Post-Traumatic Stress Disorder (PTSD): Symptoms, Triggers, and Treatment
Thrive • June 27, 2022
By Thrive Wellness Waco Coordinator of Eating Disorder Services and Therapist Sarah Neelley, M.A., LPC-Associate, 500 RYT
According to the U.S. Department of Veterans Affairs , about 60% of men and 50% of women in the U.S. experience at least one traumatic event in their lives, and about 6% of the population develops post-traumatic stress disorder (PTSD) – a distressing and disruptive condition that can impede one’s ability to function and find fulfillment in life.
WHAT IS PTSD?
PTSD is a mental health condition that a person can develop after direct or indirect exposure to a traumatic event. Exposure can include:
- Directly experiencing the event
- Witnessing the event
- Learning that the event happened to a close family member or friend
- Repeated or extreme exposure to details of the traumatic event
Anyone can develop PTSD, however, not everyone who experiences trauma develops the condition. Researchers are still unclear on why some individuals develop PTSD and others don’t despite experiencing similar traumatic events.
TYPES OF TRAUMA THAT CAUSE PTSD
Exposure to actual or threatened death, serious injury, or sexual violence are some of the most common types of trauma. Traumatic experiences can include numerous different events such as:
- Physical, mental, and emotional abuse, including child abuse
- Accidents such as car crashes, falls, and other injurious instances
- Attempted or completed sexual violence
- Being threatened with a weapon
- Combat exposure
- Witnessing serious violence
- Learning a loved one has been killed violently or accidentally
- Medical trauma, whether personal or experienced by a loved one
- Natural disasters
- Bullying and harassment
SYMPTOMS OF PTSD
PTSD involves four different categories of symptoms, which are:
- Intrusion
- Avoidance
- Negative changes in mood and cognition
- Changes in arousal or reactivity
To be diagnosed with PTSD, an individual must have symptoms in each of these categories that have lasted for more than one month since the traumatic event.
Types of intrusion symptoms include:
- Dissociative reactions, which can involve flashbacks, feeling unaware of one’s present surroundings, feeling outside of one’s body, and “zoning out”
- Intense or prolonged distress when exposed to either internal or external cues that resemble or are associated with the traumatic event
- Marked physiological reactions to internal or external cues that resemble or are associated with the trauma
- Responses may include:
- Racing heart
- Sweating
- Difficulty breathing
- Nausea
- Vomiting
- Feeling shaky
- Responses may include:
- Recurring unwanted and troubling memories of the traumatic events which may manifest as intrusive thoughts that seem random or are triggered by a reminder of the traumatic event
- Recurrent distressing dreams, which can be experienced as nightmares in which the content is directly related to the trauma
Types of avoidance symptoms include:
- Avoiding distressing memories, thoughts, or feelings related to the event
- Avoiding external reminders that arouse unsettling memories, thoughts, or feelings related to the event
Types of negative changes in mood and cognition include:
- Feeling misunderstood, detached, or estranged from others (An individual may spend a lot of time around people who love them, yet feel incredibly isolated and alone. Often they may feel as if they can’t talk about what they’re going through or as if no one would understand.)
- Inability to remember important details of the traumatic event
- Notably diminished interest or participation in significant activities
- Persistent, distorted thoughts about the event often leading an individual to blame themselves or others, such as, “If only I had done…” or “I could have stopped it if…”
- Incessant inability to experience positive emotions
- Ongoing negative beliefs about oneself, others, or the world, such as, “I am bad,” “Bad things always happen,” The world isn’t safe,” or “People can’t be trusted.”
- Persistent negative emotional state
Types of alterations in arousal and reactivity include:
- Anger outbursts, which are often verbally or physically aggressive
- Difficulty concentrating
- Exaggerated startle response
- Hypervigilance, which involves feeling “on guard” or overly aware of one’s surroundings (A person may seem “jumpy” or easily startled when approached. Their concern may be heightened about various noises or environments that cause them to feel unsafe. An example of hypervigilance includes a person wanting to sit where they can see the door or everyone in the room so they know what’s happening around them.)
- Irritable behavior
- Reckless or self-destructive behavior
- Sleep disturbance , such as difficulty falling asleep or staying asleep
WHAT TRIGGERS PTSD SYMPTOMS?
Certain sensory information can remind a person with PTSD of the traumatic event and cause them to react with one of the body’s instinctive survival modes – a “fight,” “flight,” “freeze,” or “fawn” (abandoning one’s needs to please others and avoid backlash) response, while also cuing their PTSD symptoms. Triggers are unique to every individual with PTSD, as are the traumatic events which led to the PTSD. They may include but are not limited to smells, tastes, sounds, sights, physical sensations, thoughts, emotions, and interactions.
