It turns out that the pain in your body may not be “all in your head”
It’s easy to get an X-ray to see a broken bone. Specialty surgical scopes can reveal even the smallest tears that might be causing you pain.
But what about psychological trauma? It’s the kind of pain or discomfort you might be able to feel. It might be impacting your daily life. However, it’s certainly not going to show up through a typical blood test or a single trip to the doctor.
We sat down with three experts to ask a single question: What do people need to know about psychological trauma?
Together, they revealed nine things that can help everyone gain a better understanding of exactly what psychological trauma is and how it can affect people as much — or even more so — than a solely physical injury.
Here are our experts:
Ajeet Sodhi — Attending Physician in Neurology, NeuroCritical Care, and Interventional Neuroradiology, faculty member at California Institute of Neuroscience and Director of Neuro Critical Care at California Institute of Neuroscience
Lisa Billars — Chief, Kaiser Permanente Neurology Department and Board-Certified Neurologist
Shari Harding — Assistant Professor of Nursing at Regis College and Board Certified Nurse Practitioner in Psychiatry
1. An incident doesn’t have to be considered “extreme” to cause psychological trauma.
“The severity of something that causes psychological trauma is highly variable,” says Sodhi. “However, to the person experiencing it, that incident is severe.” This means that while one traumatic incident can affect two people in widely different ways.
2. Psychological trauma can happen to anyone.
“This can be a surprise to people,” says Harding. “People often have the idea that this couldn’t happen in their family.” The truth is that psychological trauma doesn’t see gender, age, race, or social status.
3. Psychological trauma can cause the brain to do too much of what it’s supposed to do.
When someone experiences psychological trauma, “...the amygdala directly releases hormones to heighten vigilance, and indirectly increases levels of cortisol in the body,” says Billars. “In response to these chemical signals, the prefrontal cortex, a region of the brain that regulates our emotions and actions based on more nuanced elements of our environment, is inhibited. Additionally, as the area of the brain responsible for memory, the hippocampus, is inhibited by these elevations in cortisol levels.”
In other words, following an event that causes trauma, the brain and body are in overdrive; they have difficulty grasping the message that they no longer have to keep working so hard to keep survivors safe.
4. Psychological trauma can alter the physical and chemical structure of the brain.
“There are actually parts of the brain that shrink when trauma is suffered,” says Sodhi. “One of the key areas that shrinks is the frontal lobe, where our personalities come from. A recent study showed that there are multiple parts of the brain that are impacted by psychological trauma. These include the hippocampus (in the frontal lobe, which affects memory and personality), the amygdala (which regulates emotions), and the anterior cingulate cortex (which has a heavy influence on conflict resolution).
5. There’s a connection between psychological trauma and other medical conditions.
“When your body is caught in a constant state of the stress response that psychological trauma creates, other parts of your body can be impacted,” says Harding. “People can develop an increased risk for conditions like diabetes, cardiovascular complications, and autoimmune disorders.”
“In the ‘fight or flight’ state, our digestion is slowed, and our blood pressure and heart rate are increased,” says Billars. “Over time, this change causes disruptions in [gastrointestinal] function in the form of irritable bowel syndrome, which takes form as constipation, diarrhea, or alternating periods of both. The impact on blood pressure and heart rate may cause dizziness, palpitations or fainting, and long term consequences of untreated blood pressure may result in negative effects on critical organs including the heart, brain and kidneys.”
6. Someone with psychological trauma isn’t “crazy.”
“People with PTSD are used to being used as a punchline,” says Sodhi. “They’re anything but crazy. Someone with PTSD [post-traumatic stress disorder] is operating in a constant state of fight-or-flight due to something out of their control that happened to them.”
Trauma overwhelms both the body and brain in many ways.
7. People might not know that psychological trauma is making their bodies sick.
“People can over-identify with the physical manifestation of their trauma and not recognize that trauma can be the root cause or contributing factor,” says Harding.
Even when people decide to go to the doctor about how they’re feeling, their physicians can miss that trauma is causing their health problems.
“For many general practitioners, psychological trauma isn’t their area of expertise. This means that a patient with a long list of concerns that don’t have any surface cause could have trauma ignored,” Harding says. “It’s not uncommon for physicians to want to help where they can, which means treating a symptom they can impact versus a psychological condition that’s not in their wheelhouse.”
8. It’s important for patients who might be experiencing trauma to self-advocate.
When patients experiencing trauma feel dismissed by their healthcare providers, it’s easy to shut down and wonder where help is going to come from. Harding offers a different approach.
“I love it when patients come to me with lists,” she says. “Maybe it’s a list of the 10 most pressing symptoms they’re having. It could be a list of the medical concerns that are impacting their lives the most. When patients tell me what they want to deal with first, that’s a good place for us to begin looking for answers.”
9. It’s possible to treat psychological trauma/post-traumatic stress disorder.
Many people might feel that there’s little hope for a better future, especially if they’ve felt ignored for a long time by the people who they’ve trusted for help. The good news is that there is definitely help available for people with psychological trauma.
“If people are hesitant to talk about how they’re feeling, they can start by researching PTSD on the internet,” says Sodhi. “They can read up on the condition, gain some knowledge and realize that what’s going on isn’t all in their head. Research can also help people feel like they’re not alone when they discover how many other people experience similar feelings and symptoms.”
As far as treatment goes, there are a wide variety of therapies available, from medications and talk therapy, to alternate therapies like Reiki, yoga and other soothing practices.
“The people I see have the most success treating their trauma are those open to a variety of treatments, not just one,” says Harding. “These patients are able to take ownership over their lives and stop being passed from provider to provider. Instead, they become the captain of their own treatment team.”
E. Napoletano is an award-winning journalist and the recipient of the 2019 Illinois Women’s Press Association first-place prize for her feature on the traumatic effects of family separation policies at the border.