Trauma

Trauma occurs after a shocking event where one has experienced an intense threat or horror. It is different for everyone and is accompanied by strong emotional and physical reactions, which are normal and most people recover in three to four weeks.

To experience trauma, one does not necessarily have to have been the victim of the crime, hijacking, violent abuse, monstrous rape, destructive divorce or armed robbery. If a life-threatening trauma occurs and is close enough to your personal space, you can begin to experience the after-effects of the event.

When you are the witness to such things, you feel the overwhelming rush of adrenaline and emotions such as fear, powerlessness, shock, disgust, violation, anger, pain, intimidation and many other feelings.

The effects of trauma can take days, weeks and even months to set in before you start experiencing unfamiliar symptoms physically or psychologically or even both.

Common reactions to a traumatic event
Although the reactions to a traumatic event are different for every person, it's a good idea to know what to expect in order to understand the healing process fully:

• amnesia, memory problems or selective memories
• physical reactions such as trembling, headaches, disorientation, fatigue, dizziness, nausea, fainting, sweating, numbness, rapid breathing, increased heart rate or blood pressure
• changes in sleep, eating and thought patterns
• recurring memories, nightmares, intrusive or recurring thoughts, reliving the event or flashbacks.
• becoming fearful, suspicious and being hyper alert
• emotions range from shock, fear, panic and grief, to guilt, anger and denial.
• feelings of vulnerability, exposure and violation
• a feeling that life is pointless, and meaningless
• mood swings, irritability, anger outbursts or depression
• a sense of emptiness, helplessness and self-doubt
• wanting to be alone and withdrawing from others, or alternatively feeling needy and dependent
• feeling cut off and different from other people
• confused, emotionally drained and completely overwhelmed

How do you know if you're traumatised?

If a person experiences both of the following, it is usually an indication they have been traumatised:

• If a person has experienced, witnessed or was confronted with an event in which they felt under threat physically and feared for their life or that of another, that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.
• As a result of this, the person responded with intense fear and terror, a feeling of being helpless.

However, it's important to remember that not everyone experiences a traumatic event the same way, and as such, each person's response may be different.

After-effects of a traumatic event

There are a number of different symptoms a person may experience or exhibit after witnessing or being part of a traumatic event, such as depression, confusion, obsession, developing fears and guilt.

An important thing for those helping the traumatised person cope is to point out to them that although the traumatic event may have been unusual, the strong reactions they feel about it or towards it are normal.

Examples of traumatic events are: motor vehicle accidents, rape, armed robbery, hi-jacking, murder and suicide.

Reactions to traumatic incidents

Some of the more common and normal reactions people experience include:

• abnormally strong emotional and physical reactions
• emotional 'aftershocks', which can appear anything from a few hours after the event to days later.

Physical reactions to be aware of include:

• shaking/trembling
• headache
• tiredness/fatigue
• listlessness
• nausea
• dizziness
• fainting
• chest pain
• sweating
• changes in sleep patterns
• changes in appetite
• increased heart rate
• raised blood pressure
• rapid breathing

Mental/ psychological reactions include:

• confusion
• pre-occupation
• recurring memories
• nightmares
• suspiciousness
• poor attention span
• poor concentration
• poor problem-solving
• intrusive thoughts
• hyper alertness
• difficulty making decisions
• disorientation

Emotionally the reactions can include:

• emotional shock
• fear
• guilt
• vulnerability
• being exposed
• being violated
• grief
• panic
• mood swings
• denial
• anger
• irritability
• depression
• numbness
• emptiness
• hopelessness/helplessness
• self-doubt
• emotionally drained
• feeling overwhelmed

Behavioural reactions include:

• changes in ordinary behaviour
• social withdrawal
• restlessness
• tendency to avoid anything associated with the trauma
• indecisiveness
• increased risk of substance abuse
• change in personal hygiene habits
• prolonged silences

However, while these reactions are normal when taken in context and experienced relatively soon after the event (up to three months), should they continue for too long it's advisable to contact a medical professional before the person develops Post Traumatic Stress Disorder (PTSD).

Coping with trauma

Should you be feeling the effects of a traumatic event, here are some tips to help you cope:

• don't be afraid to ask for help or support from others
• make an effort to stick to your normal schedule/ routine
• talk about your experience and don't bottle it up
• remind yourself that what you're experiencing as an after-effect of a traumatic event is normal, and that you are not 'crazy'
• avoid using drugs, alcohol or medication to ease your symptoms
• stick to or work out an exercise routine to keep you busy and to keep those endorphins flowing
• structure your time and keep yourself occupied
• if the trauma happened in your normal environment (for example at home, at work, in the traffic) it is important to return to that environment and resume routine activities as soon as possible
• offer your help to others who experienced the traumatic experience with you as much as possible by sharing feelings and checking up on how they are doing
• don't be afraid to say how you feel or to let yourself feel sad/afraid at times
• write down how you are feeling and look back on it to check how you are coping
• keep doing the things you previously enjoyed
• don't be too hard on yourself and be patient, it will take a while for you to be 'yourself' again
• avoid making and big or life-changing decisions during this time
• ensure you get enough rest and eat properly
• don't get upset by recurring thoughts, dreams and flashbacks as these are normal and will decrease over time and become less painful
• if you suffer from a chronic medical condition such as hypertension or diabetes, have a medical check-up with your doctor.

Helping others cope with trauma

If you have a friend/family member who has experienced a traumatic event and is feeling the effects of trauma, you should try the following to help them get through it:

• listen to them talk about it
• make them feel as safe and secure as possible
• make an effort to understand what they went through and realise it is important, real, very distressing and not their fault.
• try get them back into a routine of daily tasks such as cleaning, cooking and so forth
• don't take their anger or other feelings personally
• refrain from statements such as "you're lucky it wasn't worse" as traumatised people are not consoled by those statements

Post-traumatic stress disorder
If the symptoms of trauma are not treated or effectively dealt with by means of counselling, the person may develop post-traumatic stress disorder (PTSD).

Common symptoms to be aware of, which could indicate Post-traumatic stress disorder, are:

Intrusive symptoms including sudden, vivid memories accompanied by painful emotions; flashbacks which can evoke feelings of actually re-experiencing the event; nightmares and disturbing dreams which have themes similar to the traumatic event.

Avoidance symptoms due to feeling emotionally numb one may begin to avoid people, places and social events; people may try and avoid their thoughts by using alcohol or drugs; avoiding anything or situations that could be associated or bring back memories of the event.

Hyperarousal symptoms depression, irritability, impaired concentration, memory problems, exaggerated startle response, agitation, panic attacks, changes in eating or sleeping patterns and physical complaints such as unjustified aches and pains, are all possible symptoms of hyperarousal.

When to see a doctor
It's important to visit a trauma counsellor or a medical professional who deals with victims of trauma as soon as possible after the event. Seek professional help before any problems arise that may cause long-term distress or impairment in the social, occupational or other functional areas of your life.