Examples of possible triggers include:
- A feeling inside the body that resembles one experienced during or after the trauma
- A wanted or an unwanted touch from another human as any touch may remind them of the trauma
- An interpersonal interaction that enacts a similar feeling, thought, encounter, etc. to one experienced during the trauma
- References and exposure to another individual involved in the trauma
- Returning to or talking about the place where the event occurred
- Seeing an environment or aspect of an environment which resembles the one similar to where the trauma occurred or where they learned of the event
- Seeing someone that resembles an individual from their trauma
- Seeing the clothes one was wearing when the event occurred
PTSD IN CHILDREN
PTSD in children can look very different than it does in adults. Younger children may lack the vocabulary or cognitive ability to verbalize their experience and therefore may act out themes or aspects of the traumatic event as well as directly reenact the trauma in play. This behavior is usually linked to an intrusive symptom. Children may also have recurrent nightmares but be unable to recall or express the exact content of the dreams which may be connected to the trauma.
ELEMENTS OF TRAUMA-INFORMED CARE
Trauma treatment may implement a variety of modalities, such as eye movement desensitization and reprocessing (EMDR) and sensorimotor psychotherapy . However, trauma-informed care should involve the following elements:
- A careful, compassionate approach: Clinicians who implement trauma-informed care consider the client’s experience as a priority at all times during their treatment. Mental health professionals generally understand that everyone experiences and responds to trauma differently as shown by the wide array of events that can lead to the development of PTSD and unique triggers for each individual. Providers who are committed to offering trauma-informed care will actively avoid re-traumatization and work to integrate the knowledge of trauma into all processes, procedures, and policies.
- Client education and empowerment: Trauma-informed care involves ensuring the client is well-aware of what treatment options are available to them and empowering them to seek out the care they need, which includes speaking up when something isn’t working for them.
- A trusting therapeutic relationship: Those receiving treatment for trauma should expect their clinician to take time to build a trusting relationship before engaging in deeper therapeutic work. Most providers will assess the whole picture of a client’s life, current functioning, and past experiences while recognizing signs and symptoms of trauma.
- Clinician flexibility: The humility and responsiveness of mental health professionals are also important aspects of trauma-informed care. As with many forms of therapy, trauma-informed care honors clients as the experts in their own lives and experiences. Providers should be willing to acknowledge their own mistakes and make any necessary adjustments in an individual’s treatment to achieve the best possible outcomes for the client. In trauma-informed care, clinicians transparently involve their clients in decisions regarding their care to empower the client with a sense of ownership over their recovery.
PTSD TREATMENT MODALITIES
While treatment for PTSD varies from one individual to another, it may include therapy, medication, primary care, and any other health care services that may be warranted based upon the individual’s unique needs. Ideally, all providers working to treat an individual for PTSD are connected and in communication with one another as integrated care can help to ensure holistic healing.
There are several evidence-based modalities that are well known as being effective for treating PTSD in therapy. Some methods take a narrative approach in which an individual works with their therapist to process each aspect of the event. Clients may even write their trauma narrative to discuss in session.
Other approaches address more of the somatic, or bodily, experience. These interventions embrace the idea that trauma can become trapped in the body. Somatic therapies don’t typically require an individual to relive their trauma experience by sharing a detailed narrative. Instead, they address the internal experience, associated symptoms, and impacts of the event.
Types of PTSD treatment modalities include:
- Cognitive processing therapy: A type of cognitive-behavioral therapy (CBT) that encourages individuals to challenge any problematic ideas related to trauma
- Dialectical behavioral therapy (DBT) : Guides individuals in implementing skills that help them regulate their emotions and live a meaningful life
- Eye movement desensitization and reprocessing (EMDR) : Uses bilateral eye movements to help change how traumatic memories are stored so that they no longer cause distress
- Prolonged exposure therapy: Encourages individuals to gradually face their trauma-related fears as a way of desensitizing them to their triggers
- Sensorimotor psychotherapy : Helps clients release stored traumatic bodily energy
- Somatic experiencing: Integrates the body into processing the traumatic event
- Trauma-focused cognitive behavioral therapy (TF-CBT): Another form of CBT intended to treat children struggling with trauma and adults with unresolved trauma from their childhood
Every approach to treating PTSD will likely involve:
- Addressing the client’s unique experience and PTSD symptoms
- Psychoeducation to help the client better understand their PTSD
- Implementing skills that help reduce the client’s symptoms such as distress tolerance, mindfulness, and interpersonal effectiveness
- Some form of therapeutic processing that helps integrate the traumatic experience and foster a sense of acceptance
RECOVERING FROM PTSD
Just as with any other mental or behavioral condition, recovery from PTSD looks different for everyone. Some individuals may live with remnants of their PTSD for long periods, experiencing complete relief from many symptoms while other symptoms dull over time. They may also have ebbs and flows in their symptoms which can be frustrating at times.
