Post-Traumatic Stress Disorder and Its Treatment

Post-Traumatic Stress Disorder and Its Treatment

What is Trauma?

Trauma, in its broadest definition, is “experiencing or witnessing an event or events that involve real or perceived injury, or that pose a threat to the physical integrity of oneself or others.” Trauma can be defined as an experience that leaves significant signs of injury, both physically and psychologically, on a living being. The normal behavioral system that exists in a healthy individual; The ability to control, to establish a connection between events, and the sense of meaning to the person or events are disrupted in the person who experiences trauma. For the traumatized individual, life literally loses its meaning. There has been an interruption in the person's usual life flow. Regardless of whether it is an unexpected or expected situation, the person experiences situations such as the feeling of being alone after the trauma, the fragility of life, the person realizing the reality of death, and the loss of ties with moral values. This devastating effect on the person's normal life; It often causes the loss of hope for the future, the injury of the feeling of loving oneself, life and others, and the damage of the sense of trust in oneself or others.

 Trauma makes the individual feel like “I always heard from others, listened to it from others, watched it on television, read it on the third page news, It is the moment when he comes face to face with things that he said "I never thought could happen to me or my loved ones", and the possibility of one day being the "protagonist" of the event or events that he was aware of, but which he held tightly to the possibility that were far from him.

 Many people, through the media or digital platforms, have an idea about the bad impact of traumas on the individual. However, the "survival mechanism" we have by nature has a natural tendency to focus on the positive instead of the negative and to center positive thinking. For this reason, even if they have an idea, most people automatically hold on to the belief that "it won't happen to me, I'm safe." On the other hand; For example, if the person had experienced a trauma-related experience that was read about on social media, he/she would have an opinion on how he/she would deal with it; Most of the time I would do this,& nbsp; This opinion includes sentences starting with "If this happened to me, I wouldn't act like that." However, after experiencing and overcoming the trauma, he observes that he behaves in many ways contrary to his prediction and is surprised. The most important reason for this situation is that the trauma experience is something completely different from ordinary life events.

 Traumas are usually sudden and unexpected events. In many people's lives, there is a time to “prepare” for events or situations, even if it is something very challenging. The time period given to oneself or life to keep up with the new event or new change, to accept it and to do something about it is important for the person, because the more time he has to prepare for a difficult life experience, the better he can cope with this experience. However, since trauma is an experience that occurs suddenly and unexpectedly, the person does not have time to prepare, so he or she must quickly decide how to act and how to think. In this case, since it requires the person to suddenly adjust his entire system accordingly, the normal behavioral system gives an "error code" and is interrupted because trauma is not a "planned experience".

 When the person looks back, he finds his cognitive and emotional or physical reactions during the trauma meaningless, most of his reactions are different from the reaction he would have in a normal situation. For the person, everything is different, it is as if the firewall has been broken. Trauma occurs so suddenly that the person does not have time to adapt to it, which is the most important reason why he exhibits behavior that is different from normal. At the same time, this situation can cause emotions such as extreme fear, horror and hopelessness to arise in the person during and after the trauma.

What are Extremely Stressful Events That Can Be Called Trauma?

We can examine traumatic experiences in two main groups; Traumas created by people (harassment, rape, violence, accident, torture, war, etc.), natural events (earthquake, flood, hurricane, tornado, sudden death, etc.)  

• A serious accident or earthquake, tornado such as flood disasters etc. natural disaster • Rape or criminal assault, having a serious crime committed against you 

• Having served in war, being in a war zone 

• Childhood sexual abuse or physical abuse or extremely severe neglect 

• Being a hostage-detention-being tortured-having to change place, country, city as an immigrant

• Witnessing a traumatic event

• Unexpected sudden death of a loved one death 

• Physical and emotional abuse within the scope of trauma 

• Loveless environment since childhood 

• Failure to meet health, education, shelter and nutrition needs • Sexual harassment

• Natural disasters (earthquake, flood, storm, etc.) 

• Fires 

• Traffic accidents 

• Wars 

• Being affected by conflict  

How Do Individuals React After a Traumatic Event?

