Acute Traumatic Stress

By Dr. Arielle Schwartz, GSN Board Member & Provider 

Do Not Wait to Heal

Acute Traumatic Stress Dr. Arielle Schwartz

If you have experienced a recent traumatic event NOW is the time to get support. Interventions immediately following a traumatic event help prevent the development of Post Traumatic Stress disorder (PTSD). Do not wait. Many people inaccurately believe that they need to “give it time” and do not take advantage of this crucial period of healing.

“This post provides recent trauma survivors with an understanding about the types of feelings and experiences common during the weeks after such terrifying and life altering events. When we have such knowledge we are less likely to feel frightened by the intense emotions, thoughts, and physical sensations that typically occur. As a result we deepen self-compassion for our symptoms and work with rather than against the body-mind connection to facilitate healing.”
-Dr. Arielle Schwartz

Wired for Survival

Acute Traumatic Stress Dr. Arielle Schwartz

As human beings, we are wired for survival. We will respond with stress whether when we experience any difficult life event.  Stress involves an increase in cortisols such as adrenaline into your bloodstream that facilitates a fight or flight response in your body. This prepares you to move in a way that metabolizes the energy released in your body. We are meant to move our bodies through running or self defense when threatened. Ideally when we reclaim safety the stress response resolves, your brain receives a signal to stop releasing these neuro-chemicals, and your cortisol levels return to baseline.

Trauma is typically understood to occur when we are in a situation that has life threatening implications with no actual or perceived exit. Typically we are trapped or immobilized that prevents us from engaging our defenses. In such a situation the body recognizes that fight and flight were unsuccessful and resorts to a “faint” or feigned death response.

You can think of it this way, a mouse is being chased by a cat. In the initial chase the mouse runs as fast as it can (flight). If the mouse makes it to the safety the rapidly beating heart and quickened breath will eventually subside (healthy stress response). When there is no place to hide the mouse runs without end exhausting resources (chronic stress). However, what if the mouse is caught by the cat? Once in the jaws of the cat the mouse faints in a last ditch attempt for survival. Perhaps the cat will mistake the mouse for dead and lose interest in the limp creature. This is traumatic stress.

Traumatic Stress and PTSD

Acute Traumatic Stress Dr. Arielle Schwartz

Differentiating between an acute traumatic stress reaction and full-fledged PTSD provides an essential key to unlock healing. There are a wide range of sensations and emotions that occur in the weeks after a traumatic event and these do not mean you will develop PTSD. Symptoms common during the initial period of acute traumatic stress include

  • Numbness
  • Disorientation
  • Disbelief or feeling that life is surreal
  • Feeling disorganized or having difficulty concentrating
  • Physical symptoms such as loss of appetite, dizziness, or difficulty sleeping

You can think of these experiences as your built-in biological protection mechanism that buffers you from the reality of the event.

When numbness subsides it is more likely to feel intense emotions such as fear, anxiety, and panic. You might also find yourself feeling depressed, helpless, or hopeless.

Like the old adage, it is better to get back on the horse that bucked you than. When we begin to avoid going to places or being with people that remind us of the trauma we are more likely to develop long term effects. PTSD is made up of symptoms that persist well after the event is over. Common symptoms include:

  • Re-experiencing symptoms such as flashbacks, nightmares, or ongoing fear
  • Avoiding situations that are reminders of the event
  • Feeling numb, cut-off, or unable to remember parts of the traumatic event
  • Feeling “keyed-up”, being easily startled, or having difficulty concentrating
  • Feelings of hopelessness, shame, or despair that persists overtime
  • Sleep problems that do not resolve

Caution

Acute Traumatic Stress Dr. Arielle Schwartz

Many people suffering from PTSD seek out medications to manage these symptoms post trauma exposure. Unfortunately, the use of such medications suppresses the very physiological and psychological processes necessary to facilitate resolution. Historically, military services have relied on prescription drugs (primarily benzodiazepines such as Valium, Xanax, Ativan, and Klonopin) to help troops manage Post Traumatic Stress Disorder (PTSD). However, as of 2012, the Army Surgeon General changed the military’s policy around prescribing benzodiazepines concluding the harm outweighs the benefits. This class of medications is now considered contraindicated for acute traumatic stress because they increase the likelihood of the development of PTSD. They are contraindicated for PTSD because they prolong the healing process.

You do not need to medicate your feelings. Intense emotions and sensations are your body’s natural adaptive healing process at work. Anxiety and panic are expected after trauma. These are signs of your mind and body seeking resolution after a traumatic event. However, if you do need support to “cut the edge off” of overwhelming emotions consider this a short term option rather than a long term solution.

Healing Trauma

Acute Traumatic Stress Dr. Arielle Schwartz

In the wake of a trauma it is important to have strategies for healing. Otherwise we are more likely to lapse into passivity or feelings of helplessness. Resilience in the face of traumatic events does not always come naturally. Recovery from acute traumatic stress involves a mindset and behaviors that help you reclaim trust in yourself and the world.

Based upon the six pillars of resilience explore these action steps to facilitate your recovery during the acute phase of trauma recovery:

  • Seek help with a provider equipped to handle the treatment of recent traumatic events (e.g. the recent traumatic event protocol offered within EMDR Therapy).
  • Talk about the event to people who are able to listen to your experience without shutting you down out of fear. Seek people who are unafraid to ride the waves of panic and fear with you and to help your mind and body process through the experience.
  • Find healthy outlets for anger and rage. These emotions are essential for healing and we need to know that we are not “bad” for feeling hateful. We need healthy outlets for anger so that this emotion does not get pushed into the shadows to create harm. Need ideas? Yell in the woods, break a set of dishes in an alley, kick and throw balls in a field, tell someone you trust your darkest thoughts. These will set you free.
  • Move your body. Our bodies hold trauma and are essential for releasing stress helping us recover from trauma. Explore what works for you… start by exploring how your body wants to move intuitively. Find healing movements such as pushing, reaching, shaking, curling up, or rocking. Add in exercise such as walking, running, dancing, and yoga as is right for you.
  • Explore complex emotions such as guilt and shame. These emotions are common after trauma. Some people describe feeling survivor guilt. You might ask, “Why did I survive when others did not?” Some describe feeling ashamed as though they were the perpetrator despite being a witness or a victim. These thoughts and feelings are common to the disorientation that comes with trauma.
  • Write about your experience of the event. Include the hardest moments. Include the moments that allowed you to survive. What did you do to make it through? Who helped you?
  • Feel grateful for simple things…your breath, your body, a flower, a sunset, a friend, a caring doctor, etc.
  • Find creative outlets such as poetry, painting, music, and dance that allow you to process your emotions. Share these expressions or keep them to yourself.
  • Reach out to your community instead of isolate. Attend support groups. Let people know that you are hurting instead of trying to be strong or hiding your true feelings out of an attempt to protect others. Allow others to support you and receive what they have to give.
  • Create change in the world. This step may take time. If you feel compelled to share your story with the world listen to that impulse inside of you. You have an important perspective based upon your experience. Your voice is important! Maybe you write a letter to your congressman, participate in a rally, write a blog, or give a public talk. Someone is out there who will benefit from your courage to speak out.