Teresa was recently involved in a car collision as she drove home from the grocery store. She received only minor bruises from the incident but the driver of the other vehicle was severely injured. Initially, Teresa rarely discussed the event and seemed to only be minimally impacted by it. However, two weeks later her husband began to notice that she was behaving differently.
Teresa was having recurring nightmares, she was beginning to verbalize extreme guilt about the injuries of the other driver, and strikingly, she started missing work due to her adamant refusal to drive anywhere. Teresa’s husband was becoming increasingly concerned about her well-being and he wasn’t sure what to do.
The psychological impact of a traumatic experience varies from person to person depending upon the personal history of the individual, the person’s psychological makeup, and the length and severity of the trauma. Although some people experience minimal psychological harm from devastating events other people may experience extreme recurring feelings of loss of safety and predictability.
This marked increase of fear can result in the emergence of Post -Traumatic Stress Disorder (PTSD.) Although symptoms of PTSD typically emerge within the first three months of a traumatic experience, there have been incidents when symptoms emerge several years later.
Regardless of when the symptoms make their appearance, they cause severe disruption and ongoing impairment in the person’s social interactions, work experiences, and interpersonal relationships. It is important to be aware of the symptoms so that you can get help if needed.
Symptoms of PTSD are typically characterized into four categories: hyper arousal, avoidance, intrusive/ruminating thought, and numbing.
1. Hyper arousal is when a person’s physical response is in such high gear that her body has difficulty resetting back to normal. You’ll see symptoms such as:
- Difficulty sleeping
- Trouble concentrating
- Heightened startle response (easily startled)
- Easily agitated
- Excessive guilt
- Hyper vigilant to danger (always on guard)
- Excessive irritability
- Increase in destructive behavior such as drinking, driving too fast, or risky sexual behavior
2. Avoidance is when a person tries to avoid all places or things that remind her of the traumatic event. She may try to avoid discussing the event altogether or she may go out her way to prevent any interaction with people, places, or things that remind her of the experience.
3. Intrusive or ruminating thoughts are when the person’s mind forces her to relive the traumatic event over and over again. This re-experiencing of the event can occur via:
- Unwanted distressful memories
- Nightmares, night terrors, or upsetting dreams about the event
- Physical or exaggerated responses to any reminders of the experience
4. Numbing is when the person dissociates from the experience and may seem to function on auto-pilot. Symptoms include:
- Lack of interest in previously enjoyed activities
- Difficulty remembering details of the event
- Feeling “numb” and empty emotionally
- Difficult feeling positive emotions
- Feeling detached from others
- Feeling a sense of hopelessness and depression
- Withdrawing and isolating oneself from others
Any extreme or life threatening event can cause a person to experience PTSD. Some of the most common events that are known to lead to PTSD include:
- Physical or sexual assaults
- Combat exposure and war
- Childhood abuse or neglect
- Threats with a weapon
- Natural disasters (i.e. fires, tornadoes, tsunamis, hurricanes, etc.)
- Robbery, mugging, or kidnapping
- Automobile, airplane, or train crash
- Life threatening medical diagnosis
- Terrorist attack or any type of torture situations
- Any other extreme or life threatening event
When It Happens
PTSD is a complex disorder and it isn’t clear why some people experience it after a traumatic event while others escape without experiencing any lasting psychological damage. However, there are risk factors that doctors and researchers believe may cause some people to be more at risk than others:
- Co-occurrence of other mental health disorders: Individuals who struggle with symptoms of other mental health disorders such as depression and anxiety may be more vulnerable to symptoms of PTSD.
- Personality: One’s temperament or personality traits may also be a significant factor in whether or not PTSD symptoms are developed.
- Brain functioning: The way a person’s brain is specifically wired to release hormones during stress may be a key to whether or not she develops PTSD.
- Life experiences: Individuals who have had a lot of trauma throughout their lives may be more vulnerable to PTSD. In addition, people who have experienced more intense trauma, longer lasting trauma, or trauma that occurred in early and middle childhood seem to be more likely to develop PTSD.
- Vocation: Individuals who are in jobs that frequently expose them to trauma, such as the military or first responders, may be more likely to develop PTSD.
- Support Systems: People who do not have an adequate support system are more susceptible to the disorder. Some people without an adequate support system also start developing unhealthy coping strategies such as misusing drugs and alcohol and engaging in other risky and/or life threatening behavior.
- Family Background: Individuals who have biological relatives who have PTSD or other mental health disorders such as depression may be more likely to develop the disorder.
It is normal to experience some negative emotional responses following a traumatic experience. However, the Mayo Clinic suggests seeing a health care professional if you or a loved one are experiencing significant duress for over a month, if the disturbing thoughts or emotions are severe, or if you’re having significant trouble getting your life back on track.
You and your therapist or doctor can develop a therapeutic plan to aid in your recovery. Studies have shown that treatment such as Cognitive Behavior Therapy (CBT) can reduce a person’s chances of her acute symptoms turning into long term chronic PTSD. However, it’s important to keep in mind that there is no “quick fix” for the treatment of this disorder. In fact, one research study shows that multiple therapies may be necessary to build an effective treatment plan. Nonetheless, it is clear that treatment in various modalities is effective for treating PTSD. Here are some of the most commonly used treatments for trauma related issues:
- Cognitive Behavior Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Exposure Therapy
- Eye movement desensitization and reprocessing (EMDR)
- Medication (i.e. anti-depressants, anti-anxiety, or sleeping medication such as Prazosin)
You may want to consider seeing a professional as soon as possible following a traumatic event, even if no symptoms of PTSD are present. Although early intervention won’t necessarily prevent acute PTSD symptoms from occurring, it could be quite beneficial especially if you are already at risk for developing the disorder. A great place to find a behavioral health provider that can help you cope with trauma and PTSD is the Inpathy online behavioral health platform.
If you or a loved one are thinking about suicide then it is essential that you reach out for help immediately, even if the thoughts are fleeting (i.e. they go away and come back again.)
Great resources include a family member or friend, a minister or clergy, your doctor, or your therapist. You can also call the National Suicide Prevention Hotline 24 hours a day at 1-800-273-TALK (8255) to reach a trained professional who can help.
If you think that you or someone that you know is in immediate danger of self-harm or suicide please call 911 immediately. Remember, suicide is a permanent solution to a temporary experience. PTSD is treatable and there are people who can help.
Want more information on treating and understanding PTSD?
Treating Trauma with CBT, by Ayrin Hnosko, LPC
Creative Trauma Support Networks, by Ralitza Treneva
The Shortage of Child and Adolescent Psychiatrists, by Aysha Ives
Spectrum Disorders Vary by Design, by Ade Ilesanmi