Recognizing the Signs of Emotional Trauma in Adults

Recognizing the Signs of Emotional Trauma in Adults

Trigger warning: This article mentions sexual assault, abuse, combat, and other potential sources of emotional trauma

Psychological trauma shapes our emotional responses, behaviors, and interactions. Whether we’re deciphering our own internal distress cues or noticing shifts within our loved ones, knowing the signs of emotional trauma in adults is critical to supporting those who may be silently struggling as well as tending to our own well-being.

What is emotional trauma?

Emotional trauma, also referred to as psychological trauma or mental trauma, is a response to an extremely distressing event or series of events that overwhelms a person’s ability to cope. Traumatic experiences can have a profound impact on emotional, psychological, and even physical well-being.

Psychological trauma can arise from various sources, including:

One-time traumatic event – Car accident, natural disaster, physical assault, witnessing a traumatic incident

Ongoing stressors – Chronic abuse, neglect, or prolonged stressful situations like bullying or living in a physically or emotionally unsafe environment

Childhood traumaChildhood abuse, neglect, or family dysfunction

Combat or military trauma – Emotional trauma related to combat, violence, or the loss of comrades

Sexual assault or abuse – Nonconsensual sexual behavior like rape, sexual coercion, or unwanted touching

Medical trauma – Serious medical conditions, surgeries, or life-threatening illnesses

Loss of a loved one – Grief and loss, especially sudden or traumatic loss

Emotional trauma is very individualized—what’s traumatic to one person may not be traumatic to another. “Someone who experienced trauma in the home may look at their siblings who don’t seem to be struggling and think, ‘What’s wrong with me?’” said Jon Caldwell, DO, PhD, chief medical officer for The Meadows, a national network of treatment centers for trauma, substance use disorders, and other behavioral health conditions. “However, while people may share the same environment, each person has a unique experience of it.”

Signs of emotional trauma in adults

The effects of psychological trauma can vary widely from person to person and emotional trauma symptoms may develop at different times. Some people experience symptoms of emotional trauma soon after a traumatic event, but for others, it may take weeks, months, years, or even decades to show up. “When we experience mental trauma, we may protect ourselves by putting it under a shell because we must go on with our life, job, and relationships, but eventually that shell starts cracking from the pressure,” said Dr. Caldwell. “Dealing with that cracked shell can come in many forms like rebellion, perfectionism, people-pleasing, eating disorders, or addiction.”

Emotional trauma symptoms can resolve over time, but sometimes people require more support. “Symptoms of emotional trauma can progress to post-traumatic stress disorder when the impact of a traumatic event becomes severe and persistent, causing significant distress and impairment in daily functioning,” said Scott Michael, PhD, director of clinical training and education at Lyra Health.

Signs of emotional trauma in adults may include:

Emotional distress – Intense and unpredictable emotions, such as anxiety, fear, anger, guilt, shame, or sadness

Mental health concerns – Depression or anxiety symptoms or a worsening of already existing mental health conditions. There’s sometimes a misconception that PTSD is the main disorder that results from trauma, but research shows over 75 percent of people with PTSD have co-occurring mental health disorders like major depression or anxiety.

Flashbacks and intrusive memories – Re-experiencing traumatic events through vivid memories, nightmares, or involuntary thoughts

Negative or extreme mood – Persistent negative thoughts about oneself, others, or the world, as well as a loss of interest in previously enjoyed activities. “For some, psychological trauma can look like anger, which can show up in things like aggression or road rage,” said Dr. Caldwell. “Others may feel anxious or depressed and isolate or withdraw from friends or family.”

Avoidance behaviors – Avoiding people, places, or activities that bring up memories of the traumatic experience

Intense reactions – Reacting strongly to a situation that wouldn’t bother many people or only slightly bother them. “Triggers or reminders could be sights, sounds, smells, or certain types of people,” said Dr. Michael. “For example, if someone gets very upset or agitated, or wants to leave the area, they could be reacting to specific triggers like a sound that reminds them of combat.”

