Many mental health issues can be invisible illnesses. Anxiety, depression, post traumatic stress disorder (PTSD), dissociative disorders are examples of conditions that may not be seen by many in the sufferers life, or if some symptoms are identified they may be misattributed to other causes. For example, how many depressed people have encountered the hurtful myth that they are just “lazy” or unmotivated? And if the conditions themselves are not seen, the causes can be even more misunderstood. I have written about how often traumatic experiences underlie many mental health conditions, not just PTSD. There is also research to suggest that some chronic physical illnesses and symptoms may be associated with childhood trauma.
Trauma impacts many and has further reaching consequences than is usually understood. Kessler et al. (1995) found that 60% of men and 51% of women in the general population reported at least one traumatic event at some time in their lives. Almost 17% of men and 13% of women who had some trauma exposure had actually experienced more than three such events. As a therapist, I expect that most people seeking help will have experienced some sort of trauma in their lives.
What follows is an overview. Every individual is different and context can intensify or ameliorate the impact a traumatic event will have. Do you have a support system? Was your family relatively healthy and able to meet your emotional needs? Was this one in a series of traumatic events? Were you able to talk about it and receive help right away? All these factors and more play a role. “Approximately 73% of individuals exposed to a traumatic incident will experience dissociative states during the incident or in the hours, days, and weeks following…However, for most of those people these dissociative incidents will subside on their own within a few weeks after the traumatic incident subsides”. –International Society for the Study of Trauma and Dissociation
Sometimes traumatic events lead to a particular constellations of reactions and symptoms that are called Post Traumatic Stress Disorder (PTSD). This is defined as and recognized as caused by a traumatic event. It is my understanding that the impact of trauma is even broader than commonly understood and is also a component underlying many psychological diagnoses.
Reactions to a traumatic event may include any or all of the following:
- Eating Disturbances
- Sleep Disturbances
- Sexual Dysfunction
- Low energy
- Chronic, unexplained pain
- Depression, spontaneous crying, despair, and hopelessness
- Memory Disturbance
- Panic Attacks
- Compulsive and Impulsive Behaviors
- Irritability, angry outbursts
- Emotional numbness
In my practice I understand many diagnostic categories as trauma related and best seen as complex trauma aftermath. Especially when we take into account the breadth of traumatic experiences (big T and little t) it becomes clearer that things like anxiety, panic attacks, depression, substance abuse, compulsive behaviors, eating disorders , dissociative disorders and personality disorders can all be related to trauma. Individuals with complex trauma histories are also often misdiagnosed! Just a couple of examples: some children diagnosed with ADHD may actually be dealing with unresolved trauma and research shows that people with Dissociative Disorders spend an average of seven years in the mental health system before getting the correct diagnosis.
Without the awareness of the role that trauma plays, standard approaches to mental heath and substance abuse treatment and other human services may re-traumatize individuals who have experienced violence. This can interfere with getting useful treatment of even lead to giving up on seeking help at all!
Our culture continues to stigmatize mental health issues and has difficulty recognizing the pervasiveness of trauma. Emotional disorders and issues are often still considered somehow less valid than physical illnesses. In reality our emotional and physical selves are connected and impact each other. Individuals suffering from any chronic illness or condition deserve appropriate treatment, understanding and respect. Speaking plainly and factually about mental health issues such as anxiety, depression and PTSD hopefully will help those impacted feel able to recognize these issues within themselves. Recognition and visibility is the first step. We cannot address what we cannot see.