Stress is something we all face. It comes in many forms. Some stressors are minor or short term, while others may be severe or become chronic. It is important to make a distinction between the stress that we face in our everyday life and the stress that comes from traumatic experiences.
According to the DSM-5, the manual that categorizes mental disorders, trauma is a specific type of stress that reflects exposure either as direct experience or as a witness to violent or accidental events. These events are generally outside the range of daily human experience and are emotionally painful, intense, and distressing.
We know that what causes stress might be different for each person but the way our body responds to stress is universal and is called “stress response”.
This stress response has been called in many different ways including the “fight or flight or freeze” response.
When our body and brain respond to stress we activate a part of our nervous system called the Sympathetic Nervous System and a specialized stress system called the Hypothalamic Pituitary Adrenal (HPA) Axis. The activation of these systems is the same as our ancestors when they were running for their lives on the savanna.
This activation results in the release of stress hormones and changes in the body to either fight the predator, to run away or to freeze and play dead to trick the predator.
When the challenge is over, another system, called the Parasympathetic Nervous System, is activated to counteract the effects of the Sympathetic Nervous System and to help the body return to a healthy balance of both systems.
Although this network of systems to respond to stress worked very well back on the savanna and for acute stressors, activating this stress response over and over and being unable to return to balance as when stress is very severe or becomes chronic can be very harmful to our physical and mental health.
Research is showing more and more links between stress and many chronic medical conditions like cardiovascular disease and stroke, and mental health disorders, including depression and anxiety.
How does traumatic stress become chronic?
When we have experienced a traumatic event, even though the crisis is over we may still be experiencing or may experience later, some strong emotional or physical reactions. Sometimes these reactions appear immediately after the traumatic event. Sometimes they appear a few hours or a few days later or even weeks, months, or years later.
When we experience the signs and symptoms of a stress reaction, those may last a few days, a few weeks or a few months and sometimes they may last much longer.
Depending on the severity of the traumatic event and the support system and relationships a person has in place, a traumatic event can be managed in a healthy way that creates resilience and growth or can be so painful that people may need the assistance of a mental health professional because the event might have been too strong for the person.
In the brain, when the stress response becomes chronic, it can be associated with long-term alterations in specific areas that include
- The amygdala – the area that processes emotions and fear.
- The hippocampus – where our memory is stored.
- The prefrontal cortex – the area of our brain that controls our executive functions like problem-solving, creativity and cognition.
As we discussed earlier, after being exposed to trauma, long term psychological and physical consequences can manifest in the form of mental health disorders or chronic medical conditions.
A mental health condition commonly associated with trauma exposure is called Post-Traumatic Stress Disorder, or PTSD which includes a variety of symptoms as:
- The re-experience of the trauma in distressing ways.
- The avoidance of trauma-related situations.
- The development of negative beliefs about oneself or others as a result of the trauma.
- Mood alterations, hypervigilance and the hyperactivation of the stress response.
Many of the symptoms are normal reactions in the first few weeks after the trauma but they can become PTSD if they persist past the first month.
Research findings from animal studies have been extended to patients with post-traumatic stress disorder (PTSD) and the MRI of the brain of these patients showed smaller volumes of the hippocampus, increased amygdala function, and decreased prefrontal cortex function. In addition, patients with PTSD showed an increased release of stress hormones like cortisol and adrenaline.
Other psychological outcomes that can result from trauma can be depression, substance abuse, anxiety disorders, and personality disorders.
On the other hand, people who experience trauma can develop physical health problems due to the effects of chronic stress on their neuroendocrine and immune systems and the continuous release of stress hormones in their body.
There are many factors that can influence how trauma will manifest in your body and increase an individual’s capacity for resilience. These factors depend depending on:
- The type of trauma
- The age that the trauma occurred
- The severity of the traumatic event
- The presence of other risk or protective factors such as genetic variability
- The presence of biological and social protective factors like the presence of a supportive relationship.
How to manage traumatic stress
The best thing to do if you are exposed to a traumatic event is to reach out to a mental health professional for help. Research shows that early intervention following trauma might prevent the development of PTSD and depression.
Type of treatments can include counseling, cognitive processing therapy, and medications.
I am here to remind you to be patient with yourself and know that recovery from a traumatic experience is possible and with time and a strong support system you can return to your normal life.
Remember to connect to your village and ask for support.
Make self-care a priority while you are recovering and take good care of your needs.
Growth after Trauma
It may encourage you to know that there is more and more evidence from science that the stress from a traumatic experience can actually act as a catalyst for growth. This phenomenon is called post-traumatic or stress-related growth and describes a positive change that can occur as a result of the struggle with a stressful experience and can stimulate the brain toward an amazing transformation.
Research is showing that post-traumatic growth can dramatically enhance the human potential for physical and mental wellbeing. This research also shows that when you use the right tools you can use this growth to literally rewire your brain towards positivity
and prevent and heal conditions like depression and anxiety.
This growth typically manifests in one or more of five main areas and you could observe:
- A sense of abundance and renewed priorities
- Improved relationships with others
- Enhanced mental and emotional strength
- A greater appreciation for life
- Existential and spiritual deepening
Although the intricacies of the impact of traumatic and toxic stress are still under study, the science is clear: there are hope and light at the end of the tunnel.
I hope this helps you in your journey and remember you have the power to harness your stress into growth, health, and happiness!
Take care,
Dr. MB