Nurse preparing with gloves and mask, symbolizing preventive trauma treatment for first responders in medicine.First responders and physicians run toward danger when most of us run away. Yet at the end of the shift, many carry invisible wounds, intrusive memories, disturbing images, flashbacks, weights too heavy to carry alone. Preventive trauma treatment for first responders has become more critical than ever as research reveals alarming rates of PTSD among healthcare heroes.

The Culture of Silence and Why It’s Harmful

In high-stakes professions, showing vulnerability has long been seen as a liability. For physicians, there’s a persistent myth that trauma somehow “doesn’t happen” to them. This couldn’t be further from the truth. The fear of professional repercussions, perfectionism, and cultural stigma often pushes doctors and first responders to keep their struggles hidden.

But research paints a different picture. A recent systematic review found that nearly 15% of physicians experience PTSD symptoms, compared to only about 3–4% in the general population. Other studies have found ranges from 4% up to 28%, depending on specialty and trauma exposure. Emergency physicians, in particular, show high rates, about one in six meet criteria for PTSD.

These numbers make one thing clear: trauma doesn’t skip over people with medical degrees or uniforms. It just hides more easily under the weight of stigma.

Need Help Now? If you’re experiencing trauma symptoms, don’t wait. Find specialized trauma therapists in your area who understand the unique challenges facing first responders and healthcare workers.

Why Trauma Symptoms Don’t Just “Go Away”

Flashbacks, nightmares, and intrusive thoughts aren’t signs of weakness. They’re the brain’s way of saying: something needs attention. Left alone, these symptoms rarely fade. In fact, they often intensify, interfering with work performance, relationships, and physical health.

Too often, the advice in medical and first responder circles is to “tough it out” or to “just talk about it.” While talking can help reduce isolation, untreated trauma symptoms don’t fully resolve without an evidence-based approach. This is where preventive trauma treatment for first responders becomes essential.

Prevention Is Not Optional; It’s Professional

Just as helmets and protective gear are standard in high-risk work environments, preventive trauma treatment for first responders should be treated as preventive maintenance. Early treatment prevents small cracks from developing into fractures.

EMDR (Eye Movement Desensitization and Reprocessing) therapy is one such approach. Unlike general talk therapy, EMDR specifically targets and reprocesses disturbing memory networks. This helps symptoms like flashbacks and intrusive images quiet down.

But treatment isn’t just about methods, it’s about people. A trusting relationship with a therapist is the foundation of healing. Without rapport and safety, no evidence-based model will work. With it, even the most painful experiences can begin to shift.

Learn More: Discover how EMDR therapy creates a safe space for trauma recovery and why the therapeutic relationship is crucial for healing.

Physicians: A Group at Special Risk

Physicians often hold themselves to impossible standards. Add to that the fear of losing licensure or professional standing, and many suffer in silence. Yet studies show the cost of ignoring mental health is high.

For example, nearly one in three medical residents experience depressive symptoms, and suicide rates among physicians are significantly higher than in the general population. The data on PTSD only adds to this urgent picture. Trauma symptoms are present, measurable, and real.

During the COVID-19 pandemic, research found that 18.3% of physicians reported symptoms consistent with PTSD, with higher risks among female physicians and trainees. This underscores the critical need for preventive trauma treatment for first responders and healthcare workers.

Related Reading: Understanding the connection between trauma and workplace burnout can help identify when professional stress crosses into trauma territory.

Changing the Culture: From Stigma to Support

Healing begins when stigma loses its power. Hospitals, fire halls, EMS bases, and clinics can create cultures of prevention by:

These changes send a powerful message: seeking help isn’t just tolerated, it’s expected.

Understanding compassion fatigue and burnout in healthcare professionals is also crucial for developing comprehensive support systems.

For Organizations: Learn practical strategies for supporting first responder relationships and creating healthier work environments for your team.

Firefighter surrounded by smoke and flames, symbolizing preventive trauma treatment for first responders.

A Call to Action

Caring for trauma symptoms is not a sign of weakness, it’s a mark of professional integrity. It shows that first responders and physicians value themselves as much as they value the lives they protect.

Preventive trauma treatment for first responders isn’t a luxury. It’s a necessity. And when professionals heal, the benefits ripple outward, to their patients, their colleagues, and their families.

It’s time to normalize trauma care in medicine and emergency services. No one should have to choose between their badge, their license, or their life.

Frequently Asked Questions

Q: What makes preventive trauma treatment different from regular therapy? A: Preventive trauma treatment focuses on addressing trauma symptoms before they develop into full PTSD. It uses evidence-based approaches like EMDR therapy to reprocess traumatic memories and prevent long-term psychological damage.

Q: How common is PTSD among first responders and physicians? A: Research shows that physicians experience PTSD at rates of 15-28%, significantly higher than the 3-4% rate in the general population. Emergency department personnel show particularly high rates, with about 18.6% meeting PTSD criteria.

Q: What are the signs that a first responder needs trauma treatment? A: Warning signs include flashbacks, nightmares, intrusive thoughts, avoidance behaviors, hypervigilance, sleep problems, and difficulty concentrating. Physical symptoms like headaches and muscle tension may also indicate trauma-related stress.

Q: Is EMDR therapy effective for first responder trauma? A: Yes, EMDR has shown significant effectiveness in treating trauma symptoms. Studies show that 77.7% of veterans experienced elimination of PTSD symptoms after 12 sessions of EMDR.

Q: How can organizations support preventive trauma treatment for their first responders? A: Organizations can create supportive cultures by protecting confidentiality, normalizing mental health treatment, providing access to specialized trauma therapists, and implementing routine mental health screenings.

Take Action: Find Support Today

If you’re a first responder or physician experiencing trauma symptoms, don’t wait for them to worsen. Preventive trauma treatment for first responders is most effective when implemented early.

Ready to find specialized trauma therapy? Search our therapist directory to connect with qualified professionals who understand the unique challenges facing first responders and healthcare workers. Many therapists specialize in PTSD treatment and can provide the evidence-based care you need.

Remember: seeking help is a sign of strength, not weakness. Your well-being matters, not just to you, but to everyone you serve.

References

Post-Traumatic Stress Disorder (PTSD) is a well-known mental health condition that arises from experiencing or witnessing a traumatic event. Post-Traumatic Stress Disorder (PTSD) is a well-known mental health condition that arises from experiencing or witnessing a traumatic event. However, a lesser-known but equally significant condition, Complex PTSD (C-PTSD), occurs when an individual endures prolonged or repeated trauma, particularly in interpersonal contexts. Understanding the distinction between PTSD and C-PTSD, recognizing symptoms, and exploring treatment options is essential for individuals seeking healing and support. Often times CPTSD is mis diagnosed, as symptoms like anxiety and depression come with it.

