Acute Stress Disorder Quotes

In response to threat and injury, animals, including humans, execute biologically based, non-conscious action patterns that prepare them to meet the threat and defend themselves. The very structure of trauma, including activation, dissociation and freezing are based on the evolution of survival behaviors. When threatened or injured, all animals draw from a "library" of possible responses. We orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze, collapse, etc. All of these coordinated responses are somatically based- they are things that the body does to protect and defend itself. It is when these orienting and defending responses are overwhelmed that we see trauma. The bodies of traumatized people portray "snapshots" of their unsuccessful attempts to defend themselves in the face of threat and injury. Trauma is a highly activated incomplete biological response to threat, frozen in time. For example, when we prepare to fight or to flee, muscles throughout our entire body are tensed in specific patterns of high energy readiness. When we are unable to complete the appropriate actions, we fail to discharge the tremendous energy generated by our survival preparations. This energy becomes fixed in specific patterns of neuromuscular readiness. The person then stays in a state of acute and then chronic arousal and dysfunction in the central nervous system. Traumatized people are not suffering from a disease in the normal sense of the word- they have become stuck in an aroused state. It is difficult if not impossible to function normally under these circumstances.

Early relational trauma results from the fact that we are often given more to experience in this life than we can bear to experience consciously. This problem has been around since the beginning of time, but it is especially acute in early childhood where, because of the immaturity of the psyche and/or brain, we are ill-equipped to metabolize our experience. An infant or young child who is abused, violated or seriously neglected by a caretaking adult is overwhelmed by intolerable affects that are impossible for it to metabolize, much less understand or even think about.

Secondary structural dissociation involves one ANP and more than one EP. Examples of secondary structural dissociation are complex PTSD, complex forms of acute stress disorder, complex dissociative amnesia, complex somatoform disorders, some forms of trauma-relayed personality disorders, such as borderline personality disorder, and dissociative disorder not otherwise specified (DDNOS).. Secondary structural dissociation is characterized by divideness of two or more defensive subsystems. For example, there may be different EPs that are devoted to flight, fight or freeze, total submission, and so on. (Van der Hart et al., 2004). Gail, a patient of mine, does not have a personality disorder, but describes herself as a "changed person." She survived a horrific car accident that killed several others, and in which she was the driver. Someone not knowing her history might see her as a relatively normal, somewhat anxious and stiff person (ANP). It would not occur to this observer that only a year before, Gail had been a different person: fun-loving, spontaneous, flexible, and untroubled by frightening nightmares and constant anxiety. Fortunately, Gail has been willing to pay attention to her EPs; she has been able to put the process of integration in motion; and she has been able to heal. p134

Some mass murderers, so deeply depressed, become schizophrenic or psychotic. Others suffer with severe anxiety and personality disorders. These are not rational people at the time of the murders even when their behaviors are calculated and decisive. Many of them are not legally insane but suffer from severe psychological dysfunctioning as a result of both chronic and acute stress.

Much, much later. when I am back home and being treated for Post Traumatic Stress Disorder (PTSD). I will be enabled to see what was going on in my mind immediately after 11 August. I am still capable of operating mechanically as a soldier in these following days. But operating mechanically as a soldier is now all I am capable of. Martin says he is worried about me. He says I have the thousand-yard stare'. Of course, I cannot see this stare. But by now we both have more than an idea what it means. So, among all the soldiers here, this is nothing to be ashamed of. But as it really does just go with the territory we find ourselves in. it is just as equally not a badge of honour. Martin is seasoned enough to never even think this. but I know of young men back home, sitting in front of war films and war games, who idolise this condition as some kind of mark of a true warrior. But from where I sit, if indeed I do have this stare, this pathetically naive thinking is a crock of shit. Because only some pathetically naive soul who had never felt this nothingness would say something so fucking dumb. You are no longer human, with all those depths and highs and nuances of emotion that define you as a person. There is no feeling any more, because to feel any emotion would also be to beckon the overwhelming blackness from you. My mind has now locked all this down. And without any control of this self-defence mechanism my subconscious has operated. I do not feel any more. But when I close my eyes. I see the dead Taliban looking into this blackness. And I see the Afghan soldier's face staring into it, singing gently as he slips into another world. And I see Dave Hicks's face. shaking gently as he tries to stay awake in this one. With this, I lift myself up, sitting foetal and hugging my knees on my sleeping mat.

