Many people face traumatic events in life. A psychological trauma results from an event that is exceptionally shocking, catastrophic or poses a threat to survival. The traumatic event may be the death of a loved one, suicide by someone close to you, a serious disease or injury, an accident, or being subjected to violence. So-called “near miss incidents” and being threatened may also cause a psychological trauma.
The extent to which the individual feels affected by the event depends mainly on the nature of the event and how shocking it is, and also on personal factors. Such factors include any previous traumatic experiences, insufficient mental reserves and the ability to adapt.
An acute stress reaction is a transient but severe disorder that develops without previous symptoms as a reaction to exceptional physical or mental stress. It usually subsides within a few hours or days, and its symptoms are mixed and changing. The symptoms include restlessness, nervousness, irritability, difficulty concentrating and insomnia.
However, a more severe disorder is post-traumatic stress disorder (PTSD). This is a prolonged or delayed reaction to a traumatic event or crisis.
PTSD usually develops in someone who has experienced a threatening or catastrophic event or other event likely to cause severe distress in almost anyone. The mental and/or physical stress that the event causes is more significant than the duration of the event itself.
PTSD symptoms include repeated episodes in which the individual relives the event, flashbacks and nightmares, always being on guard, and avoidance of situations reminiscent of the event.
A traumatic crisis usually progresses as the following phases:
- Shock phase: The shock phase begins immediately after the traumatic event. The event is still incomprehensible, and the person can either become completely “paralysed”, severely agitated or act in a mechanical way.
- Reaction phase: In the reaction phase, the person slowly begins to face the event. The person has repeated flashbacks about the traumatic event and feels the need to go through it over and over again. The reaction phase often includes fear, anxiety, feelings of guilt, insomnia and physical symptoms such as tremor or nausea.
- Processing phase: In the processing phase, the person begins to comprehend the traumatic event and is ready to face it. This phase often includes problems with memory and concentration, irritability, social detachment, and reflecting on one’s own identity, convictions and beliefs.
- Reorientation phase: In this phase, the event slowly starts to become part of the person’s life and identity. The event is not constantly in mind, even if it occasionally resurfaces with painful feelings. The person can slowly look to the future and have confidence in life.
Self-care instructions for psychological traumas
- Try to build a sense of security by spending time with your loved ones.
- Talk about the event as much as you feel you need.
- Take care of the essentials, including eating a balanced diet and getting sufficient rest.
- Let your mind slowly process the event.
- Debriefing of the traumatic event is not necessary unless you feel a specific need for it.
When should you seek treatment?
The need to seek treatment depends on the severity and duration of the symptoms caused by the traumatic event. In serious psychological traumas, you should seek treatment as soon as possible after the event. In less severe cases, you can follow the situation and see if the symptoms begin to decrease within a few weeks. Prolonged symptoms, flashbacks, severe anxiety and avoidance of things reminiscent of the trauma are reasons to seek help.
Treatment of psychological traumas
In acute stress reactions, help in daily activities and a reassuring, secure contact either with loved ones or healthcare professionals usually suffice as treatment. Providing information about the stress reaction is important, so that the person can better understand what they are going through.
PTSD that has continued for over two months is usually treated by means of psychotherapy, if necessary together with medication. The most effective forms of therapy are trauma-focused cognitive behavioural psychotherapy and trauma therapy that can be accompanied by EMDR (Eye Movement Desensitization and Reprocessing). EMDR can also be used on its own.
There are also medications available for the treatment of PTSD. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are often used. Ordinary sedatives and sleep aids should be avoided, as they may worsen PTSD.
Information sources: Duodecim Terveyskirjasto, Mielenterveystalo.fi (Mentalhub.fi)
FSHS psychologist / 4 October 2019