relate to their pain.

The image of two young children, walking away with an army personnel, their bags not on their back, small hands holding on to the officer, evoked an extreme sense of loss in me. I wondered if they would wake up at night from tremors; their little hearts racing.

I often wonder how they cope when, during the day at school, they disassociate from their surroundings, they may not remember what they were discussing or who they were talking to. These symptoms can happen out of the blue, at any time.

The sound of footsteps in the playground may take them back to that terrible day when they heard boots coming towards them, taking their friends away from them.



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