What do we mean by individual traumatic experience/experiences?
Trauma generally refers to our reaction towards a particular life event/events that have serious devastating effect on an individual’s overall wellbeing. Traumatic events cause disturbance in our thought process and generate overwhelming emotions.
Traumatic experiences can vary from person to person, depending greatly on ones perception of these events. The symptoms of trauma can lasts lifelong for most individuals, exempting few lucky ones who may develop a better coping mechanism. That being said, strong coping mechanism doesn’t attenuate ones traumatic experiences.
When we talk about trauma we usually associate ourselves to negative life altering events, like a car accident, witnessing an assault or being assaulted, subjugation to violence, military combat, and death of our dear ones and similar experiences which can cause grave damage to our cognitive functioning.
Relevance of PTSD
The full form of PTSD is POSTTRAUMATIC STRESS DISORDER.
PTSD is marked by increased stress and anxiety following exposure to a traumatic or stressful event. The individual show signs of helplessness, disturbance in daily thought process, relieving the traumatic the traumatic event and indulge in serious avoidance.
Trauma related syndrome was first identified and taken into account during civil wars and was documented. Sigmund Freud, famous psychoanalytical writer discovered a relation between neurosis and trauma.
The rising interest in PTSD came from studying the events of the aftermath of a war. The soldiers experienced intense cognitive disturbances like “shell shock” “battle fatigue” etc. The effect of the horrifying holocaust and the experiences associated with one’s mental wellbeing was studied to great lengths.
According to DSM5, PTSD can occur at any age, however young adults are more likely to be prone to it because of their greater exposure to precipitating situations.
According to historic witnesses, man’s trauma is associated with combat experience (death of dear ones, indulgence in violent activities). Woman’s trauma is associated with assault, rape and different forms of coercion and similar events. Experience of PTSD is highly subjective in nature and cannot be generalised.
According to the DSM5 there are some predisposing factors increasing the level of vulnerability to PTSD.
- Presence of childhood trauma
- Genetic vulnerability
- Recent stressful life changes
- Borderline, paranoid, dependent personality disorder traits.
- Excessive alcohol consumption
One can note certain symptoms that may indicate the existence of PTSD by the following –
Avoidance, refer to avoiding stimuli associate with trauma. Alternation in mood and cognition, hyper arousal that must last more than a month. Hyper arousal – indicative of enhanced startle. If the symptoms persist less than a month, appropriate diagnosis may be acute stress disorder.
In PTSD flashbacks are most common and the individual may experience intense degree of stress because of relieving the traumatic memories.
For instance, rape victims often have flashbacks associated to the experience of being violated. The keep imagining the presence of their perpetrator in their vicinity. Such experiences play a vital role in leading to more serious disorders.
Association of PTSD with DEPRESSION
Traumatic experiences in an individual’s life is capable of inducing serious damage to one’s cognitive functioning. Deterioration of mental health in respective individuals have strong correlation with PTSD.
PTSD is comorbid with several other mental disorders. Thus in order to delineate PTSD from other disorders, following diagnostic criteria according to DSM5, has to be kept in mind.
- Exposure to actual or threatened death, serious injury or sexual violence in one or more following ways-
- Directly experiencing the traumatic event(s)
- Witnessing an event first hand
- Learning that the traumatic event(s) occurred to close family member or close friends
- Experiencing repeated or extreme exposure to aversive details of the traumatic events. i.e. Someone repeatedly exposed to disturbing details, like child abuse.
- Presence of one or more intrusion symptoms associated with traumatic events, starting right after the traumatic event occurs.
- Recurrent, involuntary and intrusive distressing stories/memories of the traumatic events.
- Marked physiological reactions to internal or external cues that symbolises or resemble an aspect of the traumatic events.
- Negative alterations in cognitions and mood associated with traumatic event(s), beginning or worsening after the traumatic event(s).
- Inability to remember an important aspect of the traumatic events, typically due to dissociative amnesia and not due to other factors like head injury, substance abuse etc.
- Persistent distorted cognition about the cause or the consequences of the traumatic event(s) that lead the individual to blame himself or herself.
- Exaggeration of negative beliefs or expectation of oneself.
These are few of the diagnostic criteria that help distinguish PTSD from other mood disorders.
I would elucidate on how PTSD and depression has a certain degree of association between them via a real life event.
We all are aware of natural disasters like earthquake, cyclone, flood, famine etc.
In the year 2020, Kolkata, the capital of West Bengal came face to face with this notorious cyclone, named Ampan. This cyclone was categorised as the SUPER CYCLONE because of its high velocity rate of 150-160 Km/h, wind speed (93-99mph).
The cyclone caused unimaginable damage in Kolkata, Bangladesh and its neighbouring places like Sunder ban. Thousands of crops were destroyed, intensive power cute, water clogging and death of few hundreds. The consequences of this natural disaster was witnessed by whole Eastern India. People from all sections of the society faced the adverse consequences. People lost their loved ones, valuable property(s) accompanied by serious deterioration of mental health.
Local farmers suffered the most, and most went into depression. Paddy and other crops were harvested and stocked by farmer, which were completely soaked due to heavy rainfall and eventually destroyed.
Electricity poles were uprooted and huts of fishermen were destroyed. Most people eventually accepted their fate and tried to recover from the traumatic event, however many went to serious depression, being not able to cope up with their loss.
Most survivors of natural disasters gain a sense of acceptance however few individuals due to their low coping mechanism may fail to accept the reality or analyze the traumatic event and fall prey to cognitive distortion which eventually may lead to PTSD. Symptoms of PTSD don’t normally show up immediately after the event. They may day take days, weeks or even months.
It is possible to have both PTSD and depression simultaneously as both are frequently confused for one another due to the similarity of its symptoms. Some shared symptoms of PTSD and Depression are –
- Trouble sleeping or excessive sleeping.
- Emotional dysregulation, like sudden outbursts, zoned out, vague response to specific stimulus etc.
- Loss of overall interest in our surrounding, loss of one’s attention span, disinterest in daily activities.
According to professionals, people with PTSD are more likely to have depression and likewise individual with certain depressive mood disorders are highly susceptible to experiencing more anxiety and stress.
Certain ways to differentiate between PTSD and depression are the minute details and symptoms one exhibit which can only be noted on keen observation.
- In case of PTSD, people are more likely to have greater anxiety around specific people, places or event (certain holiday, date). This is likely due to the past traumatic event. Depression may on the other hand not be due to any specific issue or event that can be highlighted. Life events may trigger depression and may make it worse but depression usually functions and occurs independently of any specification.
- PTSD usually has a move specific vivid story behind its onset while depression maybe more generalised with history of onset.
Our coping mechanism greatly determine our cognitive functioning. Every individual is unique in their mental capacity and thus individual experiences shape our understanding of life events and how we perceive it. Two people with similar experiences may react differently.
Example 2 children, both victims of sexual abuse may cope differently with a different duration in time. One may gain acceptance of reality, accept the trauma and try moving forward in their life, while the other victim of sexual abuse may have a more intense reaction to the traumatic event and not recover from it, most probably leading to PTSD symptoms and then depression in their later adulthood. That’s how individual traumatic experiences may or may not lead to more serious cognitive disorders, mood disorders etc.