Reactions Beyond 4 Weeks

By TLC
Posted on October 28, 2013, in Grief and Trauma

From Trauma Debriefing Handbook

Should you experience any of these reactions beyond the initial four-week period following the incident, please call us immediately.

The traumatic event is persistently re-experienced in at least one of the following ways:

  1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, other memories of the incident.
  2. Recurrent distressing dreams (nightmares) of the incident itself or any dream content that is terrifying.
  3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience).
  4. Intense psychological distress at exposure to internal reminders that symbolize or resemble an aspect of the traumatic event. (Fear, anxiety and anger are possible examples.)
  5. Physiological reactivity upon exposure to internal or external reminder that symbolize or resemble an aspect of the traumatic event. (Nausea, difficulty breathing, startle reaction and faintness are a few examples.)


Numbing and Avoidance

Persistent avoidance of reminders associated with the trauma, numbing of your feelings or responsiveness to others.

  1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma.
  2. Efforts to avoid activities, places, or people that trigger memories of the trauma.
  3. Inability to recall an important aspect of the trauma.
  4. Markedly diminished interest or participation in significant activities often those having some association with the trauma.
  5. Feeling of detachment or estrangement from others.
  6. Restricted range of emotion (e.g., unable to have loving feelings).
  7. Sense of a foreshortened future (e.g., do not expect to have a career, marriage, children, or a normal life span: cannot even think about a few days in advance).

Hyperarousal and Persistent Symptoms of Increased Arousal (not present before the trauma - see note)

  1. Difficulty falling or staying asleep
  2. Irritability or outbursts of anger
  3. Difficulty concentrating
  4. Hypervigilance: constant worry about something else happening
  5. Exaggerated startle response (responses to sounds, smells, images, sights, tough that reminds you of what happened)

These reactions are not at all unusual during the first four weeks following a traumatic event. When involved in disasters or other external events in which physical reminders cannot be avoided and/or various aspects of the incident are kept alive such as in the case of media coverage, reactions may extend beyond the four-week acute stress period.

Should any of these symptoms persist beyond a 4-8 week period and/or emerge as delayed reactions months later, we strongly recommend consultation with a trauma consultant.

Note: Trauma can induce biological and neurological changes that play a part in the ability to sleep, levels of anxiety, concentration, and other trauma-specific reactions. Should reactions persist beyond the four-week period, consultation for temporary medication should be considered. The loss of sleep, intrusive thoughts, anxiety, and other reactions induced by trauma can deplete an individual of much needed physical rest and inner emotional calmness and precipitate yet more problems for the individual. Medication, at times, is simply a necessity. However, medication should only be temporary.

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