Symptoms of Trauma

Symptoms of trauma

How does trauma develop?

In the days and weeks after a traumatic event, most people experience trauma and stress reactions. These reactions are the result of normal and adaptive survival mechanisms. They can contain elements of post-traumatic stress, depression, anxiety, anger, and grief.

Trauma reactions often appear quickly – in the hours, days, and weeks after the event. However, delayed trauma reactions also can occur anywhere from several weeks or months to years later. Delayed trauma reactions are sometimes sparked by something that reminds the individual of the original traumatic event.

Trauma reactions tend to change in intensity and character over time and usually subside gradually during the first weeks and months after a traumatic event. Most people who have experienced a traumatic event will return to a healthy state of functioning eventually but may have a lasting vulnerability. For example, if you experience a bank robbery, you are likely to think of that event when you enter a bank, and you may experience some temporary anxiety when something reminds you of that event.

Approximately 25% of people who experience a traumatic event go on to experience lasting trauma-related difficulties. These long-term reactions can include elements of PTSD, depression, anxiety, and/or substance abuse. If this has happened to you, it doesn’t mean that you are weak. It may mean that the traumatic event was so powerful that it pushed you far past your normal coping strategies. It also means that you might benefit from working with a counselor or mental health professional who understands trauma.

Common symptoms of trauma

Individuals exposed to a traumatic event can experience a wide variety of trauma reactions after the event. However, some trauma reactions are more common than others. Given the likelihood that humanitarian workers will experience some degree of trauma as a result of their work, it is important for you to be familiar with.

The signs that you (or someone else) are experiencing an unusually intense trauma reaction and should seek support from a mental health professional.
The following table outlines some common symptoms of trauma. Many more general symptoms of stress can also be present after a traumatic event.


Intrusive symptoms

Persistently re-experiencing the event in thoughts, images, recollections, daydreams, and/or nightmares

Feeling upset, distressed and/or anxious in the presence of reminders of the event

Avoidance symptoms

Avoiding places, thoughts, conversations and/or people associated with the event
Problems recalling some aspects of the event

Losing interest in formerly enjoyable and important activities of life
Feeling “removed” from other people
Feeling numb

Arousal symptoms

Being on the alert for danger

Being jumpy and easily startled

Experiencing sleep disturbances (such as not being able to get to sleep, waking up often, or having vivid dreams or nightmares)

Difficulty concentrating

Irritability or angry outbursts

(Adapted from the Diagnostic and Statistical Manual for Mental Disorders IV-TR, 2000)

Experiencing some of these symptoms in the first days and weeks after a traumatic event is quite common, and their intensity will probably subside gradually. However, if the symptoms are severe enough to cause you significant distress, interfere with your daily routine and functioning, or last for more than a month, you may be suffering from post-traumatic stress disorder (PTSD). If you are worried about trauma reactions you have been experiencing please see links on the side of this page or contact me.

Spiritual symptoms of trauma

In addition to the symptoms listed above, there are some common spiritual symptoms of trauma. Spirituality is a core component of human nature. It shapes and informs our sense of meaning, purpose, hope, and faith. It is a foundation, guide, and motivation for morality, personal growth, and service to others. Whether due to an explicit belief in a deity, a more diffuse sense of transcendence or connectedness with nature or a life force, or a faith in human nature and solidarity, most people believe that to be fully human involves more than simply the physical dimensions of existence.

Traumatic events are usually sudden, unexpected, and very frightening. They can cause us to feel unsafe, out of control, isolated, “damaged”, or “dirty”, and/or to lose trust in other people. It’s not surprising that traumatic events may also cause us to question the fundamental beliefs and assumptions that are connected to our deepest sense of meaning and purpose in life – to our spirituality.

Common spiritual symptoms of trauma include:

Altered worldview. Your view of God, who you are in relationship to God, and how the world works, can change after exposure to a traumatic event. For example, trauma may cause you to question assumptions about the world – such as “bad things don’t happen to good people” – that you weren’t even fully aware that you held.

Troubling existential questions. Traumatic events can cause you to struggle with questions and issues related to suffering, evil, forgiveness, fairness, hope, justice, purpose, and divine order.

A loss of a sense of meaning and coherence in life. Traumatic events often raise personal questions related to what life is all about and what’s really important to you. It’s not uncommon to doubt your deepest beliefs, feel empty, and/or feel that life has lost its meaning and coherence.

