Demystifying Trauma Responses: 12 Unrecognized Signs of PTSD and Traumatic Injury

This podcast episode, hosted by Dr. Donal Snipes, delves into the often-overlooked and misunderstood symptoms of traumatic injury, distinguishing it from the initial traumatic event itself. Trauma is defined as an event causing helplessness and horror, with traumatic injury encompassing its physical, emotional, cognitive, and interpersonal effects. The episode critiques the mainstream definition of PTSD for often minimizing chronic or ongoing traumatic stress and failing to account for the subjective nature of trauma, especially in childhood. It highlights that not everyone who experiences trauma develops PTSD, but a significant portion suffers long-lasting consequences, often leading to misdiagnosis or co-occurrence with other conditions.

A central theme is the frequent misdiagnosis of trauma as other disorders, such as ADHD, generalized anxiety, social anxiety, bipolar disorder, depression, and personality/attachment disorders. Dr. Snipes emphasizes the critical need to investigate a person's history for precipitating trauma, as symptoms like difficulty with attention, irritability, emotional dysregulation, and impulsivity can stem from an activated stress response system rather than an inherent disorder. The episode also connects addiction to trauma, suggesting many individuals self-medicate unresolved pain or distress. It introduces Adverse Childhood Experiences (ACEs) as a major contributor to traumatic injury, encompassing abuse, neglect, abandonment, and household dysfunction, which are often not recognized as traumatic by society but have profound impacts.

Practical insights include the importance of a holistic assessment that considers the underlying trauma when treating various mental health conditions. For clinicians, it's crucial to determine if CPTSD fully explains a person's symptoms, as per ICD-11 criteria, and to address trauma comprehensively for maximized recovery. The podcast encourages individuals to ask what function their behaviors serve and when they developed, suggesting many are survival mechanisms. Understanding the physiological changes, particularly HPA axis disregulation, is key to recognizing how past trauma manifests in present-day symptoms.

Broader implications extend beyond mental health, illustrating the profound mind-body connection. Unresolved traumatic injury and chronic stress lead to HPA axis disregulation, which in turn impacts the immune system, contributing to systemic inflammation, autoimmune disorders (like Type 2 diabetes), and cardiovascular disease. Sleep problems, including circadian misalignment and sleep apnea, are also strongly linked. By recognizing that many symptoms are either learned survival behaviors or direct results of physiological changes from chronic stress, individuals can better understand their experiences and plan more effective recovery processes, ultimately improving both psychological and physical well-being.

"trauma is an event that caused a sense of helplessness and horror."

"traumatic injury on the other hand is the physical emotional cognitive and interpersonal effects of that trauma."

"trauma is in the eye of the beholder if it was traumatic and produced a sense of helplessness and horror for that person at that time."

"many people with addictions are self-medicating trauma whether it's physical trauma and they're medicating pain or psychological trauma and they're Med medicating distress."

"if you are hypervigilant if you don't feel safe if you're constantly scanning the room to make sure that you're safe it's going to be hard to pay attention to the math problems on the board or the Excel spreadsheet that you're working on."

"people who've experienced trauma often become what they call glucocorticoid resistant... they often feel flat they they don't feel a lot of anything they're just trying to get through the day."

"people with trauma have deficient apprais resolution and management of negative emotional states."

"high interpersonal sensitivity is another one of those things that we don't talk a lot about and it's not a traditional symptom of PTSD but a lot of people who've experienced trauma especially attachment trauma tend to have high rejection sensitivity."

"research has shown that people with PTSD may feel flooded by sensation and that people with PTSD and cptsd also have what we call impaired sensory gating."

"many symptoms can be traced back to either the development of behavior to survive or the result of physical changes due to HPA access disregulation."