With that in mind, recovery from PTSD is entirely possible and with the right support, individuals can learn to process their traumatic experiences, manage their symptoms, and begin to move forward in their lives while acknowledging the impact of the past.
SUPPORTING A LOVED ONE WITH PTSD
If you’re a family member or friend of a loved one with PTSD, below are some ways you can help them as they heal:
- Be willing to listen to your loved one
- Ask your friend or family member how you can best support them
- Find out if they are willing to share some of their triggers with you and if so, what you can do to offer support when they encounter a trigger
- Learn what things help your loved one feel safe and ways you can increase their sense of security
- Offer a loving, calm, and caring presence when you can
- Do your best to show up when they need help
- Take care of your mental health
- Remind them of the meaning and value they add to your life and why you care about their recovery
- Encourage them to seek professional help
HEALING FOR PTSD AT THRIVE WELLNESS
Many of our clinicians are experienced in treating PTSD through a variety of evidence-based methods. If you think you may be struggling with PTSD, Thrive Wellness specialists want to help you process your trauma, find the healing that you deserve, and lead a fulfilling life. Reach out to learn more about our outpatient services .
About the Author
Thrive Wellness Waco Coordinator of Eating Disorder Services and Therapist Sarah Neelley, M.A., LPC-Associate, 500 RYT
Sarah is passionate about providing holistic care to survivors of interpersonal trauma, as well as individuals struggling with eating and body image concerns.
A registered yoga instructor, she enjoys integrating her counselor education and yoga training to holistically approach mental health treatment. She is skilled at facilitating trauma-informed yoga therapeutic groups for survivors of interpersonal trauma.
As a counseling intern at Baylor University’s Counseling Center, Sarah has provided mental health support to clients facing crisis situations, trauma, anxiety, depression, OCD, substance use, and anger concerns.
Sarah holds a master of arts degree in clinical mental health counseling from the University of Mary Hardin-Baylor. She also holds a bachelor of arts degree in psychology from Baylor University.
In her free time, Sarah loves reading, spending time with friends and family, taking long walks outdoors, enjoying a good cup of coffee, and doing puzzles. She recently developed an interest in keeping plants alive. Wish her (and her plants) all the luck!
Supervised by Erin McGinty Fort, LPC-Supervisor (76628) | Texas State Board of Examiners of Professional Counselors
The post Post-Traumatic Stress Disorder (PTSD): Symptoms, Triggers, and Treatment first appeared on Thrive Wellness.
This Eating Disorders Awareness Month, we’re focusing on fighting the misinformation and stereotypes surrounding eating disorders that so often create barriers to diagnosis and treatment. Myths about eating disorders can perpetuate harmful stereotypes and keep people from receiving effective and timely treatment when they need it. It’s no secret that the field of eating disorders is riddled with misinformation, leading to confusion, stigma, and shame for those struggling. In this blog post, we'll explore the common myths about eating disorders and fight them with concrete facts in the hopes of building a more informed and educated community when it comes to these serious mental health conditions. Eating Disorder Myths Versus Facts Myth: Only those who are medically underweight have an eating disorder. Fact: Someone can have an eating disorder at any weight. In fact, less than 6% of those diagnosed with an eating disorder are medically underweight. 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This month and every month, we encourage you to fight misinformation and stick up for those experiencing eating disorders, because knowledge and education can be one of the greatest assets to recovery for those who need it. If you or someone you know is in need of eating disorder support, don’t be afraid to reach out , our team of healthcare professionals are here for you. To learn more about eating disorders and the journey to recovery, download our free eating disorders guide .