This feeling of stress triggers a cascade of physiological consequences. The hypothalamus and pituitary gland in the brain release hormones that cause the release of cortisol from the adrenal glands located on the kidneys. Cortisol increases heart rate, among other things, readying the body for “fight” or “flight.” Acutely, the release of cortisol is beneficial and helps you cope with whatever is urgently being demanded of you. But if the stress becomes chronic, maladaptive things begin to happen. Normally, the release of cortisol turns the hypothalamus and pituitary off, stopping the release of hormone, which in turn stops the further release of cortisol from the adrenal glands. It’s a nice, clean, negative feedback loop. But in the chronically stressed, the loop breaks. The brain stops reacting to cortisol. Our natural, automatic shutoff valve stops working. The brain keeps releasing hormone, and the adrenal glands keep dumping cortisol into the bloodstream, even when the stressful thing that initially triggered the stress response is no longer around. Chronic, elevated levels of cortisol have been associated with a weakened immune system, deficits in short-term memory, chronic fatigue syndrome, anxiety disorders, and depression.

For many, an explosion of mental problems occurred during the first months of the pandemic and will continue to progress in the post-pandemic era. In March 2020 (at the onset of the pandemic), a group of researchers published a study in The Lancet that found that confinement measures produced a range of severe mental health outcomes, such as trauma, confusion and anger.[153] Although avoiding the most severe mental health issues, a large portion of the world population is bound to have suffered stress to various degrees. First and foremost, it is among those already prone to mental health issues that the challenges inherent in the response to the coronavirus (lockdowns, isolation, anguish) will be exacerbated. Some will weather the storm, but for certain individuals, a diagnostic of depression or anxiety could escalate into an acute clinical episode. There are also significant numbers of people who for the first time presented symptoms of serious mood disorder like mania, signs of depression and various psychotic experiences. These were all triggered by events directly or indirectly associated with the pandemic and the lockdowns, such as isolation and loneliness, fear of catching the disease, losing a job, bereavement and concerns about family members and friends. In May 2020, the National Health Service England’s clinical director for mental health told a Parliamentary committee that the “demand for mental healthcare would increase ‘significantly’ once the lockdown ended and would see people needing treatment for trauma for years to come”.[154] There is no reason to believe that the situation will be very different elsewhere.

SENSORY AVOIDERS – SENSORY DEFENSIVENESS “And have I not told you that what you mistake for madness is but over-acuteness of the senses?” -Edgar Allen Poe, The Tell-Tale Heart (1843) Imagine a day inside Jenny’s skin. The morning alarm goes off and she startles, her heart races, her body tightens, her breathing quickens.  Her husband turns to get out of bed, grazing her foot, and she cringes, her bodily rhythms speed up another notch and her body tightens further. He sees that she seems annoyed about something and affectionately strokes her cheek. She bristles and, when he turns around, rubs where he touched her. She slowly arises to get out of bed, as she feels a bit dizzy, and quickly puts on her soft cotton house slippers, as the feel of the carpet makes her recoil, and walks into the bathroom. The bright lights her husband has left turned on assault her. Her eyes squint painfully. She quickly turns off the lights and turns on a small lamp on the sink counter. Her already overloaded system gets further destabilized. She starts to brush her teeth but the toothbrush is new and the bristles tickle her uncomfortably. She leans over to spit out the toothpaste and feels a sudden loss of balance and a surge of panic engulfs her. She steadies herself and turns on the shower. The soft spray of water from the showerhead feels like pelts of hail hitting her body. Her already stressed system is accelerating fast into overload. And her morning has only just begun!  She still has to figure out what clothes to put on, as most textures annoy her and feel uncomfortable on her body. She has to figure out what to eat for breakfast, as anything soft, mushy, or creamy repulses her. Worst of all, she has to figure out how to face the world outside that, for her, is like maneuvering through a sensory minefield. Jenny is an avoider or what is commonly known as sensory defensive (SD), a common mimicker of anxiety and panic. The sensory defensive feel too much, too soon and for too long, and experience the world as too loud, too bright, too fast and too tight, becoming easily distressed by everyday sensation