A sense of discouragement and loss of hope. This can express itself through feelings of depression, painful questioning, and/or cynicism.

Alienation and a loss of a sense of connection. You can feel isolated, or have a sense of being cut off from the connection you feel to the source of your deepest sense of meaning and purpose (whether that be God, nature, a life-force, or other people).

Symptoms of intense trauma reactions

Sometimes individuals experience more severe trauma reactions. When this occurs, they should be monitored and supported by a mental health professional. Symptoms and reactions of a severe trauma reaction include:
Severe dissociation: Feelings of enduring disconnection from your body or surroundings, derealization (feeling as if you or the world is not “real”), and depersonalization (feeling as if you are losing your identity or adopting a new identity). Dissociation may also involve “losing time” or experiencing amnesia regarding significant periods of or the entire traumatic event.

Repeated intrusive “re-experiencing” of the event: Re-experiencing occurs when some facet of the trauma (perhaps a sight, smell, or noise) triggers significant emotional distress and feelings of terror and vulnerability. In its most vivid form, re-experiencing can include flashbacks (feeling as if you are experiencing the event all over again), recurrent and terrifying nightmares, and repetitive and automatic re-enactments related to the event (such as acting out parts of the event over and over again).

Extreme withdrawal: Extreme withdrawal from normal and supportive social networks, drastic relationship changes, and/or compulsive avoidance of other people.

Extreme hyperarousal: Experiencing panic attacks (e.g., times when you hyperventilate, your heart beats very fast, and you think you are going crazy or dying), feeling unable to concentrate on anything, and/or difficulty controlling violent impulses.

Debilitating anxiety: Severe phobias or obsessions, and paralyzing anxiety attacks.

Severe depression: Feeling a constant lack of happiness and pleasure in life, and/or constant feelings of worthlessness and self-blame.

Problematic substance abuse: Prolonged and excessive use of alcohol or drugs to numb distress and aid coping.

Impaired self-care: Diminished capacity for self-care behaviors related to nourishment, hygiene, and rest.

If you, or someone you know, is experiencing severe trauma reactions, click on the links on the left to learn how to find professional help and support.

For personal reflection…

Reading through the possible trauma reactions in this section of the module may have stirred up some uncomfortable memories and feelings in you. Take a moment to “check in” with how you are feeling and decide whether you need to take a break from this study and do something else for a while. If that’s the case, think about what you feel like doing – something fun, distracting, creative, productive.

Taking care of yourself after traumatic events, and try some of the suggestions listed there.


Relaxation techniques for stress relief

Many relaxation techniques can help you achieve the relaxation response. Those whose stress-busting benefits have been widely studied include deep breathing, progressive muscle relaxation, meditation, visualization, yoga, and tai chi.

Learning the basics of these relaxation techniques isn’t difficult. But it takes practice to truly harness their stress-relieving power: daily practice, in fact. Most stress experts recommend setting aside at least 10 to 20 minutes a day for your relaxation practice. If you’d like to get even more stress relief, aim for 30 minutes to an hour.

Keep in mind that there is no single relaxation technique that is best. Many techniques are effective, but only when practiced regularly: so choose a relaxation technique or combination of techniques that resonates with you and fits your lifestyle.

Starting a daily stress relief practice

The best way to start and maintain a daily stress relief practice is by incorporating it into your daily routine. Schedule a set time either once or twice a day for your relaxation practice. You may find that it’s easier to stick with your practice if you do it first thing in the morning, before other tasks and responsibilities get in the way.

All you need to start a relaxation practice are:

A quiet environment –
Choose a secluded place in your home, office, garden, place of worship, or in the great outdoors where you can relax without distractions or interruptions.
A comfortable position –
Get comfortable, but avoid lying down as this may lead to you falling asleep. Sit up with your spine straight, either in a chair or on the floor. You can also try a cross-legged or lotus position.
A point of focus –
Pick a meaningful word or phrase and repeat it throughout your session. You may also to focus on an object in your surroundings to enhance your concentration, or alternately, you can close your eyes.
A passive attitude –
Don’t worry about distracting thoughts that go through your mind or about how well you’re doing. If thoughts intrude during your relaxation session, don’t fight them. Instead, gently turn your attention back to your point of focus.

