As the saying goes, sh*t happens. Life is full of unpleasantries, from the everyday to the world-shattering.
Nowadays, you often see people describe any negative experience as a trauma (especially on the internet). Seeing a black bear on a hike is traumatic. Hearing your favorite bar is closed indefinitely is traumatic (you’re in our thoughts, Vito’s). Being stuck inside during an atmospheric river is traumatic. Everything is traumatic.
Well, actually, no. Sure, the word ‘trauma’ is used jokingly sometimes, but it’s a very real thing. It is also distinct from other negative life experiences.
Knowing the difference is important when it comes to getting help — and healing.
What is trauma?
“There’s no clear definition in the public, and it’s hard to come up with a consensus in the clinical world too. There is still a lot of discussion of what trauma means and how to define it,” says Dr. Juan Aparicio, a psychiatrist and fellow in the UW School of Medicine Department of Psychiatry and Behavioral Sciences who specializes in women’s mental health.
The way trauma is currently defined is that it involves someone being exposed to, experiencing or witnessing a threat to life or limb or an endangerment to bodily autonomy or learning that something of this nature happened to someone they are close to. There’s often a sudden or unexpected quality to a traumatic event, too, like in the case of a shooting or wildfire.
Trauma could also be defined by how it impacts someone, though most people who experience trauma will not experience lasting mental health issues from it. Up to 33% of people will develop acute stress disorder (which lasts a month or less) within a month after a trauma and a small percentage will go on to develop posttraumatic stress disorder (PTSD) long-term, according to the National Center for PTSD.
What is an adverse life experience?
The term may seem vague, but that’s because it’s hard to define those negative experiences that so many people have that aren’t trauma but are still impactful.
“Adverse life experience is one of the best terms we have; a lot of what we know comes from studying adverse childhood experiences, things that are unfortunately very common,” Aparicio says.
This includes things like watching your parents go through a divorce, having a parent who has a substance use disorder, watching a family member’s health slowly decline, or experiencing food or housing insecurity. The Centers for Disease Control and Prevention has found that more than half of U.S. adults had at least one adverse experience in childhood.
“These are things that don’t necessarily fit our other definition of trauma but can still have lasting impacts on people, but what that impact is exactly is something we’re still trying to understand,” he explains. “The more we look into it the more we see they're relevant in all elements of health.”
Why does it matter to differentiate the two?
First off, this is not the trauma Olympics: It’s not helpful to compare traumas or compare how you respond to negative life experiences to how someone else responds.
However, it is important to define trauma because it can lead to long-term issues like PTSD that need treatment.
Adverse life experiences are unlikely to cause something like PTSD. Sure, they may cause chronic stress, which is its own problem that needs to be addressed. In general, though, treating the effects of adverse life experiences will be a little less intensive than treating PTSD. Chronic stress and PTSD also require different types of treatment.
Each year, around 5% of the U.S. population has PTSD, though this number increased recently, perhaps due to the influence of the pandemic. Women, transgender and non-binary people, and people who are Latinx, Black and/or Native American are disproportionately impacted by PTSD.
PTSD symptoms include realistic flashbacks, intrusive thoughts, nightmares and trouble sleeping, impaired memory of the trauma, avoidance of things associated with the trauma, blaming themselves for what happened, inability to enjoy things they once did, and startling easily or always being vigilant.
It is difficult to predict who will develop PTSD, Aparicio says, and most people will suffer in silence because most of the symptoms are experienced internally and are not visible to others.
Is it possible to heal from trauma?
Healing from trauma is possible and will happen for most people, though the process won’t be easy.
“Trauma therapy is really hard, it’s emotionally taxing; it is not uncommon for things to feel worse before they feel better, because we’re looking at something that we’ve tried to put away, we’re opening up a wound to clean it out, but that’s painful,” Aparicio says.
If someone experiences a traumatic event, there are a few things that are particularly important that help prevent acute stress disorder and PTSD and aid in healing:
- Reestablishing safety right after the event is crucial. This could mean having someone physically go to a safe place, feel like they are in a safe space in which to process what has happened, or both.
- Connecting with others is especially important because people tend to isolate themselves after a traumatic incident.
- Cognitive behavioral therapy (CBT) can help people process what has happened, understand how it affects them and regain a sense of control over their lives. It can also guide people in exposure therapy, slowly reintroducing them to things that trigger fear or avoidance to retrain their brain that the danger has passed.
- Medications such as antidepressants can be helpful, as can other medications that will help with insomnia or other symptoms. Medications are about meeting someone where they’re at, Aparicio says, to enable them to start the healing process from a place of more stability.
- Eye movement desensitization and reprocessing (EMDR) therapy involves a therapist leading eye movements while bringing up memories of the trauma. Psychiatrists don’t fully understand how this therapy works, but research suggests it might be effective.
“The most common response to trauma is healing — it’s true in a physical sense as well as mental health standpoint,” Aparicio says.