Demystifying PTSD in the Era of Covid-19

We have all heard the word “Post-Traumatic Stress Disorder (PTSD),” but what does it really mean?

What is Trauma?

There is a societal misconception that PTSD affects war veterans, survivors of sexual abuse or people who experience an event that ended in severe injury or harm. Anything that someone experiences or perceives as threatening is a trauma and can result in the development of PTSD.

Trauma is defined as “anything that is too much, too soon or too fast for our nervous system to handle, especially if can’t reach a successful resolution.”

We need to expand our awareness and understanding that trauma symptoms can affect anyone that has experienced, was exposed to, witnessed or learned about an event(s) that led to feeling threatened.

One might think, “What I went through was not as bad as my friend who was shot” or “I ended up being safe and unharmed in the accident so it should not affect me as much as it does.” The nervous system does not know the difference between a real or perceived threat. This means that whether or not the event(s) resulted in “actual or physical” harm it can still leave a psychological, emotional or spiritual impact.

The Trauma of the COVID-19 Pandemic

Due to the COVID-19 pandemic, it can be argued that all people have experienced or are currently experiencing a traumatic event(s). Examples include but are not limited to:

• front line workers or family members witnessing people die or taking care of the severely ill;
• being diagnosed or experiencing symptoms of COVID-19;
• being hospitalized;
• the fear of yourself or a loved one becoming ill;
• the threat of losing ones job, income or house; or
• not being able to leave the home.

These current traumatic events can also retrigger past trauma(s) that were previously forgotten, resolved or buried. 

Starting at the moment the trauma occurs, the body and mind begin to produce sensations, thoughts and feelings that can be overwhelming. These symptoms fall into multiple categories as laid out by the Diagnostic Statistical Manual V (DSM-5) that help decipher and identify our internal trauma experiences. 

1. The first group of symptoms are called “intrusive symptoms.”

An intruder is something or someone that enters into a space that does not belong to them; they are unwanted. It can be very distressing when we begin to re-experience the traumatic event(s) through unwanted upsetting memories, nightmares, flashbacks, emotional distress or physical reactivity after exposure to traumatic reminders.

The COVID-19 pandemic is complex because it is an ongoing trauma, which means it does not just happen once nor does it have a specific end date. Additionally, it can be complicated by grief and loss, multiple stressful events occurring at the same time, past traumatic experiences and the sense of loss of control.

This real or perceived lack of control creates a sense of panic and the uncertainty of the pandemic may exacerbate these symptoms. Currently, there are many traumatic reminders that people encounter on a daily basis including frequent news and social media updates, people talking about the COVID-19 and having to maintain 6 feet of distance from others.  It is almost impossible to completely remove ourselves from these trauma reminders, which can lead to a constant state of distress.   

2.    The next category of PSTD symptoms are called “avoidance symptoms.”

There are two ways that people avoid trauma related stimuli. The first way is avoiding thoughts or feelings that bring up reminders of the event(s). People try to avoid feelings of shame, guilt, loss of control, helplessness or distrust which may lead to avoidance of connecting with others or trying new things.

The second is avoiding external reminders such as watching the news, going on social media, walking outside, going to the grocery store, etc. Anything that someone perceives as connected to the traumatic event(s) are avoided, including any smells, sounds or tastes. The goal of avoidance is to keep the person safe, but can lead to worsening anxiety, angst and depression.

3.     A trauma or series of traumatic events leads to significant changes in one’s thoughts and mood.

It may happen suddenly or develop over time and can include:

• exaggerated blame of self or others for causing the trauma;
• negative emotional response or feelings;
• decreased interest in activities;
• feeling isolated and difficulty experiencing positive emotions or sensations.

Additionally, some people experience memory loss or the inability to remember certain aspects of a traumatic event(s). One might describe these episodes as “blacking out.”

Due to the trauma, people may to develop overly negative thoughts and assumptions about oneself or the world. This can manifest in various ways such as losing trust in the world, believing the world or someone specifically is “out to get them” or starting to believe negative things about themselves such as they are weak.

4.     In addition to shifts in thoughts and mood, how we respond to internal and external experiences change.

Trauma creates changes in arousal and reactivity.  Irritability or aggression; risky or destructive behavior; difficulty concentrating, and sleeping are amongst the many symptoms that can occur.

Hypervigilance is also common, which is the experience of increased arousal and sensitivity to one’s environment. People may feel as though they are on high alert all day and night and are constantly surveying their surroundings. This can manifest by being easily frightened, jumping when approached suddenly or after hearing a loud or unknown noise. 

PTSD and symptoms of trauma are not a choice or a weakness of the mind. The symptoms that manifest are not conscious or controllable behaviors/experiences. If they were, one could just mentally drive them away.

Trauma does not just occur in the mind; it also imprints on the body. The symptoms one experiences are the nervous systems’ way of communicating there is an unresolved internal threat.  Traumatic memories are storied in the body and manifest through our inner sensations.

The voice of the nervous system is sensation. When these sensations are arising, it is our body’s way to communicating with us that it needs to discharge the energy. When we consciously or unconsciously suppress sensations out of fear or desire to avoid the uncomfortable feelings, the energy remains stuck in our bodies and symptoms continue to manifest after the trauma is no longer physically present.

Sensations are not something to fear; rather, they provide us with valuable information that we can use to move towards healing.

By changing our perspective from fear to curiosity, understanding the role of the nervous system and befriending it, we can reduce the personal sense of shame that we should be able to “control” or “just stop” the trauma symptoms from arising. 

If you notice any of these symptoms and they are creating emotional distress or impairment in your life, it may be helpful to speak to a licensed social worker or counselor for support. Impairment can look like difficulty managing life circumstances such as a job, parenting or social situations.

This article is not intended to diagnose or treat symptoms of PTSD or trauma.

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