You can either stick to this straightforward relaxation exercise, or branch out into other relaxation techniques. Keep in mind that traditional relaxation techniques aren’t the only effective stress reducers. Spending time in nature, talking to a friend, listening to music, curling up with a good book, writing in a journal—anything that you find calming can relieve stress.

Deep breathing for stress relief
If you’d like to explore relaxation techniques, deep breathing is a good place to start, since it is used in many relaxation practices including yoga, meditation, and visualization. Deep breathing involves not only the lungs but also the abdomen, or diaphragm.

Most of us don’t breathe from the diaphragm. Instead, we take shallow breaths from our upper chests. When we’re stressed, our breath becomes even shallower. The problem is that shallow breathing limits the amount of oxygen we take in—which makes us feel even more tense, short of breath, and anxious. Deep breathing, on the other hand, encourages full oxygen exchange throughout the chest and lungs.

Chest Breathing vs. Abdominal Breathing

When you breathe from your chest, you inhale about a teacup of oxygen. Instead, you should breathe from your abdomen. When you breathe from your abdomen, you inhale about a quart of oxygen. The more oxygen you inhale, the better.

How you breathe also affects your nervous system. Chest breathing makes your brain create shorter, more restless brain waves. Abdominal breathing makes your brain create longer, slower brain waves. These longer and slower brain waves are similar to the ones your brain makes when you are relaxed and calm. So, breathing from the abdomen helps you relax quickly.

With its focus on full, cleansing breaths powered by the diaphragm, deep breathing can help you get your stress levels in check. The next time you feel uptight, try taking a minute to slow down and breathe deeply:

Sit comfortably with your back straight. Put one hand on your chest and the other on your stomach. Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little. Exhale through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little. Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count slowly as you exhale. If you have a hard time breathing from your abdomen sitting up, lie on the floor, put a small book on your stomach, and try to breathe so that the book rises as you inhale and falls as you exhale. Breathing techniques can be practiced almost anywhere and can be combined with other relaxation exercises, such as aromatherapy and music. All you really need is a few minutes and a place to stretch out.

Anxiety Overview


As with all articles on this site this article is a brief overview of Anxiety, Medication, and Interventions. It is meant as an insightful article giving further understanding and awareness of issues that might be affecting you. At all times medical advice and intervention should be sought if you are in need or just want to talk, medical interventions are always changing and the information in this article may need updating.

Anxiety Overview

Anxiety is a feeling of apprehension, fear, or worry. Some fears and worries are justified, such as worry about a loved one. Anxiety may occur without a cause, or it may occur based on a real situation, but may be out of proportion to what would normally be expected. Severe anxiety can have a serious impact on daily life.

Anxiety can be accompanied by a variety of physical symptoms. Most commonly, these symptoms are related to the heart, lungs, and nervous system. You may feel as if you are having a heart attack.

Anxiety Causes

Anxiety may be caused by a mental condition, a physical condition, the effects of drugs, or from a combination of these. The doctor’s initial task is to see if your anxiety is caused by a medical condition.

Common causes of anxiety include these mental conditions:

Panic disorder: In addition to anxiety, common symptoms of panic disorders are palpitations (feeling your heart beat), dizziness, and shortness of breath. These same symptoms also can be caused by coffee (caffeine), amphetamines ("speed" is the street slang for amphetamines when they are not prescribed by a doctor), an overactive thyroid, abnormal heart rhythms, and other heart abnormalities (such as mitral valve prolapse).

Generalized anxiety disorder
Phobic disorders
Stress disorders
These common external factors can cause anxiety:
Stress at work
Stress from school
Stress in a personal relationship such as marriage
Financial stress
Stress from an emotional trauma such as the death of a loved one
Stress from a serious medical illness
Side effect of medication
Use of an illicit drug, such as cocaine
Symptom of a medical illness

Lack of oxygen - In circumstances as diverse as high altitude sickness, emphysema, or pulmonary embolism (a blood clot with the vessels of the lung)
The doctor has the often-difficult task of determining which symptoms come from which causes. For example, in a study of people with chest pain that could be heart disease but turned out not to be heart related, 43% were found to have a panic disorder—a common form of anxiety.

