PTSD, Compassion Fatigue, and Constant Stress
As I mentioned in my last post, today I will be talking about the impacts of various forms of traumatic stress compared with (or in conjunction with, as was my case) burnout.
Now, to start of, I want to reiterate that I am not a mental healthcare provider or in any way an expert in this field. I took one behavioral neuroscience course in undergrad to get some background better understand the physical and chemical responses happening in the body when people are experiencing mental health issues, because I believe that this is key in fighting stigma towards mental health. If we measure success only on letter grades, this was my least successful course in my entire education career-- from kindergarten up to finishing my graduate thesis.
If anyone is reading this and is an expert in this area and wants to write a guest post-- please let me know. But for now, I will work to explain what I have learned along the way.
There are various forms of stress related issues.
The first is post-traumatic stress disorder (PTSD), which occurs after a life-threatening or intense trauma occurs in one's life. Signs can show up quickly after the event (although for it to be classified as PTSD rather than Acute Stress Disorder, it must appear or still be present more than a month after the original trauma occurs), or can appear months or years after the incident. PTSD interferes with daily life, work, and/ or relationships. Symptoms fall into four categories: re-experiencing, which include flashbacks, nightmares, and/or frightening thoughts; avoidance which includes avoiding places, events, objects or even thoughts relating to the experience; reactivity symptoms including angry outbursts, difficulty sleeping, being easily startled, or being on edge; and cognition and mood symptoms including difficulty remembering key things about the traumatic event, feelings of guilt, negative outlook on one's self or the world at large, and/or loss of interest in enjoyable activities.
The second type of stress related issue is Secondary Traumatic Stress Disorder, also known as compassion fatigue. This is the gradual lessening of compassion that is often seen in medical professionals, first responders, therapists, teachers, and activists. It can cause hopelessness, increased stress and anxiety, nightmares, inability to focus, and self-doubt, and is many ways looks like PTSD.
Here is a helpful chart I found on the National Child Traumatic Network website:
As you can see from the super helpful chart above, burnout and Secondary Traumatic Stress Disorder have overlap, but are not the same-- with the main difference that burnout is caused by general occupational stress or overwork, not exposure to trauma.
Our bodies are designed to respond to threats. When we are under threat, the body releases cortisol (aka the stress hormone). This is very useful for if you are under attack (fight or flight reflex). It allows the body to focus its energy on functions that are necessary for immediate survival, like running away. It does this by cutting back on non-urgent functions like digestion.
This heightened state is not designed to be commonplace. PTSD and Secondary Traumatic Stress activate cortisol when there is not necessarily a credible threat to ones safety. This causes the body to be functioning in fight or flight when it does not need to be.
Additionally, if one is in a long-term situation that causes intense stress (and therefore high cortisol levels), they are living in with heightened levels of cortisol. Under constant stress, which could include financial stress, job insecurity, workplace conflict, family strife and so on, one is not necessarily under life-threatening-at-the-moment attack, but are under attack nonetheless. That heightened state of increased cortisol can produce symptoms similar to PTSD and burnout such as forgetfulness, decreased productivity, and irritability.
We are not designed to live constantly in that heightened state. PTSD and Secondary Traumatic Stress Disorder are situations in which people are living in this heightened state.
Additionally, the nervous system experiences structural issues that I honestly don't totally understand from increased cortisol levels, including impact to the dendrites, which pass information through the nervous system. Physical changes occur to all systems of the body from increased cortisol.
Nationally, we are in a heightened state. Some are being directly persecuted, some are seeing it happen to those close to them, some have yet to be realized worry or dread (aka constant stress) about what tomorrow's executive order or vote on a bill could mean for their immigration status, water and air safety, or access to health care. This takes a physical toll on the body, and if we are not aware of it, we won't know to seek help when we need it. Getting timely help with both traumatic stress and the early stages of burnout can make them more manageable. While burnout can be prevented by decreasing overwork, PTSD and Secondary Traumatic Stress Disorder cannot. Trauma occurs in our lives regardless of how hard we try to prevent it. There are factors beyond our control. But we can seek help when we need it, and encourage others to do the same.