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What is trauma, defining it, different kinds of trauma & how to recognize it, but also what are the impacts of trauma?

On Friday, February 12, the Ledger Dispatch started a series on Resilient Amador. We hope to educate our family of readers on ACEs, learning what it means to be Trauma-Informed, challenges of COVID, Resilience, local resources, and how you can get involved in Resilient Amador. The articles are all online and available for free as a public service. Today we take a look at Trauma, as the next part of our journey.

Defining Trauma

Trauma is a pervasive problem. It results from exposure to an incident or series of events that are emotionally disturbing or life-threatening with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, and/or spiritual well-being.

Experiences that may be traumatic include:

• Physical, sexual, and emotional abuse

• Childhood neglect

• Living with a family member with mental health or substance use disorders

• Sudden, unexplained separation from a loved one

• Poverty

• Racism, discrimination, and oppression

• Violence in the community, war, or terrorism

Although trauma can occur at any age, it has particularly debilitating long-term effects on children’s developing brains. Often referred to as adverse childhood experiences (ACEs), exposure to these experiences is common across all sectors of society:

62% U.S. adults with at least one ACE

25% U.S. adults with three or more ACEs

However, research has shown that the risk for ACEs is particularly elevated within certain populations such as people who identified as black, Hispanic, or multiracial; people with less than a high-school education; people with low-income or who were unemployed or unable to work; and people who identified as gay, lesbian, or bisexual.

Effects of Trauma on Health

The landmark ACE Study and the Philadelphia Urban ACE Study reveal that the more a child is exposed to stressful and potentially traumatic experiences, the greater his or her risk for chronic health conditions and health-risk behaviors. Traumatic events can have deleterious effects on health at any age.

What are the long-term effects of trauma on health?

The original ACE Study asked people to indicate the number of traumatic events they had experienced prior to age 18 and provided them with a corresponding “ACE score.” Compared to people with no ACEs, individuals with an ACE score of four or more were approximately: 

2 times as likely to smoke

2.5 times more likely to have sexually-transmitted infections

4 times more likely to have chronic obstructive pulmonary disease

7 times more likely to consider themselves an alcoholic

10 times as likely to have injected street drugs

12 times as likely to have attempted suicide

(Source: Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults)

What is the relationship between trauma and health-risk behaviors?

People affected by trauma may develop coping mechanisms to help alleviate the emotional and/or physical pain they feel as a result of trauma. Sometimes, these strategies involve maladaptive behaviors — such as unhealthy eating, tobacco use, or drug and alcohol use. These coping mechanisms may provide some relief, but they can also simultaneously contribute to anxiety, social isolation, and chronic diseases. 

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What is the impact of trauma on relationships?

Regardless of the type of trauma a person has experienced, traumatic experiences impact relationships. This includes, but is not limited to, relationships between people, communities, and the delivery systems that support individuals’ health and social needs. When a person experiences trauma, he or she may feel unsafe, betrayed, and/or have difficulty trusting others. This can lead to heightened emotions, such as anger or aggression, or a tendency toward shame, numbing, and/or isolation. Within the context of health care, this can negatively impact the bond between a patient and their provider, and thus a patient’s engagement in care.

Can the effects of trauma be avoided or addressed?

Protective factors, such as supportive relationships with family members, a teacher, or others in the community, can help shield individuals from the effects of trauma and build resilience to help overcome adversity and confront challenges. Trauma-informed approaches to care, including relational healing and trauma-specific treatments, can help patients begin processing their experiences in a healthy way.

The Science of Trauma

Although the field of trauma-informed care is still coalescing, our understanding about how people’s brains and bodies respond to trauma — and the negative long-term effects of toxic stress on health — is well understood. Toxic stress is an emotional and/or physical response that occurs when a person experiences strong, frequent, and/or prolonged adversity without adequate support.

How does trauma affect neurobiology and the physical development of children?

In the first 1,000 days of life, children’s brains are in a critical period of development. Trauma can negatively impact areas in the brain responsible for cognitive functions, such as short-term memory and emotional regulation. This is due in part to the fact that the body regulates stress through the release of two critical hormones: cortisol and adrenaline. Exposure to these stress hormones plays an important role in keeping people safe during times of danger; however, repeated or prolonged exposure is associated with poorer early childhood brain development.

What does experiencing childhood trauma mean for adults?

Adults who experienced trauma in childhood are often “wired” differently than those who did not. Their brains, primed to deal with nearly constant stress, can struggle to respond appropriately to situations that would otherwise appear normal and non-threatening. This partly explains why many adult trauma survivors struggle with depression, anxiety, and other issues related to emotional regulation. These resulting mental health issues can contribute to long-term difficulties maintaining healthy relationships, and lead to problems at school and/or work.

Why do traumatic experiences impact some people more than others?

Many children facing abuse and neglect carry the markers of stress, such as increased cortisol levels, well past the time of exposure. Exactly how stress alters the structure of our brains — and even our DNA — is not yet fully understood. However, research has shown that “protective factors,” such as a loving caregiver, can decrease the impact of traumatic events.

Trauma Symptoms, Causes and Effects

Trauma is defined by the American Psychological Association (APA) as the emotional response someone has to an extremely negative event. While trauma is a normal reaction to a horrible event, the effects can be so severe that they interfere with an individual’s ability to live a normal life. In a case such as this, help may be needed to treat the stress and dysfunction caused by the traumatic event and to restore the individual to a state of emotional well-being.

What Are the Main Sources of Trauma?

Trauma can be caused by an overwhelmingly negative event that causes a lasting impact on the victim’s mental and emotional stability. While many sources of trauma are physically violent in nature, others are psychological.

