WHAT IS TRAUMA?
Any event that threatens our physical and psychological integrity is trauma. It is a sudden blow to our basic life references, such as integrity and continuity, on which we base our existence, at a moment we least expect and in a way that we can never be prepared for, no matter what we do. It is a state of timelessness that separates us from our past and future for a certain period of time - depending on its severity. Feelings such as extreme fear, helplessness, loss of control over our lives, hopelessness and insecurity about the future in the face of the event; Thoughts such as “I am not safe”, “The world is unfair and cruel”, “I am alone and vulnerable” arise. In traumatic events, there is a threat to our life, physical integrity, belief systems and loved ones. Separation and divorce, job loss, domestic violence, rape, traffic accident, sudden illness, disability and sudden death are included in the personal trauma list; War, terrorism, natural disasters, and large-scale economic crises are also discussed under the heading of social traumas. When it comes to the effects of social trauma, those most at risk are those who are directly exposed, those who witness it, and those who narrowly escape, respectively. Responding medical teams, police/gendarmerie, rescue teams, friends, and family members are the risk groups that will still experience the effects of trauma, although to a lesser extent. Those who have been victims of another disaster in the past, those who have family problems, those who have experienced losses in the recent past, those who do not have strong social ties, those who experience psychosocial problems or those who have a chronic disease are the groups at risk of experiencing the effects of trauma most severely.
Trauma. 10-20% of victims recover shortly after the incident. Approximately 70% of those exposed to trauma are affected by this trauma and show "stress reactions" (acute stress disorder). The remaining 10-20% show “stress reactions” for a long time. When these stress reactions are continuous, the person is diagnosed with Post-Traumatic Stress Disorder.
Post-Traumatic Stress Disorder Symptoms
Repetition symptoms (living the event over and over again in the mind)
Avoidance symptoms ( Avoiding stimuli related to the event or remembering the event)
Excessive symptoms of arousal (guilt, shame, physical symptoms, etc.)
Duration criterion (persistence of symptoms for a long time)
Impairment of functionality in social, occupational or other areas
These symptoms It may occur immediately after traumatic events or may occur years later.
POST-TRAUMATIC REACTIONS
Emotional reactions: Shock, sadness, anger, anxiety, guilt, hopelessness. , anxiety, fear, pessimism, dullness, extreme irritability, helplessness, not feeling like oneself, and exacerbation of past traumas and losses are emotional reactions. Fear and anxiety are common reactions in children. Fear is a normal reaction to any danger that threatens human life. Children may often be afraid of the event happening again, of death, of being separated from their family, or of being alone. In addition to the fears triggered by the real event, they may also experience fears produced by their own imagination.
Ideational reactions: Disbelief, lack of thought and attention, forgetfulness, sometimes suicidal thoughts, distorted and generalization-based (everything and everyone is bad) Such reactions include frequent thoughts, images related to the event, and experiencing the event over and over again.
Physical reactions: Headache, chest pain, heartburn and/or nausea, heart palpitations, sensitivity to noise. Physical reactions such as increased or decreased appetite, constant fatigue, shortness of breath and getting sick easily are actually a kind of self-expression of our body in the face of trauma.
Behavioral reactions: Sleeping and eating disorders, withdrawal from the social environment. Self-neglect, introversion, alcohol and substance use, avoidance behaviors, not speaking, inattention and disorganization, constantly dealing with the same thing, acting as if nothing had happened, are the main behavioral patterns shown in the face of trauma. The most common problems in children are related to sleep hours. They may not want to go to bed on their own, have difficulty falling asleep, wake up frequently at night, and/or have nightmares. At times like these, it is NORMAL that children want to be close to their parents and parents want their children to be with them. C Under stress, children may revert to behaviors they did at a younger age (such as bedwetting, clinging to the mother, thumb sucking). It is normal for such behavior to appear for a short time. If parents overreact to these behaviors, the behaviors may continue for a longer time.
Any social trauma damages our belief in a good, safe and worth-living world and leaves us alone with chaos. “I don't understand what's going on”, “I don't know what to do”, “Where is everyone?” Reactions such as these are reactions that occur in social traumas such as terrorism and natural disasters. Those who are directly exposed to trauma, as well as those who go to help them, may start by thinking "I can help, there is a lot I can do" and after a while they may find themselves thinking "everything is so bad, nothing I do has any meaning".
Epidemiology
Post-traumatic stress disorder is seen in 51-65% of women and 60-75% of men. Its higher incidence in women has been associated with greater avoidance. In general, it has been found to occur in 10-20% of people who encounter a traumatic life event.
Etiology
Factors that are effective in developing post-traumatic stress disorder; These can be listed as personally experiencing or witnessing the traumatic event, duration of exposure to trauma, having experienced a trauma in the past, type of trauma, lack of social support, strength of the trauma and genetic predisposition.
Differential Diagnosis
The main feature that distinguishes post-traumatic stress disorder from other anxiety disorders is the presence of a detectable traumatic event. Specific symptoms of other anxiety disorders (e.g., phobia, obsession, compulsion, spontaneous panic attacks) are not the expected symptoms of post-traumatic stress disorder.
HOW CAN YOU COPE?
What you can do to restore your sense of continuity and integrity:
Gaining knowledge, acquiring small but responsibilities/roles that you can fulfill, never losing your social ties, grouping up with friends you trust, not being alone, and never forgetting that: your reactions are the same as normal people's reactions to abnormal situations. These are typical reactions. It's not you, the situation that happened to you is ABNORMAL! To be physically strong, never neglect yourself and eat well. Give yourself time to rest. Exercising is one of the best ways to reduce stress. Stay away from alcohol and drugs.
Things you can do to recover emotionally:
Know what awaits you emotionally in the near future, get information. Allow yourself to experience your grief, do not try to appear strong. Stay in touch with people who understand and support you, ask for support from your circle or a professional if necessary, share your troubles.
What you can do to collect your thoughts:
Accept the reactions you show as normal. Remember that what happens to you is beyond your control and no matter what you do, you cannot be prepared for such situations. Avoid making generalizations (this hasn't happened and won't happen just to you or your loved ones). Examine your behavior. Get your life in order (this may be different from your previous order). You can change the priorities of your life. You can disable things that you find meaningless and do not want to do. You can meet more often with people who are important to you and establish deeper relationships. You can take care to live today.
Treatment
The aim of post-traumatic stress disorder treatment is to eliminate the symptoms caused by the trauma. For this purpose, cognitive behavioral psychotherapy is applied in addition to medication.
Each of us has memories stored in our memory like a personal photo album. In addition to beautiful photographs such as marriages, weddings, ceremonies, graduations and circumcision ceremonies, there are also large photographs of dark days... We, psychiatrists, cannot delete these large photographs, but we can make them smaller. Psychiatric help is required to turn a crisis we are experiencing into an experience that will brighten our future. Just like the picture on the wall of a loved one whose loss is very painful teaches us the value of life, we can turn pain into learning.
>
Read: 0