What is Complex PTSD?

Complex PTSD is a psychological disorder that develops in response to chronic trauma over an extended period. This type of trauma often occurs in situations where escape is difficult or impossible, such as childhood abuse, domestic violence, emotional neglect, or prolonged bullying. Unlike PTSD, which can result from a single traumatic event, C-PTSD stems from sustained traumas, particularly when inflicted by caregivers or authority figures. These traumas can be less noticeable, like microaggressions, but over time they wear down a persons ability to function.

How is C-PTSD Different from PTSD?

While PTSD and C-PTSD share similarities, they differ in key ways:

Symptoms of C-PTSD

The symptoms of C-PTSD can be grouped into several categories:

  1. Emotional and Psychological Symptoms:
  1. Cognitive and Behavioral Symptoms:
  1. Interpersonal Symptoms:
  1. Physical Symptoms:

Treatment Approaches for C-PTSD

Healing from C-PTSD is a complex process, but with the right therapeutic support, individuals can learn to manage symptoms, develop resilience, and improve their quality of life. Some of the most effective treatments include:

  1. Therapy:
  1. Medication:
  1. Somatic and Body-Based Therapies:
  1. Lifestyle and Self-Care Practices:

The Path to Healing

Recovery from C-PTSD is not linear, but with the right support, individuals can regain a sense of safety, self-worth, and emotional balance. Seeking professional help, building healthy relationships, and practicing self-compassion are critical steps toward healing.

If you or someone you know is struggling with C-PTSD, reach out. It is important to find a practitioner who understands CPTSD and can facilitate an effective treatment plan. CPTSD is not a life sentence, you can take the first step toward reclaiming a life free from trauma’s grip.

GoodTherapy | From Service to Support: A Veteran's Guide to Healing the Pain That Is UnseenMy journey from the disciplined ranks of a US Army combat engineer to a bastion of support for those battling internal wars has been both enlightening and deeply personal. This path, paved with both my own experiences and those of the individuals I’ve had the honor to help, underscores a critical yet often overlooked side of veteran care: the silent, unseen wounds of PTSD and complex trauma. Through this article, I aim to delve into the transformative potential of trauma-informed care, advocating for a shift from merely enduring survival to embracing a thriving existence, especially for veterans confronting the specter of suicidal ideation. 

Unveiling PTSD and Complex Trauma 

PTSD and complex trauma are more than clinical terms; they are lived realities for countless veterans, embodying the enduring aftermath of combat and service. Unlike physical injuries, which are visible and quantifiable, these mental health challenges lurk unseen, their symptoms echoing the tumult of past traumas. Veterans may find themselves in the grip of intense flashbacks, plagued by insomnia, or wrestling with an incessant sense of alertness that transforms even the most mundane environments into potential threats. Such manifestations are not merely remnants of their service but pervasive influences that color every side of their daily lives. 

The journey of understanding these conditions is akin to navigating a labyrinth, where each turn reveals new challenges and complexities. PTSD, traditionally associated with a singular traumatic event, can sometimes overshadow the nuanced and compounded nature of complex trauma, which arises from prolonged exposure to distressing experiences. This distinction is crucial in tailoring interventions and support systems that acknowledge the depth and breadth of the trauma experienced by veterans. 

The Silent Battle Within: A Closer Look 

Beyond the clinical symptoms lies a more profound struggle—a battle for identity, meaning, and connection. Many veterans, accustomed to the camaraderie and purpose found within the military, find themselves adrift in civilian life, where their experiences seem alien and incomprehensible to those around them. This disconnection fosters a sense of isolation, worsening the symptoms of PTSD and complex trauma and, tragically, steering some toward suicidal ideation. 

The story of “John” (a pseudonym to protect confidentiality) is illustrative of this struggle. A veteran of multiple deployments, John’s return home was marked not by peace but by a relentless battle with his memories and a pervasive sense of dislocation. In our sessions, it became clear that John’s journey to healing needed more than just coping strategies; it demanded a redefinition of his relationship with his past and a rekindling of hope for his future. Through a concerted approach grounded in trauma-informed care, we embarked on this journey together, navigating the intricacies of his experiences with empathy and patience. 

Trauma-Informed Care: A Beacon of Hope 

The essence of trauma-informed care lies in its acknowledgment of trauma as a pervasive element that influences the physical, emotional, and psychological well-being of individuals. This approach shifts the paradigm from pathology to understanding, emphasizing the need for safety, choice, collaboration, trustworthiness, and empowerment in the therapeutic process. It challenges us to see beyond the symptoms, to recognize the person grappling with the trauma, and to tailor our interventions in a manner that is respectful, informed, and healing centered. 

For veterans like John, and indeed for many others, trauma-informed care offers a pathway out of the darkness. It is not a quick fix but a journey—a process of rebuilding trust, redefining self-worth, and rediscovering purpose. By integrating principles of safety and empowerment, we create a therapeutic environment where veterans can explore their traumas without fear of judgment, where their stories are heard and validated, and where healing begins with understanding. 

Expanding the Narrative: Education, Advocacy, and Community Engagement 

The journey from service to support does not end with individual therapy; it extends into the realms of education, advocacy, and community engagement. It is about broadening the narrative around veterans’ mental health, challenging stigmas, and fostering a society that recognizes the sacrifices of its veterans not just in words but in actions. By educating healthcare professionals, policymakers, and the public about the realities of PTSD and complex trauma, we can build more robust support systems that reflect our collective gratitude and responsibility towards those who have served. 

In Conclusion 

The transition from surviving to thriving is more than a personal journey for veterans; it is a societal imperative. As we continue to explore and advocate for trauma-informed care, we not only aid in the healing of our veterans but also enrich our collective human experience. The scars of service, though unseen, are indelible markers of sacrifice and resilience. By acknowledging these wounds, by offering our understanding, empathy, and support, we honor the entirety of the veteran experience, fostering a community where healing is not just possible but embraced. 

Woman looking thoughtfully out a windowIn the years following the wars in Iraq and Afghanistan, media reports of veteran violence began accumulating. Formerly social and kind people returned from war angry, and often violent. Rates of domestic violence among former combatants surged. Some veterans killed their partners or families. Many people were shocked, but the truth is that research has long linked PTSD to feelings of anger, and even violent aggression. People with PTSD may be angry about the trauma they survived or feel helpless or out of control.

In the popular imagination, posttraumatic stress (PTSD) is an anxiety disorder. Many envision people who cannot leave their homes, who are easily triggered into fear or panic attacks. Anger, though, is a common symptom of PTSD—so common, in fact, that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifically lists anger as a common emotional reaction among people with PTSD. Feelings of anger can make it difficult to get support from loved ones. A person who feels angry or out of control may feel guilty or ashamed, intensifying the isolation of experiencing trauma.