Hypervigilance – Being constantly on edge, easily startled, or having difficulty concentrating due to heightened awareness of potential threats

Trouble functioning – Struggling to perform daily tasks at home or work due to the impact of mental trauma

Hyperactivity – Engaging in restless or impulsive behaviors as a way to cope with emotional trauma. “When the nervous system is overactive, it can make people hypervigilant, constantly looking behind them, startling easily, or quick to anger,” said Dr. Michael.

Physical reactions – Physical symptoms such as headaches, stomachaches, rapid heartbeat, sweating, intense startle response, or trembling. “One way we may start to feel emotional trauma in the body includes being tired or rundown or experiencing various aches and pains,” said Dr. Caldwell.

Sleep disturbances – Insomnia, nightmares, or restless sleep patterns that are linked to the traumatic event

Social withdrawal – Pulling away from social interactions, isolating oneself, or having difficulty connecting with others

Changes in eating habits – Sudden weight loss or gain, decreased appetite, or irregular eating patterns

Cognitive changes – Difficulty concentrating, making decisions, or organizing thoughts. “Your concentration and focus can suffer because your brain is in overdrive processing stress responses,” said Dr. Michael.

Feeling helpless – Constantly feeling overwhelmed, hopeless, or powerless in response to your thoughts and emotions

Feeling detached – A sense of emotional detachment from self or others, often described as feeling numb or disconnected

Substance use – An increased reliance on alcohol, drugs, or other substances to cope with emotions related to psychological trauma. “Sometimes things we’ve been doing to keep trauma under wraps take on a life of their own,” said Dr. Caldwell. “Maybe we use alcohol to push down nightmares and that evolves into an alcohol use disorder. We eventually can’t use alcohol as a coping tool anymore and the feelings start coming up.”

Relationship and trust issues – Struggling to trust people, even close loved ones, due to feelings of vulnerability or betrayal. “Since emotional trauma during childhood happens in the context of important attachment relationships, it’s common for those trauma symptoms to impact people’s adult relationships, especially romantic relationships,” said Dr. Caldwell. “If we find we’re exceedingly fearful about our partner leaving, sensitive about what they’re doing beyond what’s needed for the situation, or more reactive than necessary, these are clues that there’s something else going on.”

Chronic fatigue – Persistent tiredness and lack of energy, often due to disrupted sleep patterns and emotional stress. “All the things we do to manage mental trauma take energy and can leave us worn out,” said Dr. Caldwell. “Pair that with poor sleep from trauma symptoms, and you can feel exhausted a lot of the time.”

If symptoms of emotional trauma are threatening your health, relationships, or work, you may need to step into a higher level of care. For example, if you’re feeling more depressed or anxious than usual, or you’re at the start of an addictive process, it can be helpful to pursue therapy or counseling.

How to recover from emotional trauma

Unaddressed mental trauma can take on a life of its own, invading all areas of our lives. But recovery is within reach. Healing from emotional trauma may include self-care and practices like:

  1. Exercise – Engaging in regular physical activity can release endorphins, which are natural mood lifters. Exercise also helps regulate the nervous system and can contribute to an overall sense of well-being.
  2. Maintain healthy relationships – Staying connected with supportive friends, family, and loved ones can provide a sense of belonging and help prevent feelings of loneliness.
  3. Trauma groups – Joining an emotional trauma support group can offer a safe space to share experiences, gain insights, and receive validation from others who have gone through similar situations.
  4. Practice stress management – Learn techniques to manage your nervous system’s response to stress, such as deep breathing exercises, progressive muscle relaxation, or other relaxation techniques.
  5. Meditation and mindfulness – “One tragedy of trauma is distressing thoughts intruding into the present moment,” said Dr. Caldwell. “It’s hard to be present when memories, nightmares, or flashbacks cause constant worry about possible danger in the future. You rotate between being in the past or future—not in the present.” Mindfulness practices can help you stay present, reduce anxiety, and manage overwhelming emotions by fostering self-awareness and reducing the impact of negative thoughts.
  6. Find a support system – Establishing a strong support system that includes friends, family, mental health providers, and support groups can provide you with various avenues for emotional support.
  7. Acknowledge and accept feelings – Allowing yourself to acknowledge the range of feelings that arise, including the difficult ones, and not judging them or yourself for having them gives them less power over your emotions and behaviors.

