What is… trauma vs. PTSD

In this series, I dig a little deeper into the meaning of psychological terms.

This week’s term: trauma vs. PTSD

I wanted to take a look at the difference between experiencing trauma and having PTSD (post-traumatic stress disorder). Part of this is that I believe that I have experienced trauma, but while it still impacts me to some extent, I do not meet the criteria for PTSD.  So is there a firm dividing line between the two, or is it more of a continuum?

According to the Sidran Institute, psychological trauma occurs when an individual is faced with highly distressing events that overwhelm their ability to integrate their emotional experience, or threatens life, limb, or sanity.  The traumatic event often involves “abuse of power, betrayal of trust, entrapment, helplessness, pain, confusion, and/or loss.”  Wikipedia adds that these events often involve  “a violation of the person’s familiar ideas about the world and their human rights, putting the person in a state of extreme confusion and insecurity. This is seen when institutions depended upon for survival violate, humiliate, betray, or cause major losses or separations instead of evoking aspects like deserve, special, safe, new and freedom.”  The traumatized individual is left feeling helpless in a dangerous world.

It is not the event itself that determines trauma but rather the individual’s subjective response to it, so not everyone who experiences the same potentially traumatizing event will have the same response.  Responses to stressors may be proactive, reactive, or passive.  Proactive responses are taken before the stressor can have a large impact, reactive responses occur after the stressor, and passive responses include emotional numbness or avoidance.  An individual’s response can vary depending on the nature of the event, the person’s background (including childhood trauma), personality, coping resources, and level of available support.  The Sidran Institute states that severe psychological trauma is most likely to occur with human-caused stressors that are repeated, unpredictable, sadistic, occurring in childhood, and carried out by a caregiver.  Protective temperamental and environmental factors can improve coping in response to stressors.  Such factors included limited early life stress, resiliency, and active help-seeking behaviour.

Having some trauma-related symptoms is a normal reaction to major stressors, and represent part of the process of making sense of what happened and gaining perspective.  These responses may last anywhere from a few days to a few weeks or even months, although there may be recurring responses to triggers.  PTSD develops when the mind is left in a state of psychological shock and unable to process the trauma, and the person’s overall functioning is impacted.  Trauma symptoms may be forms of adaptation that were helpful while the trauma was occurring (such as dissociation) that become problematic when they instinctively continue after the stressor is removed.

The DSM-5 (Diagnostic and Statistical Manual 5th ed.) diagnostic criteria for PTSD are clustered around 4 different areas:

  • Intrusion symptoms: recurrent memories, traumatic nightmares, flashbacks, psychological distress and physiological reactivity to trauma reminders
  • Persistent avoidance: avoidance of both thoughts/feelings and external reminders
  • Negative alterations in cognition and mood: dissociative amnesia, persistent negative beliefs, distorted blame of self/others, negative trauma-related emotions, diminished interest in activities, detachment from others, inability to experience positive emotions
  • Alterations in arousal and reactivity: irritable/aggressive behaviour, self-destructive/reckless behaviour, hypervigilance, exaggerated startle response, problems concentrating, sleep disturbance

To be diagnosed, a person must have symptoms from each of the four areas, although people’s symptoms may be more concentrated in one area rather than others.  These symptoms must have been present for at least one month, and must impair functioning in social, occupational, or other domains.

What does this all mean?  If there are a group of people who are subjected to a particular stressor, a certain subset of those exposed will have a trauma reaction.  Among that group, some will be able to process the trauma and move forward, while others will remain stuck and develop PTSD.  Those who access therapy for PTSD will work on finally processing and integrating the trauma memories.  For myself, I’ve experienced trauma, but I think my processing was slowed rather than stuck, so it didn’t develop into PTSD.

What are your thoughts?  Is there a difference between trauma and PTSD, and how do we separate the two?

 

Sources:

You can find the rest of the What Is series here.

PTSD Treatment Options: An Overview from Mental Health @ Home Store

 

Visit the Mental Health @ Home Store has a mini e-book on PTSD Treatment Options: An Overview, which covers a number of evidence-based therapies for PTSD.  It’s also available as part of the Therapy Mini-Ebook Collection.

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62 thoughts on “What is… trauma vs. PTSD

  1. Marty says:

    Supposedly their are a small percentage of people that are highly resistant to PTSD.

    In battle, war there is a certain time I think like 60 days where after that point ptsd spikes

    We have the same ptsd rates as the British since we mirrored their structure.

