Category: Post Traumatic Stress Disorder

First responders are the first people to arrive at the scene of an emergency. We rely on them to be the first to bring us to safety and take control of the situation, whether through administering medical aid or helping people evacuate the situation. They are integral to our communities, but having such an intense, fast-paced job can take its toll. Many first responders are responding to high-risk, high-stress situations that are often traumatic not only to the victim, but to anyone on the scene. Having to experience these traumatic emergency situations on a daily basis is difficult for anyone, and can lead to several stress and trauma-related disorders. Post-traumatic stress disorder (PTSD) is a mental illness that can be triggered by either experiencing or witnessing a traumatic event, and often results in symptoms of flashbacks, avoidance and depressive moods (Mayo Clinic, 2018). First responders who are witnessing these traumatic events often are at high risk for developing PTSD. In fact, approximately “30% of first responders develop behavioral health conditions including…depression and posttraumatic stress disorder, as compared with 20% in the general population” (Substance Abuse and Mental Health Services Administration, 2018). 

PTSD in first responders is especially concerning because several aspects of the job can exacerbate the symptoms associated with the disorder. For example, many first responders such as EMS personnel and firefighters have erratic schedules with long shifts. Because they are first responders, they have to be ready to go at any time when there is an emergency. As a result, many first responders suffer from lack of sleep and fatigue. These are two conditions that are detrimental to mental health and can result in issues with being able to regulate emotions (Kelley, 2019). A common symptom of PTSD is changes in emotional reactions such as irritability, aggressive behavior, fear, suspicion, or overwhelming guilt or shame (Mayo Clinic, 2018). Lack of quality sleep can make this symptom even worse, and first responders with PTSD are especially at risk for this. Furthermore, many first responders turn to alcohol for comfort after a stressful experience at work. There is a sense of camaraderie and support that comes with getting a drink with coworkers after work. This is normal for many individuals, not just first responders; however, another symptom of PTSD is substance abuse and drinking with coworkers can easily turn into binge drinking. Alcohol abuse along with an erratic sleep schedule can make symptoms of PTSD worse and make it very difficult for first responders to keep from spiraling into depression or suicidal tendencies (Kelley, 2019). This is why it is increasingly important to spread awareness about PTSD in first responders and how their jobs can affect them.

Many first responders often suffer in silence. They prioritize their job first, helping those in need, but are unable to help themselves. There is a stigma surrounding PTSD and they are unable to speak up comfortably about what they are experiencing (Fitzpatrick, 2020). There is an attitude that mental illness is weakness—that by being affected by the atrocities they are witnessing everyday, they are somehow inferior to others. This fosters a negative environment where first responders are forced to bottle up and push aside their emotions or avoid seeking help lest they be looked down upon. This stigma against mental illness and PTSD in first responders is so pronounced that in a survey of 2,000 first responders, 40% stated that they would have faced negative repercussions at work for seeking help (Ebersole, 2019). Preventing our first responders from getting help services no one. By damaging the mental health of our first responders, they will not be able to do their job effectively and more importantly, they will be more at risk for exacerbating their symptoms and suffering. It is vastly important that the stigma against mental illness in emergency workers is eradicated and resources are being offered for help. Our first responders sacrifice so much to help society; it is only fair that they receive help and support in return when they need it. For anyone who knows a first responder, be aware of the symptoms and signs of PTSD and encourage the individual to seek help if needed. Above all, offer your support and be aware of triggers. First responders often receive questions about the worst emergency they have been called to or if they have experienced a highly dangerous situation before (Kelley, 2019). These can be triggering questions and bring up painful, traumatic memories. Although the intention is innocent, the effect on the individual can be devastating. 

First responders are more at risk for developing PTSD compared to others due to the stressful nature of their job and their constant exposure to traumatic events. PTSD can develop just from witnessing a traumatic event, which is something these individuals do almost on a daily basis without having enough time to fully process and recover from it. Reducing the stigma surrounding mental illness in first responders and offering resources and support is incredibly important to allow first responders to heal from the traumas they are witnessing. 

