This Is When to See a Mental Health Professional About Your Anxiety

It seems everyone is talking about anxiety these days, and that’s not a bad thing. Shining a light on mental health helps reduce the stigma that keeps many people from seeking support.

At the same time, it can be hard to know if the worries and racing heart you experience at the thought of, say, meeting new people, is run-of-the-mill stress, or if you’re actually experiencing some level of anxiety and could benefit from seeing a professional.

“I can’t tell you how many people I see who say, ‘I don’t know if I should be coming in here,’” clinical psychologist Robert Duff, