Trauma and PTSD
Signs of unresolved trauma in adults
It rarely announces itself as trauma. It usually turns up as insomnia, a short fuse, exhaustion, or a life that has quietly narrowed.
Almost nobody arrives in my office saying they have unresolved trauma. They arrive saying they cannot sleep, or they snapped at their kid again, or they feel nothing much about anything and would like that to stop.
Trauma is often a diagnosis of the second conversation, not the first. Here is what tends to be in that second conversation.
1. Sleep that never came back
Trouble getting to sleep, waking at the same hour every night, dreams you cannot remember but wake up braced from. Frequently people can date it — “I have not really slept properly since 2014” — without having connected the date to anything.
2. Reactions that outsize their trigger
A tone of voice, a smell, a particular street, someone coming up behind you. The response arrives before the thought does, which is the tell: this is not a judgement being made badly, it is an alarm system firing on a pattern match.
3. Avoidance you have stopped noticing
This one hides well because it does not feel like a symptom, it feels like a preference. You take the longer route. You do not do highways any more. You have not been to that part of town in years and there is always a reason. Add up the reasons and you can see the shape of what is being avoided.
4. Numbness
Often mistaken for depression, and it can coexist with it. But this one has a specific flavour: not sadness, an absence. Watching your own life through glass. Good news arrives and you note that you should be pleased.
Numbing is protective. It got you through something. It does not switch off selectively, which is why the same mechanism that dulled the unbearable also took out your capacity to be delighted by anything.
5. Over-functioning
The one nobody treats as a symptom, including the person doing it. Constant motion, taking on everyone else’s load, an inability to sit still in an empty house. Being useful is a socially rewarded way of not stopping, and stopping is when it catches up with you.
People whose trauma presents this way are frequently the last to seek help, because by every visible measure they are doing well.
6. Trouble with closeness
Either direction. Keeping people at a distance that is comfortable and lonely, or getting very close very fast and then feeling trapped. Relationship difficulty that repeats the same shape across different people is worth being curious about.
7. Your body keeping the score
Jaw, shoulders, gut, chronic pain with no clear medical cause, a startle response that has never settled. Get these checked medically first — several things that look like trauma symptoms are not. But when the investigations come back clear and the symptoms do not shift, this is worth putting on the table.
8. Shame that does not match the facts
Especially in people who were harmed as children or by someone with power over them. The conviction that you are fundamentally defective, held with a certainty that no amount of evidence dents. Shame is very often the load-bearing wall.
“But it wasn’t that bad”
Almost everyone says a version of this, usually while comparing themselves to somebody who had it worse. There is always somebody who had it worse; the comparison is not the test. The test is whether it overwhelmed you at the time and whether it is still costing you now.
What to do with this
If a few of these landed, that is worth a conversation with someone who assesses this properly — a therapist or your physician. Trauma responds to treatment, and it responds to treatment decades later. The passage of time is not the obstacle people assume it is.
Sources
Read next on this site