Trauma affects everyone differently. In the 2014 book “The Body Keeps the Score,” author Dr. Bessel van der Kolk writes, “One does not have to be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma.”1
But what is trauma, and how does it appear in a person’s life? Trauma refers to an event or series of events that cause significant stress. When the memory of that stressful event lingers, it can lead to unexpected symptoms like low self-esteem, sleep problems, headaches, and more.
Here’s what you should know about trauma, how to cope, and when to seek help.
What Is Trauma?
According to the American Psychological Association, trauma is an emotional response to a terrible event.2 The definition of a terrible event varies widely: being directly harmed, witnessing someone else be harmed, or living in a stressful situation are all potential sources of trauma.
Trauma responses can take many forms, such as anxiety, anger, fatigue, and withdrawal. Although people respond differently, it’s important to remember that these are normal reactions to abnormal circumstances. 3
It’s natural for people to experience traumatic events in the course of their lives. Most survivors quickly bounce back without long-term consequences, especially if they have coping strategies and social support to deal with the effects. However, others struggle to move on, for reasons clinicians don’t fully understand.
Experiences that may be traumatic
The following is a non-exhaustive list of potentially traumatic events. Any situation that makes you feel an intense negative emotion, like you’re abandoned, trapped, or unsafe, can be traumatic. It might be a one-time event or something that happens over days, months, or even years.
Examples of traumatic experiences include: 4
- Accidental gun shooting
- Home invasion
- Homicide or suicide
- Loss of a loved one
- Natural disasters (such as an earthquake or wildfire)
- Transport accidents (such as a traffic collision)
- Violence (such as domestic, physical, or sexual)
- Witnessing trauma
Types of Trauma
There isn’t a single, definitive list of trauma types. After all, it can take many forms, individuals and communities respond differently, and some symptoms can fit into multiple categories.
However, the following groupings can help frame a person’s feelings and potential paths forward: 4
Adverse Childhood Experiences (ACEs)
An ACE refers to a traumatic event that affects a child, such as abuse, divorce, or living with a substance-addicted parent. ACEs can increase a child’s risk for chronic health conditions and risky behaviors. 5
This risk is high among marginalized populations, such as people who have less than a high school education or identify as Black, Hispanic, or multiracial. 6
Community and cultural trauma
Community and cultural trauma refer to events that impact the safety within an area, such as a neighborhood, reservation, or school. Examples include hate crimes, prejudice, and shootings. This category also contains racial and generational traumas (also known as historical trauma).
True to its name, individual trauma affects one person. The traumatic event might occur once, such as a mugging or violent attack, or over an extended period, such as a life-threatening illness.
This type of trauma involves conflicts with other people, such as parents and children, partners, or spouses. Examples include abuse, domestic violence, and sexual assault.
Group trauma affects a specific group of people. Discrete groups, like first responders and military personnel, are exposed to different types of traumatic events that tend to be repeated. Examples include nurses caring for patients during the COVID-19 pandemic, rescue workers sent into natural disaster areas, and military personnel deployed to war zones.
Human-caused traumas result from human failure or design, such as technological catastrophes or warfare. Survivors may struggle to understand why the event happened, who is to blame, and who the perpetrator was.
These are natural events that affect a small number of people. Examples of natural traumatic events include a fallen tree, flood, or epidemic.
As opposed to some other trauma types, natural trauma is unavoidable and unintentional.
Symptoms of Trauma
Trauma symptoms are difficult to pin down because they can manifest in so many different ways. Headache? Trouble focusing? Fatigue? Procrastination? Those might be the side effects of a rough night’s sleep. They might also be signs of trauma.
That’s not to say that every headache is a trauma response. However, it’s common for people to feel a range of symptoms after a traumatic experience:3
Physical symptoms of trauma
- Changes in appetite
- Frequent sickness
- Muscle tremors
- Nausea and stomach problems
- Trouble sleeping
Emotional symptoms of trauma
Behavioral symptoms of trauma
- Apathy and withdrawal
- Decreased activity
- Increased substance use
- High-risk behaviors
- Social relationship problems
- Tendency to argue
Cognitive symptoms of trauma
- Difficulty concentrating
- Difficulty making decisions
- Distorted perception of time and space
- Intrusive thoughts or trauma flashbacks
- Magical thinking
- Memory problems
- Suicidal thoughts
If you have suicidal thoughts and need immediate support, call the Suicide Prevention Lifeline at 1-800-273-TALK (8255).
