June is National PTSD Awareness Month. In honor of this, in this post I will discuss PTSD and trauma in more depth. It is more common than you may realize! Did you know that you can have PTSD even if you have never served in the military and never been in combat? PTSD can develop from a variety of situations, military service included. I’ll be sharing with you an excerpt from the second chapter of “Healing Beyond Trauma” to better explain what PTSD is and how you may be affected.
I used to think trauma only referred to a catastrophic event, like being on the receiving end of a bomb and having some limbs blown off, or falling out of a four-story window. I never considered that trauma was anything I had ever experienced. I didn’t realize that a trauma is any event that overwhelms your ability to cope in that moment. That is a pretty broad definition, and can mean different things to different people. In fact, traumas can be categorized as “Big T” and “little t” events. “Big T” traumas include things such as: natural disasters, rape, sexual attack, physical or sexual abuse, a life-threatening car accident, combat, and being robbed or beaten. “Little t” traumas include things like: non-life-threatening car accidents, divorce, infidelity in relationships, unexpected job loss, betrayal by someone close, financial or legal difficulty, and interpersonal conflict. Most people encounter a variety of “little t” traumas in their lifetime, but if a person encounters an exorbitant amount of “little t” traumas in conjunction with one or more “Big T” traumas, they may develop what’s known as C-PTSD (Complex-PTSD). Those “little” traumas have a bigger impact than they get credit for.
DSM-5 Criteria For a PTSD Dx:
How do you know if you have PTSD, C-PTSD, or suffer from a trauma-related disorder? Do your research, first of all. I am always a proponent of clients/patients being their own advocates and educating themselves. If you have particular “symptoms” that are hindering your functionality, investigate what possible disorders those symptoms correlate with. Keep in mind that you can have symptoms of many disorders and not actually have any disorder. According to the standard, you must meet all required criteria to be officially diagnosed with a disorder, and you can only be diagnosed by a mental health professional. Also keep in mind that each person is a unique individual and how any particular disorder affects you may differ from the “norm” or standard. Rest assured that with appropriate treatment most disorders can be overcome to go on and live a happy, productive life. The point of my book, “Healing Beyond Trauma,” in fact, is to help you be your best self DESPITE any potential diagnosis you may have. For the purposes of determining if this book applies to you and may be helpful, I am listing the diagnostic criteria for PTSD (must also be met for C-PTSD) below:
Full criteria are available from the American Psychiatric Association. All of the criteria are required for a diagnosis of PTSD. Below is a summary of the diagnostic criteria:
Criterion A (one required): The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):
· Direct exposure
· Witnessing the trauma
· Learning that a relative or close friend was exposed to a trauma
· Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)
Criterion B (one required): The traumatic event is persistently re-experienced, in the following way(s):
· Unwanted upsetting memories
· Nightmares
· Flashbacks
· Emotional distress after exposure to traumatic reminders
· Physical reactivity after exposure to traumatic reminders
Criterion C (one required): Avoidance of trauma-related stimuli after the trauma, in the following way(s):
· Trauma-related thoughts or feelings
· Trauma-related reminders
Criterion D (two required): Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):
· 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 (two required): Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):
· Irritability or aggression
· Risky or destructive behavior
· Hypervigilance
· Heightened startle reaction
· Difficulty concentrating
· Difficulty sleeping
Criterion F (required): Symptoms last for more than 1 month.
Criterion G (required): Symptoms create distress or functional impairment (e.g., social, occupational).
Criterion H (required): Symptoms are not due to medication, substance use, or other illness.
Two specifications:
· Dissociative Specification. In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli:
· Depersonalization. Experience of being an outside observer of or detached from oneself (e.g., feeling as if "this is not happening to me" or one were in a dream).
· Derealization. Experience of unreality, distance, or distortion (e.g., "things are not real").
· Delayed Specification. Full diagnostic criteria are not met until at least six months after the trauma(s), although onset of symptoms may occur immediately.
WHAT DO YOU DO IF YOU THINK YOU HAVE PTSD:
I would recommend making an appointment with a therapist to get another opinion, and to confirm if this is an actual diagnosis for your symptoms. If so, there are several different models of therapy that have been shown to be quite effective in treating PTSD. You will probably want to find a therapist experienced in working specifically with trauma and/or PTSD, as the treatment styles can vary a little from traditional therapeutic issues. The therapist will most definitely need to be “trauma-informed,” or they may accidentally cause harm without realizing. You will want to research and try different coping mechanisms to help reduce your anxiety and to help you manage triggers, as well. Your therapist can help you with this, but you can also find and practice different methods on your own, such as: meditation, deep breathing, self-soothing using your five senses (DBT skillsets), and other relaxation methods. You will have to explore a bit and find what works for you, but the symptoms can be reduced and self-managed with help until you are able to address the root traumas behind the diagnosis. Have hope that you can regain a normal life with a little patience and work! 😊
RESOURCES FOR ASSISTANCE:
https://www.ptsd.va.gov/about/ptsd-awareness/ptsd_awareness_month.asp
VETERANS CRISIS LINE: 1-800-273-8255
· Call 911
· Go to the nearest Emergency Room
· Call the Suicide Prevention Lifeline 988
· Contact the Veterans Crisis Line: 1-800-273-8255, press 1 (text 838255)
REFERENCES:
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, (5th ed.), Washington, DC: Author, 2013.
National Center for PTSD, VA Medical Center. White River Junction, VT, 2015.
National Center for PTSD. PTSD Research Quarterly: Advancing Science and Promoting Understanding of Traumatic Stress, Vol. 26(4).
If you are interested in a sample therapy session to learn more, or to see if you are really interested in investing the time and expense embarking on a therapeutic journey might entail, I am offering a 30-minute "mini-session" for $50 (click below to book one!).
The spiritual aspects of Trauma and healing:
If you are interested in learning more about the spiritual and mental effects trauma has on every area of your life, and would like to learn how to work yourself to healing, I have collaborated with a Christian spiritual coach to develop a brief, intensive Master course on healing the roots of trauma. She combines her spiritual and Biblical knowledge of healing with my therapeutic expertise to address the roots from both angles. This course includes 4 individual coaching sessions with her and one intensive therapy session with me. More information can be found at the link below:
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