Trauma- & Stressor-Related Disorders

Trauma impacts millions of people around the world. It’s defined by the American Psychological Association (APA) as a physiological reaction to a tragic occurrence, such as:

• An accident
• A shooting
• A rape
• A natural disaster

After a situation like the above has occurred, denial and shock are extremely common. Eventually, reactions can lead to strained relationships, flashbacks, erratic emotions, and even physical discomfort like nausea and headaches. These symptoms can make it hard for some people to move past a terrifying or traumatic experience.

If you’re suffering from trauma, know that you can get your life back and regain function with the help of treatment, social support, and lifestyle adjustments.

Types of Trauma

A highly stressful event can make recovering a normal state of mind difficult. Some people encounter mental health issues because of traumatic experiences. We all come from different backgrounds and have varied life experiences, which is why it’s important to consider all possible causes of a person’s mental health condition. What traumatizes someone else may not traumatize you. Learn more about the different types of trauma, along with their symptoms and diagnoses.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a psychiatric or mental health condition that develops when an individual experiences intense trauma or other dangerous or terrifying events. It is estimated to impact approximately 8 million U.S. adults each year.

Although it’s typical for the first signs of PTSD to appear in days following a traumatic event, symptoms can even surface months later.

PTSD Symptoms and Diagnosis

Symptoms of PTSD can be categorized in four ways:  

• Intrusion: Examples of intrusive thoughts include unconscious and often persistent, recollections, terrifying dreams, or upsetting flashbacks to the incident. People who experience flashbacks sometimes feel like they are witnessing or reliving a painful event.
• Avoidance: Avoiding things, people, places, activities, items, and situations that could bring back painful memories is one way to prevent reminders of the traumatic incident. People may try to forget or stop thinking about the experience.
• Negative changes in thinking and mood: These can include an inability to recall key details of the traumatic event, distorted ideas about the consequences or cause of the event, which leads you to wrongly blame yourself or others, and negative emotions leading to distorted and persistent beliefs about yourself or others.
• Changes in physical and emotional reactions: These can include anger, self-destructive and reckless behavior, irritability, insomnia, and paranoia about your friends, relatives, and surroundings.

In the days following a stressful occurrence, many people are affected by these symptoms. But for you to be diagnosed with PTSD, your symptoms must last for more than one month and cause you severe discomfort or difficulty with everyday functioning.

Get Help Immediately

It can be challenging to manage PTSD, and trauma can make the prospect of recovery seem overwhelming. To help manage and reduce the severity of PTSD, Footprints provides an accessible source of high-quality, professional mental health services. You can contact us here.

If you or someone you know has self-harm ideas or suicidal thoughts, obtain help immediately by reaching out to the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).

Childhood Post-Traumatic Stress Disorder (PTSD)

PTSD affects people of all ages, but when symptoms appear in a child, it’s referred to as “childhood post-traumatic stress disorder,” or childhood PTSD.

A child with PTSD is plagued by unsettling memories and ideas of the past. He or she is physically or emotionally terrified by an event. PTSD symptoms may appear immediately after a traumatic experience, or they may not occur for six months or more. Some children with PTSD experience long-term consequences, like lengthy periods of emotional numbness. When it affects children, PTSD frequently develops into a chronic issue.

Childhood PTSD Symptoms and Diagnosis

When exposed to stimuli that remind people living with PTSD of the traumatic incident, they experience severe emotional and physical distress. Some may repeatedly go through trauma. Throughout the day, they could experience nightmares and unsettling memories. They could also:

• Have issues sleeping
• Feel gloomy or depressed
• Feel tense, twitchy, or observant and attentive (on guard)
• Give up on activities they formerly found enjoyable
• Be unresponsive and appear distant or numb
• Have issues displaying affection
• Be more combative and violent than before
• Avoid circumstances or locations that bring up bad memories
• Recall past events – feelings, noises, smells, or visuals can all cause a young child to think that the incident is reoccurring.
• Lose awareness of reality

Once the diagnosis has been made, the priority is to help the child feel safe by enlisting the help of parents, friends, and school personnel, as well as by doing all you can to reduce the likelihood of another traumatic experience. Psychotherapy can be conducted with the child, the family, or a group where the child can speak, draw, play, or write about the traumatic incident.

