Trauma and Stressor-Related Disorders

Trauma and stressor-related disorders are mental health conditions that sometimes develop following traumatic or stressful events. For some, trauma leaves invisible imprints on both mind and body, creating ripple effects that can alter every aspect of life. However, understanding how to heal from post-traumatic stress disorder (PTSD) as well as the connection between trauma and various stressor-related disorders is a critical first step on the path toward healing and recovery. With the right support, recovery isn’t just possible; it’s within reach.

What are Traumas and Stressors?

A stressor is a condition or event that leads to emotional or physical stress and requires some coping strategy. Trauma, on the other hand, is any experience that someone perceives as notably dangerous, frightening, or shocking ^[1]. Some examples of traumatic experiences can include natural disasters, car crashes, acts of violence, or the loss of a parent.

While traumas and stressors are slightly different, both are associated with various mental health disorders that are categorized as trauma- and stressor-related disorders by the DSM-5 (a comprehensive manual used by mental health professionals to diagnose and classify mental disorders ^[2]. 

After witnessing or experiencing traumatic events, most people cycle through a range of emotions. For many, these responses do not develop into a disorder. Research-based insights from the World Health Organization reveal that while roughly 70% of people will experience a traumatic event at some point in their lives, only an estimated 5.6% will develop PTSD ^[3]. That said, some people continue to experience symptoms long term, interrupting their normal functioning and leading to the development of a trauma-related disorder. 

Trauma- and stressor-related disorders include:
 

• Post-traumatic stress disorder (PTSD)
• Acute stress disorder
• Adjustment disorders
• Prolonged grief disorder
• Reactive attachment disorder (diagnosed only in children)
• Disinhibited social engagement disorder (diagnosed only in children)
• Other specified trauma- and stressor-related disorders

PTSD Symptoms

Among trauma- and stressor-related disorders, post-traumatic stress disorder (PTSD) is the most familiar term for most people. Additionally, it’s the most studied, as scant research is available for other types of stressor-related disorders. 

PTSD is characterized by the following symptom clusters:

Intrusion/re-experiencing: Symptoms include intrusive memories, nightmares, and flashbacks where the person feels or acts as if the traumatic event is happening again. Often accompanied by intense psychological reactions, these symptoms can be triggered by reminders of the trauma or they can occur spontaneously. Re-experiencing also includes PTSD with psychosis, involving delusions, hallucinations, and paranoia associated with the traumatic event ^[4]. 

Avoidance: People with PTSD may make persistent efforts to avoid trauma-related thoughts, feelings, or external reminders. Avoidance might include sidestepping conversations, places, people, activities, or situations that trigger distressing memories, thoughts, or feelings about the traumatic event. 

Changes in cognition and mood: Mood and cognition symptoms manifest as persistent negative beliefs about oneself or the world, distorted blame of self or others, persistent negative emotions, diminished interest in activities, feelings of detachment, or an inability to experience positive emotions. 

Changes in arousal and reactivity: Those with PTSD often report feelings of irritability and may experience sudden angry outbursts. They might engage in reckless or self-destructive behaviors, misuse substances, be excessively alert to their environment, become easily startled, and struggle with concentration or sleep disturbances. 

Stressors and Co-Occurring Disorders 

While PTSD might be the most recognized trauma-related disorder, several other stressor disorders can result from trauma ^[5]:

• Acute stress disorder: This condition shares many symptoms with PTSD but occurs within the first month following trauma exposure. When symptoms persist beyond this point, the diagnosis may evolve into PTSD.
  
• Adjustment disorders: An adjustment disorder is diagnosed when a person experiences difficulty adapting to identifiable stressors within three months of the stressor’s onset. Symptoms include distress that’s disproportionate to the stressor as well as significant impairment in social and occupational functioning ^[6].
  
• Other specified trauma and stressor-related disorders: These conditions don’t meet the full criteria for other disorders, but they cause clinically significant distress. Examples include prolonged grief disorder, which is characterized by intense grief that persists abnormally long after a loss ^[7].

It’s also important to note that health and substance use disorders can go hand in hand. When they occur simultaneously, they’re called co-occurring disorders, also known as dual diagnosis.

According to the 2023 National Survey on Drug Use and Health, among those 18 and older, more than 58 million people had a mental illness (e.g., PTSD) in the last year. And within this group, roughly one-third (20.4 million people) had a substance use disorder ^[8]. 

Thus, a mental health disorder like PTSD can occur alongside alcohol use disorder, as well as other substance use disorders. To ensure effective and lasting recovery from co-occurring disorders, specialized, integrated care that treats both disorders concurrently is required.

How to Heal from PTSD

A host of evidence-based treatment options offer multiple ways to manage trauma symptoms, ranging from eye movement desensitization and reprocessing (EMDR) to brief eclectic psychotherapy (BET). However, guidelines from both the American Psychological Association and the Veterans Health Administration and the Department of Defense (VA/DoD) Clinical Practice Guideline Working Group suggest the following treatments ^[9].

