Personally Speaking is our quarterly newsletter in which we discuss mental health topics.  The purpose of our newsletter is to inform and educate the community on personal issues, concerns facing our community, methods of treatment, and developments in related fields.  It is Avenues intent to not only provide care for individuals but to promote and create a healthy environment for our families.

Teenage Romance: Puppy Love or Addicted Love Disaster?
The Many Faces of Anxiety
Looking to the Mirror to Find Themselves
ADHD vs. the Bipolar Child: Facts vs. Fiction
Self-Mutilation vs. Suicide Attempts: The Tragedy of Mood Instability
Coping with Trauma
The Power of Perception
Sharpen Your Saw this Spring

Coping with Trauma

In the wake of the national tragedy that occurred September 11, we have all faced many different obstacles. All of us have at least been indirectly affected by this tragedy, and some of us have been directly affected through loss of a loved one. It is important to talk about not only how the community can cope with this tragedy, but how anyone who has faced other traumatic events can cope in times of loss and extreme stress.

Psychological trauma is a rapidly expanding area of scientific and medical inquiry. Psychological trauma is a state of severe fright that we experience when we are confronted with a sudden, unexpected, potentially life threatening event over which we have no control. A trauma is considered to be outside the realm of ordinary experiences. It is estimated that over 14% of all Americans are victims of crime each year. A trauma can include:

• natural disasters (tornados, tidal waves)
• catastrophes that we have no control over, such as car and plane crashes
• being the victim of or witnessing a violent crime such as assault, rape, and murder
• being directly involved in a war
• physical, sexual or emotional abuse
• physical or emotional neglect
• chronic illness
• life threatening illness

Traumas can be sudden, such as a car crash, or chronic, such as repeated sexual abuse. Symptoms are usually more intense and longer lasting when the trauma is personal, as in rape or other violent crime.

• the nature and severity of the event
• the relationship they have with the offender of the crime
• previous trauma experience
• intelligence, cultural and religious values
• the person's ability to cope with stress before the trauma occurred
• the availability of supports and resources
• family background
• biological predisposition
• temperament
• duration of the event
• age

If you or anyone you know has suffered a trauma and is not coping with it well, they might need to seek professional help. They might be suffering from a trauma based disorder, such as Post Traumatic Stress Disorder (PTSD), Acute Stress Disorder, and Adjustment Disorder. PTSD was first identified during World War I , when soldiers were observed to suffer chronic anxiety, nightmares and flashbacks for weeks, months, or even years following combat.

Symptoms of PTSD include:

• repetitive, distressing thoughts and/or nightmares about the event
• intense flashbacks as though reenacting the trauma
• attempts to avoid thoughts, feelings, events, or external situations associated with the trauma
• sense of foreshortened future
• restricted range of emotion
• emotional numbness
• feelings of detachment or estrangement from others
• loss of interest in activities that used to give pleasure
• persistent symptoms of increased arousal such as:
  • difficulty sleeping
  • concentrating
  • startling easily
  • hypervigalence
  • irritability
  • anger outbursts

These symptoms need to have persisted for at least one month. If symptoms occur for less than one month's duration, a diagnosis of Acute Stress Disorder would be given. Adjustment Disorders are for people who have various distressing symptoms but do not meet the full criteria for either of these disorders.

What could cause a person to commit any violent crime? Although no one has a direct answer to that question, there are many theories, both medical and psychological, that attempt to make sense out of senseless acts. Some common medical and psychological conditions may contribute to violent acts including:

• Temporal Lobe Epilepsy
• Major mental illness such as Bipolar Disorder and Schizophrenia
• Alcohol and substance abuse- (enough alcohol will disinhibit the brain's control systems and lead to destructive behavior)
• Post Traumatic Stress Disorder -a paradox in itself- PTSD can lead to violent outbursts in victims of abuse. According to a study of inmates, those with PTSD symptoms had a seven times greater chance of having been arrested for a violent offense within the preceding 12 months to their own trauma as those without such symptoms
• Organic Personality Disorder (stroke or head injury victim, etc)
• Intermittent Explosive Disorder
• Antisocial Personality Disorder
• Conduct Disorders

Other factors in human violence include:

• The need for revenge for real or imagined injustices
• Fears' of abandonment or rejection, which cause these people to go to major lengths to drive others away
• Boredom
• Anger
• Those without meaningful goals in their lives
• Jealousy
• Envy
• Sadism
• Prejudice
• Need to control
• Group evil

Intensive psychotherapy to work through intense feelings of fear, loss and/or guilt surrounding the original traumatic event is typically the most effective means of treatment. Psychotherapy can also assist the victim in restoring a healthier belief system.

Other treatment options include:

• Psychiatric evaluation for medication
• Hypnosis
• Family therapy
• Grief counseling
• Support groups

• Panic disorder
• Eating disorders
• Obsessive compulsive disorder
• Somatoform disorder
• Depression
• Addictions to drugs and alcohol
• Personality disorders
• Multiple personality disorder.

No one deserves to be a victim of a trauma, but there are some things in our lives that we cannot control. What we can control is how we cope with the trauma in the here and now.

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