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Midshipmen Development Center

Trauma Symptoms and Effects

Psychological trauma is frequently explained as “a normal response to abnormal circumstances.” A better way to describe it might be as “a normal response to overwhelming circumstances that shock, flood, and confuse the brain and body,” as the causes and perpetuation of trauma occur too frequently for “abnormal” to seem like the correct descriptor. The important point is that the body’s way of responding to these circumstances is normal given the context from which they arouse. Trauma symptoms and effects are not “crazy;” they are either adaptations that assisted survival during the traumatic experience or direct effects of those adaptations. They become troubling as symptoms when the situation is such that they are no longer needed for survival or when they interfere with one’s ability to function or to find pleasure and peace in the present moment. For example, being hypervigilant (on high alert) is adaptive if you are in a high stress environment in which you lost control or feel out of control. It becomes a problem when it persists into and impedes your ability to rest or enjoy social gatherings. Difficulty remembering the exact details of a sexual assault is not evidence of someone lying but rather an effect of the hormonal surge of the HPA axis activation, which effectively floods the hippocampus, the area of the brain where new explicit memories are formed; like any other sensitive instrument, the hippocampus does not function as usual when flooded. With sleep and careful lines of inquiry, trauma victims can often remember more details over time. Reactivation of the HPA axis, however,  can happen when someone is simply reminded of the trauma through any of the senses. A smell, a sight, a sound can all reactivate the HPA axis, and when this happens, the hippocampus is flooded repeatedly. This often results in general difficulty concentrating, memory problems, and usually a temporary decline in grades for students.

The following table from the National Institutes of Health’s National Library of Medicine provides a more inclusive, though not exhaustive, example of the wide-range of reactions that may be experienced in the aftermath of trauma.

Immediate Emotional Reactions
Numbness and detachment
Anxiety or severe fear
Guilt (including survivor guilt)
Exhilaration as a result of surviving
Anger
Sadness
Helplessness
Feeling unreal; depersonalization (e.g., feeling as if you are watching yourself)
Disorientation
Feeling out of control
Denial
Constriction of feelings
Feeling overwhelmed
Delayed Emotional Reactions
Irritability and/or hostility
Depression
Mood swings, instability
Anxiety (e.g., phobia, generalized anxiety)
Fear of trauma recurrence
Grief reactions
Shame
Feelings of fragility and/or vulnerability
Emotional detachment from anything that requires emotional reactions (e.g., significant and/or family relationships, conversations about self, discussion of traumatic events or reactions to them)
Immediate Physical Reactions
Nausea and/or gastrointestinal distress
Sweating or shivering
Faintness
Muscle tremors or uncontrollable shaking
Elevated heartbeat, respiration, and blood pressure
Extreme fatigue or exhaustion
Greater startle responses
Depersonalization
Delayed Physical Reactions
Sleep disturbances, nightmares
Somatization (e.g., increased focus on and worry about body aches and pains)
Appetite and digestive changes
Lowered resistance to colds and infection
Persistent fatigue
Elevated cortisol levels
Hyperarousal
Long-term health effects including heart, liver, autoimmune, and chronic obstructive pulmonary disease
Immediate Cognitive Reactions
Difficulty concentrating
Rumination or racing thoughts (e.g., replaying the traumatic event over and over again)
Distortion of time and space (e.g., traumatic event may be perceived as if it was happening in slow motion, or a few seconds can be perceived as minutes)
Memory problems (e.g., not being able to recall important aspects of the trauma)
Strong identification with victims
Delayed Cognitive Reactions
Intrusive memories or flashbacks
Reactivation of previous traumatic events
Self-blame
Preoccupation with event
Difficulty making decisions
Magical thinking: belief that certain behaviors, including avoidant behavior, will protect against future trauma
Belief that feelings or memories are dangerous
Generalization of triggers (e.g., a person who experiences a home invasion during the daytime may avoid being alone during the day)
Suicidal thinking
Immediate Behavioral Reactions
Startled reaction
Restlessness
Sleep and appetite disturbances
Difficulty expressing oneself
Argumentative behavior
Increased use of alcohol, drugs, and tobacco
Withdrawal and apathy
Avoidant behaviors
Delayed Behavioral Reactions
Avoidance of event reminders
Social relationship disturbances
Decreased activity level
Engagement in high-risk behaviors
Increased use of alcohol and drugs
Withdrawal
Immediate Existential Reactions
Intense use of prayer
Restoration of faith in the goodness of others (e.g., receiving help from others)
Loss of self-efficacy
Despair about humanity, particularly if the event was intentional
Immediate disruption of life assumptions (e.g., fairness, safety, goodness, predictability of life)
Delayed Existential Reactions
Questioning (e.g., “Why me?”)
Increased cynicism, disillusionment
Increased self-confidence (e.g., “If I can survive this, I can survive anything”)
Loss of purpose
Renewed faith
Hopelessness
Reestablishing priorities
Redefining meaning and importance of life
Reworking life’s assumptions to accommodate the trauma (e.g., taking a self-defense class to reestablish a sense of safety)

Copyright: NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

From https://www.ncbi.nlm.nih.gov/books/NBK207191/table/part1_ch3.t1/?report=objectonly

If you are experiencing symptoms from the above list, please know that you are not alone, you are not losing your mind, and you are worthy of receiving help and feeling better. Information about healing after trauma is available in the Healing from Trauma page.

Counseling resources at USNA include MDC, Behavioral Health Clinic at NHCA, and Fleet and Family Services.

If you have experienced sexual violence (rape, assault, unwanted touching, sexual exploitation, etc.) SAPR Victim Advocates can provide non-counseling support, resources, transportation to medical care, and information about reporting options:

 

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