Don't suffer alone with trauma

Many people have experienced trauma such as serious accident or injury, being shot, stabbed, held up at gunpoint, rape and other sexual assaults, or the unexpected death of a close friend or relative.

People who experience major trauma are at high risk for developing mental-health problems such as depression and posttraumatic stress disorder.

T: Trauma, when the trauma is life threatening, there is an increased likelihood that the person may develop mental-health problems. Rape is an intensively frightening experience and often leaves the person feeling helpless. People who experienced sexual abuse as children are often severely damaged psychologically and develop a host of mental-health problems. Some of my most challenging patients are those who experienced long-term abuse and trauma as children.

R: Re-experience: One feature of posttraumatic stress disorder is that individuals have frequent flashbacks of the events in which they have upsetting images and memories. In addition, some people have dreams and terrible nightmares involving the trauma.

U: Uncovering the trauma. We often bury memories of the trauma to reduce the pain. These memories are often pushed into our subconscious. Triggers are people, places, things and sometimes thoughts that remind individuals of the trauma. People who have experienced trauma therefore avoid the triggers. An individual who was involved in an accident may avoid driving in taxis or on the road on which the accident occurred. A woman who was raped may avoid people who remind her of the rapist.

M: Memory — People who have experienced trauma may have difficulty remembering aspects of the trauma. That is the body's way of blocking out the painful memories. A man who was involved in a motor vehicle accident in which his brother died was driving along the highway when the memory of the accident was activated. Immediately, he had severe anxiety attacks and since then has refused to drive along the highway.

A: Arousal increased. People who have experienced trauma often find that their levels of arousal increase. They become very vigilant and are always looking for something to happen. The woman who was held up will always be on the lookout for robbers. She will be careful when getting in and out of her car. When people's arousal levels increase, they become very irritable and may have difficulty sleeping.

Seek help

The experience of the trauma may wear some people down to the extent that they become very nervous, anxious or depressed. They might have difficulty coping and develop other mental health problems. Some people who were involved in accidents and suffered injuries may find that as a result of the psychological pain attached to the experience, the physical pain is more intense. These people may be difficult to treat as a result of their intense emotional distress.

I am surprised at the number of persons who have experienced trauma who silently suffer alone. This need not be so. One of the most effective treatment for trauma is cognitive behaviour therapy. It helps individuals come to terms with the trauma and develop new methods of coping.

Dr Wendel Abel is a consultant psychiatrist and head, Section of Psychiatry, Dept Of Community Health and Psychiatry, University of the West Indies, 977-1108; email: yourhealth@gleanerjm.com.

Wendel Abel, I AM WHAT I THINK