The Trauma Response; A Look At PTSD
Post traumatic stress disorder (PTSD) is a mental health condition that can emerge after being involved in or witnessing a traumatic event. The condition evolves into an acute sense of danger and has an effect on an individual's fight or flight response. The event includes a real or perceived threat of injury or death. Signs can include hypervigilance, and flashbacks. PTSD can also occur vicariously through knowledge of someone else having experienced a traumatic event.
Signs of PTSD can include fear of intrusions, avoidance, arousal and reactivity, and fluctuations in mood. Effective interventions include a combination of medication; therapy such as cognitive behavior therapy is highly effective, in addition to support groups. Signs must be present for longer than a month and be persistent in nature to meet the criteria for the condition of PTSD.
There are different types of events or situations that can lead to PTSD. Natural disasters such as flooding or ice storms, army combat fatigue, physical or sexual abuse or violence, a work or car accident can lead to a traumatic response. Chronic long-term trauma such as experiencing physical or verbal abuse, can also lead to PTSD as well as having been bullied. The onset of a sudden or terminal illness can also cause signs of PTSD as well as the shock and angst of a loved one dying.
Acute Stress Disorder and Complex PTSD are two distinct types of conditions closely similar to PTSD . In the former, signs appear one month following the traumatic incident. Signs that go beyond four weeks are considered to be an indication of PTSD. The latter occurs in those that have experienced long-term trauma or abuse such as in cases of domestic violence or long term physical or sexual abuse. In addition to typical signs of PTSD these individuals show more difficulty with emotional regulation, a fragile sense of self, and trouble with relationships.
Individuals with PTSD have a different fight or flight or response than the average person. They are constantly on edge as though any possible threat is imminent and are often on their guard. They live with a chronic and constant state of stress and anxiety even when in a comfortable environment which is free from any possible danger.
The term shell shock was used to describe the state of PTSD as this term derived from survivors or war veterans returning from the Gulf War or Vietnam with many psychological scars. There is a high number of war veterans afflicted by PTSD, and PTSD can affect most anyone, and the understanding has now extended beyond war veterans. Even those who have undergone minor medical surgery may suffer from PTSD signs and have a fear of the medical procedure or show signs of trauma. Heart attack victims are more likely to also develop signs of PTSD following the event.
Intrusive symptoms include having nightmares or experiencing flashbacks causing a sensation that you are reliving the experience or event. This memory may occur, thus intruding spontaneously in your mind. This causes extreme psychological, spiritual or physical distress. These flashbacks are very vivid and feel very real.
Avoidance may include not wanting to be anywhere close to people or situations that may remind you of the traumatic event or physically close to where the event occurred. The individual also prefers to avoid thinking or talking about the traumatic event or expressing any feelings related to the event.
Signs of physiological arousal that may be disturbing include sweaty palms, breaking out in a sweat, feeling irritable and lashing out in anger for no apparent reason, feeling constantly on edge and having an exaggerated startle response. There is a higher incidence of engaging in reckless or self-destructive behaviour and being overly aware of one’s surroundings.
Cognitive disturbances include but are not limited to suffering from low self-esteem and engaging in negative self-talk which may include making derogatory statements about oneself and being overly harsh or critical. Constant feelings of guilt, shame or anxiety are ever present, and there is a disinterest in activities you once enjoyed.
People that suffer from the PTSD condition may also suffer from signs of depression which adds to the complexity of effective therapeutic outcomes. Signs may be more persistent and more resistant to help and healing, but it is possible with patience, continuing appointments, and trusting the process.
Some individuals may even suffer from panic attacks, such as trouble breathing or rapid heart rate which leads them to mistaken possibly having a heart attack from a panic attack. Feeling faint and lightheadedness and possibly fainting. Feeling constantly restless or agitated and suffering from headaches more often than before. There is a sense of feeling detached from others and an inability to enjoy anything positive.
Women suffer from PTSD more than men, are more likely to show signs of an exaggerated startle response and show a heightened sensitivity to any reminders of the trauma. They also show more signs of emotional numbness and suffer from signs of depression and anxiety as well. Research also shows that the brain may experience changes neurochemically following a traumatic event. The hippocampus region, involved in processes such as memory and emotion, appear smaller than the average person. Stress response hormones such as cortisol also appear to be higher. Higher cortisol levels are also implicated in a deterioration of overall health and well-being as stress has a negative impact on the body and mind. This also causes a disruption in the fight or flight response.
Individuals who have PTSD also have a higher chance of suffering from mood disorders and anxiety disorders, substance abuse, and are at a higher risk of experiencing suicidal ideation. This complicates the condition and the effectiveness of therapeutic outcomes. Given the complexity, a combination of interventions are conducive to promoting wellness on the healing journey as well as compliance to consistent appointments and adhering to a program that enhances wellness.
PTSD is more common in those who have less social support, army fatigue or sexual abuse or assault, traumatic events experienced during childhood, physical injuries as a result of event, feelings of extreme helplessness or horror in the face of the event, comorbid conditions such as substance abuse also increase the risk of developing the condition.
Resilient factors following traumatic events include being able to lean on loved ones such as a family and friends or support groups in a safe environment, developing healthy coping strategies, developing a positive mindset, being able to participate in day-to-day activities, in spite of feelings of fear, providing support to others who have experienced disasters or trauma.
A combination of healing remedies may help improve outcomes such as anxiolytic medication and therapy such as talk therapy and practicing cognitive behavior therapy techniques such as replacing and reframing inner dialogue.
If you experience any signs of suicidal thoughts and feel you may be a risk to yourself, don’t hesitate to call for help such as 911 in Quebec or your local emergency number. If you have tried to manage and need extra help don’t hesitate to reach out to a qualified therapist to get on a plan to wellness.
Research also shows that the brain may experience changes neurochemically following a traumatic event.