Even when loved ones want to be supportive, they may not fully understand the severity of the trauma, leaving trauma survivors feeling as if their suffering has been ignored or forgotten.

The Link Between Anger and PTSD

Trauma can be deeply isolating. Loved ones may not understand the trauma or may react inappropriately. For example, rape survivors frequently report being interrogated about their own behavior, while returning soldiers say that civilians are often eager to ask about violent combat experiences. Even when loved ones want to be supportive, they may not fully understand the severity of the trauma, leaving trauma survivors feeling as if their suffering has been ignored or forgotten. This can trigger anger, distrust of others, and related emotions.

Trauma itself may also cause feelings of anger. For example, a birthing person abused by a doctor may be angry both about the abuse and about losing a more positive birth experience. A child abuse survivor may have overwhelming feelings of anger directed at their abuser.

Sometimes a person’s feelings of anger are complicated. A returning solider might be angry about politicians who do not understand war, while also feeling proud about their service. An adult child abuse survivor may love their parents but be very angry about the abuse they suffered. These mixed emotions can make it difficult to manage feelings of anger and rage. In some cases, a person might feel like their anger is unacceptable or be unable to articulate why they feel angry or at whom.

How Anger Complicates PTSD Symptoms

Spending time with an angry person can be difficult. The friends and family of people struggling with PTSD-related anger may eventually grow tired of dealing with mood swings or angry outbursts. They may experience compassion fatigue or even end their relationship with their loved one. This can intensify feelings of alienation and anger.

People with anger from PTSD may feel both ashamed of their emotions and entitled to them. This challenging cocktail makes it difficult to talk about how they feel or to try new coping strategies. For example, when a person feels righteously indignant about being abused, they may not want to try meditation or other coping skills. After all, the thinking goes, they shouldn’t have to have experienced trauma, and shouldn’t be the one stuck coping with the after-effects. While these feelings make perfect sense, they can also be quite self-defeating.

Research has also uncovered a correlation between PTSD, anger, and other mental health conditions. A 2014 analysis, for example, found that 30.3% of people with intermittent explosive disorder (IED) also have PTSD, compared to 14.3% in the general population. When a person presents with a secondary condition, such as depression or IED, their PTSD may go unnoticed and untreated. This prolongs their suffering and may cause them to drop out of treatment, especially when they do not see results.

Other Symptoms That May Co-Occur with Anger

The hallmarks of PTSD include persistently reliving memories or experiences associated with the trauma, such as in dreams, flashbacks, or emotions during the day. People with PTSD also may avoid stimuli associated with the trauma, and experience depression, sadness, anxiety, and anger.

People who experience PTSD-related anger are more likely to experience certain other symptoms, such as:

Getting Help for PTSD-Related Anger

PTSD can disrupt a person’s life and relationships. It can make them feel hopeless and even suicidal. But no one has to live with the aftereffects of trauma forever. PTSD is highly treatable. Some strategies that can help include:

A person may have to experiment with treatment options or therapists before they find what works for them. This persistence can be challenging for someone who is already in pain. Friends and family should offer support, research treatment best practices, and remind their loved one that there is hope.

As with all mental health diagnoses, it is important to note that PTSD, even PTSD that causes intense anger, does not make violence inevitable. People with mental health conditions are far more likely to be victims of violence than perpetrators. Stigmatizing mental health issues can deter treatment, especially when people are dismissed as violent or needlessly angry.

Find a compassionate therapist who understands the many complex emotions a person with PTSD faces here.

References:

  1. Center for Substance Abuse Treatment (U.S.). (2014). Trauma-informed care in behavioral health services. Rockville, MD: Substance Abuse and Mental Health Services Administration (U.S.)
  2. Mental health myths and facts. (2017, August 29). Retrieved from https://www.mentalhealth.gov/basics/mental-health-myths-facts
  3. Morris, D. J. (2014, April 17). PTSD contributes to violence. Pretending it doesn’t is no way to support the troops. Slate. Retrieved from https://slate.com/technology/2014/04/ptsd-and-violence-by-veterans-increased-murder-rates-related-to-war-experience.html
  4. Reardon, A. F., Hein, C. L., Wolf, E. J., Prince, L. B., Ryabchenko, K., & Miller, M. W. (2014). Intermittent explosive disorder: Associations with PTSD and other Axis I disorders in a US military veteran sample. Journal of Anxiety Disorders, 28(5), 488–494. doi: 10.1016/j.janxdis.2014.05.001

Shadows of parents holding child's handMany might assume that the intergenerational transmission of trauma from parent to child occurs through abuse or neglect, but this is not always the case.

Trauma can also be passed on through changes in gene expression. This is known as the epigenetic transmission of trauma. Epigenetics is understood as changes in gene function that are heritable and not associated with changes in one’s DNA sequence (Dupont, Armant, & Brenner, 2009). It is thought that epigenetic changes can occur as a result of extreme stress, such as in the case of parents with histories of trauma.

Heritability of Trauma

Research with children of Holocaust survivors has indicated that children can inherit the traumatic memories of their parents. The evidence is so compelling that some have argued children can inherit the unconscious minds of their parents. Some children of Holocaust survivors have even been known to have genocide-themed nightmares. Although it can be argued the children receive Holocaust imagery through shared stories and narratives, it does not explain their increased vulnerability to stress-related diagnoses such as complex trauma (C-PTSD) and posttraumatic stress (PTSD).

While may be more difficult to prove the inheritance of traumatic memories, we do know that psychological stress can affect gene expression patterns via the nervous system.

While may be more difficult to prove the inheritance of traumatic memories, we do know that psychological stress can affect gene expression patterns via the nervous system. It may be that the disposition to develop PTSD and C-PTSD is passed down through an epigenetic route (Kellermann, 2013).

When Symptoms Occur Without a History of Trauma

It is important to understand that trauma can be inherited independently of difficult family circumstances. A child can develop anxiety, depression, or other stress-related issues such as PTSD as a result of an inherited vulnerability rather than direct trauma.

Research has shown that secure mother-child attachment is key for childhood development (Meins, Bureau, & Fernyhough, 2018). A recent study shows that “good-enough” parenting is adequate for a child to develop a secure attachment to its mother. What this means is that perfect parenting is not required for the child to grow up securely attached, a state that is associated with the best outcomes for mental health (Lehigh University, 2019).

The research has two sides. On one, the research shows us that we do not require perfect parenting and a stress-free environment to be secure and healthy. The flip side of this research is that some children will inherit trauma even with a gentle upbringing. In these cases, a child can inherit symptoms of trauma, including nightmares and anxiety, even without being exposed to trauma.

Can Epigenetic Changes Lead to Positive Outcomes?