References

Ebersole, R. (2019, October 26). First responders struggle with PTSD caused by the emergencies, deaths, tragedies they face every day. The Washington Post. https://www.washingtonpost.com/health/first-responders-struggle-with-ptsd-caused-by-the-emergencies-deaths-tragedies-they-face-every-day/2019/10/25/9c4c9a0e-d4b8-11e9-9610-fb56c5522e1c_story.html

Fitzpatrick, A. (2020, July 28). First responders and PTSD: A literature review. Journal of Emergency Medical Services. Retrieved April 8, 2021, from https://www.jems.com/administration-and-leadership/first-responders-and-ptsd-a-literature-review/

Kelley, R. (2019, October 28). America’s first responders’ struggle with PTSD and depression. EMS1. https://www.ems1.com/ptsd/articles/americas-first-responders-struggle-with-ptsd-and-depression-LsgD4lAsb0ycVuQH/

Mayo Clinic. (2018, July 6). Post-traumatic stress disorder (PTSD) – Symptoms and causes. Retrieved April 8, 2021, from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

Substance Abuse and Mental Health Services Administration. (2018). First responders: Behavioral health concerns, emergency response, and trauma. https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf

Relationships can be hard for anyone especially when it comes to communication, trust and intimacy. However, for individuals with Post Traumatic Stress Disorder (PTSD), it can be especially difficult to maintain healthy relationships due to the debilitating symptoms of the disorder. Post Traumatic Stress Disorder is a psychiatric disorder that can occur in those who have either experienced or witnessed a traumatic event (Torres, 2020). These traumatic events can range from natural disasters to abuse and the impact they have on the individual can be devastating, making it very difficult to sustain healthy relationships. 

Individuals with PTSD often experience symptoms such as flashbacks or nightmares about the trauma they endured, avoidance of situations relating to the trauma, and increased feelings of anxiety or depression (Bridges to Recovery, 2018). These symptoms are difficult to deal with on a daily basis, and as a result can affect the relationships of the individual. Survivors of trauma dealing with PTSD may go to great lengths to avoid any potential triggers of traumatic memories (U.S. Department of Veterans Affairs, 2020). This can involve refusing to go outside in fear of experiencing any triggers or even withdrawing completely from social interactions. Increased avoidance compounded with feelings of depression and anxiety can place a strain on relationships, as individuals with PTSD struggle to trust the people around them and enjoy social interaction. The negative change in their behavior as a result of their trauma can in turn affect their loved ones and elicit negative responses to their actions. A lack of understanding or frustration from their close relationships can further exacerbate symptoms in those with PTSD and a cycle of negativity begins to form (Bridges to Recovery, 2018).

Although it can be hard to maintain relationships, especially after experiencing great trauma, social support is incredibly important to the road to healing. Creating a personal support network will help one cope with PTSD and the trauma that they suffered from. Communication and understanding are very important and, in a relationship, it is important to establish boundaries. If an individual with PTSD is surrounded by people who understand them and support them on their journey to dealing with PTSD, then this can help speed up the healing process and make it easier to maintain a healthy relationship despite their symptoms (Axelrod, 2016). In addition, to people who know someone with PTSD, it is vital that you are giving them space for recovery while showing that you still love and care for them. Do not blame them for their symptoms or minimize their trauma (Villines, 2020). PTSD is a serious and very real condition that they are not at fault for. Empathy and patience is crucial to ensuring a healthy relationship and that they know they can trust and rely on you. 

The symptoms of PTSD can be hard to deal with individually and even harder to deal with when in a social setting. The loss of control and fear can make one too anxious to continue relationships as they had previous to their trauma. However, support from friends, family and loved ones is essential to healing from the trauma and learning to live with PTSD. Those with PTSD, do not lose hope and be patient with yourself. Take time to slowly heal and gradually learn to rely on others. For those who know someone with PTSD, just being there, empathizing with them, and supporting them through their journey are simple things one could ask for. 

