Trauma and Post Traumatic Stress Disorder (PTSD)
Tom had been an Emergency Medical Technician for 7 years, responding to hundreds of different accidents, crimes, and traumas. Family and friends alike marveled at his ability to handle them without any visible repercussions. But recently when he was dispatched to the scene of a hit and run accident that killed a six-year old girl, something changed. He hasn’t been able to shake that night from his memory, and in fact, he thinks about it over and over again. He’s had difficulty falling asleep, and once he finally does, he has nightmares of returning to the scene. What’s more, all of the thoughts surrounding the death of children have left him increasingly paranoid about his own daughters’ safety. When he felt so keyed up on the job the other day that he lashed out a co-worker, he knew he couldn’t deny something was wrong any longer.
Sharon had been a winsome and well-liked high-schooler. She made excellent grades, performed in the show choir, and was captain of the cheerleading squad her senior year. No one was surprised when she got in to the university of her choice and headed out of town after graduating. But now, some two years later, people hardly recognize her. She’s lost twenty pounds, let all of her hobbies and extra-curricular interests go, and has extreme difficulty concentrating on schoolwork, particularly after a night of fitful sleep, which is more often than not. The girlfriends she made during her freshman and sophomore years report that she’s become increasingly distant over the past six months, and some think it coincides with the night one of their male friends offered to walk her home after a party. Sharon tells them nothing happened, but no one knows how that night pervades her thoughts. When her friends finally got her out to see a movie last week, she ran out of the theater crying after a scene involving rape.
Richard grew up in a small Midwestern suburb. His family was good at keeping up appearances, but things inside their home were often chaotic and abusive. His father’s alcohol use rendered him a true “Dr. Jekyll/Mr. Hyde,” and Richard wrestled under the constant fear that a drunken tirade would end up with him, his mother, or one of the siblings seriously injured or dead. Though it left him racked with feelings of guilt, he exited the home at eighteen for college for his own survival. Now at 30 years of age, he felt as though he never fully “launched,” and tended to drift aimlessly from job to job, even though he was capable of doing good work. And he had a real self-sabotaging streak, the most profound example being when he would drink to excess and pick fights, often getting beat up in the process. He was certain it all had to do with his upbringing, but he persistently avoided talking about it and hadn’t been to his childhood home in years. Most frightening of all, he had an impending sense that his life was destined to end early.
Trauma Comes in Many Forms, and Impacts Everyone Differently.
Some individuals will experience little to no distress after a trauma, while others may develop post traumatic stress disorder or notice an increase in anxiety or depression. How we respond to a trauma has to do with many different factors, and regardless of your response, it does not mean you are weak or have failed in some way. Genetics, early childhood experiences, and previous traumas are just a few of the variables that can influence your response to a traumatic experience. (Read the story of one of Change, Inc.’s own counselor’s journey with PTSD here.)
What is Post-Traumatic Stress Disorder (PTSD)?
While not everyone who goes through something traumatic will be diagnosed with post-traumatic stress disorder (PTSD), it is helpful to understand the components of the diagnosis. In order to be diagnosed with PTSD, an individual must have either directly experienced a traumatic event, witnessed one in person, learned of a close family member or friend being threatened, or experienced first-hand repeated exposure to averse details of a traumatic event.
In short, Post-Traumatic Stress Disorder is when someone has been threatened in some way or witnessed or heard about another person being threatened and thus develops serious emotional and mental discomfort.
Do I have PTSD?
Regardless of how one feels during a traumatic event (or series of them), the behaviors that occur thereafter can help to determine whether or not a person might need additional support. There are 4 categories of behaviors to look for as indicators that you may have PTSD: Avoidance, Re-experiencing the event, Negative cognition (thinking) or mood, and Arousal.
- Avoidance refers to how individuals may attempt to either physically or mentally distance themselves from the trauma. For example, if a trauma occurred in the evening or in a particular area of town, the person might not go out at night or stay away from the place the trauma occurred. If there are thoughts, feelings, or memories that remind them of the event, the person may try to avoid these through excessive drinking, eating, or disengaging from triggering conversations.
- Re-experiencing the event may look like dreams or nightmares about the trauma, or an actual “flashback” to the event, where the person experiences themselves as being in the event again, even though they’re not. Physical symptoms may also be a sign — for example, a survivor of sexual trauma might suddenly begin to wet the bed.
- Negative cognitions and mood also take many different forms and can be a sign of trauma. In a case of post-traumatic stress disorder, an individual might persistently blame themselves or others after a trauma. They may also become disengaged from people or activities they once enjoyed, and may have difficulty remembering the traumatic event altogether or details about it.
- Increased arousal may look like aggressiveness, self-destructive behaviors, or “hyper-vigilance” – feelings, thinking, and behaviors that look as though someone is “constantly on guard.” A person might appear to be in “fight” or “flight” mode if they feel triggered, or may show an increased difficulty concentrating. Some children who have experienced a trauma may be inaccurately diagnosed with ADHD, when in actuality they are experiencing a difficulty concentrating as a result of the trauma.
Is there any help for PTSD in St. Louis?
There is help for individuals who have experienced trauma. Several best-practices for treating post-traumatic stress and other negative emotional experiences that come from experiencing a trauma exist. The length of trauma treatment varies for each individual, but here are a few things you can start doing today to help jumpstart your recovery:
- Relax your body – The first tenant of trauma therapy is for the person to (re)develop an ability to self-regulate. Self-regulation techniques are often simple, but require regular practice to be effective. One simply way to relax your body is to focus on breathing slowly and deeply. If this does not come naturally, you can practice breathing in for four counts, holding for four counts, and exhaling for four counts.
- Bring awareness to your body – Often when people are experiencing anxiety or post-traumatic stress, they become “disconnected” from their bodies. In extreme cases this may lead to dissociation, a phenomenon where an individual is no longer aware of their present state and might feel like they are no longer in their body. If you are feeling triggered, practice bringing awareness to your body through your senses, and orient yourself to what is going on, right then, right there. Start by saying three things you see, three things you hear, and three things you physically feel (e.g. your hand holding a pen). Then name two things you see, hear, and feel, and then one. This will help to keep you grounded, and reduce the risk of dissociation or a flashback.
- Get professional help – While each individual is different and everyone’s trauma is unique to them, trauma trained professionals like those on staff at Change, Inc. St. Louis Counseling & Psychiatry are a large source of help and hope. Consider contacting a mental health professional who is trained to work with individuals who’ve experienced trauma. Don’t be afraid to ask about their experience of working with people who have experienced the type of trauma you’ve been through, or, be afraid, but ask anyhow! You can read more about the various types of trauma therapies here.
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