The Effects of Trauma
Trauma can profoundly impact a person’s mental and emotional well-being. At New Directions Psychiatry PLLC, we recognize the long-reaching impact of trauma and the effects it can have on your daily life, relationships, and overall well-being. As a psychiatrist, Dr. Whitney Gilley has extensive professional training and experience in working with patients that have had traumatic experiences. She is certified as a Clinical Trauma Professional and is dedicated to providing compassionate, person-centered care and individualized treatment options.
What is Psychological Trauma?
Trauma can take many forms. It can result from experiences such as physical or sexual abuse or assault, neglect, witnessing violence, natural disasters, accidents, painful or emergency medical procedures, or other life-threatening situations. It can occur with direct experience or learning a loved one experienced a traumatic event. Trauma can occur with a singular, overwhelming event or through a series of distressing events over a long period of time. Childhood trauma can result from longitudinal verbal abuse or emotional neglect, even without a singular, profound event we may most often associate with trauma.
Not everyone who experiences trauma develops post-traumatic stress disorder (PTSD) or a trauma-related disorder. But traumatic events can shatter an individual's sense of safety, trust, and well-being, with lasting emotional and psychological effects.
The Effects of Psychological Trauma:
Emotional Impacts:
Psychological trauma can cause intense emotional responses, including persistent fear, anxiety, sadness, anger, or guilt. Individuals may also experience mood swings, emotional numbness, or difficulty regulating emotions.
Intrusive Symptoms:
Trauma can lead to intrusive thoughts, nightmares, flashbacks, or distressing memories related to the traumatic event. These symptoms can significantly impact daily functioning and overall quality of life.
Avoidance and Withdrawal:
Individuals may develop avoidance behaviors to cope with reminders or triggers associated with the trauma. This may lead to withdrawal from social activities, relationships, or situations that might evoke distressing memories or emotions.
Relationship Impacts:
When trauma leads to avoidance, it can impact existing relationships and create additional challenges when forming new ones. It is not unusual for trust and intimacy (the ability to share ourselves emotionally or physically) to become especially difficult after trauma.
Hyperarousal (when the “Fight or Flight” response keeps going):
Trauma survivors may experience hypervigilance, exaggerated startle responses, difficulty sleeping, or problems with concentration. They may be constantly on guard, anticipating potential threats or danger.
Negative Self-Perception:
Psychological trauma can impact an individual's self-esteem and self-worth. Survivors may develop a negative self-image, feelings of guilt or shame, or a sense of disconnection from others.
Trauma-related Conditions and Disorders
Not everyone experiences trauma in the same way, and not everyone will develop a trauma-related condition or long-lasting effects from a traumatic experience. It is important to understand the context in which trauma occurs. The effects on an individual are impacted by factors including the severity of the trauma, whether the trauma was inflicted by another person, history of prior traumatic experiences, individual biology, social supports, and the personal meaning the event. Trauma-related disorders and conditions encompass a range of symptoms that can develop as a result of a traumatic event. These conditions can affect individuals of all ages and backgrounds and may include:
-
Because traumatic events can trigger our body’s fight or flight response, anxiety symptoms can emerge or worsen after a traumatic event. This can manifest as increase in generalized worry, anxious thoughts and feelings, panic symptoms or panic disorder, phobias, avoiding social situations, or other avoidance behaviors.
-
Trying to make sense of a traumatic event can lead to internalizing what happened, leading to self-blame or thinking negatively about oneself. Or, the traumatic event is generalized, leading to negative thoughts about life and the world. Depression symptoms include feeling down, sad, or irritable more days than not, having difficulty enjoying things previously enjoyed, loss of energy, changes in sleep and appetite, and frequent thoughts of death or thoughts of suicide.
-
Not all grief is traumatic in nature. However, witnessing the loss of a loved one after a painful or protracted illness or witnessing an unexpected or violent death can significantly impact the grief process. This can cause symptoms associated with traumatic experiences. Traumatic grief can contribute to the development of prolonged grief disorder.
-
Adjustment disorder occurs when it is hard to cope with and adjust to a significant life stressor, such as a traumatic event, leading to emotional and behavioral symptoms.
-
Acute stress reaction is a short-term response to a traumatic event that can include symptoms such as anxiety, dissociation, confusion, and mood disturbances.
-
PTSD is a condition that may develop after a traumatic event with symptoms such as intrusive thoughts, nightmares, avoidance behaviors, and hyperarousal (feeling "on edge" or in a heightened state of tension or anxiety).
-
When trauma occurs repeatedly or over a long period of time, PTSD can develop that includes additional symptoms, such as self-deprecating thoughts or negative self-image and difficulty with emotional regulation.
-
Dissociative disorders involve disruptions or disconnections in a person's identity, memory, or perception of the world, often as a way of coping with overwhelming trauma.
