Treatment

 

Children and adolescents who have been traumatized can develop an intense fear regarding any reminders of the traumatic event. This fear may encourage the child to avoid any traumatic reminders and may not want to talk about what occurred. The child may become more isolated, not express his or her feelings or thoughts, and feel emotional numbing and tension.

 

Exhibiting one or several of these symptoms or behaviors places the child at risk of having problems at school, of isolating themselves from others, of having conflicts or lack of communication with parents and peers. These symptoms or behaviors, if left untreated, may impede the child’s normal course of development.

 

This stressful state can cause the child to develop symptoms such as:

 

A large and growing body of research indicates that toxic stress during childhood can harm the most basic levels of the nervous, endocrine, and immune systems. Changes to the brain from toxic stress can affect such things as attention, impulsive behavior, decision-making, learning, emotion, and response to stress. Children growing up under these conditions often struggle to learn and complete schooling. They are at increased risk of becoming involved in crime and violence, using alcohol or drugs, and engaging in early sexual activity, unprotected sex and suicide attempts. They are susceptible to disease, illness, and mental health challenges over their lifetime. Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, family, jobs, and depression throughout life—the effects of which can be passed on to their own children.

 

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an effective evidenced-based treatment for trauma. TF-CBT can help parents recognize and respond appropriately to their child’s trauma responses, while setting appropriate behavioral limits and rebuild trust and safety.

Life is full of stressful changes. Some stressful experiences can be good, such as the birth of a child, some bad, such as financial difficulties. In our everyday language we use the word trauma for many types of stressful experiences. However, traumatic experiences are unique because they specifically threaten us with serious physical injury or death. Common examples include car accidents, rape, assaults, war, fires or natural disasters. Often, traumas caused by people (e.g., violent crime) have additional psychological challenges as compared to natural disasters (e.g., floods or earthquakes). Individuals who witness such dangerous situations or their immediate aftermath may also experience traumatic reactions.

 

Trauma reactions commonly last for several weeks or months before people start to feel normal again. The majority of individuals report that they feel better within the first three months. On-going exposure to a threatening experience may produce more prolonged stress because of the continual reminders that the threat of danger is not over.

 

Life-threatening situations will produce a variety of intense and unusual stress reactions in our emotions, thoughts and actions. The most common symptoms of trauma fall into three broad areas: re-experiencing, avoidance and hyperarousal. Other emotions such as guilt, anger, and depression can also commonly occur following a trauma.

 

Re-experiencing: repetitive, vivid, and intrusive thoughts, images, memories, and sensations about the trauma and its consequences are hallmark symptoms and can create tremendous anxiety. Traumatic images or thoughts may intrude during the day as “flashbacks” or during sleep as nightmares. Other typical thoughts may include: believing you are in danger; believing that you should foresee and control these dangers; believing that you should have somehow been able to do more to stop the event from happening, and that your personality and future are permanently damaged.

 

Hyperarousal: difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, being hypervigilant, a general inability to unwind and becoming easily startled are common physical symptoms of anxiety that may occur following a trauma. Panic attacks, racing heart and appetite disturbances are also common.

 

Avoidance: not wanting to be around reminders of the trauma. This may include avoiding some of the people, places and things that remind you of the event or were present at the time, but it can also include avoiding certain conversations, thoughts and feelings. Emotional numbing and a diminished ability to experience pleasure are typical. Some people may forget important aspects of the trauma, report being unable to have loving feelings toward others and may have less interest in carrying on with their daily lives. People may withdraw socially, begin to feel alienated and mistrustful of others and report an increase in conflicts with others. Avoidance can also take the form of strange, almost dream-like, experiences called depersonalization and derealization. You might feel unreal or disconnected from your surroundings, nearby people or your own body. Alcohol and/or other substances are another method often used to avoid traumatic feelings and memories through “self-medicating.”

 

When symptoms are severe enough during the first month to impair social or occupational functioning, Acute Stress Disorder (ASD) may be diagnosed. If these more immediate and disruptive patterns last beyond one month, the syndrome is called Post-Traumatic Stress Disorder (PTSD). Approximately half of those who have post-traumatic symptoms will recover within 3 months. The likelihood that you will continue to experience these symptoms beyond three months depends upon a variety of factors. For example, direct exposure to the traumatic event, the seriousness of the threat to life, amount of times trauma was experienced, a history of past trauma, psychological difficulties prior to trauma are all factors that may increase the likelihood that your symptoms will not go away on their own with time.

