ptsd and trauma: what to expect after the unexpected
the impact of trauma
Trauma can have a powerful and lasting effect on our physical and mental health. We tend to experience immediate reactions to trauma such as fear or anxiety. However, trauma can also disrupt our sleep, can make us more agitated or fearful and even affect the way we behave socially.
Some of these symptoms may reduce after the immediate shock, however some symptoms can be more long-lasting and can even be experienced years after the event if a person is triggered.
There are treatment options available to help a person cope after a traumatic event and in many cases, the sooner the treatment, the better.
WHAT IS ACCUTE STRESS DISORDER?
In the days and weeks following a traumatic event, you may begin to experience many different emotions or behaviours. A traumatic event might include;
- Witnessing a death
- Experiencing or witnessing a threat of death to yourself or others
- A threat of serious injury
Witnessing or experience such an event can lead to feelings of immense fear, horror, helplessness or even guilt. The prolonged experience of these symptoms can lead to a disorder called, Acute Stress Disorder or ASD. Acute Stress Disorder can develop in the period immediately following a traumatic event and can last up to one month.
SYMPTOMS OF ACUTE STRESS DISORDER
1. INTRUSION SYMPTOMS
Sometimes memories might force their way into your mind without your control and these can be very distressing. A person may experience constant and distressing dream.
2. NEGATIVE MOOD
A person may feel that it is difficult to experience positive emotions. A constant feeling of being sad, down, or depressed.
3. DISSOCIATIVE SYMPTOMS
A person might feel like they are in a daze, almost like an outer-body experience or that time has slowed.
4. AVOIDANCE SYMPTOMS
A person may avoid memories, thoughts or feelings associated with the trauma. A person may avoid people or things that remind them of the trauma.
5. AROUSAL SYMPTOMS
You might find it difficult to fall asleep or stay asleep. You might experience more irritable behaviour. You might find that you have trouble concentrating.
WHAT IS POST-TRAUMATIC STRESS DISORDER?
Post-Traumatic Stress Disorder (PTSD) is a severe psychological reaction to the experience of a traumatic event, similar to those events described in Acute Stress Disorder. Post-Traumatic Stress Disorder develops when a person struggles to recover after a traumatic event and goes on to experience quite severe and long-lasting symptoms.
Several criteria have to be met in order to provide a diagnosis of PTSD. An brief example of the criteria are as follows:
CRITERIA FOR POST-TRAUMATIC STRESS DISORDER:
Criterion A: Traumatic Event
The traumatic event includes the experience of an actual or threatened:
- Serious Injury
- Sexual Violence
The experience may be directly related to the person or witnessed by the person. It might also include indirect experiences such as hearing of a relative or close friend who has suffered the event. The experience can also include repeated indirect experiences, such as the constant experience of trauma by police officers or paramedics.
Criterion B: Intrusion of Re-experiencing
A person constantly finds themselves reliving the traumatic event. This could occur in the form of:
- Thoughts or memories that seem to force their way into your mind.
- Nightmares related to the traumatic event.
- Flashbacks and feeling like the event is happening again.
- Emotional reactions to triggers that remind you of the event, like seeing a large truck after you had been involved in a car accident.
Criterion C: Avoidant Symptoms
Avoidant symptoms describe how a person might try to avoid thoughts, memories, places or even people who remind them of the traumatic event.
Can include avoidance of feelings related to the event. Can include avoidance of people or places associated with the event.
Criterion D: Negative Alterations in Mood or Cognitions
This criterion describes feelings of being sad or depressed. It can also include problems that a person might experience with their memory and thinking.
Symptoms might include:
- General memory problems
- Negative thoughts or belief about life
- Feeling a sense of blame or guilt that could be seen as excessive or even distorted
- The experience of being stuck in severe emotions such as horror, shame or sadness
- Reduced interest or motivation for activities you used to enjoy
- Feeling isolated or disconnected from other people.
Criterion E: Increased Arousal Symptoms
This criterion describes feelings of being nervous or apprehensive after a traumatic event. A person might find themselves constantly being wary or scared that something bad might happen. More specifically, symptoms might include:
- Difficulty concentrating
- Irritability, anger or having a short temper
- Difficult falling or staying asleep
- Being easily startled
- Hypervigilance, which means that a person might feel heightened states of awareness or nervousness.
WHAT IS THE DIFFERENCE BETWEEN ACUTE STRESS DISORDER AND POST-TRAUMATIC STRESS DISORDER?
The major characteristic that differentiates Acute Stress Disorder from Post-Traumatic Stress Disorder is the period of time that the person has experienced the symptoms.
Acute Stress Disorder is diagnosed when a patient experiences symptoms for between three days and one month.
Post-Traumatic Stress Disorder is diagnosed when symptoms are present for longer than one month.
TREATMENTS THAT CAN HELP
There are several treatments that can help you after you have experienced trauma. As noted, early intervention is best when treating a person after a traumatic event. Almost like “mental first aid”, treatment usually focuses on providing support and therapy in the early stages after a traumatic experience. However, treatment can also be offered in the later stages after a traumatic event.
TRAUMA-FOCUSED COGNITIVE BEHAVIOURAL THERAPY
Trauma-Focused Cognitive Behavioural Therapy focuses on addressing the needs of people with Post-Traumatic Stress Disorder. This type of therapy helps an individual identify and cope with emotions, thoughts and behaviours that they might be experiencing after a traumatic event. Therapy might involve education, relaxation, regulating expression and moods and developing tools to improve thoughts and feelings surrounding the event.
PROLONGED EXPOSURE THERAPY
Prolonged Exposure Therapy is a technique that has been designed to treat PTSD. In order to reduce feelings of anxiety or distress associated with a traumatic event, a person may actively try to avoid thoughts or memories or even people or places that remind them of the event. Prolonged Exposure Therapy provides a very safe place for a person to work through the memories and thoughts of the event to reduce symptoms of anxiety and reactions to possible triggers. Whilst this may seem confronting, the therapist will guide a person through this process and provide coping tools along the way.
After trauma, people with PTSD often have trouble making sense of what happened to them. EMDR can help process upsetting trauma memories, thoughts, and feelings related to the trauma. By processing these experiences, they can get relief from PTSD symptoms and start to heal. In EMDR, the client will pay attention to a back-and-forth movement or sound while thinking about the upsetting memory long enough for it to become less distressing.
People who may be experiencing PTSD are sometimes referred for a medical review by a GP or Psychiatrist. This condition may be treated in a similar way to other anxiety disorders.
Where medication is considered, the use of SSRI antidepressants are most common. An SSRI or Selective Serotonin Reuptake Inhibitor, represents a type of medication that increases the level of serotonin in the brain. Serotonin is one of the chemicals in our brain that can affect the way we feel and increasing serotonin can help ease symptoms commonly seen in PTSD.