-
Our mind and body are connected. Psychological trauma is experienced by the body and mind. The body can express experiences of psychological trauma in varied ways that can be very distressing and cause impairment. Symptoms of functional neurologic disorders can include movement difficulties or changes, difficulty swallowing or speaking, weakness/paralysis, numbness or tingling, vision changes, or non-epileptic seizures. FND must be distinguished from other underlying causes of neurologic or medical disease.
-
Trauma can trigger or worsen substance use disorders for a wide variety of reasons. Substance use often worsens symptoms related to trauma.
-
Continuous trauma is not a disorder, but occurs when trauma experiences have not ended, such as working as a first responder or witnessing repeated traumatic events as part of work, ongoing abusive relationships, refugees, or ongoing experiences of racism.
Symptoms of trauma-related disorders and conditions can vary. They may significantly impact an individual's daily functioning and quality of life. If you suspect you or a loved one may be experiencing the effects of trauma, we recommend seeking professional evaluation. Dr. Gilley sees patients with most forms of trauma-related disorders and provides diagnosis and treatment options. She has worked with patients with a wide variety of traumatic experiences including childhood trauma.
Treatment Options for Trauma-related Conditions and Disorders
Psychotherapy
Therapy for trauma (talk therapy or psychotherapy) is a core component of treating trauma-related concerns and disorders. Because trauma manifests in so many ways, from difficulties with trust in relationships, to hypervigilance, nightmares, and numbness, Dr. Gilley tailors therapy to the individual. This may include the more traditional exposure-based or cognitive therapy such as CPT (cognitive processing therapy, a form of CBT), or an integrative therapy model that draws on the latest in our understanding of how trauma affects our body, mood, perspectives, and relationships. She also offers trauma-focused ACT (TFACT), a form of acceptance and commitment therapy that can help with trauma that includes moral injury. For those longstanding patterns left by trauma that create difficulty in relationships or ability to find meaning in life, she also offers psychodynamic psychotherapy.
Medication
For certain patients, medication may be prescribed to help alleviate symptoms such as anxiety, depression, or sleep issues and facilitate progress in therapy. When medication is considered, it is a mutual discussion between you and your doctor. How long you might take medication will depend on the types of symptoms and their severity.
Medicines used include those that help target the “fight or flight” response, reduce nightmares, or help treat depression or anxiety symptoms. Benzodiazepines, a type of controlled drug (including Klonopin®, Ativan®, Xanax®, and Valium®), are not advised for use in trauma treatment as it can interfere with recovery and effective therapeutic treatment. Benzodiazepines are not prescribed at New Directions Psychiatry PLLC.
Holistic Approaches
Activities to help re-establish feelings of safety and improve sleep quality are important in trauma recovery. Good nutrition is another factor that can support healing. Practicing stress reduction techniques can support overall well-being and aid in recovery.
Dr. Gilley believes that care can be optimized to fit your needs by understanding your stressors and supports from a whole-person perspective.
Many integrative psychotherapy techniques used in trauma treatment incorporate somatic psychotherapy techniques, which take into account the connections between our brain and body to help facilitate reconnection and healing.
When to get emergency help:
If you think you may hurt yourself or act on suicidal thoughts, get help immediately by calling 911 or your local emergency or crisis number.
If you are concerned someone else is in danger of suicide or has made a suicide attempt, do not leave the person alone without someone to stay with them. Call 911 or local emergency services immediately or take the person to the nearest hospital emergency department if you can do so safely.
You can get help for suicidal thoughts or information to help a loved one in crisis by calling the 988 Suicide and Crisis Lifeline, which is free and available 24/7. Website: Talk To Someone Now: Lifeline (988lifeline.org)
Other resources, including state-specific resources for Kentucky and Tennessee and National hotlines for a various of mental concerns, can be found here: Resources Page.
What are the effects of untreated trauma?
While traumatic stress is a normal reaction that can improve with time, some individuals develop severe or long-lasting symptoms. Traumatic stress can affect the function of certain areas of the brain involved with memory, “fight or flight,” thought, and behavior (including the hippocampus, amygdala, and prefrontal cortex). PTSD can cause changes in the way the stress hormone cortisol and neurotransmitters like norepinephrine are expressed. Besides the psychological effects of trauma on quality of life, self-esteem, relationships, and day-to-day functioning, trauma-related conditions may increase long-term risk for conditions such as heart attack or heart disease, cancer, diabetes, and chronic pain.
Why Choose New Directions Psychiatry PLLC for Treatment of Trauma?
Expertise:
Dr. Gilley is a medical doctor Board Certified in Psychiatry. Specialists in psychiatry have extensive experience in diagnosing and treating trauma. Dr. Gilley is trained in both formal talk therapy and medication treatment options for trauma recovery. She stays up-to-date with the latest research and trauma treatment modalities.