References

Axelrod, J. (2016, May 17). PTSD & Relationships. PsychCentral. https://psychcentral.com/lib/ptsd-and-relationships#Keys-to-a-Successful-Relationship

Bridges to Recovery. (2018, October 10). PTSD and relationships. https://www.bridgestorecovery.com/post-traumatic-stress-disorder/ptsd-and-relationships/

Torres, F. (2020, August). What is PTSD? American Psychiatric Association. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

U.S. Department of Veterans Affairs. (2020, January 14). Relationships. PTSD: National Center for PTSD Home. https://www.ptsd.va.gov/family/effect_relationships.asp

Villines, Z. (2020, May 27). Relationships and PTSD: What to know. MEDICALNEWSTODAY. https://www.medicalnewstoday.com/articles/relationship-ptsd#helping-a-partner

Nightmares, flashbacks, distorted thoughts and overwhelming emotions. These are all symptoms of post-traumatic stress disorder or PTSD. This disorder occurs not only in those that experienced a traumatic event such as war, rape, or an extreme accident, but also those witness to them, such as a cop studying harrowing cases. 

Individuals with PTSD tend to experience severely unsettling thoughts and feelings long after the traumatic incident has occurred, reliving the event and the emotions that came with it. People suffering from PTSD may even feel disconnected from others, remaining estranged and detached (Torres, 2020). Not everybody diagnosed with PTSD experiences the same symptoms, but scientists have discovered observable patterns through a method known as “neuroimaging” (Uniformed Services University of the Health Sciences, 2019). It was found that symptoms of PTSD can be a behavioral manifestation of stress-induced changes in brain structure resulting from previous trauma (Bremner, 2006). 

Scientists have found that long term changes caused by PTSD to the brain mainly occur in the amygdala, prefrontal cortex, and hippocampus. The amygdala is in charge of your fear response; during a stressful event, the amygdala sends a signal to release stress hormones that trigger your innate alarm system. Individuals with PTSD often have an overactive amygdala, causing fear responses to harmless events such as a loud noise. This effect on the brain is responsible for the onset of panic attacks and overwhelming emotions in circumstances that one wouldn’t normally consider a threat. In addition, studies suggest that an impaired prefrontal cortex further exacerbates symptoms. The prefrontal cortex is responsible for decision making and differentiating between fears and actual threats. Normally, the prefrontal cortex would halt fear responses once the idea of a threat is removed. However, in service members with PTSD, researchers found that the prefrontal cortex failed to carry out this function. An overactive amygdala coupled with an underactive prefrontal cortex forms a dangerous combination, as there are no mechanisms in place to slow the onslaught of stress responses. Other PTSD symptoms, such as flashbacks and distorted thoughts, are related to the hippocampus, the area of your brain dealing with memory. Due to the unbearable impact of a trauma, the stressed hippocampus fails to code information correctly, resulting in a faulty memory. This causes gaps when recalling details of the traumatic event, and individuals may constantly think about what happened because their hippocampus is working to make sense of the memory  (Uniformed Services University of the Health Sciences, 2019). 

Post traumatic stress is commonly expected with trauma, and is a typical response to something distressful. However, PTSD is a far more serious condition, changing the structure and functions of your brain. If you’re suffering from post-traumatic stress disorder, it is very important to understand how your brain may be affected and is responding to your trauma. The affected areas of your brain— the amygdala, prefrontal cortex, and hippocampus— all involve functions relating to memory, cohesive thinking and decision making, as well as the feelings and actions associated with fear. Understanding how these parts of your brain function can also aid in figuring out which therapies can help you work through PTSD.

References

American Psychiatric Association. (n.d.). What is PTSD? Home │ psychiatry.org. Retrieved March 7, 2021, from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

Bremner, J. D. (2006). Traumatic stress: Effects on the brain. Dialogues in Clinical Neuroscience, 8(4), 445-461. https://doi.org/10.31887/dcns.2006.8.4/jbremner

Uniformed Services University of the Health Sciences. (2019, May 7). How PTSD affects the brain. BrainLine. Retrieved March 7, 2021, from https://www.brainline.org/article/how-ptsd-affects-brain

Starting a new chapter in your life can be exciting and nerve-wracking all at the same time. Whether it’s preparing for college, entering the workforce, moving out of your parent’s house to live on your own, or moving to a completely different state or country, it is completely normal to feel multiple emotions all at once. Now, imagine traveling to a new country on your own where you don’t understand the native language and you’re separated from everything that is familiar to you.

