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Trauma and Personality Disorders


Trauma is becoming more and more widely recognized as a leading cause of mental health concerns. Although traumatic life events have been long recognized as creating mental distress, we have tended to expect people to "get over" events that may be traumatic… and often they appear to.

More recently however, we have come to recognize that experiencing severe stressful events (such as war, physical or sexual assault, severe accidents, extreme loss etc.) often results in a syndrome that we call Post-Traumatic Stress Disorder (PTSD). PTSD is easily recognized, diagnosed and addressed when there is a clearly identifiable traumatic event that is directly linked to a person's mental distress. There is also a clearly recognized pattern of symptoms for PTSD that are typical of traumatic distress. These include intrusive memories of the event (flash backs), bad dreams and nightmares, sleep disturbances, intense physical reactions to memories or reminders of the event (racing heart, sweating hyperventilating), feeling detached, emotionally numb and "disconnected" from your body, hypervigilance (constantly on "red alert") anxiety, depression … and a host of other symptoms.

However, we have now come to realize that there are a lot of people walking around out there who have experienced traumatic events in their lives (particularly in childhood or young adulthood) but never received treatment or attention for the event(s). Sometimes this is because the events, though traumatic for the individual at the time, may not have been recognized as a severe incident - or even thought of as "minor" (its just part of life or "growing up"), or perhaps it was not disclosed by the individual to parents or others who could have intervened. Often people were just expected to "move on", "get over it" etc.

Examples of this could be: witnessing an accident or violent incident; being bullied; experiencing the sudden death of a parent, close family member or friend; being diagnosed with a life-threatening illness; parental abuse (physical or emotional) being sexually assaulted or molested (often undisclosed); changes in caregivers and or disruptions in living situations - such as apprehension by Children's services, repeated foster home placements, adoption breakdowns etc.

Any of these could result in PTSD or PTSD-like symptoms. The results are further exacerbated if a number of the above were experienced consecutively by an individual or if they were repeated or experienced on a regular basis (such as abuse by a parent or relative).

Severe and/or repeated trauma experienced during childhood - such as repeated physical and/or sexual abuse or severe neglect, can result in what is known as Complex Developmental Trauma… which we now know can result in what are known as Personality Disorders, such as Borderline Personality Disorder or Multiple Personality Disorder (now usually know as Dissociative disorder). The link between early childhood trauma and personality disorders are clearly illustrated through movies such as "Sybll", "The Three Faces of Eve" and more recently in "Good Will Hunting".

Because many traumatic incidents were not recognized, went unreported or were"dismissed" as "part of growing up" at the time, later symptoms are not linked to the trauma and are thought to have some other cause. Thus some people who later display symptoms of depression, anxiety, anger issues, panic attacks, mood swings etc. may actually be displaying signs of untreated PTSD. However, they are often just treated based on their symptoms, not on the cause.

One of the hallmarks of traumatic disorders is the presence of mood "dysregulation" - rapidly changing emotions difficulty managing emotions and tendency to react emotionally very quickly (e.g. "flying off the handle" in anger, sudden teariness or crashing into depression, sudden onset of anxiety etc.). The reverse can also happen - suddenly becoming elated from a dark mood, periods of euphoria, suddenly snapping into a pleasant mood following an emotional outburst as if nothing happened. People who are dysregulated emotionally can have a difficult time managing themselves as they feel overwhelmed by their emotions, which seem to almost have a life of their own.

Mood dysregulation associated with trauma can sometimes be confused with or mis-diagnosed as Bi-polar II disorder where there is a cycling of moods from very depressed to very energetic or euphoric. Some bipolar disorders (particularly diagnoses such as "rapid cycling" bipolar disorder) are now being recognized as symptomatic of longstanding, untreated trauma, rather than true bipolar disorder. Some researchers now estimate that up to 80% of people diagnosed with bipolar disorder have been misdiagnosed and that the "bipolar" symptoms should be more appropriately understood as dysregulated mood resulting from previous trauma.

If you experience recurrent depression, anxiety, mood dysregulation or anger problems - and have also experienced past significant trauma - you may wish to investigate further to see if treatment for trauma or PTSD would be appropriate and effective for you.

If you are currently being treated for any of the above by a Doctor or mental health professional and you have a history of trauma, it would be worthwhile to discuss the idea that your symptoms are trauma-based and to perhaps work from that perspective, with him or her.