By Sami Shields of ContemporaryVA
Terrible events are difficult to deal with; while some people may recover naturally from a catastrophic life experience, others will find the after-effects much more painful, often feeling permanently changed by the impact of what has happened. Feelings of extreme fear, horror or helplessness can lead to a pattern of reactions that are constantly repeated and can be very disruptive to daily life. The sufferer may become numb, feeling themselves shut off from those around them, or grief or guilt may constantly weigh them down. Memories of horrifying scenes they have witnessed may intrude into their waking hours, while their sleep may be disturbed by vivid, unpleasant dreams.
What is a traumatic event?
An event is usually considered traumatic if a person has experienced or witnessed actual, or threatened, death or serious injury. Traumatic events range from common incidents to large-scale disasters and include:
- Transport disasters such as road or rail accidents
- Violence in the home or on the street
- House fires
- Natural disasters such as earthquakes or floods
- Combat experiences for both military personnel and civilians
- Terrorist attacks
- Rape and sexual assault
Other more ‘typical’ life events can also be so overwhelming for some people that they are experienced as traumatic incidents. These may include:
- Job loss or redundancy
- The end of a long-term relationship or divorce
- Miscarriage
- The death of a loved one
How is traumatic stress manifested?
Reactions following trauma can be divided into three main symptom groups:
1) Re-experiencing the event (intrusive reactions)
These are intrusive memories that are experienced as the traumatic event happening all over again; they can occur during waking hours or be experienced as dreams or nightmares during sleep. Flashbacks can be extremely disturbing, as all the physical sensations associated with the trauma are usually experienced again.
Not all individuals will experience flashbacks, although most people will have trouble switching off their recollections of a traumatic event. Simple things in daily life (for example being pushed in a crowd) can become triggers that subconsciously set off a train of traumatic associations.
2) Arousal reactions
Disturbed sleep is the after-effect most commonly reported by people who have experienced trauma and manifests itself in various ways, including heavy sweating, nightmares or recurring dreams, and waking in the early morning.
Bad temper and lack of concentration
Increased adrenaline often impacts the sufferer’s mood and they may find themselves becoming very negative, argumentative or easily irritated.
Hyper-alertness and exaggerated concern for safety
Sudden and dramatic trauma can result in increased awareness of environment – a continual assessment of potential danger. Being on such constant ‘red alert’ can also be extremely draining.
Exaggerated Startle Response and panic attacks
Avoidance behaviour
Emotional numbness
Alienation, disconnection and difficulty with intimacy
Alcohol, drugs and comfort eating
Other Reactions Following Trauma
In addition to the common reactions above, people who have experienced trauma may also find themselves affected by:
Depression and traumatic grief
It is very common for those who are grieving to go through a stage of depression, although some find it difficult to emerge from this, instead sinking further into depression. Symptoms can include feelings of negativity and worthlessness, and overwhelming fatigue.
Guilt and self-blame
Many people take personal responsibility after a traumatic event, blaming themselves for all or part of the incident, or feeling guilty for surviving when others didn’t.
Decreased self-esteem and loss of confidence
Self-blame can lead to feelings of worthlessness and very low self-esteem.
While it is likely that many of these symptoms will be present immediately after a traumatic event, for most people they usually subside during the next few days or weeks. If your reactions do not subside, but instead recur repeatedly, this is indicative of a Post-Traumatic Stress Reaction.
Post Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder is the term given to a particular range and combination of the above reactions following trauma. The diagnosis will depend on how many reactions you are experiencing, and how frequent, severe and disabling they are to you.
Management and treatment
In recent years a range of cognitive behaviour therapies has been developed for treating psychological problems. These work by addressing the patterns of thinking that are associated with a person’s problematic behaviour and symptoms, and offering strategies and techniques for breaking these negative thought processes. CBT therapy has proved to be a highly successful treatment for depression, anxiety disorders, phobias and low self-esteem, and offers an effective approach to managing Post Traumatic Stress.
Treatment is usually conducted by a therapist, but many of the CBT mechanisms have also been adapted into the form of self-help manuals. These manuals help the sufferer to recognize and address the range of reactions, thoughts and feelings that they may be experiencing, and offer a systematic program of treatment which the sufferer is advised to work through to overcome their difficulties. For a great many people, cognitive behavioural self-help manuals provide a lifeline to recovery and a better future.