Many immigrants migrate to America for various reasons. It can be due to their low socioeconomic environment, wanting to provide a better life for themselves or their family, educational purposes, or political conflicts. According to scholars Krista M. Perreira and India Ornelas, “Approximately 37 million immigrant adults and 3 million immigrant children (ages 0–17) live in the United States” (Perreira & Ornelas, 2013). 

Assistant professor at Michigan State University Farha Abbasi states, “In many respects, immigration is trauma. It is a complete loss of identity and familiarity, and immigrants are often left without the proper tools or resources to help them cope in a new environment. That transition in itself, even if it ends well, can leave deep scars” (Abbasi, 2020). Whatever stage of migrating to a new country, it has been reported that immigrants are at risk for experiencing traumatic events. According to the DSM-5, post traumatic stress disorder (PTSD) is defined as “the development of char­acteristic symptoms following exposure to one or more traumatic events” (American Psychiatric Association, 2013). 

Upon migrating to America, immigrants may have been faced with many obstacles. “Entry to the US without legal authorization can involve arduous journeys with exposure to extreme physical hardships as well as violence” (Perreira & Ornelas, 2014). This is especially prevalent in immigration detention centers and how ICE (Immigrations and Customs Enforcement) treats immigrants. 

The role that ICE plays in society involves preventing cross-border related crimes and enforcing legal immigration. While there may be good intentions to maintain law and order and preserve the safety of the citizens, this has negatively affected many families who come from immigrant backgrounds. Some families had their loved ones removed from their home by ICE without ever hearing from them again, not knowing where they are or if they’re even alive, which can be traumatizing. 

Children who come from immigrant families in particular can be emotionally traumatized by the separation of their parents, and depending on their age, they handle the disappearance of their parents differently. The psychological impact on separation affects younger children in a sense that they believe their parents simply “disappeared.” “The parents left behind struggled over whether and how to explain the disappearance, as well as how much hope to offer for a resolution” (Capps, 2007). 

Trauma affects people of different socioeconomic backgrounds, cultures, race and ethnicities differently. Seeking counseling as an immigrant can often be difficult, however. Thankfully, great strides are being made to accommodate immigrants’ mental well being with organizations such as Immigration Counseling Services (ICS).

References

Abbasi, F. (2020.). Immigration, Trauma, and the Power of Faith. Retrieved November 28, 2020, from https://careforyourmind.org/immigration-trauma-and-the-power-of-faith/

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.

Capps, R. (2007). Paying the price: The impact of immigration raids on America’s children. Washington, D.C.: National Council of La Raza.

Perreira, K., & Ornelas, I. (2013, December). Painful Passages: Traumatic Experiences and Post-Traumatic Stress among Immigrant Latino Adolescents and their Primary Caregivers. Retrieved November 28, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875301/

It would be an understatement to say that 2020 has been a rollercoaster of unpredictable events –– beloved celebrities passing away unexpectedly, riots and protests becoming increasingly violent, and the president’s questionable decisions impacting the United States. However, the most unpredictable of all that has affected people all over the world – mentally, physically, emotionally, and socioeconomically – is COVID-19. The pandemic has changed the way we live and function in which schooling and jobs were moved to virtual settings and potential milestones such as weddings, birthdays, and other gatherings, were missed.

Through scientific research and evidence, symptoms of the coronavirus have been confirmed to include the following: shortness of breath, fever or chills, fatigue, a painful chest, and congestion. Some individuals are asymptomatic, meaning they wouldn’t show symptoms even if they contracted the virus.  Furthermore, though some victims are fortunate enough to recover from the virus, the effects of COVID-19 are usually long term. In fact, the COVID-19 aftermath can potentially affect your mood, cause fatigue, and instigate organ damage to the heart, lungs, and brain, as well as blood clot issues.