Anxiety Symptoms

Panic disorders - Separate and intense periods of fear or feelings of doom developing over a very short time frame—10 minutes—and associated with at least 4 of the following:

Shortness of breath
Sense of choking
Chest pain
A feeling of being detached from the world (derealization)
Fear of dying
Numbness or tingling
Chills or hot flushes

Generalized anxiety disorder - Excessive and unrealistic worry over a period of at least 6 months associated with 3 of the following:

Easy fatigue
Difficulty concentrating
Muscle tension
Sleep disturbances

Phobic disorders - Intense, persistent, and recurrent fear of certain objects (such as snakes, spiders, blood) or situations (such as heights, speaking in front of a group, public places). These exposures may trigger a panic attack.
Stress disorders - Anxiety (also known as post-traumatic stress disorder) caused by the exposure to either death or near-death circumstances such as fires, floods, earthquakes, shootings, automobile accidents, or wars, for example. The traumatic event is re-experienced in thoughts and dreams. Common behaviors include the following:

Avoiding activities, places, or people associated with the triggering event
Difficulty concentrating
Difficulty sleeping
Being hypervigilant (you closely watch your surroundings)
Feeling a general sense of doom and gloom with diminished emotions such as loving feelings or aspirations for the future

Symptoms such as chest pain, shortness of breath, palpitations, dizziness, fainting, and weakness generally should not be attributed to anxiety and require evaluation by a doctor.

When to Seek Medical Care

Call your doctor when the signs and symptoms of anxiety are not easily, quickly, and clearly diagnosed and treated.

If the symptoms are so severe that you believe medication may be needed
If the symptoms are interfering with your personal, social, or professional life
If you have chest pain, shortness of breath, headaches, palpitations, dizziness, fainting spells, or unexplained weakness
If you are depressed and feel suicidal

When the signs and symptoms suggest that anxiety may have been present for a prolonged period (more than a few days) and appear to be stable (not getting worse rapidly), you may be able to make an appointment with your doctor for evaluation. But when the signs and symptoms are severe and come on suddenly, they may represent a serious medical illness that needs immediate evaluation and treatment in a hospital’s emergency department.

Exams and Tests

The doctor will take a careful history, perform a physical examination, and order laboratory tests as needed.

If you have another medical condition that you know about, there may be an overlap of signs and symptoms between what is old and what is new.
Just determining that anxiety is psychological does not immediately identify the ultimate cause. Often, determining the cause requires the involvement of a psychiatrist, clinical psychologist, or other mental health professional.

Anxiety Treatment

Self-Care at Home

In certain cases, you may treat anxiety at home without the involvement of a doctor. These are limited to anxiety attacks of short duration in which you know the cause, the anxiety is short, it goes away by itself, and the cause can be eliminated. For example, you may be anxious over an upcoming public performance, a final exam, or a pending job interview. In such circumstances, stress may be relieved by such actions as these:

Talking with a supportive person
Watching TV
Taking a long warm bath
Resting in a dark room
Deep breathing exercises

Medical Treatment

Treatment depends on the cause.
When the cause of anxiety is a physical ailment, treatment is directed toward eliminating that ailment. For example, if your thyroid gland were overactive and causing anxiety, the treatment might involve surgery and various thyroid-regulating medications.

When the cause is psychological, the underlying cause needs to be discovered, and, if possible, eliminated or controlled. For example, if the cause is difficulty in a marriage, the doctor may suggest marital counseling.

Sometimes, the cause cannot be identified. In such cases, the only treatment option is control of symptoms.

In the past, anxiety was treated with drugs in a class known as benzodiazepines. These include familiar names:
Diazepam (Valium)
Alprazolam (Xanax)
Lorazepam (Ativan)
A newer anti-anxiety drug is buspirone (BuSpar).
More recently, drugs of the SSRI class (selective serotonin reuptake inhibitors, often also used to treat depression) are prescribed and include the following:
Sertraline (Zoloft)
Paroxetine (Paxil)
Fluoxetine (Prozac)
Venlafaxine (Effexor)
In addition, psychotherapy may be useful. Combinations of medication and counseling are usually advisable.

Next Steps


Anxiety should be addressed and treated with your doctor. Establish an ongoing relationship. By knowing your own doctor and by having follow-up on a regular basis, you may cope with your problems and resolve them more effectively. These steps may also help you deal with medical conditions that might otherwise go undiagnosed and untreated.


Prevention of anxiety essentially involves an awareness of life's stresses and your own ability to cope with them. This can often be a difficult task in our busy and hectic 21st century.

