Disorders caused by Trauma


Post Traumatic Stress Disorder: (PTSD) is the result of a severe and extraordinary stressor in the person’s life that may be environmental (a large fire, hurricane), war, or violent crime (armed robbery, child abuse, rape), or the witnessing of violent incidents. Symptoms of PTSD are categorized as such not before the period of three months after the traumatic event. Before that time symptoms may fall into the classification of Acute Stress Disorder. People with PTSD may startle easily, become emotionally numb (especially in relation to people with whom they used to be close), lose interest in things they used to enjoy, have trouble feeling affectionate, be irritable, become more aggressive, or even become violent. They avoid situations that remind them of the original incident, and anniversaries of the incident are often very difficult. PTSD symptoms seem to be worse if the event that triggered them was deliberately initiated by another person, as in a mugging or a kidnapping. Most people with PTSD repeatedly relive the trauma in their thoughts during the day and in nightmares when they sleep. These are called flashbacks. Flashbacks may consist of images, sounds, smells, or feelings, and are often triggered by ordinary occurrences, such as a door slamming or a car backfiring on the street. A person having a flashback may lose touch with reality and believe that the traumatic incident is happening all over again.


Acute Stress Disorder: is a variation of Post-Traumatic Stress Disorder (PTSD) that lasts for a minimum of 2 days, but lasts a maximum of 4 weeks, and occurs within 4 weeks of the initial stressor. The initial traumatic event must have involved actual or threatened death or serious injury or a threat to the physical integrity of self or another person, and the person must have felt fear, helplessness or horror. During the event or immediately after, they must have experienced some of the following: numbing, detachment, derealization, depersonalization or dissociative amnesia. They must continue to re-experience the event through such methods as thoughts, dreams, or flashbacks, and avoid stimuli that remind them of the stressor. During this time, they must have symptoms of anxiety, and significant impairment in at least one essential area of functioning.


Dissociative Fugue: is characterized by sudden, unexpected travels from the home or workplace with an inability to recall some or all of one’s past. Some of these patients assume a new identity or are confused about their own identity. They seem to be running away from something of which they are unaware. After the fugue episode resolves, patients are unable to remember the events of the state. Although moving occurs in other disorders, in fugue it is purposeful and is not enacted in a confused or dazed state. In a typical case, the fugue is brief, with purposeful travel, and with limited contact with others.


Dissociative Identity Disorder (DID), formerly known as multiple personality disorder, is a disorder in which a person has more than one discrete, separate identity. Each identity is unique, and has its own sets of memories, ideas, thoughts, ways of thinking, and purposes. One identity may be the protector, while another may be a child. On average, a person with DID has between 8 and 13 separate personalities. DID generally results from a severe traumatic experience during the early childhood years.


Depersonalization Disorder: is where a person "looks at themselves from the outside", and observes their own physical actions or mental processes as if they were an observer instead of themselves. This often brings a sense of unreality, and an alteration in the perception of the environment around them, as well as the person fearing they are not in full control of themselves. Depersonalization can occur during a number of different times, and not be a disorder. In order to qualify as a disorder, it must be recurrent to the point that it interferes with daily functioning in at least one major area of life.


Somatization Disorder: The disorder is marked by multiple physical complaints that persist for years, involving any body system. Most frequently, the complaints involve chronic pain and problems with the digestive system, the nervous system, and the reproductive system. The disorder usually begins before the age of 30 and occurs more often in women than in men. Recent research has shown higher percentages of this disorder in people with irritable bowel syndrome and chronic pain patients. Somatization disorder is highly stigmatized, and patients are often dismissed by their physicians as having problems that are "all in your head." However, as researchers study the connections between the brain, the digestive system, and the immune system, somatization disorders are becoming better understood. They should not be seen as "faked" conditions that the patient could end if he or she chose to do so. No specific underlying physical cause is ever identified to account for the symptoms. Stress often worsens the symptoms.


Body memory: is the experience of phantom physical symptoms of past trauma, in non-traumatic situations. Much like a flashback, they are typically triggered. These memories are often characterized with phantom pain in a part or parts of the body — the body appearing to remember the past trauma.