According to behavior therapy, particularly cognitive behavioral therapy, children experiencing dread or concern can learn to change their thoughts and feelings by first altering their behaviors. Medication may also be used to lessen symptoms.

Acute Stress Disorder (ASD)

Acute stress disorder (ASD) also results from a traumatic experience and exhibits similar symptoms as PTSD, although the signs and symptoms appear between three days and one month after the incident. Researchers estimate that between 5% and 20% of people who experience a trauma such as an assault, car accident, witnessing a murder, or other traumatic event develop ASD.

ASD patients may experience flashbacks or dreams, relive the event, and feel numb or distant from themselves.

Several factors may place you at a higher risk for developing ASD after trauma, including:

• Having experienced other horrific incidents
• Having had PTSD before
• Having had mental health issues in the past
• Experiencing symptoms like not knowing who or where you are when faced with trauma

Secondhand Trauma

Secondhand trauma is the emotional strain someone experiences when they hear about the trauma experiences of someone else. They take on that trauma. In the U.S., more than 10 million children experience abuse, violence, natural disasters, and other traumatic events annually. Social workers who have contact with these children and therapists who support sexual assault victims are two examples of people who often experience secondary trauma.

Signs of secondhand trauma include:

• Fatigue or illness
• Reduced productivity
• Feelings of reexperiencing the event
• Avoidance of people or activities
• Persistent anger or sadness

There are steps to prevent and cope with secondhand trauma’s effects. Footprints to Recovery is available to assist you with those steps.

Reactive Attachment Disorder (RAD)

Reactive attachment disorder (RAD) occurs in children who have suffered from significant social neglect or deprivation during their early years. It may happen when youngsters lack the fundamental emotional requirements for solace, stimulation, and affection or when frequent caregiver changes prevent them from forming attachments.

RAD causes children to emotionally distance themselves from their adult caregivers. They hardly ever seek the comfort, protection, or support of caretakers, even when they are upset. They display little positive emotion in typical encounters with caretakers and may exhibit irrational fear or melancholy.

As children with RAD get older, their symptoms typically fall into one of two general patterns of behavior:

• Inhibited RAD symptoms: The child understands what is happening around them, but they don’t typically respond to outside stimulation. They also seem withdrawn. Children with inhibited RAD symptoms don’t typically demonstrate or seek affection or physical contact from parents, relatives, caregivers, or others.
• Disinhibited RAD symptoms: These children may show no connection with their parents, siblings, or caretakers and may be too friendly toward strangers. Oftentimes, these children act younger than their age and seek affection from others in an unsafe manner.

Disinhibited Social Engagement Disorder (DSED)

Most children are instinctively wary of adults they do not know. Disinhibited social engagement disorder (DSED) is an attachment condition characterized by a lack of inhibition around strangers and difficulty building emotional bonds with others. Young children who have endured abuse, neglect, trauma, or abandonment are more likely to develop this condition.

Possible causes of DSED include:

• Social neglect or deprivation
• Repetitive changes in caregivers
• Being raised in environments with limited access to relationships

DSED Symptoms and Diagnosis

Symptoms of DSED are:

• Reduced or nonexistent restraint when approaching or conversing with unfamiliar or unknown adults
• Excessively relaxed and familiar conversations with unfamiliar adults, whether by speech or behavior
• Little desire to check in with the caregiver to get confirmation or approval for behaviors and actions
• An openness to trying new things or leaving familiar surroundings with strangers

When diagnosing DSED, it must be the result of the inadequate care a child received as an infant. Impulsivity alone doesn’t qualify a child for DSED, and ADHD, autism, or other mental or physical health problems don’t explain the child’s uninhibited social interactions.

Adjustment Disorders

Adjustment disorders are stress-related conditions. In response to a stressful or unexpected occurrence, you experience greater stress than usual, which substantially negatively impacts your relationships, work performance, and academic performance.