The key point is that these patterns, while mostly stable, are not permanent: certain environmental experiences can add or subtract methyls and acetyls, changing those patterns. In effect this etches a memory of what the organism was doing or experiencing into its cells—a crucial first step for any Lamarck-like inheritance. Unfortunately, bad experiences can be etched into cells as easily as good experiences. Intense emotional pain can sometimes flood the mammal brain with neurochemicals that tack methyl groups where they shouldn’t be. Mice that are (however contradictory this sounds) bullied by other mice when they’re pups often have these funny methyl patterns in their brains. As do baby mice (both foster and biological) raised by neglectful mothers, mothers who refuse to lick and cuddle and nurse. These neglected mice fall apart in stressful situations as adults, and their meltdowns can’t be the result of poor genes, since biological and foster children end up equally histrionic. Instead the aberrant methyl patterns were imprinted early on, and as neurons kept dividing and the brain kept growing, these patterns perpetuated themselves. The events of September 11, 2001, might have scarred the brains of unborn humans in similar ways. Some pregnant women in Manhattan developed post-traumatic stress disorder, which can epigenetically activate and deactivate at least a dozen genes, including brain genes. These women, especially the ones affected during the third trimester, ended up having children who felt more anxiety and acute distress than other children when confronted with strange stimuli. Notice that these DNA changes aren’t genetic, because the A-C-G-T string remains the same throughout. But epigenetic changes are de facto mutations; genes might as well not function. And just like mutations, epigenetic changes live on in cells and their descendants. Indeed, each of us accumulates more and more unique epigenetic changes as we age. This explains why the personalities and even physiognomies of identical twins, despite identical DNA, grow more distinct each year. It also means that that detective-story trope of one twin committing a murder and both getting away with it—because DNA tests can’t tell them apart—might not hold up forever. Their epigenomes could condemn them. Of course, all this evidence proves only that body cells can record environmental cues and pass them on to other body cells, a limited form of inheritance. Normally when sperm and egg unite, embryos erase this epigenetic information—allowing you to become you, unencumbered by what your parents did. But other evidence suggests that some epigenetic changes, through mistakes or subterfuge, sometimes get smuggled along to new generations of pups, cubs, chicks, or children—close enough to bona fide Lamarckism to make Cuvier and Darwin grind their molars.

The SCID-D may be used to assess the nature and severity of dissociative symptoms in a variety of Axis I and II psychiatric disorders, including the Anxiety Disorders (such as Posttraumatic Stress Disorder [PTSD] and Acute Stress Disorder), Affective Disorders, Psychotic Disorders, Eating Disorders, and Personality Disorders. The SCID-D was developed to reduce variability in clinical diagnostic procedures and was designed for use with psychiatric patients as well as with nonpatients (community subjects or research subjects in primary care).

