Trauma and PTSD: An Overlooked Epidemic

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Trauma and Posttraumatic Stress Disorder (PTSD) can occur at any age in a multitude of ways and severely impact the mental well-being of a person daily. Trauma can stem from a traumatic injury, or from an emotionally traumatic experience, commonly described as emotional and psychological trauma.

When compared to any other cause of death including COVID-19 and all other contagious diseases combined, physical trauma contributes to more global deaths annually¹. Additionally, traumatic injuries are the number one cause of death in both children and adults regardless of economic status and race. In the U.S., traumatic incidents account for 200,000 deaths annually, while traumatic injuries account for 40% of all emergency room visits². Survivors are typically left with physical and mental disabilities that are often life-long², and those are just the statistics for physical trauma.

Yet, trauma in all its forms “receives less than 1% of global healthcare funding¹,” making this particular gap in healthcare a human rights issue and an overlooked epidemic that widens every day. This issue was even coined as an unrecognized epidemic as early as 1966 in a report by the U.S. National Academy of Science².

Trauma VS. PTSD: What’s The Difference?

To understand trauma and PTSD as an overlooked epidemic, let’s discuss what trauma and PTSD are and how these terms differ from one another.

Trauma

Emotional and psychological trauma are symptoms that arise from a stressful or terrifying experience that cause debilitating effects on an individual’s ability to perform daily functions³. Psychological trauma can hinder an individual’s sense of self and shatter their sense of security⁴. Though, psychological trauma can also occur from witnessing a traumatic event you weren’t directly affected by, not just one that you experienced.

Events that may cause psychological trauma include emotional or verbal abuse, physical assault, natural disasters, terrorist attacks, traumatic injuries, and medical conditions that endanger an individual³. Additionally, the most common traumatic injury includes those obtained using transportation such as car and motorcycle accidents¹.

A traumatic experience will typically involve a threat to an individual’s safety or life, but developing symptoms of trauma doesn’t always include physical harm. Situations that result in feelings of isolation, intense anxiety, and fear, or feeling overwhelmed can also cause psychological trauma and can either be a one-time incident or a string of ongoing events that are deeply stressful. Ongoing events that may cause psychological trauma include bullying, childhood neglect, domestic violence, dangerous living situations, and battling a life-threatening illness⁴.

Though, it is important to remember that a specific experience isn’t what determines what will be a traumatic experience; it is the subjective emotional response to an event that determines the outcome of one⁴. One event may be an extremely traumatic experience for one person but may feel easier to overcome for another.

Common Causes of Trauma

Some commonly overlooked causes of psychological trauma include the sudden death of a loved one, experiences that feel deeply humiliating, the ending of a significant relationship such as a marriage or close family connection, enduring a pandemic, and surgery⁴. Being a witness to a traumatic event can also be a commonly overlooked cause of trauma and may stem from watching a loved one become injured, battling a life-threatening medical condition like cancer, or even witnessing a stranger undergo a fatal event.

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PTSD

Meanwhile, PTSD is a specific disorder that can occur when symptoms of trauma are left untreated. This mental health condition may trigger symptoms such as anxiety, depression, nightmares, insomnia, flashbacks, and uncontrollable thoughts of the traumatic situation that was endured⁵. Symptoms of PTSD may begin anywhere between one month after a traumatic event to years after, can cause significant problems with your personal and work relationships, and interfere with your ability to participate in your daily routine and activities⁵.

Symptoms of Trauma and PTSD

Symptoms of PTSD and trauma most commonly include four different categories, ranging from avoidance, intrusive memories, negative thought patterns, and physical and emotional changes in reactions and behaviors⁵. Every individual’s experience and symptoms with trauma and PTSD will vary, with some symptoms occurring congruently with others or some not appearing at all.

Symptoms of avoidance may look like avoiding “thinking or talking about the traumatic event⁵,” or avoiding activities, people, or places that bring back unwanted memories of the traumatic event. Whereas, symptoms of intrusive memories may comprise nightmares, recurring memories that are distressing and unwanted surrounding the traumatic event, and flashbacks to the traumatic experience as if the event was being relived⁵.

Additionally, symptoms of negative thought patterns may encompass negative thoughts about yourself, other people, or the world; feelings of hopelessness; difficulty recalling memories, especially aspects of the traumatic event; feeling detached from loved ones and having difficulty maintaining those close relationships; a lack of interest in activities and participating in society; and difficulty experiencing positive emotions or conversely, feeling numb to all emotions⁵.

Lastly, symptoms of physical and emotional changes in reactions and behaviors could appear as guilt or shame that feels overwhelming; irritability and aggressive behavior; difficulty sleeping or maintaining focus; remaining in a constant state of survival mode; becoming easily startled over normal behaviors or daily occurrences; and behavior that is self-destructive such as binge-drinking, driving beyond a safe speed limit or putting oneself in unsafe positions altogether⁵.

PTSD and Trauma as epidemics

Now that we’ve established a background basis for trauma and PTSD, we can explore how this healthcare issue translates as an unrecognized epidemic. PTSD affects about 1 in 6 adults in the U.S., about 6% of the population⁶, or nearly 13 million people in any given year⁷. Additionally, women and minority groups are at a greater risk for PTSD as they are more vulnerable to adverse events. About 8% of women in the U.S. will develop PTSD, whereas only 4% of men in the U.S. will develop PTSD⁶.

