First responders and survivors of catastrophic events are faced with the crisis of immediate survival and safety, and then coping with the aftermath on many levels. But there are also many people bearing emotional wounds who have been exposed to traumatic events on a smaller scale, but a diagnosis of PTSD doesn't fit what happened to them. How would you know if treatment might helpful?
Mental health counselors will tell you that trauma events come in many forms –more than the monstrous or life–threatening ones. What kinds of symptoms or problems would we be looking for diagnosis and treatment of trauma–related symptoms?
As a counselor who often works with trauma–impacted individuals, there are various symptoms that might be noticeable:
– Overreaction is one common red flag. Do you find that in certain situations, your reaction is much more extreme than the situation called for? This overreaction might be in the form of avoidance, startle, anger, panic attack, or irrational fear. It will be associated with something associated with the troubling event.
– Onset of heightened arousal such as being verbally or physically aggressive, irritable, easily startled, or angry. This might also appear as anxiety.
– The onset of sleeping problems. This can be difficult to notice for a person suffering from pre–existing insomnia, but you may notice new problems with intrusive memories or thinking obsessively about that adverse event when trying to fall asleep or upon awakening during the night. Distressing nightmares associated with the event may also happen.
– Exaggerated negative beliefs about yourself and others can take over even though you might also recognize the thought is irrational. For example, “I'm a bad person” “I can't be safe” “I'm not good enough” are beliefs that can affect other areas of living.
– The persistence of a negative mood that blocks out happiness, satisfaction, or loving feelings.
Here's an example:
An employee at a care home for people with Alzheimer's is knocked down by a patient who is angry about a change in routine. The worker, Jan, knows this is a symptom of the disease, and it was not a personal attack. Jan was caught off guard by the situation, but admits it wasn't a big deal and was not injured beyond slight reddening of the skin. Jan was instructed to take a couple of days off work before returning. However, she finds that at the thought of returning, she becomes overwhelmed with strong, negative feelings and decides to call–in sick. On the day she plans to return to work, she become noticeably anxious, her heart is racing and she feels nervous just driving towards work. She feels embarrassed to talk about it with her co–workers because this was not an unusual situation in her field. After her shifts, she continues to think about what happened, especially at bed time, making it hard to fall asleep. Jan is affected by this assault even though it was not a serious threat to her life. If the problem persists, it could impact her employment.
– If you are having troubling symptoms associated with bad things that have happened, be careful on coping with your distress:
– Substance abuse. Using alcohol or other drugs to help you sleep, or to decrease your level of distress can cause serious long–term problems.
– Avoidance of people or social activities. Recognize that part of the healing process is receiving support and connection to other people. When you isolate yourself too much to decrease your stress, you may have even more negative thoughts and feelings like sadness and fear.
– Working too much. This type of avoidance leads to poor self–care and social isolation.
– Talk to others to give and receive support
– Relaxation methods such as yoga, meditation, breathing exercises, prayer, singing
– You can talk to your doctor about your symptoms, or see a counselor
For more information, here is an excellent self–help guide through the Substance Abuse & Mental Health Services Administration .