Traumatic memories leave a 'heavy burden'

FINDLAY — All of us, at some point, have experienced or will experience trauma. But how it affects us, and the degree to which it disrupts our lives, can vary widely. "Trauma and trauma response are not pathological," said Dr. Christian Steiner, a psychiatrist with the Findlay-based Psychiatric Center of Northwest Ohio, part of Blanchard Valley Health System. "That's part of the human experience." For example, it's fairly common to become a more anxious driver after being in a car accident. For most of us, the feeling subsides over time. But for some, it lingers. A diagnosis of post-traumatic stress disorder indicates that a person has been experiencing symptoms for more than six months, Steiner said. More of your friends and neighbors are living through this than you may realize — about 1 in 20 of them. The National Center for PTSD reports that about 5% of U.S. adults have PTSD in any given year. In 2020, that was about 13 million Americans. Veterans are more likely to have post-traumatic stress disorder than civilians, particularly veterans who deployed to a war zone. Women are more likely to develop PTSD than men. About 8% of women and 4% of men will have PTSD at some point in their lives, "in part due to the types of traumatic events that women are more likely to experience — such as sexual assault — compared to men," the National Center for PTSD webpage states. The National Center for PTSD reports that most people who go through a traumatic event will not develop PTSD, however. If a military truck is hit by an IED, for example, some of the survivors may have serious trauma symptoms afterward and some may have hardly any, Steiner said. It isn't always clear who will be more affected, he said, but biological, social and psychological factors play a role. Some people might have a biological predisposition. Mental Health America reports that social support immediately after an incident may help. Sharing your experience and feelings with people you trust, or who have a similar story, may help you feel less alone, the organization states on its website. Common incidents resulting in PTSD include war or combat situations, violence and abuse, especially sexual violence, disasters, including natural disasters, mass violence or terrorism, and public health emergencies. Trauma in the brain and body So what's going on when we experience trauma? Mental Health America reports that when the body experiences trauma it releases adrenaline, the stress hormone that triggers "fight or flight" mode. This in turn stimulates the amygdala, which is the part of the brain that plays a significant role in emotions, behavior and fear processing. The problem is that then the amygdala might become oversensitive and very quick to respond, Steiner said. He likened the amygdala to our brain's "alarm system." After someone has experienced trauma, it's possible that the "alarm" starts going off far more frequently and with little provocation, so that person is in "fight or flight" mode for extended periods of the time when they don't need to be. Symptoms of PTSD might include re-experiencing the trauma through intrusive flashbacks or nightmares, emotional numbness and avoidance of places, people or activities that remind you of the trauma, and heightened arousal, such as irritability, feeling jumpy or having trouble sleeping or difficulty concentrating, according to Mental Health America. Steiner said PTSD is experienced as a "recurring, vivid, intrusive memory of the event." But when someone experiences a PTSD flashback, they aren't actually going back to the events they experienced — they're returning to the memory of how they felt. "You relive the fear and the feeling that you went through," not the specifics of exactly what occurred, Steiner said. "Our memory's kind of tricky like that." First responders' closeness to trauma PTSD doesn't always result from one major incident. Steiner said someone who experiences multiple relatively "small" traumas might also be affected. Seeing other people's trauma may take its toll on the person witnessing it as well. As first responders, law enforcement are often "exposed to others' trauma," Steiner said. At a car accident, explosion or incident of any kind, police and emergency personnel are usually first on the scene, witnessing the immediate aftermath. Sometimes, "you can rationalize through trauma," Steiner said. This may be easier for a first responder, who knows why they are at a particular scene, than for, say, the victim of an assault, who may perceive it as random. But while police expect to encounter difficult scenes daily on the job, logic and rationalizing have their limits. If someone witnesses terrible things over and over, day after day, it will add up. "Again, it's just that burden," Steiner said. "That repetitive burden can weigh very heavily." Law enforcement also may be working late nights, and away from their families, which can add to the stress, Steiner said. Additionally, many police departments are understaffed, and officers may worry that by coming forward to say that they are struggling, "they're going to let their brothers in law enforcement down," he said. Often there are large portions of the job that an officer cannot talk about, such as information related to an ongoing investigation that is confidential. Steiner said shortly after an incident, often, "you hear the rumor mill starting and you can't say anything. And I think that takes a psychological toll as well." Steiner has consulted with leaders of law enforcement agencies throughout his career. In recent years he has seen more recognition of mental health. But while "it's getting better," there is still a stigma, and many officers may not feel comfortable talking about it, he said. While he can recognize that the individual may be experiencing mental health symptoms caused by stress, often individuals themselves may still view it as "weakness," he said. Steiner has found that demographics may also play a role in people's willingness to talk about their trauma. Older individuals tend to be more reluctant to talk about things, and men are in general less open than women. "A lot of policing is based in military thought … 'Loose lips sink ships.' So it's ingrained," he said. "But it's getting better." It can get easier Steiner said loved ones supporting law enforcement — or anyone who has experienced trauma — can help by validating the person. Peer support can make a huge difference, as well. A tangible example of this type of support includes off-the-clock time together where officers may be more willing to talk about their experiences. Following the terrorist attacks of Sept. 11, 2001, research found that those who had been close to the events benefited from just talking to others who had been through it along with them. Peer support can, in some of these instances, be at least as valuable as professional care, Steiner said. His advice for peers, family members or loved ones who do want to offer support? "Listen more, talk less," he said. Mental Health America's website also recommends sharing your story with others, along with practicing relaxation strategies like meditation, muscle relaxation or breathing exercises, or spending time in nature. "Grounding techniques help distance your mind from distressing thoughts or emotions and refocus on what is happening in the present moment," the website states. "A common one is the 5-4-3-2-1 method — use your senses to notice your surroundings and name five things you see, four things you hear, three things you can touch, two things you smell, and one thing you taste." A list of other grounding techniques can be found at https://www.healthline.com/health/grounding-techniques. The National Center for PTSD is at https://www.ptsd.va.gov. Resources for survivors of sexual violence can be found at https://rainn.org. Anyone in crisis, or concerned about a loved one in crisis, can call or text 988.