Treating Trauma
Recently, TOPPS’ social media has targeted Men’s Health Awareness Month; however, June harbors another national observation: Post Traumatic Stress Disorder awareness. PTSD, as this illness is shortened, is not unlike many other mental health related disorders: often stereotyped and thought to affect only particular demographics (war veterans, for example, are frequently cited victims). However, while veterans can be victims, PTSD results from a plethora of traumas and, given last month’s mental health awareness agenda, we now seek to highlight said traumas, define PTSD, reference ways in which victims may heal, and cite how one might help a suffering loved one. Please note, while this blog is written with educational purposes in mind, it’s subject material may be emotionally triggering.
The term ‘trauma’ is frequently used to describe physical repercussions; for example, bodily trauma sustained via car accident or head trauma acquired in a nasty football play. However, regarding PTSD, trauma is an “emotional response to a terrible event like an accident, rape or natural disaster” (American Psychological Association, 2017). It should be noted, though, that an individual can suffer both physical and mental trauma. Symptoms include: unpredictable emotions, flashbacks, strained relationships, and physical ailments such as headaches or stomach pain.
To better understand the event of trauma response, it is essential to examine how damaging events effect the brain. Typically, our brain works in a ‘top down’ fashion; the cortex (forebrain) controls our “cognitive processing, decision-making, learning [and] memory…functions,” the limbic (midbrain) section “processes emotions and conveys sensory relays,” and the brain stem (lower brain) dictates our instinctual behavior and “autonomic body processes” (Rosenthal, 2015). However, when we undergo a traumatic situation, the brain stem lurches into action and we enter “survival mode.” Stress hormones soar and our body prepares for perceived battle (Rosenthal).
Types of trauma are various and unique to the victim. For example, something that is damaging to one person may not elicit the same response from another. However, listed below are several common catalysts:
Sexual abuse or assault (“coercive sexual contact, exposure to age-inappropriate material…and sexual exploitation”)
Physical abuse or assault
Emotional abuse
Neglect (this is most commonly reported form of child abuse but does not just refer to children; “It can also happen when a primary caregiver fails to give an adult the care they need, even though the caregiver can afford to, or has the help to do so”)
School violence (such as a shooting or classmate suicide)
Bullying
Natural or manmade disasters (earthquakes or chemical spills)
Displacement/war/terrorism (Substance Abuse and Mental Health Services Administration, 2016)
However, what happens if, following a traumatizing situation, we are unable to return to the restorative ‘top down’ brain function? What if our brain stem continues to take charge, perceiving constant threat and keeping us poised in survival instinct limbo? It is at this point we frequently observe PTSD’s development. The U.S. Department of Veterans Affairs website defines Post Traumatic Stress Disorder as a “mental health problem that some people develop after experiencing or witnessing a life-threatening event” (U.S. Department of Veterans Affairs, 2016). Symptoms of PTSD are like those of trauma response, although intensified, and signs for which to look are:
Frequent reliving of stress-inducing event (“flashbacks”)
Avoiding situation reminiscent of traumatic experience
Harboring increased negative emotion and beliefs
Feeling “keyed up” (hyperarousal: jitters, trouble sleeping, irritability, reckless behavior)
Some victims of PTSD may demonstrate further and exacerbated symptoms:
Hopelessness, shame, despair
Depression or anxiety
Excessive drinking or drug use
Physical pain
Employment difficulty
Relationship problems (U.S. Department)
Eradicating one’s PTSD is more than just “getting over it;” in fact, many “chemical and biological imbalances” are created in a traumatic event’s wake. Typically, we see three main imbalances: 1). An overstimulated amygdala (this brain mass identified threats and associates emotions with memories; in PTSD, the amygdala is trapped in a frenzy loop and constantly searches for/perceives threats), 2). An underactive hippocampus (following trauma, the stress hormone glucocorticoid destroys hippocampus cells and thus makes the hippocampus less able to consolidate memories; the body remains in a combative state and cannot recognize that a threat has passed), 3). Ineffective body regulation (due to the constant onslaught of stress hormones, the body has trouble with regulation and the sympathetic nervous system remains on high alert; the body becomes fatigued as does many of its systems) (Rosenthal).
PTSD can certainly cause its victims considerable distress, both internally and within external relationships, but it is treatable. Essentially, treatment works to reinstate the ‘top down’ brain function: relax the amygdala, amp up hippocampus memory consolidation, and re-enable the nervous system. Cognitive Behavioral Therapy has proven useful; most commonly utilized are Cognitive Processing Therapy and Prolonged Exposure Therapy. Cognitive Processing Therapy (CPT) helps victims understand trauma and the ways in which it alters their thoughts and feelings. Prolonged Exposure Therapy (PE) pushes victims to speak about their trauma repeatedly until memories are no longer unsettling or all-consuming. This creates heightened control over thought processes and subsequent emotional responses (U.S. Department). Finally, medication can be used to quell overactive and powerful memories (U.S Department).
It is understandably difficult to observe loved ones battling PTSD; perhaps frustrating and confusing as well. However, there are ways you can support your loved one on their recovery journey. Educate yourself on the disorder; understand symptoms and the reasons behind certain PSTD behaviors (for example: angry outbursts, sleep disturbance, and heightened tension are all examples of hyperarousal). Speak with and listen to your loved one, encourage them to seek treatment and to actively participate in their own life. Also, given PTSD is a very personalized mental health disorder, try not to provide advice (unless it is requested). Above all, just be there for your loved one. Show them you care (Psych Guides, 2017)
References
American Psychological Association. (2017). Trauma. Retrieved on June 12, 2017, from http://www.apa.org/topics/trauma/.
Psych Guides. (2017). How to Help Someone With Post-Traumatic Stress Disorder. PsychGuides.Com. Retrieved on June 14, 2017, from http://www.psychguides.com/guides/how-to-help-someone-with-post-traumatic-stress-disorder/.
Rosenthal, Michele. (2015). The Science Behind PTSD Symptoms: How Trauma Changes The Brain. Psych Central. Retrieved on June 14, 2017, from https://psychcentral.com/blog/archives/2015/09/16/the-science-behind-ptsd-symptoms-how-trauma-changes-the-brain/.
Substance Abuse and Mental Health Services Administration. (March 2, 2016). Types of Trauma and Violence. Retrieved on June 12, 2017, from https://www.samhsa.gov/trauma-violence/types.
U.S. Department of Veterans Affairs. (October 4, 2016). What Is PTSD? Retrieved on June 12, 2017, from https://www.ptsd.va.gov/public/ptsd-overview/basics/what-is-ptsd.asp.
