What Is Traumatic Stress?
Traumatic events are shocking and emotionally overwhelming situations.
It is natural for people who experience or witness them to have many
reactions. Some of these are intense fear, horror, numbness, or
helplessness. These events might involve actual or threatened death,
serious injury, or sexual or other physical assault. They can be
one-time occurrences, such as a natural disaster, house fire, violent
crime, or airplane accident, or they can be ongoing, repeated, and
relentless, as is often the case in combat or war. Child abuse and
neglect, and other forms of domestic violence are additional examples of
this. Most often trauma is accompanied by many losses. Unfortunately,
traumatic events are quite common.
Reactions to traumatic events vary considerably, ranging from
relatively mild, creating minor disruptions in the person's life, to
severe and debilitating. It is very common for people to experience
anxiety, terror, shock, and upset, as well as emotional numbness and
personal or social disconnection. People often cannot remember
significant parts of what happened, yet may be plagued by parts of
memories that return in physical and psychological flashbacks.
Nightmares of the traumatic event are common, as are depression,
irritability, sleep disturbance, dissociation, and feeling jumpy.
Some of the problems people encounter after traumatic events are part
of the diagnosis of acute stress disorder (ASD). ASD describes
experiences of dissociation (e.g., feelings of unreality or
disconnection), intrusive thoughts and images, efforts to avoid
reminders of the traumatic experiences, and anxiety that may occur in
the month following the end of the events. When these experiences last
more than a month after traumatic experiences have stopped, they are
described by the diagnosis of post-traumatic stress disorder (PTSD).
Other equally uncomfortable problems or symptoms may exist with or
instead of PTSD. For example, a traumatic event often challenges the
person's sense of personal safety and control, leaving him or her
feeling less secure and more vulnerable. Physical health may suffer as
well, and individuals may notice increased feelings of fatigue,
headaches, and other physical symptoms. Many people traumatized in
childhood also experience revictimization (being harmed again) or
aggression, identity disturbance (a feeling that you don't know who you
are), bodily problems such as illnesses or aches and pains without
detectable physical cause (somatization), difficulty staying on an even
keel emotionally, and relationship problems.
What can be helpful after trauma?
It can be helpful to stay connected to natural support systems, whether
they are friends, coworkers, family, neighbors, other familiar groups,
personal beliefs, or community. Taking care of basic needs is important
after trauma. This includes trying to get enough sleep, eating well,
exercising, drinking enough water and juice, and avoiding alcohol and
caffeine. Keeping to routines and activities if possible, and finding
ways to assist someone else, can be helpful for many. And it is
particularly important to know you can ask for help.
How to decide whether you need help
People who have had traumatic life experiences cope the best way they
can with their memories and painful effects. For many people, reactions
gradually diminish. Some find it helpful to talk about what happened and
their feelings, to get support from people who can be trusted, or to be
involved in other activities that help them to reconnect with people and
find meaning in their lives. But for some people, the symptoms and
disturbing reactions persist or even worsen. This can lead people to
find ways to cope that are not so helpful, such as withdrawing from
friends and family, using drugs or alcohol, or avoiding activities that
are empowering. It is important to consider seeking help if important
areas of life, such as relationships, work, or school, are being
affected by traumatic stress. Likewise, people who become more and more
depressed or anxious or for whom the use of alcohol or other drugs
increases significantly may need treatment. Some traumatized people
speak over and over about traumatic events without relief of symptoms.
These people may benefit from treatment.
There are many types of treatment for traumatic stress, from individual
therapy to support groups. Interpersonal, relational, and psychodynamic
psychotherapies, which focus on the meaning of trauma and how it has
affected relationships, may help people understand the source of their
current problems and how these relate to their traumatic experiences.
For some, medication can be effective. Also, anxiety management,
cognitive therapy (focusing on thoughts and beliefs), and exposure
therapy (helping the person confront painful memories and situations
that are realistically safe although still frightening, through talking
about or imagining them) are helpful for reducing PTSD and related
reactions. A combination of psychotherapy and medication is often
helpful for depression and anxiety following traumatic experiences.
No single treatment is effective for everyone, and it may take time
to find the right treatment. There also may be difficult periods in any
treatment. Therefore, it is important to find a trained psychotherapist
or physician, preferably one with experience treating people with
traumatic stress, who can work together with the survivor to find a
treatment approach that makes sense for the individual. A comfort with
language, cultural considerations, and style of expression may enhance
rapport in treatment.
Where to go for help
For people who wish to consider psychotherapy, a family doctor, clergy
person, local mental health association, state psychiatric,
psychological, or social work association, or health insurer may be
helpful in providing a referral to a counselor or therapist with
experience in treating people affected by traumatic stress.
© 2005 International Society For Traumatic Stress Studies. All