Traumatic experiences can leave behind mental wounds that struggle to heal. Trauma disorders form when the wounds are so great that they cause life-altering symptoms, such as dissociation (separating oneself from the experience), emotional numbing, re-experiencing, or hyperarousal.
Trauma disorders include post-traumatic stress disorder (PTSD), acute stress disorder (ASD), reactive attachment disorder (RAD), adjustment disorders, and disinhibited social engagement disorder (DSED). Unspecified or other trauma disorders also exist and are diagnosed in certain cases.
Nearly all trauma disorders are characterized by some sort of unwanted fixation on the trauma, as though the mind is struggling to let go, and cannot properly cope or move on. This leads to symptoms that can include unwanted or invasive thoughts, irritability, low mood, anxiety, and more.
Dissociation can occur when a person has separated themselves from the experience as a subconscious coping mechanism. They might not remember what happened or feel like what happened to them happened to someone else. Their mind can’t process the events in the way they occurred, and thus something else takes its place. Specific forms of dissociation after trauma include amnesia (memory loss), depersonalization (feeling separated from one’s body), derealization (feeling removed from reality), and identity confusion.
Emotional numbing can also occur, wherein the trauma is remembered, but the person either consciously or subconsciously avoids anything that reminds them of the experience or feels emotionally numb towards what happened. Emotional numbness is different from being ambivalent towards a traumatic experience. It can seem like a much more severe emotional void, where the mind copes by simply trying not to feel anything at all.
Re-experiencing can include frequent flashbacks and nightmares, distressing images or unwanted (intrusive) thoughts, and a physical reaction to these images, thoughts, and memories, such as shaking, breaking out into a sweat, or nausea. Symptoms of re-experiencing can be triggered, or may occur out of nowhere, even in the absence of specific stressors. Another hallmark of re-experiencing is constant guilt or self-blame.
Hyperarousal is a response to trauma characterized by the feeling of being on-edge constantly. It can include irritability and paranoia, as well as reacting excessively to the slightest sound or touch, to the point of being unapproachable.
It’s much more difficult for someone with hyperarousal to relax, and they may have recurring anxious thoughts about what happened, or that it might happen again. These reactions and thoughts are unwanted and visceral and may be related to changes in a person’s automatic fight-or-flight response, wherein it’s been “over tuned” as a result of the trauma.
Trauma disorders can commonly co-occur with other mental disorders. Common co-occurring disorders include mood disorders like depression, anxiety disorders, and substance use disorders (often as a maladapted coping mechanism). A holistic treatment approach will take a person’s entire mental wellbeing into perspective, identify how (if at all) their conditions may be linked, and consider treatments that can help address multiple symptoms.
Human reactions to a traumatic event are entirely subjective. A devastating accident can trigger a trauma disorder in some people, but not others. The way trauma symptoms develop is also individual, and treatment must be tailored to the person’s circumstances and coping difficulties. Specialized treatment for trauma disorders includes eye movement desensitization and reprocessing (EMDR) and neurofeedback treatment.
Other treatment methods include talk therapy and specific medications to address mood problems (such as depressive symptoms, and thoughts of self-harm), as well as anxiety and restlessness.