After a traumatic experience, individuals often experience different reactions than "normal reactions". However, it should not be forgotten that “an abnormal response to an abnormal situation is a normal response.” The reactions that usually occur in the individual after trauma are; It manifests itself as reliving the trauma over and over again in one's mind, avoiding things related to or reminding of the trauma, being more tense, restless or more alert than usual, being depressed and crying.

1. Experiencing the Trauma Over and Over in the Head

When the survival mechanism comes into play, the mind tries to store it against a possible re-experiencing of the trauma. Although this seems useful when there is a real perception of threat, it is not very functional when the danger has passed and there is no longer a need for protection.

After the trauma, the person may repeatedly experience the emotions, thoughts or images during the trauma, and these experiences; It can include anger, fear, helplessness, sadness, anxiety, terror,  and other emotions. Some images, tastes, smells, and unpleasant physical sensations may also be experienced again. This situation depends on the person himself. It can destroy the feelings and thoughts of trust, love, togetherness and security towards oneself, one's environment and the world.

2. Recurring Nightmares, Distressing Dreams and Insomnia

 One of the most common situations we encounter after trauma is the deterioration in sleep patterns and quality. The person may have recurring distressing dreams or nightmares, whether related to the trauma or completely independent of it. This situation causes frequent interruption of sleep. In addition, after a certain period of time, the person may show an avoidance reaction in falling asleep or staying asleep because he is afraid of having nightmares. Both conditions seriously affect sleep patterns and quality and cause the person to feel constantly tired.

3. Flashback

 One of the most common situations experienced by an individual after trauma is flashbacks. Trauma is such a painful experience that after the trauma, the person can often feel pain, sound, smell, sight, and physical sensations similar to the one experienced during the trauma, over and over again, as if the trauma were being experienced again. It is so powerful that it makes the person feel that they are experiencing the physical sensations, emotions, and thoughts during the trauma as they were during the trauma. Having dreams about disturbing or other things related to the trauma that scare you, feeling that the trauma is repeated - reliving the trauma very strongly, being very disturbed, restless when you encounter events or feelings that remind you of the trauma, being very disturbed, restless when you encounter events or memories that remind you of the trauma, for example, It is possible that you may experience uncomfortable physical reactions such as heart palpitations, dizziness, etc.

4. Avoiding Trauma-Related Events and Numbing

 The system that a person has in his existential order has the ability to protect him from painful emotions during or after trauma. Therefore, after the trauma, the individual may become numb to situations that will cause him or her great pain. Thoughts, feelings and conversations related to trauma n may avoid, avoid places, people and events that remind of the trauma, may not remember some memories related to the trauma at all. He may also experience situations such as feeling embittered by life, thinking of himself as a separate person from the people around him, not being able to feel his usual emotions, and feeling as if he is living a borrowed life. Reluctance to think about or talk about the trauma, changing the subject to avoid further questions when someone asks how you feel after the trauma, safety behaviors; Doing something differently that was done before the trauma, checking, rituals, and completely avoiding (the situation or the tool) are common avoidance and numbing reactions.

5. Overstimulation Reactions

After trauma, a state of being more "alert" than usual can be observed in the individual. These manifest themselves as follows; Difficulty falling asleep or staying asleep, irritability and outbursts of anger, difficulties with concentration and memory, increased attention and exaggerated concerns about your own or others' safety, physical reactions to situations that remind you of your trauma, sexual difficulties.

Physical, Emotional, Cognitive and Interpersonal Reactions after Trauma

 The mentioned normal stress reactions affect the sympathetic and parasympathetic nervous system in our body. emerges based on . The sympathetic nervous system is activated as soon as danger is detected. It enables the necessary changes to occur in order for the body to prepare to escape from a dangerous situation or to fight against danger. Its activity is felt as acceleration in heartbeat and breathing, sweating, movement in the digestive system, muscle tension, fatigue, difficulties in falling asleep, aches and pains in different parts of the body, changes in appetite, nausea and changes in sexual urges. After the danger is eliminated, the parasympathetic nervous system comes into play; It ensures the reversal of the changes caused by the sympathetic system in the body and the return of body activities to normal.

 Traumatized people experience shock, fear, grief, anger

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