Healing from emotional trauma is a journey. It’s important to find a combination of strategies that resonates with you personally. A mental health professional can provide personalized strategies and support tailored to your specific needs.

Treatment for emotional trauma

When left untreated, symptoms of emotional trauma can become more debilitating. “If it’s been a month or more since the traumatic experience and you’re still having high levels of distress that are getting in the way of your life, it may be time to consider professional support,” said Dr. Michael.

Treating emotional trauma often involves a combination of approaches, and it’s helpful to work with a qualified mental health professional to determine the most suitable treatment plan for your needs. Here are a few evidence-based treatments for psychological trauma:

Therapy – Emotional trauma recovery requires practical skills like healthy coping mechanisms to manage triggering situations and thoughts. “Trauma-focused psychotherapies are first-line agents,” said Dr. Michael. “Evidence-based approaches help people confront what happened and emotionally process it.”

Trauma-focused therapies include:

  • Cognitive behavioral therapy (CBT) – Helps identify and challenge negative thought patterns and behaviors related to trauma. CBT has been shown to decrease PTSD symptoms by changing unhealthy associations and perceptions formed after trauma.
  • Prolonged exposure therapy – Gradually exposes the individual to memories, situations, and thoughts around trauma-related distress. This is done in a systematic and controlled way, allowing the person to process and reduce the intense emotional responses associated with the traumatic experience.
  • Cognitive processing therapy (CPT) – Helps trauma survivors identify, challenge, and reprocess trauma memories and learn skills to manage trauma symptoms in healthy ways.
  • EMDR (eye movement desensitization and reprocessing) – Involves recalling distressing memories or feelings around those memories while engaging in a series of eye movements or other rhythmic sensory input, reprocessing and reducing the emotional impact of traumatic memories.

Medication – In some cases, medication might be prescribed to manage symptoms and signs of emotional trauma, such as anxiety, depression, and sleep disturbances. Antidepressants, anti-anxiety medications, or other medications could be part of the treatment plan.

Co-occurring disorder treatment – People with PTSD have a higher likelihood of experiencing other mental health issues or substance use disorders simultaneously. They may use drugs and alcohol to cope with distressing thoughts and emotions or have anxiety or depression. Treatment is most effective when it addresses all of these concerns at the same time. “If substance use becomes a problem, it’s not necessary to get sober before trauma treatment because you need to address both at the same time,” said Dr. Michael. “Treating substance use and trauma at the same time helps you learn to manage triggers without drugs and alcohol.”

Mindfulness and meditation – These practices can help you become more present and aware of your thoughts and feelings, allowing you to develop greater control over your responses to triggers and stressors.

“The body has become an important element of trauma treatment,” said Dr. Caldwell. “Body therapies like mindfulness and various approaches that use movement have come to the forefront and changed the way we think about trauma therapy from only a frontal lobe, intellectual, reasoning, and talking treatment approach to one that also considers the physical ways we hold and experience trauma.”

Trauma treatment can help significantly. Research shows 75-80 percent of people who fully engage in treatment will experience symptom improvement. “Blood pressure medications don’t even have that level of effectiveness,” said Dr. Michael.

In addition to these therapies, family therapy or couples counseling may be recommended. Psychological trauma not only affects the person who experienced it but can also have a significant impact on family dynamics. Family members may be directly involved in the trauma or indirectly affected by its aftermath. Family therapy can help identify how mental trauma has influenced family relationships, communication, and roles. “Often the whole family needs support so they can take ownership in their part of the family dynamic,” said Dr. Caldwell.

Some people also benefit from group therapy. Joining a trauma-specific support group can offer a sense of community and understanding, allowing you to share experiences, learn coping strategies, and receive validation from others who have experienced similar psychological trauma. There are many treatment options and most people benefit from a combination of different approaches. The Meadows and Lyra work together to make sure people receive the right level of care for their needs.

