Trauma and PTSD: Sources, Symptoms and Treatment (Guide for Adult Patients and Loved Ones)

(Click here to view a PDF version of this guide: English)

Trauma is an emotional response to an extremely stressful or upsetting life event. For example, trauma can be common after witnessing a shocking death or an act of violence against the self or others. Trauma erodes a person’s sense of safety, making them feel frightened and vulnerable in their daily life.

Trauma is a normal reaction to disturbing events, but it can often pose challenges to a person’s daily functioning. With time, many people can recover from a traumatic experience and return to normal functioning. In other cases, a person may be unable to resolve their feelings of grief and hopelessness, leading to conditions like post-traumatic stress disorder (PTSD).

Almost 3 in 4 people will experience at least one traumatic event in their lifetime. However, only about 1 in 15 will meet diagnosis criteria for PTSD. Women are as much as 3 times more likely than men to experience PTSD, although there are many factors besides gender that affect prevalence of trauma and PTSD.

Common Sources of Trauma

Trauma can result from any event or incident that diminishes a person’s sense of safety, autonomy, or purpose. However, there are some specific types of events that are commonly traumatizing when experienced or witnessed.

• Psychological, physical, or sexual abuse
• Physical or sexual assault
• Domestic violence
• Sudden or violent loss of a loved one
• Community violence
• Natural or man-made disasters
• Serious accidents or life-threatening illnesses
• Acts of terrorism
• Refugee or war experiences
• Military service or combat experiences

Trauma is often grouped into two main categories based on the frequency of the traumatic event(s):

➤ Single-incident Trauma

As its name suggests, single-incident trauma (also called single trauma) is psychological trauma from an event that occurred only once. Examples could include a natural disaster, a robbery, a severe car wreck, or a sexual assault. It is possible for a person to suffer from multiple single-incident traumas; the important distinction is that the traumatic events are unrelated from each other and non-recurring.

➤ Complex Trauma

Complex trauma refers to traumatic events that are recurring and often interrelated. Complex trauma frequently occurs within the context of a specific relationship or situation. Common examples include domestic violence, physical/emotional/sexual abuse, and military combat experiences. Complex trauma can seriously impair a person’s psychological growth and development, especially if it begins during childhood or adolescence.

Symptoms of Trauma and PTSD

Reactions to traumatic events can vary between individuals and may depend on factors like severity of the trauma, frequency of the trauma, and cultural norms. However, some common reactions are listed below.

➤ Intrusive memories

• Unwanted, distressing memories
• Flashbacks
• Nightmares
• Emotional distress after a reminder of the event

➤ Avoidance behaviors

• Avoiding thinking about the event
• Avoiding talking about the event
• Avoiding places, things, activities and people associated with the event

➤ Changes in thoughts and mood

• Negative thoughts about the self, other people, or the world
• Feelings of hopelessness
• Feelings of isolation
• Difficulty experiencing positive emotion
• Lack of interest in hobbies

➤ Changes in behavior and demeanor

• Irritability or aggressiveness
• Risky or self-destructive behavior
• Hypervigilance
• Heightened startle response
• Difficulty sleeping
• Difficulty concentrating

A person who has experienced trauma may be able to recover on their own or with assistance, resulting in symptoms disappearing over time. If their symptoms persist for an extended period, then they might meet diagnosis criteria for post-traumatic stress disorder.

An individual may be diagnosed with PTSD when all of the following criteria are met:

• The person directly experienced, witnessed, or learned about an instance of actual or threatened death, actual or threatened serious injury, or actual or threatened sexual violence.
• The person persistently re-experiences the traumatic event(s) through unwanted upsetting memories, nightmares, flashbacks, emotional distress after traumatic reminders, and/or physical reactivity after traumatic reminders.
• The person actively avoids trauma-related stimuli, including trauma-related thoughts and feelings and/or trauma-related reminders.
• The person has negative thoughts or feelings that began or worsened after the trauma, including at least 2 of the following: inability to recall key features of the trauma, overly negative thoughts and assumptions about oneself or the world, exaggerated blame of self or others for causing the trauma, negative affect, decreased interest in activities, feelings of isolation, and difficulty experiencing positive affect.
• The person experiences trauma-related arousal and reactivity that began or worsened after the trauma, including at least 2 of the following: irritability or aggression, risky or destructive behavior, hypervigilance, heightened startle reaction, difficulty concentrating, difficulty sleeping.
• The person’s symptoms have persisted for more than one month.
• The person’s symptoms cause them distress or functional impairment.
• The person’s symptoms are not the result of medication, substance use, or another illness.

Treatments

Trauma and PTSD can be extremely challenging to live with, but they are treatable, and individuals who experience trauma can go on to live full, normal lives. If post-traumatic stress does not resolve itself naturally, then therapy and medication can help to reduce your symptoms.

➤ Therapy and Skills Training

Professional therapy and counseling are important components of treatment for trauma and PTSD. Treatments like individual therapy, group therapy, and skills training can help individuals learn how to manage symptoms of post-traumatic stress.

Some common therapeutic practices include:

• Teaching you what trauma is and how it affects different people.
• Reviewing the traumatic event(s) with a therapist in a safe environment.
• Having you describe the traumatic event(s) in writing (known as “creating a narrative”).
• Talking about the way you think about yourself and how these thoughts make you feel. When talking about these thoughts, the therapist may be able to help change thoughts of guilt or self-blame and help you feel differently.
• Helping you confront and reprocess traumatic memories in order to become less troubled by them in the future. This can be done using techniques like cognitive processing therapy (CPT), exposure therapy, and eye movement desensitization and reprocessing therapy (EMDR).
• Looking at your hobbies and interests and working on ways for you to participate in them while enjoying yourself.
• Talking about whom you feel close to and the different relationships in your life, and discussing how these relationships can ease your distress.
• Guiding you through relaxation, meditation, and deep breathing techniques, and teaching you how to perform these techniques on your own.
• Teaching you personal safety skills to help ease feelings of anxiety.
• Teaching you how to take care of your personal health, including how to keep a healthy diet and get enough exercise.

