There has been a great deal of talk about Post-Traumatic Stress Disorder (PTSD) in recent years, especially around combat veterans. However, trauma encompasses a much broader range of experiences, and can have lasting impacts on many people. First, it is important to distinguish between experiencing trauma, traumatic stress, and PTSD.
A traumatic event can be any experience which overwhelms an individual’s ability to regulate or integrate emotions and where the person experiences a threat to their life or safety, or that of those close to them (Early Trauma Treatment Network, Nd). Examples include: Sexual or physical abuse or assault; serious accidents or medical events; natural disasters; domestic violence; witnessing or experiencing violence; unexpected death of a loved one; terrorism or mass violence.
Traumatic stress, in and of itself, is how a person reacts to or initially copes with a traumatic experience. It is important to understand that these coping strategies are not necessarily a “disorder,” but may be very normal responses to an abnormal situation. However, Post Traumatic Stress Disorder occurs when the symptoms of traumatic stress do not go away, and increasingly interfere with an individual’s ability to live as they normally would (Hapke, 2006). PTSD causes significant distress and particular types of problems, and needs to be diagnosed by a professional. Major symptoms of PTSD can be grouped into “types,” and include:
Re-experiencing symptoms, including: Flashbacks or intrusive thoughts about the traumatic event; intense physical or emotional reactions to reminders of the event; nightmares.
Avoidance symptoms, including: Avoiding thinking or talking about the trauma; avoiding people, places, activities or sensations that remind you of the trauma.
Negative changes in your thinking and emotions, including: Feeling more down, depressed, angry or anxious; feeling shameful or guilty; being unable to remember important parts of the trauma; having more negative thoughts about yourself, other people and the world.
Hyper-arousal or emotional/physical reactivity, including: Being always on guard and/or easily startled; being unusually quick to anger; doing things that are risky (e.g., impulsive sex, binge drinking); having trouble sleeping.
Complex Post-Traumatic Stress Disorder (C-PTSD) is another mental health possibility after trauma, and has many symptoms in common with PTDS. C-PTSD also includes:
Problems in managing one’s feelings; problems of self-image, like feeling completely divided from others and having negative self-view; interpersonal and relationship problems, including being unable to trust others (Neria, Nandi, & Galea, 2007).
This is not a complete list, and symptoms can vary by individual.
These symptoms occur as the results of changes in the brain which take place during a traumatic event. Changes include altered responses in several brain structures, which result in a heightened “fight or flight” response, the mind’s inability to distinguish between reminders of the event and actual danger, and imbalance in hormones which help the body calm down from stress responses (Olff, Langeland, & Gersons, 2005).
Luckily, both PTSD and C-PTSD often respond well to different kinds of treatments and supports from professional Psychologists. Trauma-focused psychotherapy (talk therapy) and Cognitive Behavioral Therapy (CBT) are the most common treatments. Trauma-focused psychotherapy focuses on helping the individual process the trauma, understanding the meaning of the experience, and helping to change the individual’s beliefs about the trauma and traumatic event. CBT is an approach with focuses on the relationships between thoughts, feelings, and behaviors, and may help to change patterns of behavior which might be causing difficulties in regular functioning (Zalta, 2015). There are several different sorts of CBT which can be helpful in addressing PTSD, and a professional psychologist can help tailor treatment to the individual.
Other approaches may include an array of treatments. Some people may benefit from medication to help address symptoms such as depression, anxiety, and an inability to manage emotions. Others could find significant relief from a method called Eye Movement Desensitization and Reprocessing (EMDR), which works towards “re-training” the brain by briefly focusing on the trauma while regular eye-movements are occurring. This process uses the way the brain naturally makes associations between eye movement and memory and can significantly reduce the intensity and distress of traumatic memory (Bisson, et.al., 2007; Calancie, Khalid-Khan, Booij, & Munoz, 2018).
As with most psychological and emotional treatments, no single thing will work for everyone. A professional psychologist with experience and education in trauma-focused approaches will be able to help each individual person understand their experience and their needs, and help develop an approach which works best for that person.
References:
Bisson, J. I., Ehlers, A., Matthews, R., Pilling, S., Richards, D., & Turner, S. (2007). Psychological treatments for chronic post-traumatic stress disorder: Systematic review and meta-analysis. British Journal of Psychiatry, 190(2), 97–104.
Calancie, O. G., Khalid-Khan, S., Booij, L., & Munoz, D. P. (2018). Eye movement desensitization and reprocessing as a treatment for PTSD: current neurobiological theories and a new hypothesis: EMDR and PTSD. Annals of the New York Academy of Sciences, 1426(1), 127–145.
Hapke. (2006). Post-traumatic stress disorder. European Archives of Psychiatry and Clinical Neuroscience., 256(5), 299–306.
Neria, Y., Nandi, A., & Galea, S. (2007). Post-traumatic stress disorder following disasters: a systematic review. Psychological Medicine, 38(4), 467–480.
Olff, M., Langeland, W., & Gersons, B. P. (2005). The psychobiology of PTSD: coping with trauma. Psychoneuroendocrinology, 30(10), 974–982.
Zalta, A. K. (2015). Psychological Mechanisms of Effective Cognitive–Behavioral Treatments for PTSD. Current Psychiatry Reports, 17(4), 560–560.