Trauma- And Stressor-Related Disorders: Causes, Diagnoses, And Treatments

That’s why it can be valuable to review the types, causes, and treatments for these disorders, and to distinguish them from traumatic brain injuries (TBIs). These mental health conditions are complicated but treatable and often require the compassion and expertise of a therapist to address. If you feel you may be experiencing symptoms of such a disorder, it’s generally recommended that you meet with a mental health professional who can provide a clinical evaluation and a diagnosis, if applicable.

What are trauma and stressor-related disorders?

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes trauma- and stressor-related disorders as a complete category, separate from anxiety disorders. The following diagnoses are included in the trauma- and stressor-related disorder category in the current version of the Diagnostic and Statistical Manual of Mental Disorders:

• Post-traumatic stress disorder (PTSD)
• Acute stress disorder (ASD)
• Adjustment disorders
• Reactive attachment disorder (RAD) (diagnosed only in children)
• Disinhibited social engagement disorder (DSED) (diagnosed only in children)
• Other specified trauma- and stressor-related disorder
• Unspecified trauma- and stressor-related disorder

Of these, the stress disorder PTSD and acute stress disorder may be some of the most commonly discussed, as both conditions were recently revised in the DSM-5 to reflect their wide range of symptoms. Specifically, the DSM-5 removed the required feelings of “fear, helplessness, or horror” in reaction to traumatic events. This is because both acute and longer-term responses to trauma can vary based on individual temperament, culture, age, and other factors and may not always be recognizable as fear, horror, or other visible expressions.

Effects of trauma and stressor-related disorders 

Trauma and stressor-related disorders, such as acute stress disorder and post-traumatic stress disorder (PTSD), can have profound effects on an individual's mental health. These disorders often develop following exposure to a traumatic event or stressful event, significantly impacting daily functioning. Acute stress disorder manifests shortly after the trauma, while posttraumatic stress disorder persists for a longer duration. 

Anxiety disorders are common among those experiencing these stressor-related disorders. Additionally, conditions like social engagement disorder can arise, affecting an individual's ability to form and maintain healthy relationships.

What can cause trauma- and stressor-related disorders?

True to their name, trauma- and stressor-related disorders stem from a traumatic experience(s). However, trauma can be complex, and an event that one person experiences as traumatic may have a lesser impact on someone else. Often, it’s a person’s perception of threat or danger that can lead to trauma.

People who are diagnosed with a trauma- and stressor-related disorder may have experienced one or more traumatic and stressful events, including but not limited to the following types of situations: 

• Physical and/or emotional violence or abuse
• Sexual assault or abuse
• Neglect or family/childhood abuse 
• Family conflict 
• A natural disaster
• Combat or other military experiences
• Being a first responder to an accident
• Incarceration
• Severe or terminal illness
• Loss

These are all examples of “stressors,” which are any events that increase physical or psychological demands on a person. If the demands are too high, they can lead to one of the disorders mentioned previously. Note that an individual doesn’t have to personally experience a stressor to develop a disorder—acute or otherwise—either. After witnessing a loved one endure a distressing event, for example, they could still develop symptoms related to a trauma disorder. 

If you are experiencing sexual abuse or have experienced a sexual assault, note that the Rape, Abuse, and Incest National Network (RAINN) has a hotline dedicated to supporting individuals experiencing sexual assault, harassment, or intimate partner violence. You can contact them any time by calling 800-656-HOPE (4673) or using the online chat.

What is a traumatic brain injury? (TBI)

Sometimes, trauma- and stressor-related disorders coincide with a traumatic brain injury (TBI), or physical damage to the brain issue, which is often sustained during a traumatic experience. According to the Centers for Disease Control and Prevention (CDC), TBIs most commonly develop from the following injuries:

• Falls, which lead to nearly half of the TBI-related hospitalizations
• Motor vehicle accidents
• Physical assault
• Firearm-related suicide attempts

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. They are available 24/7 to offer support. 

TBIs can range from mild to severe. If you have a concussion, for example, a doctor may describe your injury as a “mild TBI.” More severe TBIs can lead to long-term health problems and may affect brain development in children, particularly if proactive treatment is not sought.

