PUBLISHED: 13:43 EST, 11 June 2012 | UPDATED: 14:37 EST, 11 June 2012
An increasing number of Holocaust survivors are only now suffering from post-traumatic stress disorder decades after the horrors of the Nazi death camps.
Most patients with PTSD, such soldiers returning from conflict, develop symptoms within six months of a traumatic event.
But in the cases of those incarcerated or fleeing Hitler during World War Two, the incubation period is proving to be many years longer.
Holocaust researchers say the problem is coming to the fore partly because few survivors sought psychiatric help soon after the event.
What is less clear, however, is why they may be showing signs of the illness only now in old age.
While some did suffer early on, experts believe others appeared highly resilient as they set their minds on work, family and a new life, and it is not yet fully understood whether the symptoms are completely new or aggravated forms of a long-suppressed condition.
Sonia Reich was first hunted by the Nazis as an 11-year-old orphan seeking shelter in the Polish countryside.
Like many in her position, she was not offered therapy, but went on to spend 50 years as a suburban mother and wife in Chicago, Illinois, apparently without any symptoms.
Until one day, in her 60s, when her son Howard received a phone call.
‘I received a call at midnight saying that my mother had run out of her house and been picked up by the Skokie police,’ the Chicago arts critic told the Boston Globe.
Mrs Reich had been screaming that someone was trying to kill her.
After her husband died, her children began to notice some odd traits, such as sleeping with an axe under her pillow.
‘We did not connect those behaviors with what she went through as a child in the Holocaust,’ said Mr Reich, who consulted a geriatric mental health specialist and was told his mother had late-onset PTSD.
Mr Reich said: ‘People say to me, “If only she’d talked about it, it would be much better.” Well, that is not necessarily true.
‘Some people’s way of dealing with memory is to put it aside. And that enabled people like my mother to have a beautiful life in America.’
Prominent scholars have written about re-emerging trauma in elderly Holocaust survivors over the last few decades and one support group in Israel estimates that as many as 40 to 65 per cent fall into that category.
But many carers and nursing homes appear ill-equipped to deal with or are unaware of the condition.
And it is not just Holocaust survivors, but servicemen and women who witnessed the horrors of war that have been found to suffer delayed onset PTSD a long time after the event.
WHAT CAUSES PTSD?
PTSD is a reaction to a traumatic event where we can see that we are in danger, our life is threatened, or where we see other people dying or being injured in circumstances out of our control.
Many victims of serious accidents, military combat, terrorist attacks, disasters and life-threatening illnesses have been diagnosed with suffering from PTSD.
The symptoms of PTSD can start immediately or after a delay of weeks or months following the event. But in some cases it can even be years or decades before symptoms emerge.
People with PTSD suffer from depression, anxiety, feelings of guilt, flashbacks and nightmares, feeling numb and withdrawn, hyper alertness, and physical symptoms caused by stress.
There are many different forms of treatment and people suffering with the symptoms of PTSD are advised to see their GP.
Professor at Anglia Ruskin University Jamie Hacker Hughes, who specialises in traumatology and veteran mental health, said it is not that unusual for patients who suffered trauma during World War II to suffer PTSD many years afterwards.
He said: ‘A lot of research has been carried out into the delayed onset of PTSD and it has become quite well known for symptoms to occur many, many years after the event for Holocaust survivors and other survivors of World War II.
‘When we talk about trauma that occurred during war time Britain, there are huge cultural differences between then and now in how people express their emotions.
‘In war time Britain people spoke of ‘keeping a stiff upper lip’ and were encouraged not to express their feelings ot talk about their emotions whereas now it’s the opposite.
‘People are now encouraged to talk about it and to ask for help if they need it.
‘I have treated several military veterans for delayed onset PTSD. One patient was in the a Royal Air force during the Blitz but wasn’t referred to see me for another 50 years until the mid-1990s.
‘The symptoms of PTSD can sometimes be hard for the patients to recognise because the trauma causing it happened so long ago.
‘It may be bad dreams, nightmares, increased response or hyper vigilance that they just shrug off or put down to something else.
‘But it’s very treatable and I would urge anyone suffering with the symptoms of PTSD to go to see their GP and get a referral.’
Psychiatrists recommend anti-anxiety or anti-depressant medications as well as cognitive behavior therapy for severe forms, while others help elderly survivors record their Holocaust narrative in an attempt to gain control over their memory fragments.