Traumatic Stress: what to expect
Traumatic events generate strong emotions some of which you may feel for the very first time. You could be experiencing unfamiliar emotions or familiar emotions with an unfamiliar intensity. Even though it is commonplace to experience an array of stress responses in the initial period after a traumatic event, it may frighten you and as a result prompt further dysregulation and emotional overload. Hence, the need for this article. Read it through with a “this is why I feel the way I do, it makes sense” type of approach. Normalizing your reactions, as uncomfortable as they may be, will help you relate to your emotions in a calmer manner, manage them better and return to normalcy sooner. But first things first. What is considered a traumatic event?
What is a traumatic event?
A traumatic event is any incident which involves a threat to your physical integrity or life (e.g., robbery at work, accidents, natural disasters, terrorist attacks, etc.). The threat does not necessarily need to be directed to you personally but could be directed to your loved ones, co-workers or customers. The more you feel at risk, the more daunting the experience. Fear is the dominating response which is usually accompanied by a sense of helplessness. Feeling helpless over the situation is often reported as being more distressing than the threat of violence or violence itself. Witnesses (direct or indirect via media) and first aid workers are also affected as well as those who could have been involved in the incident had they not, for example, made last minute changes to their plans or worked a different shift that day.
Does a traumatic event lead to post-traumatic stress disorder (PTSD)?
The initial period after a traumatic event includes an array of stress responses including hyper-arousal, vigilance, agitation, irritability, reduced ability to concentrate, recurrent distressing thoughts, difficulty sleeping, nightmares, emotional numbing, decreased interest in one’s responsibilities, a depressed mood, flashbacks and avoidance of people, places and sounds that serve as a reminder of the event. The event may be over and you may be safe but it doesn’t feel like it.
Expression of strong emotions are expected reactions and do not necessarily signal the need for additional interventions beyond ordinary supportive contact. Experiencing distress, fear and/or agitation, however undesirable, does not constitute a disorder. Concern rises when despite the effort to modulate your reactions, they persist and cause impairment in your social, occupational or other important areas of functioning.
When talking about PTSD, we are referring to a constellation of reactions – many of which are mentioned in the previous paragraph – that cover 4 categories: recurrent re-experiencing of the traumatic event, avoidance of trauma-related stimuli, negative changes in thoughts and mood as well as trauma-related hyperarousal and reactivity. The duration of the disturbance and its interference with daily functioning needs to be more than a month. However, the impact of the traumatic event need not be felt immediately. It is not unusual for its onset to be delayed significantly.
A similar experience that lasts from 3 days up to a month is referred to as acute stress disorder. Acute reactions tend to be temporary before re-adjusting to your daily functioning levels.
A tad bit of self-help advice …
Be there for yourself and accept your initial responses no matter what they may be. Don’t pressure yourself to feel a certain way nor give into anyone else’s pressurizing.
Practice self-care by focusing on nutrition, sleep, activities that create positive emotions, rest and exercise. Think about what helped you cope with negative situations in the past and utilize those same resources to help you now.
Rather than focusing solely on what is wrong and needs fixing, consider shifting your focus on discovering those instances when you feel better and more like your usual self – even for a little while. No problem occurs 24/7. Study those exceptions when you catch yourself feeling a bit safer, a bit calmer, a bit happier and so on. Are you with particular people, engaging in certain activities or talking to yourself in a way that seems to be working? Identify those ‘strategies’ you are unconsciously employing and are evidently working for you and consciously utilize them throughout your days.
Establish and maintain a daily routine such as eating meals at regular times and following an exercise programme which will help reclaim stability.
Ask for support from people who care about you and who will love, listen, empathize, encourage, reassure and bolster your resilience.
Experiencing strong emotions after a traumatic event should not be automatically translated into the assumption that you cannot manage them on your own and that professional support needs to be enlisted. If you opt for individualized support, select one that is led by an appropriately qualified professional whose approach goes beyond chewing over the event and how it made you feel.
Finally, monitor and evaluate your progress in order to confirm that what you are doing to help yourself is actually proving to be beneficial.
This too shall pass.