Trauma- and stress-related disorders: Pathology review

A 31 year old female named Amelia comes to the mental health clinic complaining of trouble sleeping due to vivid nightmares recounting an armed bank robbery she witnessed 4 months ago.

Ever since that event, she has avoided going to crowded places that remind her of the bank, to the point where she had to give up her job at the mall.

Suddenly, your phone starts ringing and Amelia jumps from her seat. You apologize, and she then mentions that this happens whenever she hears sudden or loud noises.

Okay, based on the initial presentation, Amelia seems to have some form of trauma or stress-related disorder.

Many individuals at some point in their lives experience trauma, which can be thought of as a distressing event that causes an overwhelming amount of stress, exceeding one’s ability to cope or process the emotions caused by that experience.

Trauma can be caused by one single event, such as a serious car crash or sexual assault or abuse; or can last for a more prolonged period of time, such as experiencing poverty, neglect during early childhood, or military combat.

Most of the time, with support from loved ones, individuals are able to recover from a traumatic experience.

Unfortunately, some individuals may develop trauma and stress-related disorders, where traumatic experiences lead to symptoms like flashbacks, nightmares, and anxiety, all of which can interfere with day-to-day activities like working, studying, eating, and sleeping.

Now, the underlying cause of trauma and stress-related disorders is poorly understood; but what you need to remember is that individuals affected usually have altered levels and response to stress hormones like adrenaline and cortisol.

For your exams, the most high-yield trauma and stress-related disorders are post-traumatic stress disorder, acute stress disorder, and adjustment disorder. Okay, let’s start with post-traumatic stress disorder, or PTSD for short.

This usually occurs in individuals who have either directly experienced a traumatic event or witnessed as it happened to others, but it can also affect someone who just heard that a close family member or friend was involved.

In a test question, make sure to also keep an eye out for someone with prolonged or extreme exposure to graphic details of traumatic events, such as a police officer or paramedic, as well as a military veteran.