Understanding Trauma
What is Trauma?
Trauma is an emotional response to a very negative event like an accident, loss of a loved one, physical or sexual assault, serious injury or illness, natural disaster, war or witnessed violence. Shock and denial are typical immediately following the event, while later reactions may include unpredictable emotions, flashbacks or nightmares, strained relationships and avoidance of social situations, and even physical symptoms like headaches or nausea.
If you’ve endured trauma, you may find it difficult to move on with your life. And trauma can precipitate emotional and behavioral health conditions, including oppositional defiant disorder (ODD), reactive attachment disorder (RAD), anxiety disorders, post-traumatic stress disorder (PTSD), acute stress disorder, borderline personality disorder, affective disorders, pervasive developmental disorders and major depression.
Signs and Symptoms
Immediately after the negative event, a person experiencing trauma may show the following symptoms:
- Decreased awareness of surroundings
- Denial or disbelief that the event occurred
- Disorientation
- Inability to recall critical details
- Numb or detached feelings
Emotional and physical symptoms that may appear days, weeks or months after the traumatic event and last longer may include:
- Agitation
- Anger, irritability and mood swings
- Anxiety
- Avoidance of certain places, people and activities
- Difficulty concentrating
- Disrupted social or occupational functioning
- Disturbed sleep
- Fast heartbeat
- Fatigue
- Flashbacks, recurrent thoughts or nightmares
- Guilt, shame or self-blame
- Hypervigilance
- Muscle tension, aches and pains
- Restlessness
- Sadness or hopelessness
Diagnosis
Trauma itself is not a diagnosis, but it can trigger emotional and behavioral health conditions, including oppositional defiant disorder (ODD), reactive attachment disorder (RAD), anxiety disorders, post-traumatic stress disorder (PTSD), acute stress disorder, borderline personality disorder, affective disorders, pervasive developmental disorders and major depression.
Behavioral health physicians use criteria for these conditions listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to determine if symptoms indicate any of these conditions.
Diagnostic tests include:
Physical examination: A provider will perform a physical exam and ask questions about a person’s health to determine if his or her symptoms could be linked to an underlying physical health problem.
Psychiatric evaluation: A behavioral health provider will ask about symptoms, thoughts, feelings and behavior patterns as well as the event(s) that led up to the symptoms. Personal and family history of mental illness, anxiety disorders and other mood disorders will also be discussed.
Causes
Trauma is caused by experiencing or witnessing an overwhelmingly negative event that affects a person’s mental and/or emotional stability. Young children and those who’ve experienced repeated negative events are especially vulnerable. All causes of trauma involve an external force, a sense of violation and a loss of control.
Risk Factors
Risk factors that could make someone more vulnerable to trauma include:
- Childhood
- Ongoing or intense stress
- Repeated losses or exposures to negative events
Prevention
Trauma cannot be prevented. But, if you seek treatment and develop coping strategies following an episode of trauma, you may reduce your risk of experiencing it again.
Prognosis
Most emotional and behavioral health conditions triggered by or associated with trauma are treatable with some combination of psychotherapy, coping strategies and behavioral changes, and medication. Untreated, these conditions may lead to serious complications. Most people recover from trauma.
Treatment
Early Intervention
Early intervention improves outcomes for children who’ve experienced trauma. It involves ensuring a safe and stable living situation and connecting the child with support services, individual or group therapies, and coping strategies.
Psychotherapy
Working with a therapist experienced in treating trauma and associated disorders can reduce symptoms; help with family, job or social issues; and provide coping skills to control fear, anxiety, avoidance and other symptoms.
Medication
Medication can help treat some people who’ve experienced trauma, and it is typically prescribed along with therapy. You may need to try a few different medications, or medication combinations, before you find the one that’s right for you. Some medications take a few weeks before their full effect is obvious. Some cause side effects for certain patients. If you experience any side effects, it’s important to talk to your provider immediately but not to abruptly stop taking the medication, which could cause a worsening of symptoms.
These medications may include:
- Antidepressants: Antidepressants may be prescribed to help manage sadness, worry, anger or numbness.
- Sedatives: These medications may be recommended for a short term to help with severe episodes of anxiety or until antidepressants take effect.
- Sleep medications: Certain sleep medications may be prescribed to reduce nightmares associated with trauma.
Lifestyle Changes
Lifestyle changes along with therapy and medication can help people recover from trauma. Specific lifestyle changes that are recommended include:
- Physical activity: Regular exercise helps reduce stress and improve mood.
- Avoid alcohol and drugs: Self-medicating with alcohol or drugs can interfere with medical treatment and prevent healing.
- Stay social: Surrounding yourself with a support system of family and friends can help you heal faster.
Complications
Early and ongoing treatment is especially helpful for trauma. Left untreated, complications can arise, including:
- Drug and alcohol abuse
- Depression
- Anxiety
- Suicide
- Social, occupational and physical disability