While the news that trauma can be passed down despite good parenting may sound disheartening, epigenetics also creates changes in a positive way as well. When we have good nutrition and are raised in a nurturing and loving environment, over generations, epigenetic changes can also occur for the better. Researchers investigating epigenetics in animal models have found that rat pups with mothers who lick and groom them often are more likely to grow up to be calm, while pups who are not groomed frequently by their mothers may grow up to be anxious (Kirkpatrick, 2017).

What we know from epigenetic research as it relates to the intergenerational transmission of trauma is that we can have at least some influence on our children’s ability to be calm and resilient to stress. By providing a loving and nurturing environment for them, we can diminish the intensity of inherited trauma. Each succeeding generation can whittle away at the effects of trauma through consistent nurturing and loving parenting. Trauma does not have to continue from one generation to the next.

References:

  1. Dupont, C., Armant, D. R., & Brenner, C. A. (2009). Epigenetics: Definition, mechanisms and clinical perspective. Seminars in Reproductive Medicine, 27(5), 351-357. doi: 10.1055/s-0029-1237423
  2. Kellermann, N. P. (2013). Epigenetic transmission of Holocaust trauma: Can nightmares be inherited?. The Israel Journal of Psychiatry and Related Sciences, 50(1), 33-39. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24029109
  3. Kirkpatrick, B. (2017, December 12). Cuddling can leave positive epigenetic traces on your baby’s DNA. Retrieved from https://www.whatisepigenetics.com/cuddling-can-leave-positive-epigenetic-traces-babys-dna
  4. Lehigh University. (2019, May 8). ‘Good enough’ parenting is good enough, study finds. ScienceDaily. Retrieved from https://www.sciencedaily.com/releases/2019/05/190508134511.htm
  5. Meins, E., Bureau, J. F., & Fernyhough, C. (2018). Mother–child attachment from infancy to the preschool years: Predicting security and stability. Child Development, 89(3), 1,022-1,038. doi: 10.1111/cdev.12778

Blurred view of elderly woman with a migraineMigraine headaches are one of the most common chronic conditions worldwide. Depending on the study, chronic migraines affect around 1 in 10 people, with twice as many sufferers being female.

Migraine headaches are disabling and cause significant loss of productivity and quality of life. Once they strike, a migraine can last anywhere between 4 and 72 hours. In addition to substantially reducing quality of life, frequent migraines can place one’s job at risk and prevent daily functioning.

Currently, the causes of migraine headaches are not well understood. Genetics are thought to play a role as well as environmental effects and changes in the way the brain interacts with the trigeminal nerve, a pain pathway.

Maladaptive Response to Stress?

It may be that migraine headaches are a result of the brain’s maladaptive response to stress. Researchers have found that when a migraine is triggered, the body’s responses (pain, increases in stress hormones, nausea, and vomiting) are in excess of what is normal. Even during migraine-free periods, a migraine sufferer’s brain is more excitable in response to stimuli.

If we understand how the brain operates on a neural level, we know that much of what is going on inside the brain is inhibitory. It is not optimal to have cascades of neurochemicals circulating through the brain. Overexcitability in the brain reduces the effectiveness of the calming mechanisms in the brain and increase pain sensitivity. What this means is the brain’s response to stimuli between attacks is heightened in an abnormal way.

We know the experience of stress is a significant factor in migraines. Work stress and home stress contribute to the likelihood of a migraine episode.

Childhood Trauma and Headaches

We know that too much stress can change the brain and its reactivity to one’s inner environment, or thoughts, and one’s outer environment, or lights, sounds, and other stimuli. Adults who were exposed to ongoing stress or trauma while growing up often have an impaired ability to calm themselves both mentally and physiologically in response to stress.

A difficult childhood is not a life sentence of heightened stress and suffering. We can take steps to alter our response to stress.

When we look at migraine sufferers as a group, we see a connection between adverse childhood experiences (ACE) and migraine headaches. Examples of ACE are domestic violence, emotional neglect, emotional abuse, and sexual abuse.

Researchers have also begun to investigate the connection between adverse childhood experiences and headaches. Individuals who suffer from migraine headaches are more than twice as likely to have experienced ACEs such as domestic violence while growing up.

How Trauma Results in Migraine: A Possible Mechanism

The connection between childhood stress and migraines is likely linked, at least in part, through the hypothalamic-pituitary-adrenal axis (HPA axis).

The HPA axis is a complex set of interactions among the pituitary gland and the adrenal glands. This hypothalamic-pituitary-adrenal axis controls and regulates bodily processes related to stress reactions. It is easily understood as the fight or flight response. When an individual senses a threat, the body reacts appropriately. Energy is taken away from the digestive and immune systems and is moved to the muscles in order to get ready to run or fight. The adrenal glands are stimulated, and heart-rate, blood pressure, and breathing rates increase. This is an energy-expending state and not optimal for growth or restorative activities.

It is well understood that repeated exposure to stress and trauma during childhood often results in an impaired ability to regulate the stress response over one’s lifetime. Childhood trauma affects the HPA axis. What this means is that over time, the HPA axis loses its ability to effectively control the stress response. During times of upset, the person has an intense reaction that lasts too long. The result is overexposure of the body and brain to high levels of the stress hormone, cortisol.

Migraines may be tied to the same neurochemical conditions associated with trauma, depression, and anxiety, with an overactive stress response (de-regulation of the HPA axis) playing a role. An investigation into certain neurochemicals in migraine sufferers found abnormal patterns of hypothalamic hormonal secretion, a condition also associated with trauma and child abuse.

What Can We Do to Help?

A difficult childhood is not a life sentence of heightened stress and suffering. We can take steps to alter our response to stress. Exercise and meditation have been shown to help calm the mind and body. These activities can begin to reverse the damage caused by an overactive HPA axis. Cognitive behavioral therapy (CBT) is also an effective tool for learning coping strategies and allows individuals to take greater control of reactions to daily life events that cause stress.

Research on migraines and childhood trauma is relatively new and is not well understood. However, if we understand that stress plays a role in migraines, taking steps to reduce stress may help reduce the frequency and duration of migraine episodes. At the very least, a reduction in stress can help us in every area of life, giving us more resilience to deal with a migraine once triggered.

If you think stress or trauma are a source of migraines for you, learning how to manage your stress response in therapy could help. Begin your search for a licensed and compassionate counselor here.