The Science of Trauma
If you’re dealing with trauma symptoms, it’s tempting to think it’s all in your head. In reality, trauma affects systems throughout your body, from hormones to nerve cells.
This is especially true for victims of ACEs: Adults who experienced childhood trauma are more vulnerable to developing chronic disease, physical and mental illness, and substance-related disorders.3
How does trauma affect the brain?
Trauma affects the brain by triggering your defense mechanisms.
The human race’s entire evolutionary history is built upon staying alive. Any threat to your safety immediately triggers reactions in your brain and body designed to protect you from harm.
You might have heard this chain of reactions called the fight-or-flight response (which has since expanded to include other responses, like fawn and flop). Your brain’s nerves and chemicals change in response to trauma: Your brain stimulates the release of stress hormones, which prepare your body to respond to danger.
Once the threat has passed, your systems usually return to normal. But sometimes, the effects of trauma linger. When the effects of trauma stick around for over a month, it’s classified as post-traumatic stress disorder (PTSD).
It’s not clear why the effects of trauma linger longer for some people. Factors like a person’s coping skills, connections with their family and community, and the type of trauma play a role.
What happens in the brain when the threat never really goes away? In a review article published in 2012, researchers discussed the effects of PTSD on children who experienced traumatic events. 7
The children had higher levels of the stress hormone cortisol than youths with no trauma history. That’s a problem because the excessive release of cortisol over long periods is associated with memory issues.
How does trauma affect the body?
Your brain and body perceive trauma as a threat. That’s why trauma triggers reactions throughout the body.
Your heart rate increases, sending more oxygen to your muscles. Your gastrointestinal (GI) tract slows down because your body doesn’t care about digestion when you need to protect yourself. And your adrenal glands release stress hormones, which give your body a kick of energy, so you’re ready to act quickly.1
Those immediate reactions also relate to the delayed effects of trauma. For example, if your GI tract isn’t operating normally, you might encounter changes to your appetite and digestion. Similarly, if your body is surging with stress hormones, you’ll have a more challenging time falling asleep.
How does trauma affect relationships?
Trauma affects multiple people in a relationship: the survivor and the people around them. In “The Body Keeps the Score,” van der Kolk describes veterans who frighten their families with their intense emotions, the depressed wives and anxious children of men with PTSD, and children exposed to family violence struggling to establish trusting relationships as adults. 1
In part, these reactions are complex because survivors might not realize how their trauma interferes with their ability to connect with others. The International Society for Traumatic Stress Studies (ISTSS) notes that survivors might expect to be betrayed in their relationships, have difficulty trusting others, and fear getting close to people. 8
Trauma survivors may also struggle with their sense of self. They might feel shame or guilt about what happened to them or feel like they’re unlovable or damaged. In some situations, survivors form attachments with the person causing their trauma, such as domestic violence victims (also known as “trauma bonding”).
These sentiments can cause survivors to withdraw from others, feel like they’re a burden, and struggle with physical intimacy, among other effects.
It’s not uncommon for survivors to struggle with some or all of these feelings. They might not even connect these reactions to their traumatic experiences. Therapy can help people identify how trauma manifests and coping strategies to live healthier lives.
Trauma Myths Debunked
Myth: Trauma always leads to PTSD
Trauma doesn’t inherently lead to PTSD.
Trauma is an abnormal, distressing experience that affects a person or group. This stress response is also known as acute stress disorder (ASD). It’s normal for people to take a few days or weeks to recover from a traumatic event.
ASD is a short-term condition. But when those distressing symptoms last longer than a month and overtake a person’s life, it’s considered PTSD. Most people who have ASD never develop PTSD. 3
However, some factors make a person more likely to develop PTSD after a traumatic event. For example, if they lack healthy coping strategies, don’t have access to social support, or dissociate during a traumatic event, they’re more likely to develop PTSD.
Myth: There’s only one way to treat trauma
Just as everyone reacts differently to trauma, their treatment can vary, too. Exposure-based treatments are the gold standard for trauma care. Other therapy modalities include EMDR therapy, MDMA-assisted psychotherapy, and mindfulness practices.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), treatment can help people manage and regulate their emotions in a healthy way. 3
There is no one-size-fits-all approach to trauma treatment. However, a few broad types of therapy, medications, and wellness approaches can help people cope with the effects of trauma.
Remember: You’re not alone. A professional therapist can help develop a treatment plan that works for you.
Various forms of therapy can help specifically treat the effects of trauma. Here are a few examples: 9
- Cognitive-behavioral therapy (CBT): Talk therapy that emphasizes changing thinking patterns.
- Cognitive processing therapy (CPT): A type of CBT that follows a 12-session structure to help shift how a person thinks about their trauma.
- Exposure therapy: Invites people to describe and explore their traumatic memories, emotions, and associations with a therapist’s guidance.
- Eye movement desensitization and reprocessing (EMDR) therapy: Uses techniques like moving your eyes in a specific way to help process distressing memories.
- MDMA-assisted psychotherapy: This modality uses a combination of talk therapy and MDMA to help process trauma.
Medications aren’t designed to treat trauma, which has many unique symptoms. However, several types of medications can help treat common symptoms of PTSD.
Antidepressants are commonly used to treat depression and anxiety disorders such as PTSD. These medications increase neurotransmitters in the brain, such as serotonin and dopamine, which play a role in mood.
This type of medication includes SNRIs (serotonin-norepinephrine reuptake inhibitors) and SSRIs (selective serotonin reuptake inhibitors), such as Fluoxetine (Prozac®), Paroxetine (Paxil®), and Sertraline (Zoloft®). 10
Depending on what you’re experiencing, your doctor might prescribe medications to treat symptoms like anxiety and insomnia. Currently, ketamine is the only publicly available form of psychedelic-assisted psychotherapy. Talk to your doctor to see if ketamine therapy is an option for you.
It’s important to remember that medications don’t fix the effects of trauma. Instead, they help make your symptoms manageable so you can live your life and feel more receptive to other forms of treatment, like talk therapy.
As a coping strategy, mindfulness practices can help you feel more centered, relaxed, and present, especially when dealing with difficult emotions.
“Mindfulness” refers to the practice of focusing on the present. You might think of meditation (and that’s a great example), but there are many ways to practice mindfulness.
Remember, it’s called “practice” because this is something you continually explore. We’ve listed some examples of mindfulness practices below. Notice whatever helps you feel more calm and grounded:
- Focus on what you’re eating or drinking. Pay attention to the taste, smell, temperature, and texture.
- Go on a technology-free walk. Draw your attention to the sensations of your body, such as the way your feet hit the ground or the way the sun feels on your skin. Or, focus on the environment around you: the breeze, the leaves swaying in the trees, the snap of a twig under your shoe.
- Meditate, but start small. If you’ve never meditated before, sitting with your thoughts for an extended period can be difficult. Set aside a few minutes, close your eyes, and focus on breathing. If thoughts spring to mind, observe them and let them go. Stay in the moment.
- Take a yoga class. Yoga is a fantastic way to concentrate on your body and breathing with the help of a guide. Try Yin yoga for a slow, restorative practice that works well before bedtime.
What do you do when you want to take care of yourself? Self-care won’t heal the effects of trauma, but it can help you maintain your mental health.
Sometimes, “self-care” is associated with things you can buy. In reality, self-care practices are anything that help you cope.
Some of the most meaningful ways to take care of yourself don’t require special equipment: journaling, listening to upbeat music, or going on a walk are wonderful ways to take care of yourself.
Here are some other self-care ideas:
- Assert your boundaries, like saying “no” when you need time to recharge
- Cook nourishing meals for yourself
- Create something, such as writing a poem or drawing
- Exercise in a way that makes you feel good, such as lifting weights, swimming, or yoga
- Shut off electronics an hour or two before bed
- Spend time with friends and family
- Read a good book
When to Seek Help
Feeling depressed, detached, having difficulty connecting with others, and abusing substances are all signs that it’s time to speak with a therapist. If your symptoms are interfering with your daily life, it’s time to seek professional help.
Getting therapy doesn’t mean that you’re a bad person or weak. In fact, deciding that you’re ready for therapy is one of the most courageous things you can do.
Trauma therapy involves open communication, vulnerability, and honesty with yourself and another person. Talking about your feelings with a mental health professional can help you understand what you’re going through and find coping strategies that work for you.
Frequently Asked Questions About Trauma
What are the three main types of trauma?
There are several types of trauma that fall into three broad categories:
- Acute trauma results from a single incident.
- Chronic trauma refers to repeated and prolonged events.
- Complex trauma is exposure to multiple traumatic events.
What are the signs of trauma?
Signs of trauma vary widely. After a traumatic event, people may feel a range of emotions, such as anxiety, confusion, depression, detachment, and guilt. They might also experience physical symptoms, such as fatigue, nausea, restlessness, and trouble sleeping.
What does trauma do to a person?
Trauma affects everyone differently. It might make a person feel angry and irritable without knowing why. They might feel like they can’t connect with others or turn to alcohol and drugs to cope with racing thoughts.
There isn’t a single effect of trauma. However, trauma can make it difficult for a person to live a healthy life by interfering with their home life, ability to work, and even their relationship with themselves.
What are the three responses to trauma?
Decades ago, “fight or flight” were the two commonly accepted trauma responses. Since then, that list has expanded to include fight, flight, freeze, and fawn. Some researchers include flag and faint.
What are the five examples of trauma?
Any distressing, abnormal event can be interpreted as trauma. According to the National Child Traumatic Stress Network, five examples of trauma include bullying, community violence, disasters, child abuse, and sex trafficking, although there are many other examples. 11
Trauma can affect anyone, and it manifests in different ways. Some people might deal with anxiety and depression long after a traumatic event, while others might feel fine—only to have their traumatic memory triggered by a seemingly unrelated event.
There are multiple ways to heal from trauma, including therapy, medication, and mindfulness practices. If your symptoms interfere with your ability to live your life, a therapist can help you learn how to process your trauma and develop coping strategies that work for you.
Dr. Brian Pilecki is a clinical psychologist at Portland Psychotherapy specializing in psychedelic-assisted therapy and treating anxiety disorders, trauma, and PTSD. He graduated from Fordham University and completed a postdoctoral fellowship at the Warren Alpert Medical School of Brown University.
- van der Kolk M.D. B. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Illustrated. Penguin Books; 2015:464.
- Trauma and Shock. Accessed March 17, 2022. https://www.apa.org/topics/trauma
- Center for Substance Abuse Treatment (US). Understanding the Impact of Trauma. In: Trauma-Informed Care in Behavioral Health Services. Vol 57. Treatment Improvement Protocol (TIP) Series. Substance Abuse and Mental Health Services Administration (US); 2014. Accessed March 16, 2022. https://www.ncbi.nlm.nih.gov/books/NBK207191/
- Center for Substance Abuse Treatment. Trauma Awareness. Published online 2014.
- What is Trauma? – Trauma-Informed Care Implementation Resource Center. Accessed July 14, 2022. https://www.traumainformedcare.chcs.org/what-is-trauma/
- Merrick MT, Ford DC, Ports KA, Guinn AS. Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States. JAMA Pediatr. 2018;172(11):1038-1044. doi:10.1001/jamapediatrics.2018.2537
- Carrion VG, Wong SS. Can traumatic stress alter the brain? Understanding the implications of early trauma on brain development and learning. J Adolesc Health. 2012;51(2 Suppl):S23-8. doi:10.1016/j.jadohealth.2012.04.010
- Trauma and Relationships. Published online 2016. Accessed July 14, 2022. https://istss.org/ISTSS_Main/media/Documents/ISTSS_TraumaAndRelationships_FNL.pdf
- Center for Substance Abuse Treatment. Trauma-Specific Services. Published online 2014.
- Medications for PTSD – PTSD: National Center for PTSD. Accessed July 15, 2022. https://www.ptsd.va.gov/understand_tx/meds_for_ptsd.asp
- Trauma Types | The National Child Traumatic Stress Network. Accessed July 15, 2022. https://www.nctsn.org/what-is-child-trauma/trauma-types