 According to a study from the American Psychological Association, “Although large numbers of people throughout the world will show resilience to the profound loss, stress, and fear associated with COVID-19, the virus will likely exacerbate existing mental health disorders and contribute to the onset of new stress-related disorders for many” (Brown & Horesh, 2020).

The coronavirus has proven to be a traumatic experience for some individuals in different ways. It is possible to develop Post Traumatic Stress Disorder (PTSD) due to the experience of COVID-19. The DSM-5 defined Post Traumatic Stress Disorder (PTSD) as “the development of char­acteristic symptoms following exposure to one or more traumatic events” (American Psychiatric Association, 2013).

Psychiatric Times says that “The coronavirus has already led to diverse mental health problems, including anxiety, depression, PTSD, and other trauma and stress-related disorders” (Czapla & Tucker, 2020). Different groups have been traumatized by the events of the coronavirus. This includes people who have experienced COVID-19 and potential near death experiences, or individuals who had to witness a loved one go through COVID-19 due to the virus. Front line care responders such as healthcare workers and medical examiners may have been exposed to multiple patients suffering and dying from the coronavirus, which can be traumatizing as well. 

Furthermore, upon adding more stress to individuals, the coronavirus has also been emotionally traumatizing. Being socially isolated, experiencing economic hardship and unemployment, or working from home while caring for your children may all seem foreign and overwhelming. 

The comorbidity of having COVID-19 and PTSD at the same time isn’t common, but it does occur in patients. According to health officials, one of the ways to address COVID-19 if you have contracted the virus is to stay at home and recover, isolating yourself from family and friends so that you do not spread the virus to anyone else, avoid public areas at all costs, keep in touch with your doctor, and taking over the counter medicines such as acetaminophen to help you feel better.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher

CDC. What to Do If You Are Sick. (2020). Retrieved November 16, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html

Horesh, D., & Brown, A. D. (2020). Traumatic Stress in the Age of COVID-19: A Call to Close Critical Gaps and Adapt to New Realities. Retrieved from https://psycnet.apa.org/fulltext/2020-25108-001.html

Tucker, P., & Czapla, C. (2020). Post-COVID Stress Disorder: Another Emerging Consequence of the Global Pandemic. Retrieved November 16, 2020, from https://www.psychiatrictimes.com/view/post-covid-stress-disorder-emerging-consequence-global-pandemic

In his 1962 speech “Who Taught You to Hate Yourself,” Malcolm X said, “The most disrespected person in America is the black woman. The most unprotected person in America is the black woman. The most neglected person in America is the black woman.” Unfortunately, this statement still rings true decades later even after the Civil Rights Movement and the Black Panther Party, where efforts have been made to end the cycle of being treated as nothing more than subhuman. In response to Trayvon Martin’s death in 2013, three Black women formed a new generation of the Civil Rights Movement called the Black Lives Matter movement in response to police brutality, and seven years later, the social movement is expanding with more activists joining the fight. 

Recent current events have impacted people on a global scale enough to join the Black Lives Matter movement during a massive pandemic in an effort to advocate equality, eradicate systemic racism and police brutality against Black people, and finally end the ongoing cycle of oppression and systemic racism. Such events include the deaths of George Floyd, Breonna Taylor, Aura Rosser, and many other Black lives that were killed by the hands of police officers within the span of nine months this year. This kind of exposure can be strenuous and traumatic, whether it is on a first or second hand basis.

With television and newspapers becoming less common as first place news sources, social media has become a very powerful tool that serves as both a blessing and curse for this generation. Under huge platforms –– such as Facebook, Twitter, Instagram, YouTube, and many others –– there are countless videos of Black people being lynched by the hands of police for anybody to view. This kind of exposure alone can be traumatizing to anyone, which in turn can develop into something known as secondary trauma. 

Secondary trauma is defined as “the emotional duress that results when an individual hears about the firsthand trauma experiences of another” (Peterson, 2018). For every time a Black person encounters a video of another Black person being harassed or killed by a police officer, it can increase their paranoia about falling under the same fate of being lynched by law enforcement and becoming the next dead body that ends up “going viral.”