References:

  1. Anda, R., Tietjen, G., Schulman, E., Felitti, V., & Croft, J. (2010). Adverse childhood experiences and frequent headaches in adults. Headache: The Journal of Head and Face Pain, 50(9), 1473-1481. doi: 10.1111/j.1526-4610.2010.01756.x
  2. Brennenstuhl, S., & Fuller‐Thomson, E. (2015). The painful legacy of childhood violence: Migraine headaches among adult survivors of adverse childhood experiences. Headache: The Journal of Head and Face Pain, 55(7), 973-983. doi: 10.1111/head.12614
  3. Dumas, P. (2014). Calling in sick? Good conversations about migraine at work. Retrieved from https://migraineagain.com/calling-sick-good-conversations-about-migraine-work
  4. Exercise and stress: Get moving to manage stress. (2018). Retrieved from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469
  5. Maleki, N., Becerra, L., & Borsook, D. (2012). Migraine: Maladaptive brain responses to stress. Headache: The Journal of Head and Face Pain, 52(2), 102-106. doi: 10.1111/j.1526-4610.2012.02241.x
  6. Migraine. (2018). Retrieved from https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201
  7. Goadsby, P. J. (2009). Pathophysiology of migraine. Neurologic Clinics, 27(2), 335-360. doi: https://doi.org/10.1016/j.ncl.2008.11.012
  8. Lubin, E. (2018). Migraine headache FAQs. Retrieved from https://www.emedicinehealth.com/migraine_headache_faqs/article_em.htm
  9. Nelson, S. M., Cunningham, N. R., & Kashikar-Zuck, S. (2017). A conceptual framework for understanding the role of adverse childhood experiences in pediatric chronic pain. The Clinical Journal of Pain, 33(3), 264-270. doi: 10.1097/AJP.0000000000000397
  10. Peres, M. F. P., Sanchez del Rio, M., Seabra, M. L. V., Tufik, S., Abucham, J., Cipolla-Neto, J., Silberstein, S. D., & Zukerman, E. (2001). Hypothalamic involvement in chronic migraine. Journal of Neurology, Neurosurgery, and Psychiatry, 71, 747-751. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1737637/pdf/v071p00747.pdf
  11. Understanding the stress response. (2018). Harvard Health Publishing. Retrieved from https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
  12. Woldeamanuel, Y., & Cowan, R. (2015). Worldwide migraine epidemiology: Systematic review and meta-analysis of 302 community-based studies involving 6,216,995. Neurology, 86(16). Retrieved from http://n.neurology.org/content/86/16_Supplement/P6.100

Woman sits on the floor at the foot of a bed with her head in her hands.Nearly 7% of Americans will be diagnosed with posttraumatic stress (PTSD) at some point during their lives. In any given year, 3.5% of Americans have PTSD. Many struggle with sleep problems such as insomnia, sleeping too much, and nightmares. For people struggling with trauma during the day, nighttime can feel like a battleground that offers little respite from traumatic memories and intrusive thoughts.

Are Sleep Problems a Symptom of PTSD?

Trauma changes the brain, and these changes can also affect sleep. The Diagnostic and Statistical Manual (DSM) lists sleep disturbances—such as insomnia, frequent waking, or nightmares—as one of many potential symptoms of PTSD. Specifically, to be diagnosed with PTSD, a person must show at least two of six “alterations in arousal and activity.” Those changes include:

For some people, other symptoms of arousal play a role in sleep problems. For instance, a person who is anxious and hypervigilant may be too afraid to fall asleep, while a person with a heightened startle response may startle awake at every sound as they drift off to sleep. This change in sleep can also exacerbate other PTSD symptoms. A chronically exhausted person may be more irritable or have greater difficulty concentrating.

Some research suggests that sleep problems are more than just a symptom of PTSD. Instead, they may be a core component of the diagnosis. Research published in 1989 suggests that disturbances in rapid eye movement (REM) sleep are a PTSD hallmark that play a key role in other PTSD symptoms. Subsequent research has yielded mixed results. While some studies, including of animals, find a pattern of REM disturbances associated with PTSD, others do not.

A 2013 review of the literature argues that disturbances in sleep, especially REM sleep, may increase the risk of PTSD. Sleep issues may also worsen outcomes in people with PTSD. The study further argues that sleep issues can decrease the effectiveness of many PTSD treatments and that targeted treatments for sleep issues may speed recovery.

How Does PTSD Affect Sleep?

People with PTSD often find that their traumatic memories intrude on their ability to sleep. Some common PTSD-related sleep symptoms include:

A study that compared people with insomnia who did not have PTSD to those with combat-related PTSD and insomnia found important differences in the two groups. Those included:

This suggests a feedback loop between sleep issues and other PTSD symptoms. Sleep problems can intensify daytime PTSD symptoms, which may make it even more difficult to sleep at night. People who feel anxious or fatigued during the day may ruminate more on their traumatic memories, increasing the risk of nightmares and other issues when they try to sleep.

Sleep problems can intensify daytime PTSD symptoms, which may make it even more difficult to sleep at night. People who feel anxious or fatigued during the day may ruminate more on their traumatic memories, increasing the risk of nightmares and other issues when they try to sleep.

Other Sleep Problems and PTSD

Sleep issues are common, even in people without PTSD. A 2009 study found that about 30% of people experience insomnia in a given year. Some people also struggle with sleeping too much or with not feeling rested after sleeping. This may be due to:

People with PTSD who have a pre-existing sleep disorder may find their symptoms get worse following a traumatic experience. Conditions that affect sleep can also compound the effects of PTSD, leading to depression, anger, difficulty concentrating, and more trouble coping with PTSD symptoms.

Even when the symptoms of a sleep disorder are not directly related to PTSD, it’s important to get help. Getting quality sleep is an important component of PTSD self-care.

Strategies for Coping with PTSD-Related Sleep Problems

Lifestyle changes can help some people with PTSD sleep more soundly. The National Sleep Foundation emphasizes that sleep is a habit, so the right changes can help the body adopt healthy sleep habits that offer better sleep. Try the following:

Stress and anxiety management strategies can be especially helpful for managing PTSD-related sleep problems. Some people find relief from meditation or yoga. Others find that guided imagery or positive mantras as they try to sleep can help.

Medications, including anti-anxiety and sleeping medications, may help some people. However, when the underlying PTSD symptoms remain, sleep problems will likely return when you stop using medication.

Therapy can help with both sleep issues and PTSD. A compassionate therapist will help you work through your trauma in a safe space, free of judgment. Your therapist can help you set goals, cultivate new tools for managing stress, help you understand how trauma changes the brain, and work with your doctor to decide which, if any, medications are appropriate.

PTSD can feel overwhelming. Some people become depressed because they think things will never change. Others are too exhausted to work or enjoy time with their family. It doesn’t have to be this way. Reach out to a therapist who is highly skilled at treating PTSD.

References:

  1. Germain, A. (2013). Sleep disturbances as the hallmark of PTSD: Where are we now? American Journal of Psychiatry, 4(170), 372-382. doi: 10.1176/appi.ajp.2012.12040432
  2. Gradus, J. L. (2007, January 31). Epidemiology of PTSD. Retrieved from https://www.ptsd.va.gov/professional/PTSD-overview/epidemiological-facts-ptsd.asp
  3. Healthy sleep tips. (n.d.). Retrieved from https://sleepfoundation.org/sleep-tools-tips/healthy-sleep-tips
  4. Inman, D. J., Silver, S. M., & Doghramji, K. (1990). Sleep disturbance in post-traumatic stress disorder: A comparison with non-PTSD insomnia. Journal of Traumatic Stress, 3(3), 429-437. doi: 10.1007/BF00974782
  5. Phillips, K. (2015, February 4). What are the types of sleep disorders? A full list of sleep disorders. Retrieved from http://www.alaskasleep.com/blog/types-of-sleep-disorders-list-of-sleep-disorders
  6. Sleep and PTSD. (2015, August 13). Retrieved from https://www.ptsd.va.gov/public/problems/sleep-and-ptsd.asp
  7. Yehuda, R., Hoge, C. W., Mcfarlane, A. C., Vermetten, E., Lanius, R. A., Nievergelt, C. M., . . . Hyman, S. E. (2015). Post-traumatic stress disorder. Nature Reviews Disease Primers, 15057. Retrieved from https://www.nature.com/articles/nrdp201557#t1

A woman writes in her journal while sitting at a desk surrounded by greenery.George felt weighed down as he checked into yet another motel room. This was his ninth business trip in one month. He didn’t used to mind the traveling so much. Sure, it gets tiring, but he was also feeling irritable, disheartened, and down. He loosened his tie and collapsed on the bed.

Lifting his head, he noticed a notepad and pen on the bedside table. He sat there and started scribbling away, writing about everything and anything – whatever came to mind with no analysis or self-censorship. He just let words flow on to the page. After about 20 mins or so, he sat back with a sense of satisfaction. He felt lighter in his body and more clear-headed in his mind.

He decided to repeat this activity the next day before his first meeting. He even spent a few minutes in the end reflecting on some of the things that were going well in his life. As he left his room to go to work, he was pleased to feel the bounce in his step return.

Whether in movement, song, dance, art, music, or words, there is something natural and liberating about self-expression. Not surprisingly, it can be a useful medium for processing challenging moments and accumulated stress. It can also promote self-empowerment and acceptance.

I often invite my clients to try journaling. They usually ask me if there is a specific way to start. As it turns out, researchers have been studying expressive writing for a while now, seeking to determine what format works best for different issues. The following are some of the results.

Unstructured Expressive Writing

The classical writing instruction as a therapeutic practice was introduced by Pennebaker and colleagues in the 1980s. It goes as follows:

  1. Write “your very deepest thoughts and feelings about an extremely difficult or emotional event that has affected you and your life…” (Baum & Rude, 2013, p.37).
  2. Keep the flow of writing going for 20 minutes nonstop.
  3. Don’t worry about spelling or grammar.

Gratitude Writing

Researchers also found keeping a gratitude journal can have a significant positive effect on mental health. It can create a greater sense of optimism and life satisfaction (Froh, Sefick, & Emmons 2008). A simple daily or weekly gratitude journal involves taking a few minutes to bring to mind things you are currently grateful for. Items on the list can be grand or mundane: “I am grateful that my kid is healthy” and “I am grateful for my toothpaste” are both acceptable.

Then there are gratitude letters. Researchers compared the difference between psychotherapy on its own, psychotherapy with expressive writing, and psychotherapy with gratitude letters. They discovered the option involving gratitude had the greatest beneficial impact. Here’s the gist of their approach (Wong, Owen, Gabana, Brown, McInnis, Toth, & Gilman (2018)):

  1. Choose a specific person to address your gratitude letter to. The purpose is not to send the letter, though you can if you want to.
  2. Reflect on and write about what it is you are grateful for in this person.
  3. Repeat this exercise over an extended period. You can choose the same person as your addressee or a different person.

Expressive Writing for Depression

In 2013, Baum & Rude incorporated the benefits of mindfulness and self-compassion into the classical expressive writing practice. They discovered “expressive writing plus emotional acceptance” made a better impact on alleviating mild symptoms of depression than the classical approach to expressive writing. Both kinds of expressive writing helped mild depression more than regular writing. However, expressive writing was found not to be helpful for those with severe depression symptoms.

So if your depression symptoms are on the milder side, consider the following tips (Baum & Rude, 2013):

  1. Be mindful as you write, taking an observer’s stance. Witness whatever difficult emotions that come out without judging them.
  2. Include a paragraph that normalizes distressed responses in the face of difficulty and stops self-blame.

Expressive Writing for PTSD

This year, researchers published findings that expressive writing could help reduce the severity of posttraumatic stress (PTSD) symptoms. Consider the following structure (Sloan & Marx, 2018):

  1. Write for 30 minutes every day and commit for at least 5 days.
  2. Write from the present moment looking back, as opposed to imagining the trauma as if it were happening now; write while feeling anchored in the here-and-now, present and safe.
  3. Go into the details of the events as you remember them, including thoughts and emotions.
  4. Be a nonjudgmental observer of the writing.
  5. Revisit the same event in your subsequent writing sessions instead of moving on to other incidents.

If you find yourself getting stuck, consider asking yourself some of these questions I adopted from different somatic psychotherapy approaches – including Somatic Experiencing and EMDR – that work with trauma:

  1. “What happened next?”
  2. “Who was there to help you?”
  3. “When did you know you were safe?”

Expressive Writing for Test Anxiety

Studies have found expressive writing helps students with high test anxiety perform better. So if you are a teacher, consider adopting the following activity for your students (Doherty & Wenderoth, 2017; Ramirez & Beilock, 2011):

  1. Set aside 10 minutes for writing prior to the exam. (If time does not allow, 5 minutes can also be effective).
  2. Let your students know the purpose of this writing activity.
  3. Keep the writing anonymous.
  4. Let it be an optional activity.
  5. Instruct your students to write “as openly as possible” about their thoughts and feelings regarding the exam they are about to take.
  6. When they’re done, or when time is up, instruct them to crumple the paper and throw it away.

If you are a student with test anxiety, see if your teacher will give you time to do this before the exam. You can also try it yourself. Find a quiet place near the exam room about 15 minutes before the exam. Use 10 minutes to do the expressive writing exercise and the remaining 5 to get to your exam on time and get settled.

Writing for Sleep Disturbance

In some cases, writing exercises can also help with sleep issues. Spending 5 minutes writing a simple to-do list for tomorrow can help you fall asleep faster. Conversely, writing about tasks you already completed can delay your ability to fall asleep (Scullin, Krueger, Ballard, Pruett, & Bliwise, 2018). So if you want to fall asleep quickly, you can use pre-sleep writing to clarify tomorrow’s activities and de-clutter your head.