    That does not hold up for deployments. British remain close to same numbers America’s spikes heavily

    So same war different rates

    British deploy units together and do not split them up also they give more time as unit out of combat or r and r

  2. regainingmysparklex says:

    This post is helpful and really informative.💓

    I’m constantly making myself believe I’m a liar that didn’t happen that I’m a bad person. But I remember. But because it’s blurry or there’s gaps I have these thoughts that it’s all not true because I’ve remembered by seeing clips triggers making me feel sick and weird emotions seeing things and feeling all zoned out and checked out im there I can hear sometimes but sometimes I carnt I think it’s dissociation it just feels so confusing.💓 I did write a post 💓 Three other girls maybe more have said what he did and my mom knows thinking back to all the things I said but I tell myself no it’s what I saw on the tele I saw it on the soaps constantly making myself believe in a twisted person💓🌸

  3. Carol Anne says:

    Im not sure! I agree with the points that sidran makes here. I think PTSD is on a continum, just as trauma is, and peoples responses are also on a continum. xox

  4. marandarussell says:

    Personally, I feel like I had repressed trauma up until my sister committed suicide around 6 years ago. That event brought those repressed memories and feelings rushing to the surface and since then, I have had the symptoms of c-ptsd. Funny how those type of things can manifest.

  5. Melanie B Cee says:

    What are your thoughts? Is there a difference between trauma and PTSD, and how do we separate the two?
    I’m no expert and am hesitant to say much, BUT IMHO (humblest of opinions) . trauma is immediate, something that happens that may be life or world changing, but there’s a definite beginning and end. PTSD on the other hand, although possibly/probably triggered by the trauma event, is something that lingers. It affects the person’s life for (perhaps) EVER. It’s subtle and it shows up a long time after the actual trauma event occurred. But in the interim the night terrors, hypervigilance, inability to trust or form healthy, meaningful relationships occurs..and are symptoms of PTSD. I’m speaking from personal experience. I watched my husband (who served in Viet Nam) begin to deteriorate and part of the reason? PTSD. I’ve found that as time goes on I’m less and less able to cope with stressful situations, even minor ones. I don’t know if that’s another symptom or what, but there you are. And Trauma and PTSD are inextricably bound on some levels…because one of them happened and the other feeds off the reaction to the event.

  6. utahan15 says:

    it means we do not know
    as much as we would like to think we
    do
    the mind is a camera
    and has been abused
    and exposed
    to ugly situations
    words>
    thoughts?

  7. DV says:

    One of the things that really sticks with me is the extent to which a person’s ability to deal with trauma is impacted by earlier life experiences. So often resilience is characterised as a a purely individual trait, a kind of inner strength that comes from their own actions (which means that people who have less resilience are looked down on as being either defective or psychologically “lazy”) and issues such as whether or not they had secure relationships as a child, whether help-seeking behaviour was encouraged or not, and whether there was outright trauma or abuse, are completely overlooked. It’s something that tends to annoy me a bit in the writings of people like Victor Frankl. I also think it’s highly relevant to PTSD in the military population, given that many people join either to get away from an overtly bad family/social situations or at least to try and find a closeness and sense of belonging that did not exist in their family of origin. I think there is probably a subgroup who would be at higher risk of PTSD or CPTSD from subsequent military trauma because of having less inner resources to cope, especially once they are discharged and no longer “belong”.

    • ashleyleia says:

      Yes it seems like for some people with a biopsychosocial vulnerability to PTSD there is a relatively finite inner reserve to process traumatic events, and subsequent events later in life are more likely to result in PTSD.

  8. Ashley says:

    I had a single traumatic incident in which I genuinely believed I would die (car wreck), which seems to have collected other trauma with it, and my PTSD symptoms include trauma in addition to the car wreck. Car wreck has been addressed through EMDR and might be doing that again for others that are persistent five years later. I also have a very low tolerance for chaos.

  9. Meg says:

    Yeah, I have PTSD all over the place. What my parents did to me was beyond humiliating and horrific. Sometimes it plays in my mind over and over. I can’t escape the feelings of being violated and humiliated all over again, as if no time has passed, and I may as well have been nine years old yesterday. I’m fairly dissociative, but I try to “check out” with positive thoughts, which probably makes no sense. I’ve had EMDR, but I need more. The hardest thing is the feeling of humiliation. Not everyone can relate to that. It’s not the same as being afraid I’m going to die, although I don’t want to minimize that sort of wartime trauma. It’s just… degrading in the extreme, and I can’t outrun it. I’ve tried different ways of looking at it, different attitudes, etc., but it’s always there. Ultimately, I’ve gotten pretty good at putting it from my mind (more dissociating), but there are horrible triggers. One such trigger in 2006 led me to attempt suicide, and I’m not making this up–it wasn’t until recently that I realized the trigger was the cause of my suicide attempt. (At the time, I thought I was just feeling socially awkward, or something. Then recently, I thought about that horrific trigger–and it was horrific–and it just came together in my head.) I’d spent over ten years thinking I attempted suicide out of some sort of weakness or whatever. But it was that incident, the trigger at my workplace. Sorry to ramble! Great topic and very informative!

  10. me says:

    interesting post! i think the only difference between the 2 is the DSM. for those that experience it, it smells and feels exactly the same.

