Stress, Trauma and PTSD: What You Need to Know

The body remembers. Always.

It can remember a trauma event even if we’re unaware of it, says Catherine Murtagh-Schaffer, a physician assistant with Lee Health and Shipley Cardiothoracic Center.

“We may be able to block uncomfortable thoughts from our immediate cognition, but the body always knows,” Cathy says. “The body wears the scars.”

In recognition of Mental Health Month, Cathy shares some insight about Post-traumatic Stress Disorder (PTSD) and how it may prevent you from living your best life without treatment. Her e-book Stress, Burnout and PTSD: A Return to Joy discussed the mental health burdens her colleagues in healthcare have faced since COVID-19 changed the world. While her primary specialty involves heart health, she recognizes the important role that mental health plays in all our lives.

What is a traumatic event?

We’ve all experienced a stressful event at one time or another in our lives. According to the Centers for Disease Control and Prevention (CDC), when an event or series of events causes a lot of stress, it is called a traumatic event.

Events that may lead to PTSD include violent personal or sexual assaults, natural or human-caused disasters, accidents, combat, and other forms of violence. About half of all U.S. adults will experience at least one traumatic event in their lives, but most don’t develop PTSD, according to the American Psychiatric Association.

An estimated 7.8% of Americans will experience PTSD during their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD. About 3.6% of U.S. adults ages 18 to 54 (5.2 million people) have PTSD during the course of a given year.

What is PTSD?

PTSD came into the medical language in the 1980s after the APA added the condition to its diagnostic manual of mental disorders. Before that, the history of PTSD involved different names such as "shell shock,” "battle fatigue,” and “war neurosis.”

Now, PTSD is recognized as not only affecting military veterans but also anyone who has gone through an intensely traumatic experience. PTSD is an intense physical and emotional response to thoughts and reminders of the event that lasts for many weeks or months after the traumatic event, according to the APA.

Six out of every 100 American adults (about 6% of the population) will have PTSD in their lifetime, according to the U.S. Department of Veteran Affairs. Eight out of every 100 women in the U.S. will experience it in their lifetime, compared to four out of every 100 men.

Thoughts, memories, sensitivity

Cathy notes a diagnosis of PTSD requires a discussion with a trained professional, but she cites these general criteria of the National Alliance on Mental Health:

• You keep having thoughts and memories about the traumatic event, which can include flashbacks of the trauma, bad dreams, and intrusive thoughts.
• You practice avoidance, which can include staying away from certain places or objects that are reminders of the traumatic event because they might activate your PTSD symptoms.
• You may also feel numb, guilty, worried, or depressed and have difficulty remembering the traumatic event. Cognitive symptoms can, in some instances, extend to include out-of-body experiences or feeling that the world is "not real.”
• You might find yourself very sensitive to noises and sights that remind you of the trauma, causing you distress. You may have trouble sleeping or have outbursts of anger.

The body wears the scars

“Unfortunately, many people don't recognize their symptoms and eventually try to temper their despair or pain by self-medicating with alcohol or drugs,” Cathy says. “This never turns out well and can lead to accidental overdoses or an addiction problem.”

READ: Steps to Help Someone with a Drinking Problem

Bessel van der Kolk, a well-known trauma psychiatrist from Boston, wrote, “The Body Keeps the Score.” In this book, he talks about patients who have experienced trauma wearing the internal scars of trauma on their bodies;

• Clenched fists
• Hunched shoulders
• Empty eyes
• Voices edgy with anger
• Sunken chests
• Voices constricted with fear

Source: Healthcare Stress, Burnout and PTSD in the Year of COVID-19

“Because of the COVID-19 pandemic and the subsequent loss of jobs, increased anxiety and threatening economic depression, the number of those suffering with despair, anxiety and grief have increased exponentially,” Cathy observes. “And Hurricane Ian devastated our communities, in body, mind, and spirit.”

READ: After the Storm: How to Deal with Mental Health Challenges

Difference between stress, burnout, and PTSD

The differences between stress, burnout and PTSD can be found in the intensity and duration of their symptoms.

“If one day you go from feeling occasionally exhausted or anxious to feeling unrelenting exhaustion, anxiety or anger, you have probably crossed a threshold,” Cathy says. “When the days you come home from work crying or wanting to drown yourself in alcohol outnumber the days you don't, you need to seek help.”

The good news is that there is highly effective treatment available for patients who suffer from PTSD.  Multiple modes of evidenced-based treatment can be tailored to the patient. 

• Cognitive behavioral therapy (CBT): This “talk therapy” works on changing the thought process around the emotions/triggers.
• Exposure therapy: This therapy involves having the patient relive the event in a safe environment with expert guidance.
• Antidepressants: The following medications (listed by their generic and brand names) have proved effective for reducing the symptoms associated with PTSD: sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac), and venlafaxine (Effexor).
• Psychodynamic therapy: Another form of “talk therapy” that focuses on the patient gaining insight into their personal values and emotional conflicts. Its hallmarks are self-reflection and self-examination, that help the patient understand their emotional patterns and roots.
• Eye Movement Desensitization and Reprocessing (EMDR): This mental health technique can change the brain’s reaction to a traumatic event. The method involves moving your eyes a specific way or tapping movements while you process traumatic memories.
• MDMA (also known as ecstasy or molly): There is no current medication to treat the symptoms specific to PTSD (depression and anxiety, which often accompany PTSD, have pharmacologic treatments available. See “Antidepressants” above.) This hallucinogenic drug could be approved by the Food and Drug Administration (FDA) as a treatment for PTSD as soon as 2024, reports the Los Angeles Times.

How are you doing?

If the answer to that question is "not so good," please reach out for help.

• 988 – The Suicide Lifeline
• Lee Health Addiction Medicine Clinic – 239- 343-9190
• Lee Health Behavioral Health Clinic – 239-343- 9180

Hope For Healing is an initiative started by First Lady Casey DeSantis - a partnership across state agencies for mental health substance abuse support.

The U.S. Substance Abuse and Mental Health Services Administration operates a free 24/7 crisis counseling helpline for people involved in disasters, including hurricanes and tropical storms.

• Call or text 1-800-985-5990. Spanish speakers can press 2 for help in that language. Third-party interpretation services are available in more than 100 other languages.
• Español: Llama o envía un mensaje de texto 1–800–985–5990 presiona “2.”
• For Deaf and Hard of Hearing ASL Callers:  
  • To connect directly to an agent in American Sign Language, click the "ASL Now" button below or call 1-800-985-5990 from your videophone. ASL Support is available 24/7.

Post-traumatic Stress Disorder (PTSD) Alliance is an alliance of professional and advocacy organizations that provide educational resources to individuals diagnosed with PTSD and their loved ones; those at risk for developing PTSD; and medical, healthcare and other professionals. Visit www.ptsdalliance.org or call 1-877-507-PTSD.

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).