• Prolonged Exposure (PE): This therapy gently guides patients to face memories and situations they’ve been avoiding since their trauma. During treatment, patients gradually revisit their difficult memories and approach everyday situations that might trigger anxiety. This step-by-step process helps the brain learn that these memories, while painful, aren’t currently dangerous. Over time, this approach helps reduce nightmares, flashbacks, anxiety, and other PTSD symptoms.
  
• Cognitive Processing Therapy (CPT): With CPT, patients focus on how trauma has affected their thinking. Doing so guides people to identify unhelpful thoughts that developed after trauma, like blaming themselves or believing the world is dangerous. They learn to challenge these thinking patterns and to develop more balanced perspectives about themselves, others, and the world.
  
• Cognitive Behavioral Therapy (CBT): A mainstay in many forms of mental health treatment, CBT helps people connect the dots between thoughts, feelings, and actions. CBT for PTSD teaches practical skills to spot and change unhelpful thought patterns, and it offers simple coping tools like relaxation techniques, stress management, and gradual exposure to feared situations in a safe environment. 

Pharmacotherapy for Trauma Disorders

As one of the many ways to treat trauma- and stressor-related disorders, medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used for core symptoms and mood issues, either alone or alongside therapy. For nightmares, doctors might prescribe Prazosin (which is often used to treat hypertension), while antipsychotics can address hallucinations and improve sleep. In controlled therapeutic settings, some researchers are also exploring psychedelics like psilocybin and 3,4-methylenedioxy-methamphetamine (MDMA), an amphetamine derivative, though these are not yet FDA-approved.  

More Ways to Manage Trauma Symptoms

Learning how to heal from PTSD is not a linear journey, but rather a winding path with both setbacks and moments of growth. Alongside traditional therapy and medicine options, alternative or supplemental interventions are also available. Practices like acupuncture, mindfulness-based yoga, and animal-assisted interventions often provide therapeutic benefits without requiring the same level of verbal processing or trauma disclosure that traditional psychotherapy entails.  

For many people living with PTSD, connecting with others who truly understand their experiences also creates a powerful healing environment that clinical settings alone can’t provide. These peer-support communities offer validation and shared coping strategies while reducing isolation. As such, they’re often vital components of recovery journeys.

Effective Ways to Manage Stress

Trauma survivors often experience heightened stress responses that require specialized management approaches. The National Center for PTSD offers the following strategies for managing traumatic stress reactions ^[10]:

• Learn about trauma and PTSD: Understanding common trauma reactions, PTSD symptoms, and effective ways to manage stress helps survivors recognize they aren’t alone or weak. Rather, they’re experiencing normal responses shared by countless others, facilitating better coping and informed treatment decisions.
  
• Seek support from others: Connecting with others rather than isolating oneself provides emotional understanding, reduces loneliness, and offers practical assistance.
  
• Practice relaxation methods: Effective relaxation techniques include: meditation, muscle relaxation exercises, prayer/reflection, breathing exercises, time in nature, stretching, and yoga.
  
• Distract yourself with positive activities: Engaging in enjoyable recreational activities, like creating art or listening to music, provides a positive distraction from trauma memories, improves mood, reduces PTSD’s negative impact, and supports recovery.

Finding a Trauma Therapist

Locating a qualified trauma specialist represents a critical step in the recovery journey. Mental health professionals qualified to treat trauma include clinical psychologists, licensed professional counselors, licensed clinical social workers, and psychiatrists. Ideal providers will have specialized training in evidence-based trauma treatments such as CPT, PE, EMDR, or CBT, as well as experience working with specific trauma types relevant to the patient’s experiences.

When evaluating potential therapists, important questions to ask include:

• What specific training do you have in treating trauma?
• What treatment approaches do you use for trauma-related disorders?
• What is your experience treating my specific type of trauma?
• How do you measure treatment progress?

Insurance considerations can also influence provider selection. Under the Affordable Care Act, most insurance plans in the United States cover mental health and substance use disorder treatment. However, the level of coverage varies by plan, and accepted insurance plans vary by treatment provider.

The Path to Recovery

Recovery from trauma- and stressor-related disorders represents a deeply personal journey that looks a little bit different for each person. However, with appropriate support and treatment, healing is more than possible; it’s likely.

Granted, the path forward may include setbacks and challenges. However, each step represents progress. In fact, many trauma survivors discover unexpected strength and resilience through their recovery journey, sometimes developing a greater appreciation for life and deeper connections with others. Please remember, reaching out for help is an act of courage rather than weakness. Support from qualified professionals, combined with self-compassion and patience, creates the foundation for lasting healing. 

If you or someone you know is dealing with trauma or co-occurring mental health and substance use disorders, you’re not alone. Call or text the Suicide & Crisis Lifeline at 988. Free and confidential support is available 24/7, and representatives can direct you to appropriate resources.