Trauma is caused by a distressing experience that is too overwhelming to deal with, causing long-lasting effects on a person’s mental health. The effects of trauma can be wide-ranging and affect everyone differently. In response to the same experience, such as a natural disaster, one person may develop post-traumatic stress disorder (PTSD) while another person experiences no long-lasting negative effects.
Anxiety is a common symptom experienced by those who have gone through a traumatic event, causing a disturbance in the automatic nervous system and the amygdala, which are responsible for identifying threats and regulating the response.
Trauma can include physical or sexual abuse, natural disasters, combat, accidents, or witnessing violence. After a traumatic event, many people experience anxiety symptoms, such as feeling on edge, having trouble sleeping – including insomnia – and feeling irritable or easily startled. These symptoms are a natural response to the stress of the traumatic event and are known as acute stress disorder (ASD). For most people, these symptoms will gradually lessen or stop altogether. However, these symptoms persist for some people and can develop into PTSD or other anxiety disorders and phobias.
Research has shown that individuals who experience trauma are at a higher risk for developing anxiety disorders.[1]
The Role of the Amygdala
One possible explanation for the link between trauma and anxiety is the role of the amygdala, a structure in the brain that plays a key role in the processing of emotions. The amygdala is known to be involved in the fear response, and research has shown that it is activated during traumatic experiences. In individuals with PTSD, particularly those who have experienced multiple traumas, the amygdala can become overactive. This leads to the body triggering an exaggerated fear response that doesn’t match a situation’s objective severity. The amygdala can cause the fight-or-flight response to be triggered even in non-threatening situations. This can result in the development of anxiety disorders such as generalised anxiety disorder (GAD).
Negative Cognitions
The link between trauma and anxiety can also result from negative cognitions. Negative cognitions are individuals’ beliefs about themselves, others, or the world around them. These negative beliefs can develop due to traumatic experiences and can contribute to the development of anxiety disorders. For example, an individual who has experienced a traumatic event may believe that the world is a dangerous place and that they are not safe, leading to anxiety.
Trauma and the HPA Axis
There is also evidence to suggest that the link between trauma and anxiety may be due to the impact of trauma on the hypothalamic-pituitary-adrenal (HPA) axis. When a person experiences trauma, their nervous system is pushed out of balance, which can significantly affect their overall health. The constant state of stress can disrupt the normal functioning of the hypothalamic-pituitary-adrenal (HPA) axis, a crucial component of the body’s stress response system.
Chronic stress – such as abuse – can cause the HPA axis to become overactive, leading to the excessive release of hormones such as cortisol. This can result in a range of physical and mental health issues, including anxiety, depression, and fatigue.
The HPA axis is a complex system regulating the body’s stress response. Traumatic experiences can disrupt the HPA axis, leading to an overactive stress response and the development of anxiety disorders.
Treatment Options for Trauma and Anxiety
Treatment for trauma-related anxiety disorders often involves therapy, medication, or a combination of both.
Medication
Benzodiazepines are a class of drugs that enhance the activity of a neurotransmitter called gamma-aminobutyric acid (GABA), which has a calming effect on the brain. This can relieve specific symptoms of PTSD and anxiety, allowing people to experience a better level of functioning in daily tasks, such as work or study.
SSRIs are antidepressants that work by increasing the levels of serotonin in the brain. There are various SSRI drugs, with sertraline being the most common in the UK.
SSRIs are considered a first-line therapy for PTSD, and research suggests that they are associated with an average response rate of about 60% among patients. However, a smaller proportion of patients – between 20% to 30% – achieve complete remission of their symptoms through the use of SSRIs.[2]
Other therapies or interventions are seen as necessary to achieve full recovery from PTSD, addressing the root cause of the issue, providing effective coping mechanisms, and exploring thought patterns that may interrupt a person’s recovery or ability to function.
Therapy
Cognitive behavioural therapy (CBT) is one of the most common therapies for PTSD and anxiety. It is grounded in the theory that a person’s thoughts, feelings, and behaviours are interconnected and changing the negative ones can improve mental health.
Exposure therapy is a form of CBT that involves gradually exposing a person to situations or memories that trigger their anxiety or PTSD symptoms, helping them to develop coping mechanisms.
Eye movement desensitisation and reprocessing (EMDR) is a newer form of therapy that has shown effectiveness in treating PTSD. EMDR involves a series of guided repetitive eye movements or tapping while a person recalls traumatic memories, and associated thoughts and feelings, helping to reduce the emotional impact of the memory.
Finding the right therapy for PTSD and anxiety is a personal journey, and it may take time to find the most effective treatment plan. In addition to therapy and medication, several self-care strategies can help manage trauma-related anxiety, including exercise, mindfulness meditation, yoga, and relaxation techniques.
If you have a client or know of someone struggling with anything you have read in this blog, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
Sources:
[1] Kascakova, N., Furstova, J., Hasto, J., Madarasova Geckova, A., & Tavel, P. (2020). The Unholy Trinity: Childhood Trauma, Adulthood Anxiety, and Long-Term Pain. International journal of environmental research and public health, 17(2), 414. https://doi.org/10.3390/ijerph17020414
[2] Alexander W. (2012). Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents. P & T : a peer-reviewed journal for formulary management, 37(1), 32–38.