Trauma-Informed Care:
Dr. Gilley uses a trauma-informed approach to care, which means approaching each individual with sensitivity, compassion, and respect for their unique experiences. New Directions Psychiatry PLLC strives to create a safe and supportive healing environment where you can share your trauma narrative at your own pace. Dr. Gilley collaborates with you throughout the course the course of your care. She is responsive to patient concerns and adapts treatment to fit your individual needs.
Individualized Care:
We understand that each person's experience is unique. Dr. Gilley takes a personalized approach to your care and tailors treatment around your specific needs and goals. Because she offers both therapy and medication options and stays up to date on these and other interventions, she understands the full range of treatment options. This allows you to discuss different options and help you decide on the best treatment for you.
Care That Empowers Patients:
Dr. Gilley believes in empowering patients with education about their condition and treatment options. She provides counseling about trauma-related symptoms and conditions, which evidence-based therapies are most often used for the treatment of trauma-related concerns, and medication options. She counsels patients on the risks and benefits of treatment(s), so that patients can make informed decisions about their care. Dr. Gilley involves you in every treatment decision.
A Whole-Person Approach:
Dr. Gilley believes in the power of a multi-faceted approach to care to help patients achieve long-term well-being. She considers individual factors such as non-psychiatric health conditions and medications, nutrition, daily activities, family history or genetics, and prior treatment effects and experiences. To gain a greater sense of who you are as a person, Dr. Gilley prioritizes understanding your needs, stressors, supports, goals, and values.
More Time with your Doctor:
It requires time to provide quality care for trauma-related conditions. Visits are never scheduled for less than 30 minutes. Initial appointments are typically around 90 minutes—all directly with your doctor. As a psychotherapy-oriented practice, most therapy sessions are 50 minutes, and weekly therapy is an option. When you call, Dr. Gilley is the one to return your phone call.
Compassionate Support:
Dr. Gilley is committed to providing a supportive, non-judgmental environment where you can feel safe discussing your concerns and receiving the care you deserve. She is available for concerns and returns patient calls herself.
Convenient:
Our psychiatry practice offers flexible appointment scheduling, including Saturday therapy options. You don’t have to leave your home or office to receive physician specialty care for trauma-related concerns.
Confidential:
New Directions Psychiatry PLLC is a small, private psychiatry practice. It is not part of any large medical group, community health system, or hospital system. Visits are strictly confidential to ensure your comfort and privacy. New Directions Psychiatry PLLC does not hire billers, coders, schedulers, or administrative staff. Your physician takes care of these duties. Because this practice does not bill insurance, you can have more control over your personal information. See Why don't you take insurance?
Don’t let the effects of trauma define your future. Take the first step towards healing and reclaiming your well-being by calling to request an appointment today.
References and Resources
National Institute of Mental Health (NIMH) (2020): Coping with Traumatic Events https://www.nimh.nih.gov/health/topics/coping-with-traumatic-events Accessed 6.28.23.
American Psychological Association (2023) How to Cope with Traumatic Stress. https://www.apa.org/topics/trauma/stress Accessed 6.28.23.
Bremner JD, Wittbrodt MT. (2020) Stress, the brain, and trauma spectrum disorders. Int Rev Neurobiol. 152:1-22. doi: 10.1016/bs.irn.2020.01.004. Epub 2020 Feb 19. PMID: 32450992; PMCID: PMC8214870. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214870/ Accessed 6.28.23.
Anxiety and Depression Assoc. of America (2021). Trauma. https://adaa.org/understanding-anxiety/trauma#How%20common%20is%20trauma?
American Psychiatric Association (2022) Posttraumatic Stress Disorder (PTSD) https://www.psychiatry.org/Patients-Families/PTSD and https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd Accessed 6.28.23.
Mayo Clinic (2022) Functional Neurologic Disorder/Conversion Disorder. https://www.mayoclinic.org/diseases-conditions/conversion-disorder/diagnosis-treatment/drc-20355202 Accessed 6.28.23
Mayo Clinic. (2022) Post-traumatic Stress Disorder. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967 Accessed 6.28.23.
American Psychiatric Association. (2017). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
Harvard Health (2021) Past Trauma May Hurt Your Future Health https://www.health.harvard.edu/diseases-and-conditions/past-trauma-may-haunt-your-future-health Accessed 6.28.23.
CDC (2021) Adverse Childhood Experiences (ACE): Preventing early trauma to improve adult health. https://www.cdc.gov/vitalsigns/aces/index.html Accessed 6.28.23.
The Mental Health Resource Page includes a list of state resources in Kentucky and Tennessee, and a list of national hotlines related to mental health and well-being.
Whitney Gilley, MD. Articles related to Trauma and PTSD and the treatment of trauma-related symptoms: