Better Understanding the Stages of PTSD

The renowned Austrian psychiatrist Viktor Frankl famously said, “Between stimulus and response, there is a space. In that space is our power to choose our response, and in our response lies our growth and our freedom.” As a holocaust survivor, this optimism came after experiencing horrible trauma. All over the world, millions of people struggle with issues of trauma every day. Many of them are able to process this trauma in a healthy way, but for others, it can turn into addiction and mental illness, like post-traumatic stress disorder (PTSD). For these people, professional help is essential, as well as psychoeducation that helps to explain the stages of PTSD.

Better Understanding the Stages of PTSD

While instances of trauma lie in an event (or series of events), PTSD develops over time and happens in stages. These stages include impact, denial, intrusive thinking, processing, acceptance, and reconnection. Now, as you can see, these stages include both struggle and recovery. However, the recovery only happens when help is attained.

Also, the stages of PTSD are often chronological, but there is no specific timeline. Many people are surprised when they are diagnosed with PTSD because the trauma they experienced may have occurred many years prior. This is because the human brain has a cunning ability to bury trauma deep down inside so as not to create excessive levels of discomfort. Now, this is when serious issues start to manifest because these traumatic memories can fester and become unwittingly disruptive. Ultimately, it can turn to mental illness like dissociative identity disorder (DID) or PTSD. 

What Exactly Is PTSD?

Many people have heard of PTSD but are not exactly sure of what it is. According to The British Medical Journal (BMJ), “PTSD is a mental disorder that may develop after exposure to exceptionally threatening or horrifying events…. [It] can occur after a single traumatic event or from prolonged exposure to trauma, such as sexual abuse in childhood…. Patients with PTSD are at increased risk of experiencing poor physical health, including somatoform, cardiorespiratory, musculoskeletal, gastrointestinal, and immunological disorders.”

It is also important to note that there is no specific traumatic event that can lead to PTSD. Yes, there are more common instances like childhood sexual abuse and active military duty, but there are also traumas like a family illness or the death of a loved one that can lead to PTSD. 

Who Struggles With PTSD?

Also, PTSD is not unique in who it can affect. No one is immune to PTSD. It can happen to anyone who experiences trauma. Of course, there are people who are more susceptible to PTSD. Often, children who are abused are at a high risk of developing PTSD. According to the peer-reviewed thesis, Posttraumatic Stress Disorder in Children, by Doctors Torrico and Mikes, “The lifetime prevalence of PTSD ranges from 6.1% to 9.2% from national samples of the general adult population of the United States and Canada. In children, the prevalence of trauma history is estimated at 31%, and the development of PTSD by the age of 18 years is estimated at 7.8%.”

Other people who struggle with PTSD include active duty military personnel, people who experience homelessness and extreme poverty, disaster survivors, and those who experience domestic abuse from their spouse. Now, it is also important to note that larger events can cause larger swaths of people struggling with PTSD. This is often why there are counselors on site after a natural disaster or a terror attack. 

The Signs and Symptoms of PTSD

According to the National Institute of Mental Health (NIMH), “Symptoms of PTSD usually begin within 3 months of the traumatic event, but they sometimes emerge later. To meet the criteria for PTSD, a person must have symptoms for longer than 1 month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The symptoms also must be unrelated to medication, substance use, or other illness.” Now, of course, the signs and symptoms of PTSD are going to vary based on the situation, but there are some universal signs to look out for. The following are just a few of those signs:

• Struggles with sleeping and experiencing nightmares
• Having flashbacks
• Isolating and feeling detached from others
• Losing interest in activities and hobbies once enjoyed
• Mood swings and having angry outbursts
• Feelings of worry, guilt, and sadness
• Experiencing frightening thoughts
• Trouble concentrating
• Experiencing physical ailments like headaches, stomach aches, and body pains
• Trying to avoid certain memories
• Struggles remembering events
• Feeling irritable
• Being on guard (hypervigilant)
• Becoming startled easily
• Feelings of self-harm or harming others
• Having suicidal ideations

As you can see, these can be very significant (even deadly) symptoms. That is why reaching out for professional help as soon as symptoms appear is imperative. Doing so can mean the difference between short-term side effects and long-term consequences. Rarely will PTSD go away on its own; it can act as a chronic disease that continues to progress. 

The Stages of PTSD: Impact

Now, the initial stage of PTSD is known as the “impact” or “emergency” stage. This occurs right after a traumatic event and can bring with it very intense physical and emotional reactions.

Now, this stage can happen relatively quickly or last a while. It depends on the type of traumatic event, especially if the trauma happens over a period of time, such as systematic abuse. This stage can include feelings of shock, withdrawal, guilt, anxiety, hypervigilance, helplessness, and fear. It can then lead to the “denial” stage of PTSD.

The Stages of PTSD: Denial

According to the peer-reviewed journal Memory & Cognition, “The concept of denial has its historical roots in psychoanalysis. Regarded as a type of defense mechanism in the psychodynamic school of thought, it refers to a complete refusal to face certain troubling issues. The concept of denial has attracted particular attention in the domain of memory, where it has often been assumed, but not explicitly tested, that ‘memory may be far more amenable to denial.’” Denial is also highly common in PTSD; it defines its second stage.

The denial stage of PTSD can be tricky, as it can be hard to diagnose someone at this stage. Ultimately, the reason for this is that the denial prevents anyone from getting the critical information that they need. This is also why PTSD can manifest to the next stage so easily, and the next stage can be significantly more uncomfortable.

The Stages of PTSD: Intrusive/Repetitive

Now, the first aspect of this stage has to do with “intrusive memories.” According to the peer-reviewed journal Clinical Psychology Review, “After suffering psychological trauma, people can repeatedly experience sensory-perceptual impressions of the event, which intrude involuntarily into consciousness. These ‘intrusive memories’ typically take the form of visual images (e.g., pictures in the mind’s eye), but can also include sounds, smells, tastes, and bodily sensations, and come with a range of negative emotions associated with the ‘hotspots’ in the trauma memory. For example, after having a head-on collision in their car, a person may describe intrusive images of seeing “dust and smoke, debris everywhere” and hearing the “bang” of the airbags.” 

However, as uncomfortable as these memories can be, they can be the key to unlocking recovery from PTSD. This is because therapy can use a “repetitive” process during this stage to help individuals visit these uncomfortable memories and navigate them in a healthy way. Eye-movement desensitization reprocessing (EMDR) therapy helps with this stage significantly. 

According to the peer-reviewed journal Frontiers in Psychology, “Eye-Movement Desensitization Reprocessing (EMDR) is a form of Psychotherapy developed by Shapiro. Ostensibly, EMDR therapy is a trans-diagnostic, integrative psychotherapy that has been extensively researched, and there is a growing empirical base for its effectiveness for the treatment of adverse life experiences, namely Post-traumatic Stress Disorder (PTSD). EMDR therapy utilizes a theoretical framework of Adaptive Information Processing (AIP), which posits that the primary source of psychopathology is the presence of memories of adverse life experiences inadequately processed by the brain.” This is also one of the modalities that can lead to the processing stage of PTSD.

The Stages of PTSD: Processing

After an individual has confronted their trauma, they are ready to process it. However, this processing should be achieved systematically in the care of professionals. 

This is also where an individual can start to “make sense” of their traumatic experiences[s]. Also, this is the stage in which an individual may start to find a purpose in their recovery. Finding life’s purpose is critical for growth. Acceptance of the past is also critical.

The Stages of PTSD: Acceptance

Now, the key to the acceptance stage of PTSD is integrating one’s trauma into one’s life story without letting it define them. It is about living with the trauma rather than living under it. 

Acceptance and commitment therapy (ACT) is an ideal modality to utilize at this stage of PTSD. According to the peer-reviewed journal Neurotherapeutics, “ACT rests on the fundamental premise that pain, grief, disappointment, illness, and anxiety are inevitable features of human life, with the therapeutic goal of helping individuals productively adapt to these types of challenges by developing greater psychological flexibility rather than engaging in counterproductive attempts to eliminate or suppress undesirable experiences. This is achieved through committed pursuit of valued life areas and directions, even in the face of the natural desire to escape or avoid painful and troubling experiences, emotions, and thoughts. ACT is transdiagnostic (applies to more than one condition), process-focused, and flexibly delivered.”