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By spreading awareness and providing early intervention in eating disorder treatment, we can not only change lives, but save them. 2. Eating disorders are more common than you think. 9% of the US population will have an eating disorder at some point in their lives and 22% of children and adolescents worldwide show symptoms of disordered eating (NEDA). Since eating disorders can be challenging to detect, many go undiagnosed. Raising awareness for eating disorders and educating our community partners about their symptoms can allow us to catch eating disorders as early as possible and bring these statistics down. 3. Fight harmful eating disorder stereotypes. A common stereotype in association with eating disorders is that of the "thin, white, affluent female," however, anyone is at risk of an eating disorder despite their appearance or background. Stereotypes associated with eating disorders around weight, gender, age and race can create serious barriers to seeking care and major disparities in treatment. People experiencing an eating disorder can face challenges in seeking and receiving treatment or may feel unworthy of recovery when they don’t fit a stereotype, preventing them from gaining needed support and treatment. Promoting diversity and representation through awareness and education can help to break down the harmful stereotypes that have historically surrounded eating disorders. 4. Eating disorder recovery is not a one person job. Family and loved ones’ involvement in eating disorder treatment is crucial for recovery. Family-based therapy (FBT) has proven to be effective in 50% of patients being treated for anorexia nervosa, and is effective in the treatment of other eating disorders as well. A strong support system and steadfast relationships through the struggles associated with eating disorders can lead to more effective and long-lasting recovery. With more awareness and education, people will be better equipped to provide assistance to their loved ones in recovery. 5. You’re not alone. Eating disorders can be an isolating and painful disorder, making those experiencing it feel like they’re the only ones, or that no one understands what they’re going through. Building an informed community through awareness and education can be the first step towards diagnosis and treatment for those who need it. 6. Recovery is Real. Those with eating disorders are capable of long-term recovery through appropriate treatment. Research has found that the earlier intervention takes place in the treatment of eating disorders, the better the odds of long-term recovery are. Awareness and education around eating disorders helps the people that need support find it sooner, resulting in a repaired relationship with food and the body and a fuller life. How can I get involved in eating disorder awareness efforts? To get involved in eating disorder awareness efforts, start by educating yourself about the complexities and different types of eating disorders. By gaining a deeper understanding, you can become a more effective advocate. You can also consider participating in local or national events such as walks, trainings, or online webinars that aim to raise awareness, provide support to those affected, and offer education around eating disorders and their diagnosis. Another simple step for building awareness can be using your social media platform to share factual information, personal stories, or relevant resources that can help demystify eating disorders and reduce stigma. Additionally, supporting legislative efforts that promote mental health education and funding for eating disorder research can help in creating systemic change. By taking these steps, you can contribute to this important movement and work alongside us to foster acceptance, encourage early intervention, and ultimately save lives. Eating Disorder Treatment and Support Thrive offers a free eating disorder guide with more information about eating disorder symptoms and recovery. If you or someone you know is struggling with eating or body image, don’t be afraid to reach out to professionals for support. At Thrive Wellness, we offer a number of treatment options for all ages and genders, including a partial hospitalization program, an intensive outpatient program, outpatient therapy, occupational therapy, nutrition services, and more. Don’t wait to get started on treatment, contact us for a free eating disorder assessment today.
You’ve probably heard of “Dry January” or are even participating yourself. More and more people seem to be experimenting with or embracing sobriety from alcohol, but what benefits are there from abstaining? In this article, we’ll explore alcohol’s effects on mental health, the symptoms of alcohol use disorder (AUD), and the benefits of cutting back on drinking. Alcohol's Effects on Mental Health Commonly consumed as a way to relax after a long day or to lighten up in social interactions, alcohol is a widely used and culturally accepted drug despite warnings of its dangers by health experts . When a person regularly drinks, it can result in a slew of complications for their physical and mental health. Although often consumed in an attempt to escape stress, sadness, or other unpleasant emotions, alcohol itself is a depressant that can contribute to negative feelings and exacerbate existing mental health conditions, especially with prolonged use. Alcohol influences thoughts, mood, and behaviors by impacting the central nervous system in a way that slows the communication between the brain and the body. Without the ability to process information effectively, the brain isn't able to regulate emotions and consider consequences effectively which may promote unhealthy behaviors, including drinking to excess. Ways that alcohol can affect cognitive functioning include: Lowering inhibitions Contributing to poor judgment Causing confusion Causing lapses in memory Disrupting sleep Contributing to shifts in mood Alcohol and Mental Disorders According to the Journal of the American Medical Association, 37% of