➤ Medication

Certain psychiatric medications can help to reduce symptoms of stress, depression and anxiety related to trauma or PTSD.

These medications, called selective serotonin reuptake inhibitors (SSRIs), work by increasing the levels of the neurotransmitter serotonin in the brain. This in turn can reduce the severity and frequency of depression, anxiety, irritability, panic attacks, and nightmares.

Medication for PTSD is especially effective when prescribed alongside therapy that addresses the root causes of post-traumatic stress.

Supporting a Loved One with Post-Traumatic Stress

If you know someone who suffers from trauma or whom you suspect may have PTSD, then you might be looking for ways to help and support them. Family members, friends, and other supporters can be great sources of strength for individuals living with post-traumatic stress.

The following section includes tips that can be helpful for supporting someone with post-traumatic stress. Keep in mind they might not all be right for you and your loved one, but it could be useful to give them a try.

➤ Educate yourself

Stay informed about what trauma and PTSD are, what they look like, and how they can affect your loved one. Encourage them to become educated about trauma and PTSD if they have not done so already.

➤ Express your support

Let your loved one know that you care about them, are concerned for their well-being, and are there to support them. This can help quiet any doubts they may have and reassure them that you are on their side.

➤ Advocate for treatment

Ask your loved one if they are seeking help for their condition. If they are not, express to them why you think professional treatment could be helpful. Offer to help them find treatment if they would like you to.

➤ Listen

Ask how your loved one is feeling, and listen to what they tell you. Don’t try to guide the conversation too much or downplay their challenges. Sometimes people just need to be heard, and they will notice whether or not you are truly listening.

➤ Honor their privacy

Honor your loved one’s privacy regarding their trauma. Never pressure them to talk about the event(s) if they don’t want to. Revisiting trauma can be traumatic in itself, and it is not your right to know all the details.

➤ Offer to help with tasks

Ask your loved one if there are any daily tasks or obligations you can assist with. This can be helpful if their condition makes certain tasks difficult for them, or if they are short on time because of their treatment schedule.

➤ Involve them in plans

Invite your loved one to join in social events and gatherings, either with a group or just between the two of you. Continue to socialize with them as you have in the past. This will help reassure them that your relationship has not changed because of their condition.

➤ Treat them with respect

Your loved one has not changed just because they are experiencing post-traumatic stress. They are still the same person they were before. Treat them with the same respect and dignity you would anyone else, and do not patronize or talk down to them.

➤ Take care of yourself

Your well-being matters just as much as your loved one’s. Know your limits and seek support if you need it. Join support groups, check out community services, and seek professional guidance if you think it would be helpful. Don’t let your whole life revolve around your loved one’s condition.

➤ Don’t make assumptions

Even if you know a lot about trauma and PTSD, do not make assumptions about your loved one’s experiences. Ask questions and seek to understand their situation rather than telling them what to do.

➤ Don’t criticize or blame

Criticizing your loved one’s behavior or blaming them for their situation will not help anyone. Be supportive in any way possible, and understand that they did not choose the challenges they are experiencing.

➤ Celebrate their progress

Let your loved one know that you are proud of their progress both in and out of treatment. Celebrate their “wins” and successes in recovery. Encourage them to keep going!

References

➤ American Psychological Association. (2023, October). Trauma. Retrieved November 2023. https://www.apa.org/topics/trauma

➤ International Society for the Study of Trauma and Dissociation. (2020). Trauma and Complex Trauma: An Overview. Retrieved November 2023. https://www.isst-d.org/wp-content/uploads/2020/03/Fact-Sheet-I-Trauma-and-Complex-Trauma_-An-Overview-1.pdf

➤ Mayo Clinic. (2022, December 13). Post-Traumatic Stress Disorder (PTSD). Retrieved November 2023. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

➤ National Alliance on Mental Illness. (n.d.) Tips for How to Help a Person with Mental Illness. Retrieved November 2023. https://www.nami.org/Get-Involved/NAMI-FaithNet/Tips-For-How-to-Help-a-Person-with-Mental-Illness

➤ National Institute of Mental Health. (2023, May). Post-Traumatic Stress Disorder. Retrieved November 2023. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd

➤ National Institute of Mental Health. (n.d.) Post-Traumatic Stress Disorder (PTSD). Retrieved November 2023. https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd

➤ Robinson, L., Smith, M., & Segal, J. (2023, June 6). Emotional and Psychological Trauma. HelpGuide.org. Retrieved November 2023. https://www.helpguide.org/articles/ptsd-trauma/coping-with-emotional-and-psychological-trauma.htm

➤ Substance Abuse and Mental Health Services Administration. (2023, April 24). For Friends and Family Members. Retrieved November 2023. https://www.samhsa.gov/mental-health/how-to-talk/friends-and-family-members

➤ Substance Abuse and Mental Health Services Administration. (2023, March 17). Understanding Child Trauma. Retrieved November 2023. https://www.samhsa.gov/child-trauma/understanding-child-trauma

➤ U.S. Department of Veterans Affairs. (2023, June 9). PTSD and DSM-5. Retrieved November 2023. https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp