Traumatic Grief and PTSD: Thriving with Depression (Part 30)

 

Traumatic Grief

Thank you for joining me. This is such an important topic and I believe it is cathartic to talk about it. Today, I am going to continue my discussion of grief, but I am going to focus more on traumatic grief. Over the past few articles, we talked about grief- what grief is and how to manage the sadness and other emotions that accompany this difficult passage in life. We discussed ways to bring back the joy in life so that we don't let our grief control us and what to do if we can't seem to move forward. 

Please feel free to revisit any of the previous articles on grief:

Grief
Healing from Grief
You're Never Alone
Grief; Stuck in Sadness
Grief and Trauma

Grief, as I mentioned previously, is a loss. It can be the loss of anything- the death of a loved one, the loss of a marriage, a business, or the function of a body part. Grief is a dichotomy. It is a very personal experience, yet we all face it at one time or another. It is hard to measure and compare one person's grief vs. another's. However, there are some types of loss that tend to be harder to face than others. Grief from trauma can be especially difficult. 

To review what trauma means, in my last article, Grief and Trauma, I define it as a severe, sudden loss that is surprising. I believe it all comes back to expectations in life. It happens outside our "expected" cultural norms. That does not mean it is rare. Trauma related deaths are considered the #1 cause of death from ages 1-46. * According to the National Institutes of Health, about one half of US adults experience at least 1 traumatic event in their lives. 

An example of trauma is the loss of a child. While this happens to many people, it is not expected. This is especially true in developed nations where children are born in sophisticated hospitals and people usually have access to treatment in the event of injury. It is expected that we will pass before our children. Another example is the loss of a limb from a car accident. Car accidents happen all the time. Most of us expect to be in a fender bender at one time or another. What we don't expect is to lose an arm or leg in an accident. It is beyond the expected cultural norms. Let me clarify something. Trauma is something that is beyond the culture or society's norms, not your own. 

For example, I mentioned a lady in one of my previous articles who was devastated at the loss of her 92-year-old mom. As devastated as she was, this is still an example of typical grief and not grief due to a trauma. Death in your 90s and even 80s, is considered a norm in our society.

Did you notice above that we came back to the topic of expectations? We discussed expectations last time when we spoke about why some people seem to have an easier time with grief. Expectations is a key concept whenever it comes down to how well we handle life and stress. 

Post-Traumatic Stress Disorder

So, how is our grief different when faced with a trauma? Sometimes, there may not be any difference.

Other times, the main difference is the degree and depth of work you need to do to heal. This is particularly the case if faced with PTSD (Post-Traumatic Stress Disorder). When we are exposed trauma, we have the possibility of developing PTSD. According to the National Institutes of Health (NIH), the good news is that is that most people will not develop Post-Traumatic Stress Disorder. ** 

What exactly is PTSD? After a traumatic event, it is natural to feel fear. This makes sense because fear helps us avoid or prepare for any potential danger. The problem comes about when this initial response of fear does not go away leading to a variety of other symptoms. In order to have PTSD, the person must have symptoms from each of the categories below: *

At least one re-experiencing symptom

• 
  Experiencing flashbacks—reliving the traumatic event, including physical symptoms such as a racing heart or sweating
• Having recurring memories or dreams related to the event
  
• Having distressing thoughts
• Experiencing physical signs of stress

At least one avoidance symptom

• Staying away from places, events, or objects that are reminders of the traumatic experience
• Avoiding thoughts or feelings related to the traumatic event

At least two arousal and reactivity symptoms

• Being easily startled
• Feeling tense, on guard, or on edge
• Having difficulty concentrating
• Having difficulty falling asleep or staying asleep
• Feeling irritable and having angry or aggressive outbursts
• Engaging in risky, reckless, or destructive behavior

At least two cognition and mood symptoms

• Having trouble remembering key features of the traumatic event
  
• Having negative thoughts about oneself or the world
• Having exaggerated feelings of blame directed toward oneself or others
• Having ongoing negative emotions, such as fear, anger, guilt, or shame
• Losing interest in enjoyable activities
• Having feelings of social isolation
• Having difficulty feeling positive emotions, such as happiness or satisfaction

With trauma, there are other factors that make the loss more complicated and there are more emotions to handle as compared to non-traumatic grief. Because they are not "expected," we are often blind-sided when they happen to us. We have not prepared ourselves emotionally, if even we could, for any type of traumatic situation. 

Research shows that some people are at higher risk than others for PTSD#. 

1. 
   Multiple adverse experiences
   
2. Mental difficulties
   
3. Little social support 
4. Recurrent ongoing life stress
5. Physical impairment 
6. Job loss 

And, as I mentioned last time, aside from social support I believe expectations and beliefs are also important factors to take into consideration when it comes down to how well we handle life and stress. 

I discussed some ideas of how to handle grief over my last few articles.

Examples include counseling/support group, telling stories about the person/aspect of your life you lost, looking at photos to help remind you of joyous times in life, using creativity to heal, finding an activity to help you deal with your grief, making changes that help you embrace this new part of your life. I also addressed some steps to take when you get stuck in grief and can't move forward:

1. Step one: Look at your situation from an outsider's perspective. 
2. Step two: Look at your past (and heal from it). 
3. Step three: Look at your future.
4. Step four: Look at what you have to offer.

With non-traumatic grief, you may pick and choose from the menu of options and use what works for you. For traumatic grief, you will need to use many options and I believe two are indispensable. 

Indispensable Option One: The first one is a good counselor or support group. (In particular, a support group for a similar trauma). A trauma brings up a variety of emotions. But you are in so much pain that may be hard to see all of them. A counselor or support group can help you identify the different emotions you have so you can deal with them. Two big emotions are blame and guilt. Even if you did nothing wrong, you may still experience these two emotions and not even realize it. Deep down you may even blame yourself or someone else but not even realize it. This may be especially the case if this trauma reminds you or a hurt from your past. 

Indispensable Option Two: The second option that I believe is indispensable is to use creativity to help you heal. Surprised I mentioned this one? The reason is because we hold emotions deep below the surface and, as I mentioned above, may not even be aware of them. This is where using a creative medium comes into play. Drawing, painting, sculping, writing, etc. allows us to express emotions through creativity that we have difficulty verbalizing or even recognizing. 

Summary

Grief from trauma can be more complicated to handle and heal. But your expectations and social support can make a big difference in the healing process. While it is possible to develop PTSD from trauma, research shows most people will not do so. Most people will find purpose, joy, and love in life again. Yes, you will still have sad days, but the difference is that the sadness will not rule your life. Growing up my mom always quoted the old adage "This Too Shall Pass." It does not always feel like this is true, but that doesn't mean it isn't. My mom is no longer with me, but her memory, wisdom, and kindness are with me every day.