Signs You May Benefit From Trauma Therapy
Most people have strong reactions after a frightening or painful event, and most recover with time. It may be worth talking with a therapist if your reactions are not easing, keep getting in the way of work, sleep or relationships, or have you avoiding more and more of your life. These are signs, not a diagnosis.
Key points
Strong reactions after trauma are common and usually lessen over time.
Reactions that do not improve, or that interfere with daily life, can be a sign that professional help would be useful.
Avoidance, feeling constantly on guard, poor sleep and drinking more are easy signs to miss.
You do not need a diagnosis, or certainty about what to call your experience, to ask for help.
What is trauma therapy, and who is it for?
Trauma therapy is counseling that focuses on a frightening, dangerous or deeply upsetting experience and how it is still affecting you. The VA National Center for PTSD describes trauma-focused treatment as therapy that focuses on the traumatic event and what it means to you.
It is not only for people with a PTSD diagnosis. The National Institute of Mental Health (NIMH) advises seeking professional help if symptoms after a traumatic event do not improve over time or begin to interfere with daily life. That is a practical test anyone can use.
What are the signs that trauma is still affecting you?
The reactions below are described by NIMH and the VA as common after trauma. On their own, in the first days or weeks, they are expected. They can be signs that therapy would help when they hang on, grow stronger, or start to shape your choices.
You keep thinking about what happened, or it comes back in nightmares or sudden vivid memories.
You stay away from people, places or things connected to the event, and the list keeps growing.
You feel on guard and alert all the time, or you startle easily at sudden noises.
You have trouble falling asleep or staying asleep, and you feel very tired.
You feel numb, or find it hard to feel love or joy.
You blame yourself, or your view of yourself or the world has turned more negative.
You are more irritable than usual, or have angry outbursts that are not like you.
You have trouble concentrating at work, at school or at home.
How long should you wait before getting help after trauma?
There is no waiting period. You can talk with a therapist at any point, including soon after an event.
As a guide, the VA says that most people start to feel better after a few weeks. It suggests talking to a doctor or mental health provider if symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life.
Timing can also surprise people. According to the VA, symptoms usually start soon after the event but may not appear until months or years later, and they may come and go over many years. An old event that has started bothering you again is a valid reason to call. Our article on PTSD symptoms after a traumatic event explains the symptom groups and timing in more detail.
What signs of trauma do people often overlook?
Some reactions do not look like distress about the event at all, so they are easy to explain away.
The VA lists physical reactions such as stomach upset, trouble eating, a pounding heart, rapid breathing and sweating. We cover these in how trauma shows up in the body. Physical symptoms can have medical causes too, so mention them to your doctor.
The VA also describes changes in how people take care of themselves and relate to others: smoking, drinking or using drugs more, neglecting exercise, diet or regular health care, being unable to trust others, getting into fights, or pulling away from family and friends. Problems at work or school can be part of the picture as well.
None of these proves that trauma is the cause. They are reasons to have a conversation with someone qualified to sort it out. Only a mental health provider can diagnose PTSD.
What can you do while you decide?
NIMH suggests several healthy ways of coping after a traumatic event. They do not replace treatment, but they can steady your days.
Keep your routines. Try to maintain regular times for meals, exercise and sleep.
Stay connected. Spend time with trusted friends and relatives who are supportive.
Avoid alcohol and drugs. They are a common way to take the edge off, and NIMH advises against using them to cope.
Lower stress where you can. Exercise, mindfulness or other activities that help reduce stress are all reasonable choices.
Set realistic goals. Focus on what you can manage right now instead of everything at once.
How Balanced Life can help
Balanced Life Counseling Services offers trauma therapy for children, teens and adults in Salisbury and Bethesda, in person and by telehealth. Some of our clinicians are trained or certified in EMDR. If you are not sure trauma is the right word for what you are dealing with, individual counseling is a fine place to start.
In a first session, your therapist invites you to share what has been going on and any goals you have. You decide how much to say. You can read more in what happens in a first therapy session, or visit our new patients page to get started.
If you are in crisis or thinking about suicide, call or text 988 or call 911. Our office does not provide emergency services.
Frequently asked questions
Do I need a PTSD diagnosis to start trauma therapy?
No. Many people seek counseling because reactions to a hard experience are not easing or are getting in the way of daily life, which is the point at which NIMH advises getting professional help. A therapist can assess what is going on. Only a mental health provider can diagnose PTSD, and you do not need to know the answer before you call.
What if the event happened years ago?
It can still be worth addressing. The VA National Center for PTSD notes that symptoms may not appear until months or years after an event and may come and go over many years. People often seek help when a life change, an anniversary or a new stress brings old reactions back. There is no deadline for starting therapy.
What if my experience does not seem bad enough to count as trauma?
Comparing your experience to other people's is common, and it keeps many people from asking for help. A more useful question is the one NIMH uses: are your reactions improving over time, or are they interfering with your daily life? If they are interfering, that is reason enough to talk with a therapist.
Will I have to talk about everything that happened right away?
No. In a first session your therapist invites you to share what has been going on and any goals, and you set the pace. Different trauma therapies also ask for different amounts of detail. You and your therapist decide together how to proceed and how often to meet.
Sources
If you are in crisis or thinking about suicide, call or text 988 (Suicide and Crisis Lifeline). In an emergency, call 911.