When someone experiences or witnesses a traumatic event, or has gone through an extensive period of intense stress, they may be unable to resolve the emotional impact in a timely manner. While most individuals will process and heal within a few weeks following a crisis or trauma, those who have developed a trauma disorder experience psychological distress that results in impairment.
About Trauma Disorders
In 2013 the DSM-V reclassified trauma disorders from the anxiety disorder spectrum to its own mental health disorder category. While anxiety is a common symptom for individuals with a trauma disorder, there are other features, such as anger, aggression, depression, and the inability to experience pleasure, that are more prominent.
Some examples of traumatic events include experiencing or witnessing:
- Sexual assault or abuse
- Physical assault or abuse
- Active combat
- Natural disasters
- Serious auto accidents or physical injuries
- Serious auto accidents or physical injuries
- Sudden unexpected death of a loved one
- Childhood neglect
- History of childhood abuse
When someone has been exposed to a traumatic event they may struggle with symptoms months or even years after the event occurred. The symptoms generally fall into the following categories:
Intrusion symptoms. Includes distressing memories or thoughts of the trauma, flashbacks, nightmares or disturbing dreams, and dissociation.
Negative alterations. Includes problems recalling specifics about the traumatic event, fear, guilt, depression, shame, and feeling isolated.
Avoidance symptoms. Includes taking purposeful steps to avoid memories or feelings about the event and avoiding people, places or situations associated with the event.
Hyper-arousal symptoms. Includes being easily startled, jumpy, irritability, angry outbursts, substance abuse, difficulty sleeping, difficulty concentrating.
Types of Trauma Disorder
There are different types of trauma disorder, each with its own unique features:
Post-traumatic stress disorder (PTSD). Recurring thoughts, memories, or dreams with other symptoms of trauma following a highly traumatizing event that lasts for more than one month.
Acute stress disorder (ASD). Similar to PTSD, ASD is also caused by experiencing or witnessing an intensely traumatizing event, however symptoms last no more than one month.
Reactive attachment disorder. Symptoms affect children and involve emotionally withdrawn behavior, social and emotional disturbance due to neglect or a parent’s withholding of affection and nurturing.
Disinhibited social engagement disorder. Symptoms include culturally inappropriate, familiar behaviors with a stranger that results from neglect or insufficient caregiving in childhood.
Adjustment disorder. Symptoms emerge in response to a stressor, such as going away to college or problems at work, when the individual has difficulty adjusting to it. Symptoms last less than six months.
Treatment for Trauma Disorders
Treatment for a trauma disorder is multi-dimensional. When provided together these interventions can significantly improve an individual’s ability to resume normal daily functioning. Treatment elements for trauma disorders include:
- Individual sessions with a therapist allow the individual to discuss the traumatic events or stressors while expressing the emotional impact of the trauma. Therapeutic interventions may include a combination of evidence-based approaches, including cognitive behavioral therapy, which helps correct thought distortions, cognitive processing therapy, and prolonged exposure therapy.
- Group therapy. Support groups involving individuals who have trauma disorder as a common denominator can facilitate productive peer interaction that allows each person to share their stories and gain mutual support.
- Eye movement desensitization reprocessing (EMDR). EMDR is type of exposure therapy that involves the client following a therapists finger back and forth with their eyes while discussing the traumatic event and processing through an eight step process.
- Antidepressants, such as Zoloft, Paxil, Prozac, and Effexor have been found to help mitigate the psychological effects for some clients with trauma disorder. In some cases benzodiazepines, such as Ativan or Xanax, might be prescribed.
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