Post-traumatic stress disorder (PTSD) is a serious mental health problem affecting millions of people each year. It’s most often associated with military service members and first responders, but it can happen to anyone who experiences a traumatic event. The disorder can cause irritability, intrusive thoughts, and disturbing flashbacks.
A particularly severe symptom is known as retraumatization, which is when you experience a flashback so severe that it feels like you’re going through the trauma all over again. What is retraumatization, and what can trigger these severe PTSD episodes? Learn more about retraumatization and how PTSD works in the brain.
How Does PTSD Work in the Brain?
Post-traumatic stress disorder is a mental health disorder that involves your brain and body’s fight-or-flight response. It’s normal for you to experience an intense mental and emotional response to danger. When you experience a traumatic event like a car accident, assault, or disaster, your brain will prepare your body for quick action. You become more alert, vigilant, and on edge. In most situations, the stress response triggered by danger returns to normal when the danger passes.
However, PTSD causes you to revisit the fight-or-flight response to the initial trauma whenever you are reminded of it or triggered. PTSD is thought to involve the brain’s hippocampus, a part of the brain responsible for converting short-term into long-term memory. When it comes to danger, the hippocampus plays a role in helping you remember to avoid dangerous situations if they should arise again.
If you have PTSD, memories, triggers, and emotions that remind you of the traumatic event can cause your hippocampus to react as if you were experiencing the trauma again, rather than a simple memory. PTSD causes you to experience stress responses in the form of flashbacks, which are dissociative episodes that make you feel like you are there again. You may also experience nightmares, severe anxiety, and distress triggered by memories of the event.
What Can Cause PTSD?
PTSD can be caused by any number of potentially traumatic events. Military service members and first responders are among the groups with the highest rates of PTSD. Witnessing active combat situations when your life or the life of people you care about are in danger is a significant risk factor for PTSD. However, civilians can also encounter traumatic events that lead to PTSD. Common traumas that cause PTSD include:
- Car accidents
- Serious injuries
- Physical or sexual assault
- Domestic or childhood abuse
- Serious health problems
- Natural disasters
- Losing a loved one
- Exposure to war and conflict
- Torture
- Witnessing violence or accidents
- Hearing of a traumatic event a loved one experienced
It’s estimated that PTSD can occur in a third of people who experience trauma. However, very little is known about why some people develop PTSD after trauma while others don’t. In many cases, people who experience the same traumatic events don’t experience the same aftermath. Some recover, while others are left with PTSD. Like other mental health issues. Several likely factors can influence your PTSD risk, including genetics, development, and environment.
How you process the traumatic event during and after it occurs can also make a difference. For instance, talking about it with peers or professionals directly after the event to debrief can help avoid PTSD. People in jobs that have a high risk for PTSD may take preventative measures to help avoid it. Training and resourcefulness are protective factors in avoiding PTSD. A close community of support can also help mitigate PTSD risk. However, prevention doesn’t guarantee you will never experience PTSD.
What Is PTSD Retraumatization?
PTSD retraumatization is a defining characteristic of the disorder. PTSD can cause nightmares, irritability, and stress, but it can also cause intense episodes in which you experience PTSD anew. Retraumatization occurs when you are exposed to something that causes a mental and emotional response as if you are experiencing a traumatic event all over again like it’s new.
Retraumatization is closely related to flashbacks and dissociative episodes that PTSD may cause. Retraumatization is more than just cringing at an unpleasant memory; it’s experiencing trauma again because something reminded you of past trauma. PTSD causes your brain to treat memories and triggers of an event as if you are in the middle of that life-threatening or terrifying circumstance again.
In PTSD, a reminder of your trauma can cause you to experience prolonged periods of distress. Triggers can come in the form of sights, sounds, smells, thoughts, and even emotions that remind you of the traumatic event you experienced in the past. Sometimes, triggers are obvious. For instance, if you were assaulted on the street, hearing a news report about a similar assault can be a trigger. In some cases, triggers can be less apparent and harder to avoid. For example, if you experienced a traumatic event a day after you mowed the lawn, the smell of fresh-cut grass could act as a trigger.
Triggers can set you on age, make you irritable, or cause you to be on guard. However, they can also be more severe. Retraumatization is a severe response to a trigger that reminds you of your trauma. It can be so severe that it feels like the trauma just happened again. Flashbacks are an example of very severe PTSD symptoms. PTSD flashbacks can make retraumatization all the more real. To understand what a flashback is, it’s important to understand dissociation and dissociative episodes.
What Is Dissociation?
Dissociation is not a mental health problem on its own. Rather, it is a normal function of the brain that helps to shield you from trauma that may be psychologically damaging. Most people experience dissociation briefly in response to a harrowing event or a serious injury. Some people develop mental health problems where dissociative episodes continue to occur randomly after an event that caused a dissociative episode. These are called dissociative disorders. Dissociative disorders cause out-of-body experiences or moments in which you feel like you are detached from your surroundings.
Dissociations associated with PTSD are unique. Instead of causing random dissociation, PTSD causes flashbacks of the traumatic event that feel so real that you become unaware of your actual surroundings. Flashbacks can be mild, in that you do not lose connection with your current surroundings. But more severe flashbacks could cause significant detachment from the world around you.
Some researchers suggest that PTSD with significant dissociative episodes is a subtype of PTSD.
What AreRetraumatization’s Effects?
Some who experience retraumatization, among other PTSD symptoms, may experience several uncomfortable consequences in their lives. Many people who frequently experience severe symptoms may start to avoid places they associate with triggers. They may also feel shame over the fact that symptoms are getting in the way of their career, relationships, or school.
PTSD symptoms may make you feel reluctant to socialize for fear of experiencing flashbacks in public. This can lead to social isolation and withdrawal from activities you once enjoyed. Isolation can lead to worsening mental health problems. Other consequences of retraumatization include:
- Social withdrawal and isolation
- Agoraphobia
- Intense nightmares
- Frequent or intense flashbacks
- Paranoia
- Hypervigilance
- More sensitivity to triggers
- Suicidal thoughts
- Suicidal actions
- Jumpy and overactive
- Stress sensitivity
PTSD may also increase your risk of developing other mental and behavioral health disorders, including depression, anxiety, and substance use disorders.
Do Therapies Risk Retraumatization?
PTSD can be a chronic and progressive mental health disorder, but it can be treated with medication and therapy options. Several therapy options have proven useful in treating PTSD. However, therapy will require you to face hard emotions and memories tied to your trauma, and that could result in PTSD symptoms, including retraumatization. PTSD therapy often involves exposure therapy, which may involve drawing out some of the emotional triggers you may experience when talking or thinking about your traumatic event. The goal is to desensitize you to triggers and train your brain not to send you into fight-or-flight mode.
A popular therapy option for PTSD is eye movement desensitization and reprocessing (EMDR). EMDR is similar to talk therapy, in which you will work with a therapist who guides you through thoughts of your traumatic event for the purpose of reprocessing it. It also involves some motion that draws your attention, like following the therapist’s finger with your eyes. EMDR may also create some risk of a retraumatizing episode. However, treatment is important in addressing your PTSD and learning coping strategies to improve your quality of life.
If you’re not ready to confront PTSD in this way, other treatment options have a lower chance of triggering retraumatization, including medications like antidepressants.
