When to Seek More Help: How NICU Parents Can Recognize PTSD Symptoms

NICU Admissions are a stressful time and even a terrifying experience for all of those involved. Trying to figure out how to manage in a the strange NICU world can be overwhelming for many NICU Parents.

Many parents are able to cope with the additional NICU stressors with a little help, by doing things like becoming an empowered NICU Parent, finding healthy strategies for dealing with NICU stresses and discovering ways of interacting with their NICU newborn.

Some parents continue to find the NICU experience to be an overwhelming one. As noted by former NICU Parent, Kim Roscoe:

The NICU was very much like a war zone, with the alarms, the noises, and death and sickness. You don’t know who’s going to die and who will go home healthy.

NICU experiences can even continue to haunt them once they have returned home with recurring flashbacks and a hypervigilant state. Researchers are slowing realizing (and documenting) that having a child in the NICU puts parents at risk for developing PTSD or Post Traumatic Stress Disorder.

In a recent article by Laurie Tarkan for the New York Times, she summarizes three different types of traumas that NICU parents experience with put them at risk for developing Post Traumatic Stress Syndrome (PTSD):

1. Having an early, often unexpected delivery.
2. Watching your own infant and witnessing other infants enduring traumatic medical procedures and life-threatening events.
3. Receiving serial bad news.
   

The NICU adventure is more like the war zone and unlike other single traumas (like an accident), because the bad news can keep coming again and again, re-traumatizing parents every time there is a setback in their NICU baby's health.

Recognizing PTSD (Post Traumatic Stress Disorder)
The National Center for PTSD reports that there are four types of symptoms for PTSD: reliving the event, avoidance, numbing, and feeling keyed up.

1. Reliving the event (also called re-experiencing symptoms) - Bad memories of the traumatic event can come back at any time resulting in feeling the same fear and horror you did when the event took place. Nightmares and flashbacks may also occur. A flashback is a feeling like you are living through the event again.
   
2. Avoiding situations that remind you of the event - Avoiding situations or people that trigger memories of the traumatic event, even avoiding talking or thinking about the event.
3. Feeling numb - Find it hard to express your feelings.
4. Feeling keyed up (also called hyperarousal) - Feeling jittery, or always alert and on the lookout for danger.

For even more information on PTSD symptoms check the National Center for PTSD Article or the one from the Mayo Clinic.

When to Advise Seeking More Help
Any parent feeling or showing any of the following:

• Prolonged agitation or anxiety
• Depression or extreme hopelessness
• Impaired daily activities or job function
• Suicidal thoughts or ideas
• Extreme physiologic or psychological reactions
• Substantial guilt
• Substance abuse either alcohol or drug use
• Psychotic states
• Uncontrolled rage
• Prolonged, inhibited or absent grieving

Any NICU parent experiencing signs of PTSD or the other concerning signs above for more than a month should seek out their health care provider for further evaluation to help get your life back under control.

Screening for PTSD
A helpful screening tool for determining NICU parents at risk is the Perinatal Posttraumatic Stress Disorder (PTSD) Questionnaire (PPQ) designed by researcher and former NICU Parent Dr. Michael Hynan. This tool can help determine if the NICU Parents might need some additional support once the family is discharged from the hospital.

Resources
Dyer KA. 2009. NICU Admission Puts Parents at Risk for PTSD. NICU Parent Support Blog.
National Center for PTSD. What is PTSD? National Center for PTSD.
Mayo Clinic Staff. 2009. Post-traumatic stress disorder (PTSD) Symptoms. Mayo Clinic.
Tarkan L. 2009. For Parents on NICU, Trauma May Last. New York Times.

Images:
Chris Sternal-Johnson. The NICU Pod. Creative Commons License.
Sanja Gjenero. Helping Hands. Royalty Free Use.