In essence, you might develop coping mechanisms for all of life's stresses.
Strategies might include these:
Relaxation exercises including deep breathing

Interpersonal skills in dealing with difficult people and situations or parenting skills training in dealing with your children

Prevention also includes diet, regular exercise, rest, and the basics in terms of preventive health care maintenance. Diet is a large factor. Caffeine, stimulants, lack of rest, and lack of exercise all are factors that influence anxiety.


When the cause of anxiety is identified and treated, complete recovery is often made. Where no cause can be readily identified, you may feel anxiety for a long time, perhaps your entire life. Excellent medications are available to help many of the symptoms. Counseling with mental health professionals can be highly successful.


Stress Management

What happens when you are stressed?

Stress is what you feel when you have to handle more than you are used to. When you are stressed, your body responds as though you are in danger. It makes hormones that speed up your heart, make you breathe faster, and give you a burst of energy. This is called the fight-or-flight
stress response.

Some stress is normal and even useful. It can help if you need to work hard or react quickly. For example, it can help you win a race or finish an important job on time.

But if stress happens too often or lasts too long, it can have bad effects. It can be linked to headaches, an upset stomach, back pain, or trouble sleeping. It can weaken your
immune system, making it harder to fight off disease. If you already have a health problem, stress may make it worse. It can make you moody, tense, or depressed. Your relationships may suffer, and you may not do well at work or school.

What can you do about stress?

The good news is that you can learn ways to manage stress.

To get stress under control:
Find out what is causing stress in your life.
Look for ways to reduce the amount of stress in your life.
Learn healthy ways to relieve stress.

How do you figure out your stress level?
Sometimes it is clear where stress is coming from. You can count on stress during a major life change such as the death of a loved one, getting married, or having a baby. But other times it may not be so clear why you feel stressed.

It may help to keep a stress journal. Get a notebook and write down when something makes you feel stressed. Then write how you reacted and what you did to deal with the stress. Keeping a stress journal can help you find out what is causing your stress and how much stress you feel. Then you can take steps to reduce the stress or handle it better.

To find out how stressed you are right now, use this
Interactive Tool: What Is Your Stress Level?

How can you reduce your stress?

Stress is a fact of life for most people. You may not be able to get rid of stress, but you can look for ways to lower it.

Try some of these ideas:
Learn better ways to manage your time.
You may get more done with less stress if you make a schedule.
Think about which things are most important, and do those first.
Find better ways to cope.

Look at how you have been dealing with stress.
Be honest about what works and what does not.
Think about other things that might work better.
Take good care of yourself. Get plenty of rest.

Eat well.
Do not smoke.
Limit how much alcohol you drink.
Try out new ways of thinking. When you find yourself starting to worry, try to stop the thoughts.

Work on letting go of things you cannot change.
Learn to say "no."
Ask for help. People who have a strong network of family and friends manage stress better.

Sometimes stress is just too much to handle alone. It can help to talk to a friend or family member, but you may also want to see a counselor.

How can you relieve stress?

You will feel better if you can find ways to get stress out of your system. The best ways to relieve stress are different for each person. Try some of these ideas to see which ones work for you:

Exercise. Regular exercise is one of the best ways to manage stress. Walking is a great way to get started.

Write. It can help to write about the things that are bothering you.

Let your feelings out. Talk, laugh, cry, and express anger when you need to.

Do something you enjoy. A hobby can help you relax. Volunteer work or work that helps others can be a great stress reliever.

Learn ways to relax your body. This can include breathing exercises, muscle relaxation exercises, massage, aromatherapy, yoga, or relaxing exercises like tai chi and qi gong.
Focus on the present. Try meditation, imagery exercises, or self-hypnosis. Listen to relaxing music. Try to look for the humor in life. Laughter really can be the
best medicine.


I have been where you fear to go...
I have seen what you fear to see...
I have done what you fear to do...
All these things I've done for you.

I am the one you lean upon...
The one you cast your scorn upon...
The one you bring your troubles to...
All these people I've been for you.

The one you ask to stand apart...
The one you feel should have no heart...
The one you call the man in blue...
But I am human just like you.

And through the years I've come to see...
That I'm not what you ask of me...
So take this badge and take this gun...
Will you take it? Will anyone?

And when you watch a person die...
And hear a battered baby cry...
Then so you think that you can beA
ll those things you ask of me...?

"Tears Of A Cop" - author unknown