The relationship between PTSD and TBIS

In recent years, some researchers have focused on the intersection of post-traumatic stress disorder and TBIs, particularly among combat veterans and other individuals who work in physically demanding, emotionally charged environments. These individuals may develop post-traumatic stress disorder (PTSD) symptoms and other mental health disorders, and the associated stress can also cause physical damage and potentially worsen the symptoms of a TBI if present. The brain functions in complicated, sometimes mysterious ways, and scientists are still working to understand how the brain changes and heals after trauma and how certain disorders may affect its functioning.

It’s often possible for a healthcare professional to identify the source of a TBI, given that it’s a physical injury. Still, for PTSD and other trauma- and stressor-related disorders, it can be challenging to determine their causes, which often evolve from a combination of factors. Some scientists theorize that the over-involvement of the hypothalamic-pituitary-adrenal (HPA) axis may spark the development of trauma symptoms. Within the brain, the HPA axis influences the production of fear. When the amygdala is overactive, a person may experience heightened fear responses to stressful situations, based on studies of people with post-traumatic stress disorder. 

How do I know if i have a trauma- and stressor-related disorder?

While symptoms of PTSD and other trauma-related disorders may vary, trauma frequently causes angry outbursts and/or arousal symptoms. Individuals may also experience sleep problems, be easily startled, and have distressing memories or frightening thoughts. People who have experienced trauma may also tend to avoid people, places, or things that remind them of their trauma. Note that to qualify as PTSD, symptoms must last more than a month.

If you suspect you or a loved one may have a trauma- and stressor-related disorder, it’s typically recommended that you meet with a licensed healthcare professional for a proper examination and diagnosis. The DSM-5 outlines the symptoms of each trauma- and stressor-related disorder so healthcare professionals and their clients have a research-backed framework to understand the diagnosis. Post-traumatic stress disorder can be manageable with support and resources.

Treatments for trauma- and stressor-related disorders

Depending on the diagnosis, the treatment for trauma- and stressor-related disorders can vary by individual. Often, health experts recommend a combination of therapy, self-care activities, healthy coping strategies, and occasionally medication to manage the symptoms of these disorders. 

Medication

While more research is needed to understand the value of medication for PTSD and other trauma- and stressor-related disorders, your doctor may recommend a prescription based on your symptoms and history. Some medications may particularly benefit clients experiencing nightmares as a symptom.

Self-care 

For many experiencing a mental health condition, self-care can be an ongoing aspect of their treatment plan. The definition of self-care depends on the individual, but it may include any activity that helps you feel calmer and more connected to yourself and others. Popular forms of self-care include journaling, making art, participating in your favorite sport or form of exercise, or grabbing coffee with a friend to receive social support. Your therapist can help you design a self-care plan that supports your values, lifestyle, and mental health goals.

Psychotherapy

Psychotherapy is one of the most common and effective treatments for trauma- and stressor-related disorders, and a growing number of therapists are trained in trauma-informed care. Compared to more traditional approaches to therapy, trauma-informed therapists carefully attend to their clients’ triggers to try and prevent their trauma symptoms from recurring.

For clients with trauma, therapists may also use cognitive-behavioral therapy (CBT), which research suggests can help improve symptoms of PTSD, depression, and other mental health conditions. CBT can help people recognize and learn to reverse unhelpful ways of thinking and form healthier, more positive thought patterns and behaviors.

Therapists may also employ a technique called eye movement desensitization and reprocessing therapy (EMDR) to help clients with trauma-related symptoms. With EMDR, a therapist will guide the individual through a series of rapid eye movements or bilateral brain stimulation combined with talk therapy. Over time, this structured therapy may help reduce the impact of trauma memories and the symptoms they bring. Researchers are still working to understand the mechanisms behind EMDR, but current studies suggest that this therapy may reduce the vividness and emotion of traumatic memories.

Counseling options 

Depending on your diagnosis, a therapist may use a combination of the above and/or other psychotherapeutic techniques to begin your healing journey. For many people, deciding to start this journey is the most overwhelming step. If you’re concerned that you don’t have enough time or energy to commute to in-person counseling sessions to get started on this path, online therapy can represent a way to help you get started with treatment more easily. 

With a digital platform like BetterHelp, you can work through the symptoms of PTSD, acute stress disorder, or other conditions with the help of a licensed therapist. You can get matched with such a specialist based on your answers to a questionnaire and then meet with them virtually from the comfort of your home. Research suggests that online therapy can be as effective as in-person sessions for reducing symptoms of conditions like PTSD, so this format may be worth exploring if it’s more convenient for you than in-office sessions.