The fact that Breonna Taylor’s murderers still roam free with little to no consequence is not only a testament to how the system has little value for Black women. It is also one of the many examples of Black women being actively disrespected by the media, society, and in their own communities. These intersectional experiences can accumulate and Black women may begin to reflect on their own mortality and develop stress due to exposure to both direct and indirect traumatic experiences.

Northwestern University professor of psychiatry and licensed clinical psychologist Dr. Inger Burnett-Zeigler suggests that vicarious or secondary trauma can manifest into emotions such as anger and emotional fatigue. Zeigler went on to say, “That event of hearing that news and watching the circumstances unfold over the past several months can be experienced as traumatic to people in general, but particularly as Black women who might see themselves and relate to Breonna Taylor” (Holmes, 2020).

Furthermore, Black women’s intersectional experiences impact their mental wellness.  For centuries, they had to bear the burden of actively being silenced, dismissed, and negated; thrusted into cultural assimilation after being discouraged from wearing their natural hair; and labeled as nothing more than angry and irrational women for expressing themselves. This becomes intersectional experiences that are unique to Black women which can manifest into stress and trauma. According to a study conducted by several scholars, “African American women are at a greater risk for exposure to multiple traumatic events and are less likely to seek mental health services than White women” (Stevens-Watkins et al., 2014).  Black women do not seek mental health services for several reasons. Earlise C. Ward and other scholars used the Common Sense Model (CSM) to measure coping strategies, barriers to treatment seeking, and belief systems. One of the main factors that prevent Black women from seeking mental health counseling are “poor access to care, stigma, and lack of awareness of mental illness” (Ward et al. 2010). 

As demonstrated in the Black Lives Matter movement, Black women have also been known to be on the forefront of protecting and advocating Black men, but who is protecting Black women? How are we able to advocate for Black women’s mental health and understand their intersectionality? Attending protests and rallies and holding a banner that says Black Lives Matter simply isn’t enough. Actively listening to Black womens’ stories by attending rallies and joining organizations that pertain to activism and social issues can make people become more aware of various social issues.

Secondary trauma is just as impactful as direct trauma such as PTSD, ASD, and other stressor related disorders and should be taken as seriously as Black women’s struggles. Despite socioeconomic, cultural, and emotional barriers, there is an awareness growing for Black women’s mental health. There is more scholarly research being conducted to understand intersectionality, and establishments such as Therapy For Black Girls provide resources people can use. 

Even though great strides are being made to address systemic racism and Black mental health, we still have a lot to learn. Staying informed about current events is beneficial. However, there is coverage that can be deemed as harmful for somebody’s mental health. Some suggestions to cope with secondary trauma or exacerbating pre-existing secondary trauma is taking a break from social media or going for a jog, walk, or bike ride. If the weather isn’t looking too pleasant, you can seize the opportunity to meditate or catch up on reading. Recharging your mental wellness before delving back into these issues is acceptable, and you’ll be able to do more good with a balanced self.

Resources

Holmes, E. (2020, September 25). Breonna Taylor decision triggers trauma for Black community, other victims of police violence. Retrieved September 28, 2020, from https://abc7chicago.com/breonna-taylor-decision-police-shooting-violence/6546769/

Peterson, S. (2018, October 22). Secondary Traumatic Stress. Retrieved September 27, 2020, from https://www.nctsn.org/trauma-informed-care/secondary-traumatic-stress

Stevens-Watkins, D., Sharma, S., Knighton, J., Oser, C., & Leukefeld, C. (2014, July). Examining Cultural Correlates of Active Coping Among African American Female Trauma Survivors. Retrieved September 27, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149226/

Ward, E., Clark, L., & Heidrich, S. (2009, November). African American Women’s beliefs, coping behaviors, and barriers to seeking mental health services. Retrieved September 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854663/

X, M., & Haley, A. (1965). The Autobiography of Malcolm X. New York: Grove Press.