In my network of mental health counselors, many of us are recognizing a shift in how American culture processes mental health issues. On the positive end, mental health diagnoses and concerns are becoming far less stigmatized, and society as a whole is more accepting, understanding, and accommodating of mental health needs. Certainly, there are still significant limitations to this rule, but when I walk into a children’s museum with my kids and see that they offer placed noise cancelling headphones available for children with sensory processing disorders, it gives me hope that progress is truly being made.
On the negative end, however, social media’s influence on the ways we talk about mental health issues is not always helpful. Clinical terms have taken on casual use, and well-intentioned support communities often end up being toxic, pushing “solutions” and “data” that would make a trained therapist cringe and are often misguided or even harmful, promote self-diagnosis rather than professional diagnosis, and have a tendency to make certain diagnoses go “viral.”
Additionally, we have a cultural tendency to adopt clinical terms into everyday vernacular, which often waters down the clinical use of terms. For example, if someone is merely indecisive, someone might joke that they are bipolar. The word bipolar is used casually and with intended humor regularly, but if you ask a person diagnosed with bipolar disorder, most would tell you that there’s nothing funny about their struggles, and the casual use of the word has led to widespread misunderstandings of the challenges they actually face.
So we come to the word trauma. And in my experience, the word is met with all kinds of misunderstandings. In casual use, someone might imply that they have experienced trauma because someone corrected them about something or disagreed with them. When working with people who are experiencing trauma, though, sometimes they feel that the very real trauma they have experienced does not fit the definition of “trauma” because they have not experienced something like war, rape, or other atrocities that might feel bigger or more significant than what they experienced.
The truth is, trauma manifests as a response to highly stressful events or situations, with potential enduring impacts, though recovery is achievable.
Such events can occur at any stage of life, exerting lasting repercussions on both physical and mental well-being. While each individual’s encounter is unique, there exist common triggers and shared symptoms, such as anxiety, flashbacks, and disrupted sleep patterns, associated with post-traumatic stress.
Defining Trauma:
Trauma denotes the psychological response following an overwhelming event, often characterized by shock, denial, and subsequent alterations in behavior, cognition, and physiology.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), trauma encompasses experiences perceived as harmful or life-threatening, yielding lasting detrimental effects across mental, physical, emotional, social, or spiritual dimensions.
Although commonly linked to major incidents like physical or sexual assault, violence, or accidents, trauma can also emerge from prolonged exposure to adverse circumstances, such as ongoing emotional abuse or childhood neglect.
Notably, not all individuals enduring traumatic events will suffer prolonged repercussions. Approximately 20% may develop post-traumatic stress disorder (PTSD), with many others exhibiting subthreshold symptoms of post-traumatic stress.
Complex Trauma:
Repeatedly experienced trauma over time can yield cumulative effects, termed complex trauma, often rooted in childhood experiences. Early traumatic encounters can profoundly shape one’s worldview, self-conception, and interpersonal dynamics in adulthood.
The Mental and Physical Toll of Trauma:
Trauma can permeate various facets of life, impacting emotional, social, and physical well-being. During heightened stress, the body and mind become overwhelmed, triggering the fight, flight, or freeze response within the nervous system.
Post-traumatic stress symptoms stem from this overwhelmed state, impeding the full processing of traumatic events as they unfold. Common manifestations include intrusive thoughts, avoidance behaviors, hypervigilance, startle responses, and altered self-perception, often accompanied by a diminished capacity to manage emotions effectively.
Traumatic stress may also manifest in physical health issues, known as somatic symptoms, encompassing chronic pain, sleep disturbances, chest pain, and headaches.
Trauma is widespread in the United States, as per the Sidran Institute:
How Prevalent is Trauma?
- Approximately 70% of U.S. adults have encountered a traumatic event at least once. However, not all individuals who undergo trauma will develop PTSD.
- Of these individuals, up to 20% meet the diagnostic criteria for PTSD.
- Women exhibit twice the likelihood of developing PTSD compared to men.
- The likelihood of PTSD onset varies depending on the nature of the trauma. Particularly high risks are associated with experiences such as rape (49%), physical assault (approximately 32%), and other forms of sexual assault (around 24%).
According to the Centers for Disease Control and Prevention (CDC), adverse childhood experiences (ACEs) – events potentially traumatic in nature occurring during childhood – are prevalent:
- Roughly 61% of adults surveyed across 25 states reported enduring at least one ACE, encompassing instances of violence, abuse, neglect, or substance use issues within the household.
- Nearly 1 in 6 individuals disclosed experiencing four or more ACEs.
- Women and certain ethnic minority groups face heightened susceptibility to encountering four or more ACEs.
What mental health conditions are linked to trauma?
Trauma is correlated with several mental health disorders, including:
Post-Traumatic Stress Disorder (PTSD)
Notably, not all individuals experiencing trauma will develop PTSD; however, approximately 20% will meet the diagnostic criteria.
Dissociative Disorders
Dissociation commonly occurs as a response to trauma. The American Psychiatric Association suggests that 90% of dissociative disorders may stem from traumatic experiences. Such disorders comprise:
- Dissociative Identity Disorder
- Dissociative Amnesia or Dissociative Fugue
- Depersonalization/Derealization Disorder
Borderline Personality Disorder (BPD)
Research from 2021 indicates that between 30% to 90% of cases of Borderline Personality Disorder (BPD) are associated with childhood abuse and neglect.
Depression
Depression, characterized by symptoms such as fatigue and feelings of worthlessness, often manifests as a response to trauma.
Anxiety Disorders
Symptoms of anxiety, including feelings of dread and panic, frequently overlap with those of PTSD. Anxiety may arise when confronted with reminders of a traumatic event, potentially leading to the development of trauma-related anxiety disorders.
How to Recover from Trauma
Although overcoming trauma is challenging, it is achievable. Trauma-focused psychotherapy stands out as one of the most effective approaches for recovery.
The American Psychological Association strongly advocates for the following therapeutic modalities for trauma:
- Cognitive Behavioral Therapy (CBT)
- Cognitive Processing Therapy (CPT)
- Prolonged Exposure (PE) Therapy
They also conditionally endorse Eye Movement Desensitization and Reprocessing Therapy (EMDR) and Narrative Exposure Therapy (NET).
For those seeking mental health assistance, Psych Central’s “How to Find Mental Health Support” resource can provide valuable guidance.
In addition to conventional psychotherapy, expressive arts, such as creative writing or theater, can contribute to trauma healing. A 2019 study suggests that expressive writing can enhance resilience to trauma.
Many individuals who have endured trauma struggle with practicing self-care and self-compassion. Trauma therapists can collaborate with you to bolster these skills, which can have enduring positive effects across various aspects of life.
Moreover, psychoeducation can aid in comprehending your symptoms, serving as a significant stride toward healing. Engaging with healing narratives about trauma from esteemed experts can also be empowering and motivating.
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