How can unresolved trauma affect wellbeing?

Unresolved trauma can seriously impact wellbeing, self-esteem and a person’s ability to build strong personal connections with others, but the root of these issues and how to overcome them may not always appear clearly. Unfortunately, the impact of unresolved trauma can often lead to loneliness and significant mental health problems. In this article, highly respected consultant psychiatrist Dr Pavan Joshi shares his fascinating and expert insight into a trauma-informed approach to mental health care, including what this consists of and how it can be of benefit for people living with unaddressed trauma which continues to affect their daily lives and wellbeing.

What is trauma-informed mental health care?

Trauma has various forms and shapes and can therefore impact us in many ways. Most people are aware of the kind of trauma which comes from experiences of war, being in a conflict zone or natural disaster and the diagnostic term PTSD, or post-traumatic stress disorder, which is often a result of trauma.

However, although not so often talked about, trauma can also stem from adverse past experiences, including those in childhood. Trauma can also be a part of people’s present, for example, in cases of domestic violence where people are trapped in a situation where they are exposed to trauma in their day-to-day life. The ongoing trauma of being trapped in a difficult situation, whether that’s a difficult work environment or a relationship which includes abuse or domestic violence, is also very important factor.

In my role as a psychiatrist, understanding how trauma has impacted a person’s wellbeing is vital and therefore a key area of trauma-informed mental health care is taking a thorough trauma history. This may be based around a questionnaire or a structured assessment with all of the sensitivity required based on your history and your presentation to identify how trauma has impacted you. Using this information, we are then able to draw up a formulation and create a care plan based on your needs.

What impact can unresolved trauma have on one’s psyche?

Trauma can affect us in many ways. To understand the impact of trauma on our wellbeing, we can break it down into a number of key areas; psychological, physical health and social or cultural aspects.

With regards to psychology or psyche, trauma affects our self-esteem and wellbeing. Trauma can bring up concepts such as shame or guilt, create anxieties or difficulties in relationships, for example in trusting people. It can cause fluctuation of mood, impulsivity and can eventually lead to serious mental illnesses, such as depression or long-term anxiety and other significant mental health problems, such as self-harm or abuse of drugs and alcohol.

When it comes to physical health, trauma can affect our body in many different ways. When we look at the brain, for example, trauma has an effect on our primitive brain function, called amygdala, and can reduce our capacity to rationalise our thinking based on our higher cortex functions, or medial prefrontal cortex. Trauma can also affect genetics and recent research suggests that the effect of trauma can pass on through generations genetically as well as through its psychological impact.

Finally, there is the social effect of trauma. If a person’s self-esteem is affected or they experience ongoing shame or guilt, it hinders their capacity to take risks and build trusting relationships with the people around them. In this way, trauma can affect a person’s social environment and the connections they make with others, which can lead to loneliness if this factor is not understood or addressed.

How can a psychiatrist help with trauma-informed care?

Psychiatrists are trained mental health professionals, who have a sound knowledge of physical health and the body as well as a robust understanding and training with regards to psychological health and wellbeing. Additionally, psychiatrists also have a great awareness and understanding of how a person’s social, cultural and spiritual circumstances can impact on mental health and wellbeing. All of this means that psychiatrists have a deep and comprehensive knowledge of the multiple factors that can affect one’s mental health.

As I mentioned before, by beginning with a comprehensive history, one can use a trauma-informed care approach to explore and evaluate the types of traumas involved and their impact. This helps the psychiatrist to draw up a summary which can be discussed with the patient or service user to identify key areas to focus on and how to support their short and long term objectives during the path of recovery.

Psychiatrists can then lead several parts of the management, using their knowledge, skills and training, which may focus on physical health and illnesses, as well as prescribing and monitoring psychotropic medications for mental health. They can also discuss other areas, such as psychology-related matters, psychological therapies, drug and alcohol use, social aspects and any other relevant factors and make recommendations about how to seek appropriate support.

If you wish to schedule a consultation with Dr Joshi, you can do so by visiting his Top Doctors profile.