The definition of trauma is purposely left very vague so as to be inclusive of the many different types of trauma that people experience. What affects one person to the point of developing posttraumatic stress disorder may only mildly inconvenience another. The trouble with that is it sometimes makes it more difficult for people to identify what is going on. For instance, there are many people who suffer from trauma-related symptoms who do not recognize the link between the trauma and their symptoms, and other people who do not recognize that they have even experienced a trauma. As a trauma therapist, I see many survivors who are not sure what is happening to them. That is a horrible feeling. Let’s talk about some common trauma symptoms that survivors experience, to promote awareness and advocacy!
Common trauma symptoms
Sleep disturbance and nightmares
People who have experienced a trauma often have difficulty sleeping. When nightmares are present, it can be a little easier to attribute the sleep loss to the trauma itself. However, there are also sleep disturbances that can occur without dreaming of the event. Sometimes people have had difficulty falling asleep due to racing thoughts or worry, and sometimes people have either early awakenings where they are unable to fall back asleep or restless, interrupted sleep throughout the night. If you have ever tried to go about your day without proper sleep you know the importance of being rested. Seeing your medical doctor or psychiatrist to discuss sleep disturbance and entering into therapy to manage anxious symptoms and trauma responses can get you feeling better during this time!
Irritability, anger, and oppositional behavior
Many people who have experienced trauma find themselves more irritable or angry than they used to be. There is a myriad of reasons as to why this can occur. Increased stress, unmanaged feelings, and unresolved issues can make coping with normal life stressors much more difficult. The more things that pile on in life, the harder it can be to sort through the cause of our frustrations. Therapy can provide anger management strategies and coping skills to give you alternative ways to react to stressors in your life, and working through the trauma that often leaves survivors feeling less angry overall as they gain understanding and mastery.
Intrusive memories and thoughts
Trauma survivors not only deal with nightmares of the event, but they often have flashbacks where they feel like they are right back in the event or other intrusive thoughts and memories that flood back when they are triggered in some way. The most common idea of a flashback is a war veteran who hears a gunshot on a movie and is transported back in time in his mind to the traumatic event. This actually occurs with all kinds of trauma though.
A victim of a car accident can jump at a loud sound, or unsafe driver, a rape survivor can have a wave of panic flood back with a certain smell or sound. What happens is the unprocessed trauma is like a messy linen closet that, when someone walks past it, the doors fly open and everything falls out! Trauma treatment, helps survivors reorganize their experiences and neatly put them away so that they are no longer triggered by these unconnected events.
Withdrawal and avoidance of certain people, places, and things
Many trauma survivors avoid people and things that they used to really enjoy. Sometimes it’s due to a place or thing that reminds them of their trauma, and sometimes it’s due to the difficulty they are having in general, or the overwhelmed or depressed feelings that they feel. Many times it just feels like it is easier and safer to just stay home. Staying home though can lead to isolation and increased loneliness or depression. Sometimes you have to take the step to teach your loved ones about what you are experiencing and how they can best support you. Having a connection is important of the healing process, so finding a way to stay connected to certain family and friends during this time is worth this extra effort! In addition, therapy can help address the depressive symptoms, as well as different triggers that arise.
Anxiety and panic
Feelings of anxiety and panic arise from all different triggers. There can sometimes be an underlying anxiety that is constantly present, and sometimes the feeling of panic only arises when a trigger occurs. It is especially difficult for clients who are experiencing panic attacks and find themselves hyperventilating, with a feeling of dread and impending doom that can even end in people misattributing their panic to a potential heart attack. The important thing in these moments is to stay calm and ride the wave of anxiety to the end. In therapy, you will learn many helpful coping skills to manage the anxious feelings such as deep breathing and progressive muscle relaxation!
Hypervigilance and startle response
This refers that that “on edge” feeling that we talked about a little under the anxiety section. It is when people feel that they can’t relax and that something bad could happen at any moment. Have you ever watched a scary movie and then had someone jump out from behind a corner and yell “boo” only to jump three feet into the air? That is what the startle response is like. It’s being “keyed up” and then having a larger than normal reaction to things that normally wouldn’t bother you. Examples of this are fireworks or the backfiring of a car. Learning to better manage anxiety through treatment helps clients regain that life satisfaction that they used to have!
