To have PTSD, a person must have been exposed to the real or perceived threat of death, serious injury, or sexual violence – either directly, as a witness to others, or learned that the traumatic event occurred to a close loved one. Someone can also develop PTSD if they have been repeatedly exposed to disturbing details of such an event.
Symptoms of PTSD often feel intrusive and out of one’s ability to control. This may look like recurring visions or memories of the distressing event, flooding their mind. Another manifestation of the mental illness may be sleep disturbances, like insomnia or nightmares. When awake, a person may dissociate – this is when a person feels disconnected from themselves and reality. Alternatively, as if they are actually re-living the traumatic event.
When reminded of the trauma, either by an external trigger or intrusive thought or memory, it may take a great deal of time for the person to return to a calm mental and physical state.
Why? The nervous system becomes hypervigilant (think fight or flight response) and believes the person is in true danger. The mind and body essentially shield or protect the person who is recalling the traumatic event – a natural defense mechanism. Re-living trauma can feel deeply frightening and as if the trauma is happening all over again to them, for the first time.
Because of the strong physical and emotional distress that occurs with PTSD, avoidance of triggering memories, feelings, thoughts, people, and places is ever-so common. A person may become fearful of passing by the place where the trauma occurred, seeing objects or images that remind them of the event, or even certain sounds or scents connected to the trauma can be triggering. Avoidance can also sometimes develop into substance use as a way to self-medicate or numb themselves to the distress experienced. In the case of eating disorders and co-occurring trauma, preoccupation with food, body, disordered eating behaviors and exercise can all function similarly, as maladaptive coping strategies to numb and avoid the suffering caused by trauma.