It is estimated that 7 out of 10 people in America may experience a life-threatening event such as a natural disaster, serious accident, fire, physical or sexual assault/abuse, war, having a loved one die from homicide or suicide, or seeing someone be killed or injured. The recent natural disaster and ongoing trauma with Hurricane Helene in South Carolina and other areas have been on everyone’s minds and hearts.
Each person is different in how they respond to trauma, but symptoms can include upsetting memories or flashbacks, panic, worry, sleeplessness, nightmares, and generally not feeling safe. It may be difficult to go to work or school or interact with others.
While for some, the trauma response lessens over time, others may experience ongoing trauma. Symptoms of trauma can come and go, or even resurface months or years later. This type of long-term trauma response is part of a mental health condition called post-traumatic stress disorder or PTSD. Risk factors include:
- Being exposed to traumatic experiences, particularly as a child
- Getting hurt, or seeing others getting hurt or killed
- Experiencing an event that caused horror, helplessness, or extreme fear
- Having little or no social support after the event
- Having increased stress after the event, such as the loss of a loved one, pain, injury, or the loss of a job or your home
- Having a personal or family history of mental illness or substance use
Symptoms of PTSD vary from person to person, but the disorder is typically diagnosed after at least one month of the following symptoms:
At least one triggering symptom. Reliving the event and re-experiencing symptoms can feel very real and scary. Flashbacks, distressing memories or dreams, and physical signs of stress such as sweating or a racing heart are common. Seeing, smelling, or hearing something can also be trauma reminders or triggers that bring symptoms back.
At least one avoidance symptom. Avoiding things that remind you of the event may include crowds, people, places, or certain situations. Changing habits such as not driving after a car accident, not leaving the house, or staying extra busy to not think about the event are all avoidance symptoms.
At least two arousal or reactivity symptoms. Arousal symptoms include being easily startled, feeling tense, on guard, or on edge, difficulty concentrating, and difficulty falling or staying asleep. Arousal symptoms are often constant and can affect eating, sleeping, and concentration. Reactivity symptoms include feeling irritable, having angry or aggressive outbursts, or engaging in risky, reckless, or destructive behaviors.
At least two cognitive and mood symptoms. These symptoms include not remembering certain aspects of a traumatic event, experiencing ongoing negative thoughts and feelings of blame about one’s self or others, losing interest in enjoyable activities, feeling socially isolated, experiencing ongoing negative emotions like fear, anger, guilt, or shame, or having difficulty feeling positive emotions such as happiness or satisfaction.
If you or anyone you know is dealing with these symptoms and they continue to interfere with daily life, it’s important to discuss this with your health care provider as soon as possible. PTSD also increases the risk for other mental health conditions, including depression, anxiety, panic disorder, substance abuse, and suicidal thoughts, or may heighten symptoms of existing conditions. Moving on from trauma can’t happen until it has been processed in a healthy way. The earlier treatment is started, the quicker a person with PTSD can begin working on strategies to feel better.
The two main treatments for PTSD include psychotherapy with a mental health professional and medications, but one or both may be included depending on the person. Developing a trusting relationship with a primary health care provider is vital to help work through the treatment process. Your primary health care provider can refer you to a behavioral health professional who has experience working with PTSD. Working with a behavioral health professional is critical to help a person process the event and start developing a toolbox of healthy coping skills.
Therapy sessions are individualized for each person’s unique needs. Experimentation and homework are typically part of the counseling process and may include paperwork or activities to try and report back on. Depending on the outcome, the strategies may be added to the toolbox, adapted, or dropped.
Exposure therapy teaches the individual how to gradually approach fears and feelings around the event and learn that the cues and memories are not dangerous. Cognitive restructuring helps the individual make sense of the event in a realistic way since memories may skew events, and can help lessen fear, anger, guilt, blame, and shame.
Grounding techniques are helpful for dealing with discomfort and panic attacks. This means refocusing away from emotions such as fear or panic and using physical exercises to be in the present moment. Examples of grounding techniques include counting slow breaths, naming what you see or hear, or telling yourself out loud, “I am safe,” while gently rubbing your chest, stroking your forehead, or hugging yourself.
Having other fun or enjoyable tools can also help you manage PTSD symptoms. It is important to find enjoyable activities within an individual’s means, such as cooking, walking, pickleball, journaling, mindfulness, yoga, music, painting, or building things. Experimenting with different options will help discover what works. Often, it can be as simple as thinking about what you enjoyed as a child or something that makes you smile or feel carefree. It’s very helpful to be creative and eliminate barriers. One of my clients loved to paint as a child. Due to severe arthritis, the client could not hold a brush anymore but realized finger painting was a fun outlet.
Experimentation also means not worrying about what doesn’t work. The goal is to keep adding the tools and outlets that do work to the PTSD toolbox.
Other helpful lifestyle strategies include maintaining routines for meals, sleep, and movement, spending time in nature, avoiding alcohol and drugs, and enjoying time with trusted friends and family. Finding or returning to a faith-based organization can also be very beneficial for many people.
Setting realistic goals and focusing on what can be managed each day is essential. Using tools to manage symptoms that arise can help tremendously with symptoms over time. Expect symptoms to improve gradually as opposed to immediately. Regular visits with your health care provider are important to give updates on the treatment plan and how it’s working. Don’t ever give up hope! The journey can be long and challenging, but with good support and treatment, individuals can regain a sense of control and lead long, fulfilling lives.
If you’re ready to start your journey today, visit hope-health.org/services/behavioral-health-services or call (843) 667-9414 to learn more about HopeHealth’s integrated behavioral health counseling services.