Some common sources of trauma include:

• Rape

• Domestic violence

• Natural disasters

• Severe illness or injury

• The death of a loved one

• Witnessing an act of violence

Trauma is often but not always associated with being present at the site of a trauma-inducing event. It is also possible to sustain trauma after witnessing something from a distance. Young children are especially vulnerable to trauma and should be psychologically examined after a traumatic event has occurred to ensure their emotional well-being.

What Are the Signs of a Person Suffering from Trauma?

While the causes and symptoms of trauma are various, there are some basic signs of trauma that you can look out for. People who have endured traumatic events will often appear shaken and disoriented. They may not respond to conversation as they normally would and will often appear withdrawn or not present even when speaking.

Another telltale sign of a trauma victim is anxiety. Anxiety due to trauma can manifest in problems such as night terrors, edginess, irritability, poor concentration and mood swings. While these symptoms of trauma are common, they are not exhaustive. Individuals respond to trauma in different ways. Sometimes trauma is virtually unnoticeable even to the victim’s closest friends and family. These cases illustrate the importance of talking to someone after a traumatic event has occurred, even if they show no initial signs of disturbance. Trauma can manifest days, months or even years after the actual event.

Emotional Symptoms of Trauma

Emotion is one of the most common ways in which trauma manifests. Some common emotional symptoms of trauma include denial, anger, sadness and emotional outbursts. Victim of trauma may redirect the overwhelming emotions they experience toward other sources, such as friends or family members. This is one of the reasons why trauma is difficult for loved ones as well. It is hard to help someone who pushes you away, but understanding the emotional symptoms that come after a traumatic event can help ease the process.

Physical Symptoms of Trauma

Trauma often manifests physically as well as emotionally. Some common physical signs of trauma include paleness, lethargy, fatigue, poor concentration and a racing heartbeat. The victim may have anxiety or panic attacks and be unable to cope in certain circumstances. The physical symptoms of trauma can be as real and alarming as those of physical injury or illness, and care should be taken to manage stress levels after a traumatic event.

Short-Term and Long-Term Effects of Trauma

All effects of trauma can take place either over a short period of time or over the course of weeks or even years. Any effects of trauma should be addressed immediately to prevent permanence. The sooner the trauma is addressed, the better chance a victim has of recovering successfully and fully.

Short-term and long-term effects of trauma can be similar, but long-term effects are generally more severe. Short-term mood changes are fairly normal after trauma, but if the shifts in mood last for longer than a few weeks, a long-term effect can occur. 

Is There a Test or Self-Assessment I Can Do?

While there are online assessments available for trauma, professional assessment is recommended over self-assessment. The victim or loved one will be biased and predisposed to see certain things, while a professional is objective and trained to compensate for bias.

If you would like more information on getting a professional assessment for yourself or a loved one who has experienced trauma, call our hotline at . Our friendly experts are available 24/7 to take your call and provide you with all the information you need to start your recovery.

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Trauma Medication: Drug Options

While trauma, unlike some other mental disorders, is induced by an event or experience, it can be treated through the use of certain medications. Not all trauma requires medication, but it can be a useful tool in treating the symptoms of trauma, such as anxiety and depression. It is important to work with a healthcare professional to determine whether medication is necessary.

Trauma Drugs: Possible Options

Drug options will depend on the individual’s psychological and medical history as well as the severity of the symptoms. If depression is severe and felt over an extended period of time, it may be treated with common antidepressant drugs. Clinical depression is defined as any depressive episode lasting longer than three months. Many trauma victims fall under the category of anxiety sufferers who are eligible for anti-anxiety medication.

Medication Side Effects

One of the considerations in whether or not to medicate for the symptoms of trauma is the presence of medication side effects. All medications have side effects, and the severity varies widely depending on drug class and individual body chemistry. Some side effects are more manageable than others, and potential negative side effects should always be compared to the potential benefit to the patient.

Drug Addiction, Dependence and Withdrawal

Unfortunately, it is not uncommon for victims of trauma to turn to drugs as a means of self-medicating and coping with the effects of trauma. Government studies estimate that 25 percent of people experience trauma before the age of 16, and those individuals are much more likely to become addicted to drugs or alcohol. 

Medication Overdose

Medication overdose occurs when someone ingests a significant enough amount of medication to cause physical harm. Overdose often occurs in conjunction with substance abuse, but it may be accidental and occur under regular circumstances. Any instance of overdose should be taken seriously, and professional help should be sought to ensure that an overdose does not reoccur and to determine if the cause is substance abuse.

Depression and Trauma

Depression and trauma have high comorbidity rates, and feelings of despair, malaise and sadness can last longer than a few days or even weeks. When a trauma occurs, post-traumatic stress disorder often occurs. The Department of Veteran Affairs estimates that depression is between three to five times more likely to occur in trauma victims who develop PTSD than in the general population.

Dual Diagnosis: Addiction and Trauma

When the symptoms of PTSD, depression and anxiety become too much to cope with through normal means, many victims of trauma turn to substance abuse. As mentioned, victims are much more likely to develop addictions than other members of the general population. It is essential for the loved ones of a trauma victim to look out for the symptoms of addiction after trauma, even if the addiction is the only outward sign of PTSD.

Getting Help for Trauma-Related Issues

Resilient Amador strives to create a more resilient Amador by educating individuals, communities, and organizations about adverse childhood experiences (ACEs), trauma and resilience; and by providing training and resources for making policy and practice changes that are needed to create healing in our citizenry, organizations, and systems. To learn more or get involved, contact Amador Child Abuse Prevention Council at (209) 223-5921, email: info@amadorcapc.org or visit their website at www.amadorcapc.org