Understanding Trauma and Stressors
With the Coronavirus pandemic at large, the entire world on its toes, we are dealing with a once in a lifetime occurrence that has everyone under exceptional stress. The impact of the pandemic is all the more evident now, considering that the inconceivable death toll inches closer and closer to hitting the 1 million mark. Under such circumstances, the chances of encountering or hearing of a traumatic event rise exponentially.
As medical students or working medical professionals, it is more likely that one would come across such incidents, be it as a first responder or as an affected party (due to the constant exposure to highly stressful events). This is why we, at Project you, wish to discuss this matter at length to help you be better equipped at comprehending any unforeseen circumstance of this kind.
Therefore, the important question here is, why is it imperative to understand what Trauma and related disorders are?
Traumatic events are ubiquitous in nature and a vast portion of the medical population likely goes through one or more at some point in their lives. Essentially, trauma presents itself in various forms; its impact primarily determined by the three things:
the circumstances under which it occurred
the actions of the first responders and
the personality of the affected individual themselves
Usually, in trauma-related events, the typical emotions expressed by the victims are anxiety and shock. More often than not, they’re accompanied by a wider range of emotions- such as rage, horror, guilt and shame, in addition to the aforementioned fear and anxiety.
This is the facet of trauma that we would be exploring here: Psychological shock, pre-event or post-event stressors, what prolonged untreated trauma could lead to and most importantly, exploring the ways and means by which an individual could handle themselves in a situation that calls for quick thinking and diligent care.
So, what is Traumatic Stress?
Traumatic stress is defined as the reaction to any traumatic event. These events are usually extremely shocking and emotionally overburdening; typically involving actual or threatened death, serious injury, or an impending threat to physical integrity.
Most people that go through traumatic events would ideally experience stress responses that could be defined as normal (ranging from confusion, sadness, anxiety, numbness etc.). We could go as far as to say that many witness considerable difficulties in just going about their regular tasks for a period of time too. However, the moment, an individual experiences abnormally significant distress and disproportionate amounts of trauma reactions, they are said to have a trauma-related disorder. Typically, Post Traumatic Stress Disorder and Acute Stress Disorders are the mental health diagnoses linked to traumatic stress reactions.
One must note that the reactions of individuals to traumatic events most definitely vary from one another, considering that they range anywhere from relatively mild (creating minor disruptions in the person’s life) to severe (debilitating in its impact on the person’s life).
To put into perspective all that we’ve learnt about traumatic stress, let’s take the example of a fictional individual named Sally.
Sally is working as a full-time nurse and has been recently transferred to the emergency care section of the hospital. One unfortunate day, on Sally’s night shift, the emergency ward receives a 60-year-old man that was the victim of a hit and run incident. The man has nearly lost a limb and has sustained severe head injuries. While this is a case that the ER is normally well equipped to handle, the extreme blood loss coupled with the time it took to bring the victim to the hospital renders the first-aid efforts null and void. The patient passes away.
Now, as a person that’s reading this situation, the primary emotion evoked in you is sympathy and sadness towards the loss of a life at the hands of an unfortunate accident. However, despite having witnessed multiple bloody instances and gory encounters as a nurse, this incident, in particular, has a profound impact on Sally. She is in a state of complete shock, a numbness taking over her body, leaving her next to useless during the emergency at hand.
If Sally fell under the majority of the population that goes through traumatic events, she would be uncomfortable manning cases with similar injuries for a while, would most likely be plagued by intrusive thoughts about that unfortunate event and probably experience nightmares on occasion. These can be called normal reactions to abnormal events. Eventually, probably not completely, she would get over this incident through normal coping mechanisms.
Unfortunately, Sally has had a different reaction to it. Her father, whom she is very close to, is the same age as the man that lost his life in the ER room that day. She has made the correlation that it was or could have easily been her dad in the same position and that thought alone shifted her entire perspective astronomically. Over a month or so, Sally finds herself unable to work on the night shift again, constantly visited by disturbing memories of that traumatic experience. In addition to that, sleepless nights are dominated by nightmares, she’s continually living the moment through recurring flashbacks and hopelessness contaminates her daily functioning. We go as far as to say that she found herself unable to use ketchup or squeeze ketchup out of a bottle because it reminded her of the terrifying image of blood loss of the dying man in the ER that night.
Sally, exhibiting symptoms of intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions; basically, exhibiting abnormal reactions to abnormal events is a classic case of an individual suffering from PTSD.
NOTE: Before we proceed any further, it is important to remember that while we’re highlighting severe – life-altering traumatic events and their impact on an individual, other stressful incidents that probably lie outside the definition of trauma, can still cause serious problems. These could range from anything between a sudden death in the family or taking care of someone with a debilitating disease.
According to an article written by the Harvard Medical School, “Trauma pushes your ability to cope, so if you have a predisposition toward anxiety, for example, it would push you over the edge.” It added to this by saying that “incidents like these can also produce PTSD – like symptoms in certain people. When people go through traumatic or complicated grief, they can experience pretty similar symptoms to those they might experience with trauma.”
With this blog, we have covered the essentials of understanding what trauma entails and how it impacts different individuals in different ways. As medical students or professionals in the healthcare field, it’s second nature to bear witness to shocking events and circumstances; ever more so during the Pandemic. While most of them might escape the realm of conscious thought, some might stick around and cause problems to the extent of hindering daily functioning. It is important to remember that not everyone develops PTSD like symptoms as a response to trauma. As stated, most of the population will use healthy coping methods (however painful it may seem at the time) to overcome a traumatic experience. Despite this statistic, it is not wrong to seek help if you feel like you or a loved one has gone through something painful. Professional mental health help will always aid in the process of recovery.
Speaking of PTSD, an upcoming blog about its impacts, essentially an extension of this article, will delve deeper into the technicalities of this infamous disorder stemming from an abnormal reaction to trauma. We felt it was necessary to ward off myths and misunderstandings related to trauma before we proceed with what it means to live with PTSD as a medical professional. We hope you take back something from this and hope to see you for the next instalment!