  11. Author D.A.Hopkins says:

    As a PTSD sufferer I am only still in the whole reason why and if I can do something or not to be able to get some kind of idea that I can see it through my life as I am 43 and I have quite a few more in me. I was in Hospital a few weeks ago and I was in complete control of the whole thing, but I’m not going to get it that easy. As I stepped out of the waiting area I had barely finished placing my foot down on the 1st step and I was in panic and trying to get my breathing back . If you have the ability to close your eyes and try to make it stop and I opened my eyes and I was done. I was not even aware that they were finished.
    The last time I was in my car I don’t know how but I have been a little stressed for years but I am not sure how to fix it, because I have no idea how it works. I was a depression master and I wanted to see that there in its place. At least knowing the triggers are the only thing I wish for.
    2014 was the issue of my own life as well as 2 of my kids have a bigger problem with life because of the carelessness of others on the road. #share

  12. Author D.A.Hopkins says:

    The other side effects of the same thing as the people who have been able to find a way to cover it is a little more worn by each passing day in the world of treatable disease this is where I have been able to get a little peace with knowing that they are not going to find the answer. Its really a little more devious than its sister, depression. That’s for bringing it to the world

  13. Denise Hisey says:

    You’ve given a great explanation. I thought of something to expand on.

    It seems like the word “Trauma” has been thrown into the PTSD bucket and a lot of people are afraid to say they’ve been traumatized, for fear of being labeled or diagnosed with PTSD.

    I think it’s fairly obvious to most people that everyone who has PTSD has experienced trauma, but maybe not so clear that some people experience trauma without developing PTSD. Like you mentioned – two people at the same event can have two different experiences/results.

  14. lavenderandlevity says:

    I work with data, much of it health data. I’ve noticed this really bizarre trend at the last two trade conferences of someone with very high ACES – 8 or higher – speak as a “poster child for resilience” in more detail than I think is healthy to a group of consultants, policymakers, epidemiologists and health practitioners about what they went through and why they they think they were “so resilient” as to not develop PTSD from “so much” childhood trauma (eye roll). While I hate the practice in general – do they not get that they have people like me with sitting on the other side of that stage who have equivalent scores and are triggered by the whole thing? Trauma/PTSD aren’t *just* the domain of the ‘othered’ patient – the point seems generally to be to raise awareness of social support in resilience to trauma. If the person experiencing trauma had at least one supportive relationship during the period of trauma, they are less likely to develop PTSD from it, even if their ability to take any concrete action to thwart the threat was nil. I suppose that’s fine. I have equivalently high an ACE score, did not have any true supportive relationship growing up to buffer its effects, and do have complex PTSD. I do have social support in my current crisis (aka my Partner), and that has certainly helped compared to facing the same events alone last time. So I’ll add social support/social response as another variable, though I hate how the health community is pointing that out lately. Have the trauma responded to supportively by your community, you’ll likely have lower risk of PTSD from it. Have it met with shame, secrets, lies or silence and your risk goes up for PTSD.

  15. suninthespring says:

    I experienced trauma and have PTSD. It is somewhat clear to me what the distinction is between the two because my family members experienced the same events (although in their own ways), yet in the only one still suffering four years later. I notice little things every now and then that make me think the accident is still impacting them, too, but for the most part I deal with it much more than they do.

  16. regainingmysparklex says:

    Today I went through some old photos of when I was little and it didn’t spark any memories or anything it didn’t feel anything nothing when looking at them and I thought maybe it would be hard the clothes I was wearing I don’t remember and the way I looked I don’t remember how I looked when I’ve remembered what happend I don’t remember what I looked like surely I should have ❤️🌸💓🌸

  17. Karen says:

    A single trauma event may be shocking and have a huge impact at the time, eg a car crash, which may cause abnormal worry over driving, especially driving the same route. If you were to have a second crash in the same place, this may intensify the initial trauma.

    Being exposed to a trauma situation repeatedly or for a long time causes the brain to operate in survival mode where processing of events is suspended, so the brain stores the threat in the current area rather than the past, the brain doesn’t know that you are now safe and reacts as though the threat is still there. EMDR helps the brain process the memory and reduce the fear.

    I didn’t consider I could have ptsd, but when the psychologist told me his diagnosis it made so much sense.

  18. artandhealingheart says:

    I believe I have ptsd although I’ve not been diagnosed. Someone did something when I was nine and ever since the event I can’t stand to be startled Especially from behind. The same person continued to be inappropriate up until I was 19 years old and I think it’s truly done some damage. The night of my wedding reception I had a nightmare about them bc I’d seen them at the reception. Nightmares happen regularly and 5 years ago when I was on Lexapro I hallucinated this person in my bedroom.

    At this point I avoid the person the best I can but under the circumstances it isn’t always possible.
    I don’t like self diagnosing but all I know is it’s miserable and I get uncomfortable talking about it so I haven’t explored it in depth in counseling.

    • ashleyleia says:

      That sounds like a perfect storm of conditions to cause PTSD. Another thing to look into is complex PTSD (c-PTSD), a type of PTSD that can happen when there is repeated exposure over an extended period of time.

      • artandhealingheart says:

        Its so odd because I made the connection of events as an adult. I had a sibling relationship with this person but we weren’t related. I realized the entire basis for that makeshift relationship was because someone suggested he saw me as a sister. This was not the case, and it let to more inappropriate interactions. Because so much time had passed, even my husband was uncomfortable with cutting him off because my view of him changed overnight.

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