 

Cognitive Behavioral Therapy and Dialectical Behavior Therapy are evidenced-based treatments for trauma. These treatments generally aim to help people see themselves and their worlds more adaptively by modifying the distorted or unhelpful ways of thinking that have been linked to problems in emotion. The therapist helps the client view the trauma and their reactions to it in ways that are more helpful and balanced. Therapy also helps to create new relaxation behaviors and encourage a sense of empowerment, self-worth, and strength.

 

Anxiety disorders most often start when people are teenagers. Anyone can get one, but they are more common among women and girls. They are also more common in people who were neglected/abused as children, or who are neglected/abused as adults.

 

Anxiety disorders can range anywhere from mild to severe and this is why it can sometimes be hard for some individuals to determine whether or not they may have an anxiety disorder themselves, especially if they have been living with feelings of anxiety for a long time.

Generalized Anxiety Disorder

 

Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.

 

Obsessive-Compulsive Disorder (OCD)

 

Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called “rituals,” however, provides only temporary relief, and not performing them markedly increases anxiety.

 

Panic Disorder

 

Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.

 

Post-Traumatic Stress Disorder (PTSD)

 

Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

 

Social Phobia (or Social Anxiety Disorder)

 

Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation – such as a fear of speaking in formal or informal situations, or eating or drinking in front of others – or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

Researchers are finding that both genetic and environmental factors contribute to the risk of developing an anxiety disorder. Although the risk factors for each type of anxiety disorder can vary, some general risk factors for all types of anxiety disorders include:

 

• Temperamental traits of shyness or behavioral inhibition in childhood
• Exposure to stressful and negative life or environmental events in early childhood or adulthood
• A history of anxiety or other mental illnesses in biological relatives
• Some physical health conditions, such as thyroid problems or heart arrhythmias, or caffeine or other substances/medications, can produce or aggravate anxiety symptoms.

 

Stress Vs Anxiety

 

It can be hard to distinguish between chronic stress and anxiety as they have similar symptoms and wear us down mentally and physically. If you are lacking the nervousness or fear that often comes from anxiety, you are most likely dealing with chronic stress and will need to receive treatment and help for that. If left unchecked, chronic stress can lead to disease, anxiety and other mental health problems.

 

Depression can present different symptoms, depending on the person. But for most people, depression is feeling sad and not being able to snap out of it and having it last for weeks. People also often report feeling unmotivated, fatigued, irritable and having a lack of interest in things that they used to find enjoyable. Many people experiencing depression report changes in sleep patterns and eating behaviors. For some people, it can include having negative intrusive thoughts about self-worth and even thoughts of suicide.

Depression is among the most treatable of mental disorders. Between 80 percent and 90 percent of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.

 

It is usually advisable to get a general check-up by your medical doctor to rule out any health issues, like thyroid problems, that may be contributing to a depressive episode. For some people, medication may be prescribed by their physician or by a psychiatrist. The most frequently recommended form of treatment is medication, talk therapy, or a combination of the two. Increasingly, research suggests these treatments may normalize brain changes associated with depression.

 

Psychotherapy or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, psychotherapy is often used in along with antidepressant medications. Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) have been found to be effective in treating depression. CBT is a form of therapy focused on the present and problem solving. CBT helps a person to recognize distorted thinking and then change behaviors and thinking. DBT has components of mindfulness and validation of a person’s strengths during treatment. Skills are learned during sessions and rehearsed during the week to strengthen the new behaviors.

 

When treating teens and children forms of integrated CBT and DBT Play Therapy can be most effective. Through non-verbal expression, many of the areas of therapy can be addressed in a way that is more developmentally appropriate and effective for younger people. The use of play and art is often a means to communicate feelings and issues. The parent is still considered the support person for the child and is also engaged in the therapy process, to assist in supporting and reinforcing the objectives of therapy at home.
Depending on the severity of the depression, treatment can take a few weeks or much longer. In many cases, significant improvement can be made in 10 to 20 sessions.

 

There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feelings and improve mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol can also help reduce symptoms of depression. Engaging in a positive self-care routine is very important and can include engaging in sports, hobbies, art, being out in nature and having a pet.

 

Depression is a real illness and help is available. With proper diagnosis and treatment, the majority of people with depression will overcome it. If you are experiencing symptoms of depression it may be time to seek professional care.

 

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

 

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

 

Also consider these options if you’re having suicidal thoughts:

• Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
• Call your doctor or mental health professional.
• Reach out to a close friend or loved one.
• Contact a minister, spiritual leader or someone else in your faith community.