Racing heart, headaches, stomach aches
Many people experience body sensations or pains as a result of psychological pain. Just like it’s not uncommon for people to experience headaches when they feel stressed, it is not uncommon for people to have random aches, pains, or body sensations after trauma. The good news is that by managing the psychological pain through treatment, these sensations and pains usually subside too!
Hopelessness about the future
Feelings of sadness and depression are common symptoms that result after a trauma. Client’s often express hopelessness about the future and sadness about where they are at and things that have occurred. It is important to remember that this is a normal response to the event. Nonetheless, there are things that you can do to improve your mood. In treatment, client’s learn different types of coping skills, including cognitive coping, which teaches clients ways to reframe their thinking and begin to think less negatively, which then improves mood!
Memory problems or difficulty concentrating
Have you ever tried to focus on a test when you have a big life event going on? Whether it is a breakup or death in the family, people often give themselves more of a break when it comes to other things. Then, they expect that they “shouldn’t be” letting a trauma get in the way of their concentration/memory. Learning that the symptoms you are experiencing are normal and usually temporary and practicing kindness to yourself is the main skill to learn here!
Lack of interest in activities you once enjoyed
This piece ties into the depression/sadness. One of the first signs that something is going on is losing interest in things that you once enjoyed. Pay attention to changes in yourself during this time. See what you used to love and haven’t given a second thought to lately. Of course, sometimes interests change. However, if you find that you used to enjoy doing several activities that you have recently given up, it could be a sign that more is going on. Talking to a professional, and identifying symptoms is a good place to start to get re-connected in your life.
Numbness is different from sadness. Often survivors of sexual assault, in particular, describe feeling numb, or nothing at all. People often don’t know what to do or where to turn when they are used to feeling every gamut of the feelings scale, and then suddenly feel nothing at all. The numbness is often associated with being in a state of “shock” and can be worked through together with a therapist to deal with the core issue, and practice feeling different feelings again!
Overwhelming guilt or shame
No matter what type of trauma that a person has experienced, guilt and shame tend to appear. It is difficult to shake the trauma of a car accident or dog bite until the event has processed, even though clients know that these events weren’t their fault. The trauma narrative section of Trauma focused- Cognitive Behavioral Therapy (TF-CBT) focuses on re-processing the traumatic event in a meaningful way so that clients are able to let these unreasonable feelings go!
Many survivors of trauma engage in a range of risky behaviors for different reasons. For instance, a sexual assault survivor may engage in increased risky sexual behavior as a means to regain a feeling of control over their sexuality. Or, a person may engage in increased drinking to numb emotional pain. Whatever the reasons for the behavior, it can create additional problems in the survivor’s life. A therapist can gently point out problematic behavior and address reasons behind the behaviors that are causing additional problems for you!
The article focuses on recognizing current symptoms of trauma. That way, you can get a better understanding of what may be going on, and how therapy can help. I think it is also important to recognize that untreated trauma can have long-term life effects. that were not previously addressed and are often overlooked when considering the negative impact of surviving trauma. Below are some common effects that trauma survivors experience:
- Respiratory difficulties (such as asthma)
- Poor school or work performance
- High rates of dropout
- Increased likelihood of incarceration
- Drug and alcohol abuse
- Chronic medical and mental illness
There are many potential long-term effects of untreated trauma. Many trauma survivors wish to just “move on” and “forget about it”. Unfortunately, this is the equivalent of “sweeping it under the rug”. Eventually, the mound under the rug becomes so large that it’s impossible to pass by and complete normal tasks because you keep tripping on it. Seeking trauma treatment to address symptoms, and process the event decreases the chance of these long-term effects.
Through TF-CBT, I teach survivors to identify triggers, implement relaxation techniques, and learn different coping skills to manage symptoms. Once day to day functioning has improved, and clients have the tools to manage the feelings that arise when discussing the trauma, then we move on to the trauma narrative, to gain mastery of the traumatic event. The goal is to get clients feeling better as soon as possible because no one should suffer alone. If you or a loved one have experienced trauma, we are here to help!