Duress is to do with feeling pressure under threat or violence. Prolonged Duress Stress Disorder is a stress disorder that is deep rooted of stress, feelings of loss of control or feelings of being trapped. When talking about PDSD, it is linked to the Complicated Subtype of PTSD.

There are 6 main categories when explaining PTSD, and they range from Acute where there is a small time frame for up to 6 months that the trauma is suffered for. The next being Chronic PTSD and this is where the suffering is beyond 6 months for an additional 6 months (having to be reanalysed if suffering from PTSD after each bracket of time). The 6 months does not have to be exact but is a good indication if the suffering is from around half a year to over this and onto the longer term. Delayed PTSD, is where the response to the trauma is delayed and comes up at an unpredictable period in time; arousal coming from one trigger that alerts feelings that have been suppressed for perhaps days, weeks, months or even years. It is unpredictable and can strike at any moment. The subconscious does not know of time nor space, there for allowing a person to relive the trauma as if it had just happened. The next step being Delayed and Chronic PTSD, this is where the symptoms of trauma do not appear until after 6 months and for longer than 6 months. Giving the delay and unpredictable aspect along with the longer lasting suffering of trauma. An example of this can be people who have fought in the war, and they suppressed these traumatic feelings of intense events for so many years and then when they watch a war film or are reminded of the time they were on the battlefield through museum exhibition and so on, they then have feelings of intense trauma brought back up, to the time of the event. These feelings come back over the victim as if suffering from trauma for the first time. The 5th step being Simple PTSD, this is where the person has no previous suffering of any mental illness, nor suffering or traumatic events during their life. This is explained as Simple, however that is not to say that the situation is simple and should still be taken with as much caution and care like the other subtypes of PTSD. Simple PTSD is where the trauma can be directly linked to one specific event. And then we come onto the Complicated subtype, PDSD which I will go on to explain in further detail.

Complicated PTSD or ‘PDSD’ is when the person has had a background of traumatic events over their life. There is not one direct cause to their suffering but instead had been inflicted to suppressed suffering over days, months, years before their trauma even appears. There may be a series of incidents that are seen as traumatic that come before the diagnosis of PDSD.

Prolonged Duress Stress Disorder can also be known as Sequential Traumatisation, again referring to a repeated series of traumatic events. The traumatic events become deep rooted into the individual instead of being addressed at each time; this perhaps due to the prolonging of the trauma and continual attack.

An example of someone who suffers from PDSD is perhaps someone in the police force. Who goes out on a job and sees dead bodies over and over again, perhaps working on the field and having to deal with people jumping in front of a train every week. This at first would be very shocking for them, but by the time the next week comes around they have to go over and do the same procedure over again. In the meantime, instead of dealing with what they had been asked to do and completed said task, they instead block it out with a drink or suppress it by just not allowing yourself to feel what trauma has taken place. Perhaps, after years of such work repeatedly seeing the debris of suicide victims they see a victim hit by a train, but this time a baby’s body. The difference between an adult and a child might have been the trigger in the catalyst in feeling horror to the traumatic event. But perhaps, getting to know the reasons why the trauma in the first place, became aroused is from a long time ago and had been suppressed over and over.

The canteen culture, of pretending one is at peace with the work they do and are not phased by the horror they have endured can perhaps be a key player in the work by the police force and the onset of PDSD. Especially men having to act macho and under control about it all, opposed to be shocked and traumatised by picking up dead body parts sprayed across the tracks.

Another example may be a victim of domestic abuse, and then later rapped by another person and then gone on to being robbed at night on the street. This long and terrible list of incidents may not have erupted a feeling of trauma in the person each time; however these feelings are pushed away and not dealt with properly and have deeper rooted aspects of trauma as each one goes on. This can also be a painful timeline of trauma, suffering one after another and they seem to continue on for the victim.

Signs and symptoms of PDSD can include irritability, re living the trauma, fear, worry, through flashbacks of intense emotions, this can also affect their sleeping patterns. There can be constant alerts of feeling like there is danger around and perhaps even feeling emotionally numb.

Getting people to open up to help if suffering from PDSD can be slightly more challenging, especially if the reasons and causes are not easily outlined. In the example above to do with the police force, this is slightly more linear to investigate as the trauma has come from working in the police and it is a build up of events since being in the force. Otherwise, there is a way of investigating such trauma and this is through the Trauma Trail. The Trauma Trail is a way of finding out the timeline and events that have come along with each traumatic event. It is perhaps like drawing a map of how the person has ended up with PDSD.After each event of a trauma has been discovered, assets and investigated, other events may appear from the thread work and so on. Therefore getting this (map of incidents) Trauma Trial. It may not be easy to do but it is very important that things are uncovered and so the person can heal and relieve the suffering.

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To conclude, PDSD is a complicated form of PTSD. This is predominantly where the trauma is cumulative rather than sudden.