In a study published by Women’s Midlife Health, researchers found that 70% of their women participants self-reported as having experienced a struggle with their mental health. The study also cited national U.S. surveys, which revealed half of the adult women on the surveys “reported exposure to a traumatic event at some point in their life⁸.” The same study also cited “61% of Black and 51% of Hispanic children having at least one Adverse Childhood Experience⁸.” All but three participants in the study reported experiencing a traumatic event in their life⁸.

The COVID-19 pandemic has also brought on a multitude of traumatic events for billions of people globally and presented an abundance of another form of trauma coined as moral injury. The Scientific American Journal defines moral injury as “a specific kind of trauma [that] results when a person’s core principles are violated during wartime or a pandemic⁹.” When presented with options that go against your morals or values with no other choice, this can cause extreme duress for individuals. Although this type of trauma is more commonly seen in military veterans who experienced war events, many people faced moral dilemmas during the pandemic in addition to an uptick in struggles with mental health.

Despite trauma’s prevalence in the U.S. and globally, most research into PTSD and trauma as an epidemic has not advanced since the U.S. National Academy of Science deemed this healthcare issue as one over 50 years ago² and funding toward the issue remains slim, even with the recent mental health problems that accompanied the pandemic. Awareness of mental health conditions and access to resources may have expanded significantly over the years, but much more research and funding are still needed, especially for symptoms of trauma and PTSD.

Ketamine for Trauma and PTSD Treatments

Common treatments for symptoms of trauma and PTSD include cognitive behavioral therapy, eye movement desensitization and reprocessing, hypnotherapy, and antidepressants. However, treating psychological trauma requires cognitive behavioral therapy as a baseline approach for treatment. These treatments may work for some, while others struggle with symptoms of psychological trauma for the rest of their lives despite treatment.

If your treatment plan for PTSD and trauma doesn’t seem to improve your symptoms, ketamine infusions may help. Previously used as a field anesthetic, ketamine is used to treat a wide variety of mental health symptoms including trauma and PTSD. Ketamine allows patients to enter a dissociative, relaxing state and can relieve feelings of anxiety, depression, and PTSD. Ketamine treatments can also be paired with cognitive behavioral therapy sessions, which allows some patients to discuss difficult topics more freely without the intensity of their emotions.

Avesta Ketamine and Wellness

At Avesta Ketamine and Wellness, we value your mental health and are committed to improving your well-being. If you are interested in learning more about ketamine as a part of your treatment plan for trauma and PTSD, please schedule a consultation.

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Resources:

¹ Rossiter, N. D. (2021, September 14). “Trauma-the forgotten pandemic?”. SpringerLink. https://link.springer.com/article/10.1007/s00264-021-05213-z

² Trauma: A Neglected Global Epidemic. Stepping Strong Center for Trauma Intervention. (n.d.). https://steppingstrong.bwh.harvard.edu/trauma-a-neglected-global-epidemic/

³ Trauma Signs & Symptoms. Discovery Mood & Anxiety Program. (2020). https://discoverymood.com/conditions/trauma/#:~:text=Emotional%20and%20psychological%20trauma%20results,terror%2C%20or%20a%20natural%20disaster.

⁴ Robinson, L., Smith, M., & Segal, J. (2023, February 27). Emotional and Psychological Trauma. HelpGuide.org. https://www.helpguide.org/articles/ptsd-trauma/coping-with-emotional-and-psychological-trauma.htm

⁵ Mayo Foundation for Medical Education and Research. (2022, December 13). Post-traumatic stress disorder (PTSD). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

⁶ U.S. Department of Veterans Affairs. (n.d.). How Common is PTSD in Adults?. U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/understand/common/common_adults.asp#:~:text=Most%20people%20who%20go%20through,some%20point%20in%20their%20lives.

⁷ Important facts and statistics about PTSD (post-traumatic stress disorder). The Recovery Village Drug and Alcohol Rehab. (n.d.). https://www.therecoveryvillage.com/mental-health/ptsd/ptsd-statistics/

⁸ Liberatore-Maguire, E., Devlin, A., Fisher, S., Ramsey, F., Grunwald, H., Brownstein, K., & Morrison, M. (2022, October 27). The unseen epidemic: Trauma and loneliness in urban midlife women – women’s midlife health. BioMed Central. https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-022-00080-z

⁹ Svoboda, E. (2022, September 19). Moral Injury Is an Invisible Epidemic That Affects Millions. Scientific American. https://www.scientificamerican.com/article/moral-injury-is-an-invisible-epidemic-that-affects-millions/#

Photo by Alex Green: https://www.pexels.com/photo/stressed-black-man-with-dreadlocks-in-psychological-office-5699455/

Author Dr. Ladan Eshkevari, PhD, CRNA, FAAN Dr. Eshkevari is the lead clinician at Avesta, and is a long time researcher and educator in physiology, biophysics, and anesthesiology. She is passionate about assisting patients with retractable, difficult to treat mood disorders, and relies on the latest research to bring evidence to Avesta’s practice to better understand and serve patients.

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