The need to deal with PTSD in Balochistan

Post-traumatic stress disorder (PTSD) is a complex mental health condition that is induced by a terrifying event (traumatic event) either by experiencing it or witnessing it. Most of the people in normal setting experience a range of reactions after trauma, and most of them recover from initial symptoms naturally. However, those who do not recover and continue to experience problems could be diagnosed with PTSD. Most people diagnosed with PTSD may feel stressed or frightened even when there is no apparent danger.

The symptoms of PTSD are divided into four broad categories (listed below) however they may vary in intensity from person to person.

1. Intrusive thoughts: repeated memories, distressing dreams, and vivid flashbacks of the traumatic event.

2. Avoiding reminders of the traumatic event: By avoiding people, places, activities, objects, situations that remind the event or even talking about it.

3. Negative thoughts and feelings: Negative perception about own self or others, fear, horror, anger, guilt, losing interest.

4. Reactive symptoms: Irritability and angry outbursts, easily startled or having problems focusing or sleeping.

These symptoms appear within three months of the trauma, but for some they appear later. For a person to be diagnosed with PTSD the symptoms last for more than a month and often persist for months and sometimes years. PTSD poses a person to a significant amount of distress and problems in their functioning. It often occurs with other related disorders, such as depression, substance abuse, memory problems etc.

In Pakistan, there have been a handful of studies done to highlight the prevalence of PTSD among victims of certain traumatic incidences. Most of these studies followed the 2005 mega earthquake that struck Pakistan, while the others are based on Afghan refugees in Peshawar and some on 2010 floods in Pakistan. However, in the context of Balochistan, there have been no specific studies. The important thing to highlight here is the fact that the citizens of Balochistan have unfortunately experienced immensely traumatic incidences in the past years. From natural disasters such as earthquakes, floods and droughts to unnatural disasters including acts of violence and terrorism, Balochistan has seen it all.

Very recently some students of Bolan Medical College, Quetta studied about the prevalence of PTSD among the terrorism affected Hazara community of Quetta. They have reported high levels of PTSD among the community however a lot more researches need to be done to make a conclusion on this complex scenario. Moreover, studies that involve the population as a whole should also be considered by the medical researchers in Balochistan which can eventually help policy and funding on mental health issues in the region. Mental assessment of victims and their families must be considered compulsory after any unfortunate incident of violence or terrorism that is likely to cause mental health damage in the region.

PTSD and related disorders need to be managed and treated effectively and timely owing to the fact that these disorders can cause disability and/or dysfunctionality of the affected person to a great degree. Additionally, a person with PTSD or related disorders becomes dependent on the other family members until the course of their treatment. This could also push other members of the family towards minor mental disorders such as acute stress disorder adding burden to the existing load of the problem.

Another aspect of the issue stands as a severe lack of awareness among locals regarding PTSD and other mental health disorders which is in fact a national issue rather than just a provincial one. As described above, the symptoms of PTSD and of other mental disorders are highly complex, variable and difficult to catch by any observer unless you are a medical expert yourself. Treatment and management of PTSD or any other mental disorder can only be possible when the affected person is properly diagnosed, and for that the affected person or their family members need to know when to consult a psychiatrist. This is apparently the biggest loop hole in considering treatment for mental health issues in Pakistan where people would visit spiritual ‘Peers’ and ‘Babas’, before medical experts and doctors, considering a ‘Jinn’ has possessed the affected person.

In Balochistan, after the tiring efforts of the senior most psychiatrist of the region, Dr. Ghulam Rasool and his team, a separate institute for mental health was established in Quetta some years ago. The Balochistan Institute of Psychiatry and Behavioral Sciences (BIPBS) stands as the only mental health institute in Balochistan which is gradually taking pace in handling the mental health crises of the region. However, the region still needs to go a long way to properly cater to this situation in which the government can play a crucial role. Thus, proper funding and formation of a mental health policy for Balochistan can greatly help initially.