Stress can be brought on by a variety of life changes, including (but not limited to):

• Issues at work
• Moving away for education
• Becoming ill
• Losing a close relative

If you have an adjustment disorder, you still exhibit emotional or behavioral responses that can heighten your anxiety or depression.

Symptoms and Diagnosis of Adjustment Disorders

The signs and symptoms differ from person to person and depend on the type of adjustment disorder. In response to a stressful situation, you suffer more stress than is often anticipated, and the stress causes serious issues in your life. Adjustment disorders impact how you feel and think about the world and yourself. They also impact your behaviors.

Several signs and symptoms include:

• Feeling down, despairing, or lacking enjoyment for things you used to enjoy
• Frequently crying
• Worrying or experiencing agitation
• Difficulty sleeping
• No appetite
• Trouble paying attention

Within three months of a stressful incident, symptoms of an adjustment disorder begin, and they endure for no more than six months. However, chronic or persistent adjustment issues can last longer than six months, particularly if the stressor is recurring, like unemployment.

Unspecified Trauma and Stressor-Related Disorders

When there is insufficient data to determine a precise diagnosis, the illness associated with trauma and stressors may be diagnosed as an unspecified trauma and stressor-related disorder. It can be used to characterize signs of linked trauma disorders that result in distress and impairment but don’t fully fit the diagnostic criteria.

Childhood trauma stressful situations can have lifelong health impacts beyond the emotional disorders previously mentioned. In fact, a wide range of negative outcomes later in life has been directly linked to adverse childhood experiences (ACEs) according to research into their consequences. The unfavorable events considered in these investigations include:

• Sexual, physical, or emotional abuse
• Neglect, either physical or emotional
• Violence in the home, drug abuse, or mental illness
• Divorce or separation of the parents
• Responsibility for putting a family member behind bars

Results have revealed that adverse health and life consequences are more likely to occur in children who are exposed to more ACEs, such as:

• Heart condition
• Stroke
• Diabetes
• Depression
• Abuse of alcohol
• Use of illicit drugs

What Is a Dual Diagnosis?

An individual with a dual diagnosis has both a mental illness and an addiction. These circumstances regularly happen simultaneously. A substance use disorder will occur in about half of people with a mental disorder at some point in their lives. Additionally, many individuals with mental illness often end up with addictions. The two disorders can make each other worse.

Even if issues occur concurrently or if one shows up first, this doesn’t mean one issue has caused the other. In fact, it can be almost impossible to figure out which event happened first. Researchers believe there are three possible explanations for why these issues co-occur:

1. Both substance use disorders and mental problems may be influenced by common risk factors.
2. Drug usage and substance use disorders can be influenced by mental problems. For instance, individuals experiencing a mental health challenge may use alcohol or take drugs or other medications to momentarily feel better.
3. Substance use and addiction can cause mental disorders to emerge.

Others become hooked on drugs or alcohol after receiving a mental illness diagnosis, and some people become addicted before receiving such a diagnosis. Regardless of which came first, it’s critical to establish a personalized treatment strategy that addresses both illnesses. An inpatient rehab facility like Footprints can be essential when dealing with a dual diagnosis.

References:

1. https://www.apa.org/topics/trauma
2. https://www.ptsd.va.gov/understand/common/common_adults.asp#:~:text=About%206%20out%20of%20every,have%20gone%20through%20a%20trauma
3. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
4. https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd#:~:text=Symptoms%20of%20PTSD%20usually%20begin,such%20as%20relationships%20or%20work.
5. https://www.stanfordchildrens.org/en/topic/default?id=post-traumatic-stress-disorder-in-children-90-P02579
6. https://www.stress.org/acute-stress-disorder
7. https://www.nctsn.org/trauma-informed-care/secondary-traumatic-stress#:~:text=Secondary%20traumatic%20stress%20is%20the,disasters%2C%20and%20other%20adverse%20events.
8. https://www.cdc.gov/violenceprevention/aces/about.html