people with alcohol use disorders also have at least one serious mental illness. Furthermore, alcohol abuse commonly occurs alongside depression and anxiety . Research has shown that those with major depressive disorder and those with generalized anxiety disorder were more likely to report life‐time moderate to severe alcohol use disorder than those without these conditions. Frequently, individuals struggling with depression or anxiety self-medicate by drinking alcohol. Although alcohol may provide temporary relief, it expends the chemicals in the brain which help ward off anxiety and depression. When the initial effects of the drug fade, individuals are typically left feeling more depressed or anxious than they did before they began drinking. Related: Eating Disorders, Substance Abuse, and Substance Abuse Disorders Alcohol Use and Depression The slowed functioning of the brain caused by alcohol can allow individuals to numb to their suffering. As such, those experiencing depression may be inclined to drink to avoid the sadness, pain, and hopelessness associated with depression. This maladaptive coping behavior is so prevalent that research shows a clear relationship between alcohol use disorder (AUD) and major depression. Using alcohol while depressed can be extremely dangerous. Not only can alcohol negatively interact with antidepressants, but it can also place individuals experiencing depression at an increased risk for suicidal thoughts and behavior . If you're experiencing suicidal thoughts or behaviors , you can reach the National Suicide Prevention Hotline at 1-800-273-TALK (8255). Alcohol Use and Anxiety According to a study on anxiety and AUD , a person with an anxiety disorder is two to three times more likely to develop an alcohol abuse disorder. When individuals with anxiety drink alcohol, they may feel an initial alleviation of their symptoms as well as a sense of euphoria. However, the symptoms of hangovers and alcohol withdrawal following heavy drinking can heighten feelings of anxiousness and interfere with ones daily obligations, contributing to even more agitation. This feeling of dread and anxiety associated with a hangover is commonly referred to as " hangxiety ," but for those with existing anxiety conditions, this side effect of drinking can feel unbearable. Individuals with anxiety may be driven to drink more to tamper their stress and re-establish the sense of euphoria, resulting in a dangerous cycle of alcohol abuse. Unhealthy Drinking Behaviors and Alcohol Use Disorder (AUD) Most who regularly drink alcohol don't have AUD, which develops when addiction is present. However, alcohol-related side-effects on mental health are still common, and they may still benefit from mental health support . Signs of unhealthy alcohol use include: Feeling a need to consume alcohol to make it through the day Feeling unable to stop consuming alcohol Progressively feeling a need to increase consumption of alcohol Drinking to prevent or alleviate symptoms of hangover or withdrawal Feeling ashamed of ones alcohol consumption Having loved ones express concern over drinking habits AUD is a condition that is often driven by genetics, abuse, trauma, or unhealthy family dynamics. Healing from AUD is possible and it can be treated with the help of mental health professionals and a dedicated treatment plan. Signs of AUD include: Alcohol use that interferes with the ability to carry out daily activities Drinking despite the behaviors adverse effects on their life Often drinking more or for a longer period of time than intended Persistent desire and unsuccessful attempts to curb alcohol use Revolving their schedule around drinking Experiencing strong cravings for alcohol Continuing to drink despite experiencing recurring illness or social issues as a result of alcohol use Giving up activities one used to enjoy in favor of drinking Using alcohol during situations where its physically hazardous to be impaired Continuing to use alcohol despite knowing that it exacerbates a known existing health condition Developing a tolerance for alcohol, or needing more alcohol to feel the same effects Experiencing alcohol withdrawal or drinking more to avoid withdrawal What are the Mental Health Benefits of Going Sober or Drinking Less Alcohol? Reducing or eliminating your alcohol consumption can lead to a variety of mental health benefits, improving your overall quality of life. When going sober or cutting back on your alcohol consumption, some of the benefits you can look forward to are: Improved mood stability, including reduced feelings of depression and anxiety Improved sleep quality Enhanced cognitive function Increased energy levels Improved concentration and productivity Increased self-esteem More authentic social interactions Improved relationships Limiting your alcohol consumption has the capability to change your life for the better, as it can help you establish a healthier mental environment, build better connections, and improve your physical health. Support for Alcohol Abuse and its Mental Health Impacts As humans, it can be uncomfortable for us to process difficult experiences and feel intense emotions. Therapy can help heal the source of your struggles driving alcohol abuse, while also guiding you in implementing healthy strategies for processing painful emotions. Through professional mental health support, you can be empowered to embrace life without having to rely on alcohol. Thrive offers outpatient therapy for substance abuse struggles in addition to other mental and behavioral health conditions. Reach out to learn more. Additional Resources SAMHSAs National Helpline : A free, confidential, and 24/7 service for individuals and families facing mental health conditions and/or substance use disorders, reachable by calling 1-800-662-HELP (4357) or texting 435748 (HELP4U). National Institute on Alcohol Abuse and Alcoholisms (NIAAA) Treatment for Alcohol Problems : A guide for individuals and their loved ones who are looking for options to address struggles with alcohol use.
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