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For decades, post-traumatic stress disorder (PTSD) was mostly connected to veterans’ long-term issues from exposure to combat. Later the long-term effects of child abuse were seen as causes of PTSD.  More recently, health professionals have been studying how the traumas known as adverse childhood experiences, impair and impede development. Today, trauma and its long-term effects are being discussed more frequently throughout our society, especially after catastrophic events such as mass shootings, natural disasters and wars.

Trauma refers to injury and can be physical, psychological or emotional. The average human being suffers minor physical trauma on a regular basis in the forms of cuts and bruises and recovers from it without a second thought.

Emotional trauma is more complicated in that an individual’s psychological distress following exposure to a traumatic or stressful event is quite variable; it varies from person to person and from event to event.

There are many experiences or events that have the potential to be traumatic. Something traumatic for one person is not necessarily traumatic for another. However, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specified that trauma is not just for the person who directly experienced it as the victim. Trauma can occur by:

  • Directly witnessing the event
  • Learning that it happened to a close family member or friend
  • Repeatedly being exposed to extreme or aversive details of the event

The initial experience of emotional trauma is shock. A person in emotional shock is paralyzed or consumed with what just happened.  The shock of trauma can vary from a jaw-dropping second in time to days of being shut down in a zombie-like state.

In the 21st century, shocking news comes to us at the speed of light in more and more ways. It is emotionally significant that many people get notifications to their phones about news that includes the deaths of favorite celebrities and horrific tragedies, but it is noted here that the DSM does not count the shock from news stories as counting towards PTSD unless it is work-related.

Eventually a person recovers from the shock and begins to reorganize life depending how life will go on with the change. For example, the death of a favorite celebrity is sad, but it has little, direct impact on an average person’s life.

The mind of a person with PTSD may be consumed with the trauma. Their waking hours may be filled with recurring, involuntary and intrusive memories of the traumatic experience. They can have recurrent dreams about the trauma or of matters related to it. They can have flashbacks that can vary in severity to the point where they completely forget where they are and what they were doing, also called dissociation.

PTSD can include the evolution or outcome of a person changing the way they think and behave towards themselves and others.  They may hate themselves and put walls up in relationships and begin to engage in reckless, aggressive and self-destructive behaviors.

PTSD can go beyond thoughts where a person attempts to make protective adjustments by avoidance and guardedness. They seek to avoid external reminders of the trauma. These triggers or reminders include sights, sounds, smells, taste and touch. The efforts to avoid the trauma triggers can be extreme and characterized by being always on guard or hypervigilant. PTSD can dramatically degrade a person’s quality of life.

Despite these negative outcomes, people with PTSD can be quite resilient. Many live with PTSD and keep pushing on by figuring out compensations with the triggers and support from loved ones.

However, others with PTSD have impairments and disruptions to their functioning to the point of a mental health crisis that can include dissociation, suicidal ideation and panic attacks. Six to eight out of 10 people who present for mental health treatment have some history of trauma.

There are effective treatments for trauma that include talk therapy, medications, and alternative therapies such as havening or eye movement desensitization and reprocessing. These therapies can empower patients to manage symptoms, improve coping, and mitigate the long-term effects of trauma.

If you or someone you know is struggling with PTSD or trauma related mental health issues, our licensed therapists at UofL Health – Peace Hospital can help.

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Article by:

David Houvenagle, Ph.D., LCSW

David Houvenagle, Ph.D., LCSW, is the lead adult mental health therapist at UofL Health – Peace Hospital, where he has worked in various clinical capacities since 2002. He is the author of “Clinician’s Guide to Partial Hospitalization and Intensive Outpatient Practice” (Springer Publishing 2015) that has a chapter on working with borderline personality disorder patients. He earned his master’s degree in social work from the Southern Baptist Theological Seminary and his Ph.D. in urban and public affairs from University of Louisville.

All posts by David Houvenagle, Ph.D., LCSW
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