The Stages of PTSD: Reconnection

A key to the “reconnection” stage of PTSD is getting to the underlying issues of trauma and determining that they are based in skewed cognitions and emotions. It is about addressing the negative way in which one has been viewing themselves and the world around them, and thus changing the negative behaviors associated with them.

This is also often considered the “recovery” stage of PTSD, but that does not mean that the work is done. PTSD can easily rebound in one’s life if they are not vigilant and stick to a healthy plan of recovery that may include therapy and working with support groups. Many people who have co-occurring issues of PTSD and addiction also risk relapse if they fail to keep up with their recovery.

PTSD and Addiction

Mental illness and addiction occur more commonly than many people may think. According to the National Institute on Drug Abuse (NIDA), “Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa. Multiple national population surveys have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa. Although there are fewer studies on comorbidity among youth, research suggests that adolescents with substance use disorders also have high rates of co-occurring mental illness; over 60 percent of adolescents in community-based substance use disorder treatment programs also meet diagnostic criteria for another mental illness.” This includes comorbidities of PTSD.

One of the primary concerns of co-occurring PTSD and addiction is that they both heighten the symptoms of each other. Also, they pair to make potential relapses much more common. According to Frontiers in Psychiatry, “The frequent co-occurrence of post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) leads to manifestations of both conditions that are more severe and more resistant to treatment than single disorders. One hypothesis to explain this synergy is the impact of intrusive memories on craving, which, in turn, increases the risk of relapse among patients with substance use disorders.” 

These cravings are significant because they are one of the most commonly reported feelings associated with relapse. This is yet another reason why working with professionals skilled in treating dual diagnosis is so important. The good news is that there are many effective means, methods, and modalities that have been proven to help people recover from PTSD, addiction, or both.

Recovering From PTSD at the Cellular Level

So, what exactly does it mean to heal at the cellular level? Healing at the cellular level has to do with holistic healing. Now, many people get confused with this term “holistic,” thinking it only applies to Eastern medicines and treatments. This is not true. “Holistic” simply refers to “whole,” meaning one must heal the whole mind-body to heal at the cellular level. Now, this includes physical, emotional, mental, and even spiritual healing.

To heal all of these aspects, it is critical that one connect with a recovery center that focuses on individualized and comprehensive treatment. This means a personalized intake process and a focus on the “multi-angled approach.” The multi-angled approach to recovery simply has to do with utilizing as many effective means, methods, and modalities as possible. 

Recovery plans that only use one form of treatment tend to fall flat over time, as they can have a very limited growth window. Often, these multi-angled plans begin with a foundation of evidence-based recovery, such as a focus on cognitive-behavioral therapy (CBT) and/or dialectical behavior therapy (DBT). This would also be where EMDR and ACT therapy land. Then this foundation should be built upon with experiential therapies like nature immersion therapy and holistic healing methods like mindfulness meditation. The key is to create a plan that works for the individual and stick to it, especially for long-term recovery from PTSD.

Healing at the Cellular Level From PTSD With Exclusive Hawaii Rehab™

Here at Exclusive Hawaii Rehab™, we know how disruptive PTSD can be. However, we also know that we have individualized and comprehensive recovery plans that can help you recover from PTSD and any comorbidities at the cellular level.

PTSD does not have to spell the end. In fact, seeking recovery for it can spell a new beginning to a life beyond your wildest dreams. One free of fear and shame. If you are sick and tired of being sick and tired, then the time to recover is now. You can do this! We can help.

Post-traumatic stress disorder (PTSD) affects millions of people every day. Yet, many people are still unfamiliar with PTSD and its stages, as well as the most effective modalities that can help one recover from PTSD at the cellular level. The good news is that there is help and hope. If you or a loved one is struggling with issues of addiction, mental illness, or co-occurring disorders, we can help get you on the positive path toward long-term recovery right away. You don’t have to go through this process alone. For more information about recovery and the stages of PTSD, please reach out to Exclusive Hawaii Rehab™ today at (808) 775-0200.