What Is Traumatic Stress?
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.
Treatment options
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.
For more information about traumatic stress or the International
Society for Traumatic Stress Studies, call 847-480-9028.
© 2005 International Society For Traumatic Stress Studies.
All rights reserved.
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