Designing Your Own Writing Practice

If you decide to try writing your way to mental health, let yourself be curious and discover what is the best approach for you. If you already have a writing practice, great! If modifying based on the tips above, consider a combined power punch that incorporates a gratitude section into whatever writing practice you have.

If you are thinking of using expressive writing to process a traumatic incident or to manage depression, it might be helpful and even recommended that you do so with the added support of a trained mental health professional.

References:

  1. Baum, E. S. & Rude, S. S. (2013). Acceptance-enhanced expressive writing prevents symptoms in participants with low initial depression. Cognitive Therapy and Research, 37(1), 35-42. doi:10.1007/s10608-012-9435-x
  2. Doherty, J. H. & Wenderoth, M. P. (2017, August 11). Implementing an expressive writing intervention for test anxiety in a large college course. Journal of Microbiology & Biology Education, 18(2), 39. doi: 1128/jmbe.v18i2.1307
  3. Froh, J. J., Sefick, W. J., & Emmons, R. A. (2008). Counting blessings in early adolescents: An experimental study of gratitude and subjective well-being. Journal of School Psychology, 46(2), 213-233. doi:10.1016/j.jsp.2007.03.005
  4. Ramirez, G., & Beilock, S. L. (2011). Writing about testing worries boosts exam performance in the classroom. Science, 331(6014), 211-213. doi:1126/science.1199427
  5. Rude, S. S. & Haner, M. L. (2018, February 13). Individual differences matter: Commentary on “Effects of expressive writing on depressive symptoms—A meta‐analysis”. Clinical Psychology: Science and Practice, 25(1), e12230. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/cpsp.12230
  6. Scullin, M. K., Krueger, M. L., Ballard, H. K., Pruett, N., & Bliwise, D. L. (2018). The effects of bedtime writing on difficulty falling asleep: A polysomnographic study comparing to-do lists and completed activity lists. Journal of Experimental Psychology: General, 147(1), 139-146. doi:1037/xge0000374
  7. Sloan, D. M. & Marx, B. P. (2018). Maximizing outcomes associated with expressive writing. Clinical Psychology: Science and Practice, 25(1), e12231. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/cpsp.12231
  8. Wong, Y. J., Owen, J., Gabana, N. T., Brown, J. W., McInnis, S., Toth, P., & Gilman, L. (2018). Does gratitude writing improve the mental health of psychotherapy clients? Evidence from a randomized controlled trial. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 28(2), 192-202. doi:10.1080/10503307.2016.1169332

Closeup of hands held highI had an eye-opening insight during a recent training class. We were talking about the #MeToo movement and trauma that carries forward from one generation to the next. It suddenly struck me that sexual abuse and violence against women was a trauma all women bear. When I shared my newfound wisdom, many of the women in the class nodded and said something like, “No, duh!”

I could have felt embarrassed because I hadn’t understood the depth of the #MeToo movement and the impact that sexual assault has on women as a group. Instead, I felt even more connected to the women in the room. If we haven’t been abused ourselves, chances are we know someone who has. If that person is our mother, our grandmother, or our great-grandmother, we may hold the impact of that trauma in our own bodies.

How Common Is Abuse of Women?

According to the World Health Organization (WHO), 35% of women around the world have been physically or sexually abused at some point in their life. Risk factors include low income, less education, fewer job opportunities, and living in communities that value men more than women.

If you are a woman of color, your odds of being abused go up. According to the Department of Justice (DOJ), black women are 35% more likely than white women to experience violence at the hands of an intimate partner.

The WHO and DOJ studies don’t include emotional abuse or childhood emotional neglect, so I have to assume the problem is worse than the statistics show.

What Is Intergenerational Trauma?

How can abuse that happened to someone else affect us? Studies have shown that when you have a traumatic experience, it can alter your body chemistry and even change your genes. As a result, the stress from traumatic events or being sexually assaulted or abused can be passed down from one generation to the next.How can abuse that happened to someone else affect us? Studies have shown that when you have a traumatic experience, it can alter your body chemistry and even change your genes.

Rachel Yehuda, PhD, director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, studied the impact of stress on people who survived the Holocaust and 9/11. As part of her study, she looked at whether the survivors passed the stress down to their children. When the environment turns a gene on or off, it is called an epigenetic change. Dr. Yehuda found survivors of both 9/11 and the Holocaust passed these changes on to their children.

These traumatic events didn’t just affect the survivors. Dr. Yehuda found that trauma actually changed their children’s genes. The children of survivors showed the same biological and emotional effects of stress from the trauma. They had lower levels of the hormone cortisol, which helps the body manage stress. As a result, they were more likely to have posttraumatic stress disorder (PTSD) and anxiety. The children’s bodies were affected by trauma even though they didn’t directly experience the traumatic event.

The Impact of Violence Against Women Across Generations

Today, women continue to be the victims of sexual and physical violence. In the United States, we live in a male-dominated society where women often have less power. Having less power can increase one’s risk of being abused.

Recent headlines about Harvey Weinstein, Bill Cosby, and other famous men who have been charged or convicted of sexual abuse are only part of the story. It’s not just high-profile cases or ultra-powerful men. One in four women is sexually harassed or assaulted in the military. They are raped on college campuses—23% of female undergraduates report being raped. One in four women in the United States is severely abused by an intimate partner. According to a new study, 81% of women reported they were sexually harassed on the job.

Women who feel helpless in the face of abuse pass that trauma and stress down to future generations.

In this country, women of color have even less power than white women do. Because women of color are a minority, they are often more vulnerable to abuse. Over the course of history, many generations of women of color have lived through sexual bullying, assault, and abuse. Even today, they may be ignored if they choose to say “no” or report the abuse. Women who feel helpless in the face of abuse pass that trauma and stress down to future generations.

Healing and Reason for Hope

The good news, as Dr. Yehuda explains, is that inherited changes work both ways. When we learn how to soothe and manage the symptoms and stress of trauma, we pass that healing down. Even if we’ve experienced trauma, we can create change when we learn how to self-soothe. And our children may be stronger for it.

That being said, self-soothing doesn’t come easily to everyone. It’s hard to manage stress if your body is sounding an alarm even when there’s no danger. This overactive stress response happens for some people who have experienced trauma. We now know it can also occur if your parent was traumatized. Trauma therapy can help you learn how to manage emotions and work through trauma in a safe, supportive environment. You learn tactics that teach your body to return to its ideal level of arousal. When your body learns it’s not constantly under attack, you begin to feel less stressed. If you feel you could benefit from trauma therapy, start your search for a therapist here.

Self-soothing strategies go a long way toward helping you manage the stress that comes with trauma. Learning to self-soothe could also help future generations by supporting genetic changes that make it easier to thrive. But if racism, bigotry, and violence against women and minorities continues, the trauma will also continue to affect victims, survivors, and their children. If we don’t make and create change, the legacy of trauma will continue for future generations of women. It’s time for all of us to do things differently.

