Two people from Northern Ireland who saw their loved ones murdered tell Leona O’Neill how being an eyewitness to trauma can have a devastating and lasting impact on health
Veteran war reporter Fergal Keane is to step down from his role as the BBC's Africa correspondent after revealing he has Post Traumatic Stress Disorder - an anxiety disorder caused by very stressful, frightening or distressing events.
Keane, who has reported from war zones across the world over several decades, said that he'd taken the decision to help his recovery. He took to Twitter to thank those who wished him well and stated there would be "no more war or traumatising situations".
His diagnosis was the result of "several decades of work in conflict zones around the world", said the BBC's head of newsgathering, Jonathan Munro.
He added that Keane had "been dealing privately with the effects of PTSD for several years".
Two people from Northern Ireland who live with PTSD say they feel he is doing the right thing.
A Tyrone man who has battled severe PTSD for three decades after he watched his 20-year-old sister die in an IRA border bomb says the lasting impact of the horror that he witnessed is something he has to live with every day.
David Kerrigan's sister Heather, a member of the UDR, was killed in a bomb attack on the patrol he was leading down a border road in the Corgaries area, near their home in Castlederg, in July 1984. Another UDR man Norman McKinley was killed instantly. David, whose wife Irene also served in the UDR, suffered severe injuries to his back in the blast and his sister died in the Army helicopter on the way to the hospital as David lay gravely injured and helpless by her side.
Father-of-three David (62) says he still suffers flashbacks of that day and is yet to find a treatment that works for him.
"I didn't get any help after Heather was killed in 1984," he says. "I struggled on by myself for around 16 years. It was around the year 2000 before I went to the doctor for the first time to talk about what I was going through. I wasn't sleeping and I was having nightmares and flashbacks for that entire time. I felt that there wasn't something right with me.
"After speaking to my GP, I got a bit of counselling. I found that very hard, because it was all so very raw. I had never spoken to anyone about it for 16 years. It was just all going through my mind, over and over.
"What happened has affected me for my whole life. It got to a point that I wished I had never joined the Forces. It just wrecked my whole life."
David, who left the UDR and went on to join the RUC after his sister's death, has been treated for severe PTSD since 2000. He says the murder of his sister, the IRA murder of his brother-in-law Thomas Loughlin just four months before that, and his subsequent struggle with PTSD have shattered his family.
"Irene and I have three boys and they weren't allowed to do things," he says. "There was still a very high threat in the area and before we would go out I would have to check under the car. Doors were locked. The kids weren't allowed to tell anyone what their mother and father did for a living.
"One of the symptoms of PTSD is a heightened sense of alertness. I was alert all of the time. If someone banged the door I would jump. I just felt nervous all the time.
"I was never like that before Heather was killed. I had an outgoing personality. But now, even years later, I stay in the house. I don't want to go anywhere or mix with anyone. It's in my head all the time. There is no escaping it. I have the worst dreams, and they do scare me. And the next day I get up and my head is humming.
"People don't understand. They might see you out and about, but they don't know what's going through your head. People ask you how you are. You say that you're fine. But in reality I might have been lying in my bed all day with a humming in my head and feeling very depressed."
David says that he has tried everything to help combat his PTSD, but feels he can find very little to get on top of the condition. "I have been to counselling," he says. "That first time it helped me a bit to talk to someone about it. It helped me to get things off my chest and it was good that there was someone there to listen. I have done more counselling since, but I don't think it helps me. You're living through the whole thing every day and it just did me no good, so I just stopped.
"Nothing has helped me. I just want my health back, and justice. And perhaps I know deep down that I won't get those things. And that gets me down too. Closure and justice are what I need. It's what keeps me fighting on. But that takes its toll too. One thing that does help me is to know that I'm not on my own. Other people have experienced this too.
"I think it's good that Fergal is taking a step back from that line of work.
"It's a good decision for him. When you have PTSD you need to look after yourself. Your health is your number one priority."
Mid-Ulster Aontu councillor Denise Mullen was just four years old when she witnessed her father Denis being shot dead on the doorstep of her family home. The former SDLP councillor says the nightmarish memories she suppressed and the childhood trauma she endured have resulted in PTSD.
The 48-year-old mother-of-two witnessed her father, SDLP councillor Denis Mullen, being killed at their Moy home by the notorious Glenanne Gang in September 1975.
She says she is certain that what she witnessed that night - she also heard them shoot at her mother Olive as she fled across fields to safety, then sat in her blood-soaked nightie at her dead father's side waiting for help to arrive - caused her to develop the PTSD that she has lived with since.
"Growing up in the Seventies and Eighties in Northern Ireland, PTSD would have been unheard of," she says. "There was no counselling for people who suffered trauma. I think it wasn't until after the Good Friday Agreement that there started to be any real support for victims and survivors of the conflict. By that time I would have been on medication for anxiety every day, and I am still on medication. For me, it wasn't until I was around 23 years old that I got help.
"I have had nightmares and flashbacks since childhood. I had panic attacks all the way through primary school though back then I didn't know what they were. But they used to leave me in such a bad way that I was always gasping for breath.
"In later years they were really bad and I would have taken them all the time. I would sit at the back of the chapel because I was afraid of taking a panic attack if I went up for Holy Communion. It really came to a head for me when my son was a couple of months old. I was having such bad panic attacks, worrying about things like how I was going to teach my son how to tie his shoe laces or ride a bike. Finally, at the age of 23, I talked to my doctor about what I was experiencing."
Consequently, 19 years after seeing her father shot dead in front of her, Denise had a diagnosis. However, that was not the end of her problems; instead she says that she has continued to endure the worst symptoms.
"For years before I went to the doctor I had a certain type of flashback," she says. "I still do at times. I could be anywhere at any time, I don't know when it is going to happen, but a smell comes over me. It's the smell of the doorstep that night, the smell of the whole scene.
"Around 10 years ago I was speaking to a psychologist and they told me that I had one of the most severe cases of PTSD they have ever come across. They said the smell was one of the most significant symptoms."
Denise says that the PTSD is always part of her life. "I'd describe it as an anger - not towards other people, but within myself. It's like an oppressed anger stemming that strong feeling of injustice.
"I am involved in many organisations with other victims of the Troubles and other groups.
"What I notice above all else is that it affects you with regards to forming relationships. Trust issues are a huge thing.
"In the days after my daddy was murdered I developed a sore on the back of my right knee. And every time I feel very stressed or anxious now I take the worst pain in the same knee at the same spot. I went for craniosacral therapy and I found out this place is where I harbour my pain. I found that therapy useful and it did help me overcome things.
"Thankfully, I have now got away from the panic attacks - I've been helped a lot by holistic therapies like reflexology and aromatherapy. I still can't get rid of the smell flashbacks though."
Denise says that Fergal Keane is right to take a step back and look after himself. "I have taken a step back myself," she says. "And I have learned to read myself really, really well. Hence I can identify what triggers me. I also feels it's good to talk."
She adds: "It is something that you always have to live with. For me, I am just a stereotypical sufferer of PTSD. I am a workaholic, I work seven days a week. It's a coping mechanism and a way to block out things. But you just get on with life, because there is nothing else for it."
Someone with PTSD often relives the traumatic event through nightmares and flashbacks, and may experience feelings of isolation, irritability and guilt.
They may also have problems sleeping, such as insomnia, and find concentrating difficult.
These symptoms are often severe and persistent enough to have a significant impact on the person's day-to-day life.
PTSD can be successfully treated, even when it develops many years after a traumatic event. Any treatment depends on the severity of symptoms and how soon they occur after the traumatic event. Treatment options include: