Amy Orr was watching TV one night some time ago when she felt a stabbing pain in her upper abdomen. Still hurting a few days later, she went to the emergency room, where doctors suspected gallstones. But tests were inconclusive, so they gave her pain meds and sent her home. The pain vanished that night, but it showed up again and again for months. She wound up at the ER dozens of times, and nobody could figure out why. As time went on, she lost more than 70 pounds and so much muscle she could barely walk.
“I was crying all the time because it was debilitating in every way: physically, mentally and emotionally,” recalls Amy, a 36-year-old editor in Waterloo, Canada. “I was so afraid it would never go away, that I would just have this crushing pain for the rest of my life. And it was especially upsetting to feel like my doctors didn’t care.” After a year of torment, another set of physicians finally diagnosed the infected gallbladder others had missed. Amy had surgery, and the pain ceased.
Unfortunately, that wasn’t the end of Amy’s troubles. She often had nightmares about being stuck in situations in which shew as being hurt in ways she could not control. She became obsessive about regulating her diet, sleep and exercise in the hope that taking charge would ward off pain. And any pain — even a paper cut — launched her into a shaking, hyperventilating panic attack. “When I mildly burned my hand on the stove, my husband had to stop me from calling an ambulance, as I thought the pain from my hand meant the abdominal pain had come back and I was going to die,” Amy says. “My reactions were irrational.”
When she told her therapist, the woman said Amy was suffering from post-traumatic stress disorder, or PTSD. “I thought, No, that’s very dramatic. You only get that from being in war or being violently attacked,” Amy says. But as her emotional issues intensified, she realized she could trace them to her year of pain and anxiety. After months of therapy, which involved becoming aware of her PTSD symptoms and relearning how her body functioned, she was able to get back to normal.
Trauma has always been part of life, but with mass shootings, horrific hurricanes and the #MeToo movement that brought sexual assault into the mainstream conversation, we’re seeing how intense emotional experiences can haunt people years later. Many experts think the COVID-19 pandemic and other scary current events will have long-lasting traumatic effects as well.
The influential reference on psychiatry known as the DSM-5 essentially says that only people who are seriously injured, have a near-death experience, witness a death or experience sexual violence can have PTSD. However, many of those who study trauma know that it can result from many different situations. Any event (or series of events) that leads you to view your life in terms of “before” and “after” can cause severe mental-health effects, says Rachel Yehuda, Ph.D., a professor of psychiatry and neuroscience at the Icahn School of Medicine at Mount Sinai. And something like that is likely to happen to each of us at some point, says James Gordon, M.D., founder and executive director of the Center for Mind-Body Medicine and a clinical professor of psychiatry and family medicine at Georgetown Medical School. “Being in a stressful or abusive relationship or work environment is traumatic. So is losing someone you love, having a serious illness or facing discrimination,” says Dr. Gordon, the author of The Transformation: Discovering Wholeness and Healing After Trauma. “Sometimes you move through a trauma with no residue, but other times your reactions continue long after the threat is over.”
Years ago, people who faced harrowing shocks were expected to “get over it.” Soldiers came back from war and never talked about what they had seen. Women who’d delivered stillborn infants were advised to quickly have another child. Now there’s a growing realization that to recover properly, you must allow both your mind and your body
to process what happened and accept that in some ways you may be changed by it forever, Yehuda says.
Some symptoms of trauma, such as anxiety, nightmares, insomnia and/or depression, can show up immediately. But if not properly treated, a traumatic experience can put you at risk for chronic physical diseases as well. In fact, a study in JAMA Internal Medicine found that women whose first sexual experience was being raped were more likely to suffer from endometriosis and pelvic inflammatory disease later in life than other women. Dr. Gordon has seen trauma survivors develop heart disease, autoimmune disorders and digestive problems they might not have gotten otherwise. Plus, people who live through a distressing ordeal are more likely to abuse drugs or alcohol, suffer from an eating disorder or even die by suicide.
All this is because trauma has a powerful impact on the nervous system. We’re all familiar with the fight-or-flight responses to stress that help us either battle or bolt from an enemy, but a traumatic event ramps this up to an extreme level. Later, as you remember the situation or if there are ongoing incidents (e.g., seeing an abusive boss every day), the body revs back up, which can lead to inflammation and other damage.
If neither fighting nor fleeing is possible, experts now know that another possibility is freezing. Picture a mouse who bolted away from a cat but now is caught in its jaws. The freeze response produces pain-numbing endorphins and helps the animal (and us humans) psychologically detach or dissociate from the terror. This is why you might hear someone say they “left their body” during a horrific situation.
Excessive stress responses during a trauma can also prevent the memory of that episode from being stored in the usual logical way. Instead, fragments are input piecemeal. This is why someone describing a sexual assault may not remember what they were doing right before the attack, but can describe in detail the pitch of the assailant’s voice or how their breath smelled, says Dr. Gordon. It’s also why similar sensations (like minor pain, in Amy’s case) can make the brain overreact.
In some cases, traumatic events can be so overwhelming that the mind might suppress them so a person doesn’t even recall that they occurred. In his book The Body Keeps the Score, psychiatrist Bessel van der Kolk, M.D., the founder and medical director of the Trauma Center in Brookline, MA, says that such protective amnesia likely explains why so many adults suddenly remembered having been abused by priests when they were children after the church scandal went public.
Rachel (last name withheld), a yoga instructor in her 50s, is familiar with this kind of repressed memory. Throughout her life, Rachel had occasionally felt depressed, though she kept telling herself her life was good. She also frequently felt insecure and irrationally unconfident about her body and had difficulty trusting people. Two years ago, after she inexplicably burst into tears in a doctor’s office, she decided to see a therapist. That was when she began to recall how her mother had raged at her without warning, screamed at or struck her and regularly called her a failure and a disappointment. “It’s taboo to think badly about your mother, so I didn’t,” Rachel says. Overtime, working with the therapist and writing down her story to take possession of it, she was able to release her depression and self-doubt.
This doesn’t happen overnight — and it may take trial and error to find the right treatment — but effective therapies are available. It’s also important to remember that although overcoming trauma can be painful, it shouldn’t be a burden you carry alone. With help, one day you will probably look back and think, I survived that, and I am strong and can handle whatever comes my way.
Healing Your Trauma
Each person responds differently to treatments, but here are some worth discussing with a professional:
Try Trauma-Specific Therapy: Certain therapies may loosen trapped memories and emotions. There’s Prolonged Exposure Therapy, during which you reexperience the trauma as a therapist guides you in staying grounded; Eye Movement Desensitization and Reprocessing (EMDR), in which a therapist uses an external focusing technique to help you process memories; and Mindfulness-Based Stress Reduction (MBSR), a program that trains you to come back to the present moment.
Meditate: Meditation may blunt your fight-or-flight reaction, help you think clearly and rebuild brain connections.
Exercise: Some experts suggest yoga or walking; Dr. Gordon prefers a technique he created in which you vigorously shake your whole body for five minutes, stop and notice the stillness for the next three, then dance to music for another five.
Eat Differently: Chemicals the body produces during a harrowing event
can damage the intestines and alter gut bacteria, says Dr. Gordon. This may be why irritable bowel syndrome is a common symptom of PTSD. You’ll want to lean on healing proteins, vegetables and fruits.
Seek Support: Loneliness and isolation give trauma power, so find a support group and reach out to acquaintances who have been through something big.
The COVID-19 crisis has made life more challenging for everyone — especially those who are struggling with a mental illness. Visit NAMI’s COVID-19 Resource and Information Guide for additional advice. For more info on PTSD, visit the PTSD Alliance.
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