As a psychotherapist specializing in the treatment of trauma and PTSD, I work with many patients who come into therapy with symptoms such as substance abuse, self harm, relationship problems, and low self-esteem. One of the first things I want to know in working with a new patient is what has happened to them in their lifetime. Our perceptions are based on our life experiences so when someone has a history of awful traumatic things happening to them, they may develop a negative perception of themselves and of the world. Sometimes people come in with a long list of symptoms but do not necessarily connect them to their trauma history. Sometimes this leads people to feel that they are somehow failing. As a trauma therapist, I try to reframe “What is wrong with me?” into “What has happened to me and how is it affecting me?”

When we talk about Post Traumatic Stress Disorder (PTSD), we are talking about a specific cluster of symptoms that meet specific diagnostic criteria. Trauma can have a wide range of impacts on people and while the criteria for PTSD may feel stringent and specific, people can absolutely have trauma symptomology even if they do not meet the full criteria for PTSD.

Who Gets PTSD?

Often when we think of PTSD, we think of veterans coming back from war. When we see PTSD on television, we often see someone who has angry and frightening outbursts or someone who looks completely out of control. While PTSD can look like this, it does not have to. PTSD can be a result of a wide range of traumatic experiences including war, car accidents, interpersonal violence, or terror attacks.

Often PTSD will develop within 3 months of a traumatic event but it can take longer. It is estimated that approximately 7-8% of people will experience PTSD in their lifetime. In order for someone to have a diagnosis of PTSD, symptoms must be present for a month or longer and interfere with functioning in everyday life. If symptoms are present for less than a month, someone may be diagnosed with Acute Stress Disorder.

Signs and Symptoms

Trauma and PTSD can have a wide range of effects on people. There are several categories included in a PTSD diagnosis. In order for someone to meet the criteria for PTSD, they must exhibit the following…

Criterion A: (Stressor)

• The person was exposed to death, threatened death, actual or threatened serious injury, or threatened sexual violence in the following ways…
  • Direct exposure
  • Witnessing the trauma
  • Indirect exposure to the aversive details of the trauma (often first responders)

Criterion B: (Intrusive Symptoms) – must have 1

• The traumatic event is persistently re-experienced in the following way
  • Unwanted upsetting memories
  • Nightmares
  • Flashbacks
  • Emotional distress after exposure to traumatic reminders
  • Physical reactivity after exposure to traumatic reminders

Criterion C: (Avoidance) – must have 1

• Avoidance of trauma related stimuli after the trauma in the following ways:
  • Trauma related thoughts or feelings
  • Trauma related external reminders

Criterion D: (Negative Alterations in Cognitions and Mood) – must have 2

• Negative thoughts or feelings that began or worsened after the trauma, in the following ways:
  • 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
  • Feeling isolated
  • Difficulty experiencing positive affect

Criterion E: (Alterations in Arousal and Reactivity)

• Trauma-related arousal and reactivity that began or worsened after the trauma in the following ways:
  • Irritability or aggression
  • Risky or destructive behavior
  • Hypervigilence
  • Heightened startle reaction
  • Difficulty concentrating
  • Difficulty sleeping

Symptoms of PTSD in children can look different from those listed above. Children may experience hyperactivity, bedwetting, temper tantrums, mute behavior, acting out scary event during playtime, or being unusually clingy.

How to Help Someone with PTSD? 

People who have experienced trauma can often feel isolated and alone. As mentioned previously, having a support system works as a resiliency factor in preventing or recovering from PTSD. Below are some tips on how you can be helpful to someone after they experience a trauma…

• Offer support, encouragement, and patience. Providing someone the space to share their story can be very helpful to survivors. Group therapy can also be very helpful.
• Learn about PTSD in order to have a better understanding of what that person is going through.
• Listen to his/her feelings and pay attention to situations that trigger his/her PTSD symptoms
• Join in on activities that help survivors regulate their nervous systems- i.e. yoga, meditation, exercise, breathing techniques

How to Help Yourself Post-Trauma?

If you have experienced a trauma and are struggling to cope, the following tips may be helpful…

• Talk with your doctor about treatment options (medication, therapy)
• Physical activity- this can help with getting back into our bodies and learning to feel safe again
• Set realistic goals and expectations for yourself- I hear people say all the time “I don’t understand why I can’t just get over it”. As we’ve discussed in previous blogs, trauma can cause many changes in our brains and bodies that make “just getting over it” unrealistic and unattainable. Enlisting a therapist who specializes in trauma can be helpful in understanding what is happening and coming up with a plan to work toward recovery.
• Share openly with those you trust- having a support system can help survivors feel more understood and less alone which is essential to trauma recovery.

If you are struggling with PTSD and would like to know more about Shannon’s services, contact her today for a free consultation.