How to help someone with emotional trauma

Supporting a loved one dealing with emotional trauma requires patience, empathy, and understanding. Here are some ways you can help:

  1. Listen and be present – Let your loved one know that you’re there for them and willing to listen without judgment. Allow them to share their feelings and experiences at their own pace. Show that you’re engaged by asking open-ended questions and reflecting back what you hear. This can help them feel understood. “Try to refrain from saying, ‘Stop thinking about it.’ That doesn’t work with trauma,” said Dr. Michael. “The more you try not to think about it, the more you do think about it. Be supportive rather than trying to reduce the distress.”
  2. Set boundaries – Many of us struggle with setting boundaries, but it’s crucial in taking care of ourselves as well as our loved ones. “Trauma by nature is a boundary crossing. Someone or something has intruded on us in a way that’s hurtful or overwhelming. Boundary setting is a form of authenticity and love,” said Dr. Caldwell. “If we enable a loved one to be destructive by not setting consequences for their behaviors, we’re doing them a disservice and they won’t get better.”
  3. Avoid pressure – Don’t pressure them to “get over it” or “move on.” Healing from emotional trauma takes time and they need to process at their own pace. “Provide support and validation, but don’t push them if they don’t want to talk about it,” said Dr. Michael. “People are often reluctant to get into trauma processing right away in treatment, so understand that this is normal behavior.”
  4. Offer validation – Let them know their feelings are valid and you believe their experiences. Validation can help reduce feelings of isolation and self-blame.
  5. Support without enabling – Instead of trying to “fix” their problems, empower them to find their own solutions. Offer guidance if they seek it, but avoid imposing your solutions on them. “Offer a loving, supportive ear, but don’t become a crutch for them,” said Dr. Michael. “Don’t go to the grocery store for them if they’re isolating or play a role in helping them stay stuck.”
  6. Respect their space – While it’s important to offer support, also respect their need for space and privacy. Create a safe and non-judgmental space where they can express themselves without fear of criticism or rejection.
  7. Do your own work – We can’t change someone else, but we can work on ourselves and how we respond. “When we change ourselves and how we relate to others, and show up in a way that honors ourselves, people often notice and think, ‘This dance we usually do is different; you reacted differently,’ then the ball is in their court to do something different,” said Dr. Caldwell.

Remember that everyone responds to emotional trauma differently. The key is to show empathy, patience, and willingness to support them in the way they find most helpful. If their trauma is impacting their well-being, encourage them to seek professional help.

Reclaim your life

“Addressing trauma not only changes our life trajectory, but also positively impacts the people we spend time with—our children, partners, and loved ones,” said Dr. Caldwell. “We are social creatures, and relationships are so important in our lives. At the end of my life, what will mean the most is if I loved and allowed myself to be loved. Trauma gets in the way of that.”

If you’ve experienced emotional trauma and are struggling to cope with its effects, seeking help is a crucial step towards healing and recovery. Talking to a mental health professional can provide you with a safe and supportive space to process your feelings, understand the impact of the psychological trauma, and develop effective coping strategies. Seeking help is a courageous decision to prioritize your well-being.

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About the reviewers
Scott Michael, PhD

Dr. Michael earned a doctorate in clinical psychology from the University of Kansas and received specialized trauma training at the National Center for PTSD and the Northwest Mental Illness Research, Education, and Clinical Center. Dr. Michael has been a national trainer and consultant in prolonged exposure therapy for the VA Evidence-Based Psychotherapy training and dissemination program and developed the mood and anxiety disorders postdoctoral fellowship program for VA Puget Sound Health Care System.

Jon G. Caldwell, PhD

Dr. Caldwell is a board-certified psychiatrist and clinical research investigator who specializes in the treatment of adults who are healing from relational trauma and addictive behaviors. He is currently the chief medical officer of Meadows Behavioral Health and The Meadows. Dr. Caldwell has published a number of articles on child maltreatment, attachment theory, emotion regulation, and mindfulness. He is also a noted international speaker and trainer on these and other topics.

By The Lyra Team
12 of September 2023 - 14 min read
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