Schizoaffective Disorder: The term schizoaffective disorder describes patients with acute psychotic symptoms such as hallucinations and delusions along with disturbed mood. These patients tend to function well before becoming psychotic; their psychotic symptoms last relatively briefly; and they tend to do well afterward. The current definition contained in (DSM-IV) recognizes patients with schizoaffective disorder as those whose mood symptoms are sufficiently severe to warrant a diagnosis of depression or other full-blown mood disorder and whose mood symptoms overlap at some period with psychotic symptoms that satisfy the diagnosis of schizophrenia (e.g. hallucinations, delusions, or thought process disorder). Many researchers believe schizoaffective disorder may owe its existence to both disorders. These researchers believe that some people have a biologic predisposition to symptoms of schizophrenia. On one end of the continuum are people who are predisposed to psychotic symptoms but never display them. On the other end of the continuum are people who are destined to develop outright schizophrenia. In the middle are those who may at some time show symptoms of schizophrenia, but require some other major trauma to set the progression of the disease into motion. It may be an early brain injury--either through a complicated delivery, prenatal exposure to the flu virus or illicit drugs; or it may be emotional, nutritional or other deprivation in early childhood. In this view, major life stresses, or a mood disorder like depression or bipolar disorder, may be sufficient to trigger the psychotic symptoms.


Depression: Clinical depression (also called major-depressive disorder or unipolar depression) is a common psychiatric disorder, characterized by a persistent lowering of mood, loss of interest in usual activities and diminished ability to experience pleasure. While the term "depression" is commonly used to describe a temporary decreased mood when one "feels blue", clinical depression is a serious illness that involves the body, mood, and thoughts and that cannot simply be willed or wished away. It is often a disabling disease that affects a person’s work, family and school life, sleeping and eating habits, general health and ability to enjoy life. The course of clinical depression varies widely: depression can be a once in a life-time event or have multiple recurrences, it can appear either gradually or suddenly, and either last for few months or be a life-long disorder. Having depression is a major risk factor for suicide; in addition, people with depression suffer from higher mortality from other causes. Clinical depression is usually treated by psychotherapy, antidepressants, or a combination of the two. Clinical depression may be a stand alone issue having differing features in patients, or as part of a larger medical issue, such as in patients with bipolar disorder. Symptoms include persistent sad, anxious, or “empty” mood , feelings of hopelessness, pessimism, feelings of guilt, worthlessness, helplessness, loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex, decreased energy, fatigue, being “slowed down”, difficulty concentrating, remembering, making decisions, insomnia, early-morning awakening, or oversleeping, appetite and/or weight loss or overeating and weight gain, thoughts of death or suicide; suicide attempts, restlessness, irritability, persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain. Mania: abnormal or excessive elation, unusual irritability, decreased need for sleep, grandiose notions, increased talking, racing thoughts, increased sexual desire, markedly increased energy, poor judgment, and inappropriate social behavior.


Eating Disorders: In any trauma, much of the anxiety that arises comes from the survivor’s inability to control the situation. Whether it is a car accident, the divorce of parents, or the death of a friend, trauma is a reminder to the survivor that she can be powerless. A natural reaction is to find new ways to enhance the sense of control. And since our culture has given great attention to body image, and equating thinness with self-control, food and diet represent areas in which the trauma survivor can receive near-instant feedback. Eating disorders are serious behavior problems. They include. Anorexia nervosa, in which you become too thin, but you don’t eat enough because you think you are fat, Bulimia nervosa, involving periods of overeating followed by purging, sometimes through self-induced vomiting or using laxatives, and binge-eating, which is out-of-control eating. Women are more likely than men to have eating disorders. They usually start in the teenage years and often occur along with depression, anxiety disorders and substance abuse. Eating disorders can cause heart and kidney problems and even death. Getting help early is important. Treatment involves monitoring, mental health therapy, nutritional counseling and sometimes medicines.


Self-injury (SI) or self-harm (SH) is deliberate injury inflicted by a person upon his or her own body without suicidal intent. These acts may be aimed at relieving otherwise unbearable emotions, sensations of unreality and numbness. It is listed in the DSM-IV-TR as a symptom of borderline personality disorder and is sometimes associated with mental illness, a history of trauma and abuse, eating disorders, or mental traits such as low self-esteem or perfectionism. There is a positive statistical correlation between self-injury and emotional abuse.