When it comes to trauma, no two situations are ever the same. Two people can be standing side-by-side and witness or experience the same traumatic event and maybe exhibit immediate reactions, yet only one of them is later diagnosed with PTSD. It really comes down to the amount of resiliency and development of coping strategies, including social supports, to help them deal with the aftermath and effects of the trauma. Some trauma survivors have difficulty regulating emotions such as anger, anxiety, sadness, and shame—this is more so when the trauma occurred at a young age (van der Kolk, Roth, Pelcovitz, & Mandel, 1993). Those who are older and functioning well before the trauma occurred, usually have more shortened emotional dysregulation responses.

Initial reactions to trauma can include exhaustion, confusion, sadness, anxiety, agitation, numbness, dissociation, confusion, physical arousal, and blunted affect. You could experience a few or all of these symptoms but they don’t usually last for more than 3 months after the traumatic experience. Some people may experience delayed responses to trauma which can include persistent fatigue, sleep disorders, nightmares, fear of recurrence, anxiety focused on flashbacks, depression, and avoidance of emotions, sensations, or activities that are associated with the trauma, even remotely.

The diagnostic criteria for PTSD place emphasis on psychological symptoms, but some people who experience trauma may present with physical symptoms. This is important for primary care physicians to remember because they may be the first and only provider the traumatized patient sees. There is a significant correlation between trauma and chronic health conditions. These could include gastrointestinal issues, sleep disturbances, neurological, cardiovascular, muscle aches/pains, respiratory complaints, dermatological disorders and substance use disorders. Many of these are often found in people with unresolved adverse childhood experiences (ACEs), even when there is no family history of the disorder. As an example, early ACEs and other traumas affect brain development and can increase vulnerability to experience interpersonal violence as an adult which can lead to developing chronic diseases and other physical or mental illnesses (Centers for Disease Control and Prevention, 2012).

Often the psychological effects of trauma are noticed first and can lead to the disruption in the day-to-day life of the individual. This could include depression, anxiety, anger, intense fear, flashbacks, paranoia, dissociation and in some instances cognitive abilities. The traumatic experience could also affect and/or alter cognitions which can lead to the belief that the World or their surroundings are unsafe and people are dangerous, or in extreme cases create altered personalities (DID) to help them cope with the trauma that is happening to them (see the blog on DID for more information).

People cope with their trauma in many different ways and self-medication is one of those methods they use in an attempt to regain control. However, this often leads to further emotional dysregulation. Therapy, and at times medication management, tend to be the best course of action for those with traumatic experiences. If you or someone you love are dealing with recent or past trauma and would like to be evaluated for PTSD or other trauma related disorders and possibly receive further treatment, please reach out to us at Charmed Counseling.

Written by Debra Winter, LMHC, LSWAIC, Clinical Therapist at Charmed Counseling
Debra@charmedcounseling.com, www.charmedcounseling.com