References:

  1. Campus sexual violence: Statistics. (n.d.) RAINN. Retrieved from https://www.rainn.org/statistics/campus-sexual-violence
  2. Chatterjee, R. (2018, February 21). A new survey finds 81 percent of women have experienced sexual harassment. NPR. Retrieved from https://www.npr.org/sections/thetwo-way/2018/02/21/587671849/a-new-survey-finds-eighty-percent-of-women-have-experienced-sexual-harassment
  3. Military sexual assault fact sheet. (n.d.) Protect Our Defenders. Retrieved from https://www.protectourdefenders.com/factsheet
  4. Rodriguez, T. (2015, March 1). Descendants of holocaust survivors have altered stress hormones. Retrieved from https://www.scientificamerican.com/article/descendants-of-holocaust-survivors-have-altered-stress-hormones
  5. Statistics. (n.d.). National Coalition Against Domestic Violence. Retrieved from https://ncadv.org/statistics
  6. Tippett, K. (2015, July 30). How trauma and resilience cross generations. Retrieved from https://onbeing.org/programs/rachel-yehuda-how-trauma-and-resilience-cross-generations
  7. Violence against women. (2017, November 29). World Health Organization. Retrieved from http://www.who.int/news-room/fact-sheets/detail/violence-against-women
  8. Women of color network facts & stats: Domestic violence in communities of color. (2006). Retrieved from https://www.doj.state.or.us/wp-content/uploads/2017/08/women_of_color_network_facts_domestic_violence_2006.pdf

Sunlight shines through the window, illuminating a soldier and wife embracing.Posttraumatic stress (PTSD) can develop following any exposure to trauma—including trauma another person experienced. A military spouse may get PTSD after learning about or otherwise being exposed to trauma their partner faced. This is sometimes called vicarious trauma or secondary trauma.

How Do Military Spouses Get Traumatized?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person doesn’t have to directly experience trauma to develop PTSD. Witnessing someone else’s trauma, learning a loved one was hurt, or repeatedly hearing details about a traumatic event can also cause PTSD.

A military spouse might develop PTSD stemming from their partner’s trauma by:

Some military spouses also develop PTSD due to their own military-related trauma. Depending on the mission, a spouse may not be able to locate or talk to their deployed partner. They may spend months or years terrified about their partner’s well-being. This fear can be compounded by graphic media coverage.

Military spouses who experience symptoms of PTSD should know that military combat is not the only reason people develop posttraumatic stress. PTSD symptoms may be related to another trauma, such as a car accident, sexual assault, or child abuse.

A 2011 study followed 170 female military spouses who reported symptoms of PTSD. Researchers asked about the women’s experiences of stress and trauma and found:

For people who have already experienced trauma, exposure to a loved one’s trauma may re-trigger the previous trauma.

How Common Is PTSD Among Military Family Members?

PTSD is a common experience. According to the National Institutes of Health, about 7.7 million Americans have PTSD at any given time. The 2011 study above found 21.6% of military wives qualified for a PTSD diagnosis.

Whether or not a military spouse develops PTSD depends on multiple factors, including:

Children can also be affected by a parent’s military experiences. Children who develop secondary trauma may have nightmares, unusual fears, or increased irritability. Trauma can also shift the way children relate to one or both parents. The likelihood of a child developing PTSD depends on their age, gender, and general family functioning.

Military Spouses and Compassion Fatigue

Military spouses who act as caregivers for their loved ones can experience compassion fatigue. Over time, the demands of continually caring for someone can deplete empathy. A spouse might begin feeling resentful instead of compassionate. Compassion fatigue can harm the relationship, and it may lead to worsening symptoms of PTSD in one or both spouses.

Trauma is not a contest…Everyone affected by PTSD needs and deserves help.Support from expert caregivers, such as therapists and doctors, can be crucial. Regular breaks from the demands of caregiving can also be important. A person who intends to provide all the care their loved one needs, without any assistance, is much more vulnerable to compassion fatigue.

Romantic relationships are an important outlet for many people. Spouses often rely on one another for emotional support, freely venting and seeking empathy. When a partner is struggling with serious mental health symptoms, they may be less able to provide comfort. This change deprives the caregiving partner of an important source of emotional support during a time when they need it most.

Therapy can help partners manage the effects of PTSD on a relationship. With the right therapist, military spouses can stop feeling like caregivers and begin feeling like partners again. Therapy can also help the care recipient feel understood and supported. A couple may find the process of navigating trauma together deepens their relationship in the long run.

Self-Care for Military Spouses

As a military spouse, you may feel guilty for struggling with your own trauma. You may believe you cannot have PTSD if you didn’t experience combat. Or you may recognize your symptoms but hide your distress because your spouse “had it much worse.”

Trauma is not a contest. You might face unique stressors that your partner does not. It doesn’t matter who has it worse or who has suffered more. Everyone affected by PTSD needs and deserves help.

Some self-care strategies that can help military spouses cope include:

Military spouses who struggle with secondary PTSD can find much relief in therapy. Therapy helps you understand how your partner’s trauma affects you. It may also help you identify traumatic experiences in your own life that play a role in your PTSD. Therapy can be a supportive place to discuss your feelings without judgment. The right therapist can help you make healthy lifestyle changes and boost your resilience.

PTSD isn’t just for soldiers. You don’t have to suffer alone. You can find a therapist who can help you manage secondary trauma here.

References:

  1. Cook, C. R., Slater-Williams, A. A., & Harrison, L. R. (2012). Secondary PTSD in children of service members: Strategies for helping professionals [PDF]. In VISTAS (Article 6). Retrieved from https://www.counseling.org/resources/library/VISTAS/vistas12/Article_6.pdf
  2. How to deal with stress as a caregiver. (2018, March 21.) Military OneSource. Retrieved from https://www.militaryonesource.mil/-/how-to-deal-with-stress-as-a-caregiver
  3. Renshaw, K. D., Allen, E. S., Rhoades, G. K., Blais, R. K., Markman, H. J., & Stanley, S. M. (2011). Distress in spouses of service members with symptoms of combat-related PTSD: Secondary traumatic stress or general psychological distress? Journal of Family Psychology,25(4), 461-469. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156850
  4. PTSD: A growing epidemic. (2009). NIH Medline Plus, 4(1), 10-14. Retrieved from https://medlineplus.gov/magazine/issues/winter09/articles/winter09pg10-14.html
  5. Yehuda, R., Hoge, C. W., McFarlane, A. C., Vermetten, E., Lanius, R. A., Nievergelt, C. M., . . . Hyman, S. E. (2015, October 8). Post-traumatic stress disorder. Nature Reviews Disease Primers, 1. Retrieved from https://www.nature.com/articles/nrdp201557/tables/1
Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.