ANXIOUS CONTRACTIONS Life is movement. It’s dynamic and pulsating like a swift moving river. To be in a contented and happy state is to be in a state of flow where your thoughts and feelings follow a natural current and there is no inner friction or need to check in on your anxiety every five minutes. When you feel in flow, your body feels light and your mind becomes spontaneous and joyful. Anxiety and fear are the total opposite. They’re the contractions of life. When we get scared, we contract in fear. Our bodies become stiff and our minds become fearful and rigid. If we hold that contracted state, we eventually cut ourselves off from life. We lose flexibility. We lose our flow. We can think of this a bit like pulling a muscle. When a muscle is overused and tired, its cells run out of energy and fluid. This can lead to a sudden and forceful contraction, such as a cramp. This contraction is painful and scary as it comes without warning. In the same way, we can be living our lives with a lot of stress and exhaustion, similar to holding a muscle in an unusual position for too long. If we fail to notice and take care of this situation, we can experience an intense and sudden moment of anxiety or even panic. I call this an “anxious contraction,” and it can feel quite painful. Learning how to respond correctly to this anxious contraction is crucial and determines how quickly we release it. Anxious contractions happen to almost everyone at some point in their lives. We suddenly feel overwhelmed with anxiety as our body experiences all manner of intense sensations, such as a pounding heart or a tight chest or a dizzy sensation. Our anxiety level then is maybe an 8 or 9 out of 10. We recoil in fear and spiral into a downward loop of more fear and anxiety. Some might say they had a spontaneous panic attack while others might describe the feeling as being very “on edge.”   THE ANXIETY LOOP It’s at this point in time where people get split into those that develop an anxiety disorder and those that don’t. The real deciding factor is whether a person gets caught in the “anxiety loop” or not. The anxiety loop is a mental trap, a vicious cycle of fearing fear. Instead of ignoring anxious thoughts or bodily sensations, the person becomes acutely aware and paranoid of them. “What if I lose control and do something crazy?” “What if those sensations come back again while I’m in a meeting?” “What if it’s a sign of a serious health problem?” This trap is akin to quicksand. Our immediate response is to struggle hard to free ourselves, but it’s the wrong response. The more we struggle, the deeper we sink. Anxiety is such a simple but costly trap to fall into. All your additional worry and stress make the problem worse, fueling more anxiety and creating a vicious cycle or loop. It’s like spilling gasoline onto a bonfire: the more you fear the bodily sensations, the more intense they feel. I’ve seen so many carefree people go from feeling fine one day to becoming fearful of everyday situations simply because they had one bad panic attack and then got stuck in this anxious loop of fearing fear. But there is great hope. As strange as it sounds, the greatest obstacle to healing your anxiety is you. You’re the cure. Your body wants to heal your anxiety as much as you do.

Many self-mutilators, as well as anorexics and bulimics, come from families where physical appearance and prowess were stressed more than feelings and thoughts. Eating disorders are particularly rampant among female athletes, dancers, models, and others from whom approval is explicitly tied to their body. Like self-mutilators, anorexics and bulimics tend to be perfectionists who never feel good enough, despite their considerable achievements. Often they are the "good little girl"—the perfect, straight-A student, the quiet, conscientious one who never gave here parents any trouble—an identity they strenuously cling to in order to avoid conflict and abuse. But beneath the mask, they feel loathsome and defective, anything but special. They develop a rigidity of character and a right-or-wrong style of thinking that makes them acutely sensitive to criticism. Everything is either black or white, good or bad, success or failure, fat or thin. There is no in-between, no comfort in just being adequate.

between a quarter and a half of all those exposed to extreme weather events will experience them as an ongoing negative shock to their mental health. In England, flooding was found to quadruple levels of psychological distress, even among those in an inundated community but not personally affected by the flooding. In the aftermath of Hurricane Katrina, 62 percent of evacuees exceeded the diagnostic threshold for acute stress disorder; in the region as a whole, nearly a third had PTSD. Wildfires, curiously, yielded a lower incidence—just 24 percent of evacuees in the aftermath of one series of California blazes. But a third of those who lived through fire were diagnosed, in its aftermath, with depression.

My shrink said I had experienced acute loss and trauma caused by placing my baby for adoption, resulting in post-traumatic stress disorder.

During the depersonalisation or derealisation experiences, reality testing remains intact. C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, medication) or other medical condition (e.g., seizures). E. The disturbance is not better explained by another mental disorder, such as schizophrenia, panic disorder, major depressive disorder, acute stress disorder, posttraumatic stress disorder, or another dissociative disorder.

He knew some of the signs of post-traumatic stress disorder and she had now survived two near-fatal attacks. In the immediate aftermath of losing half his leg in Afghanistan, he, too, had experienced dissociation, finding himself suddenly and abruptly removed from his present surroundings to those few seconds of acute foreboding and terror that had preceded the disintegration of the Viking in which he had been sitting, and of his body and military career.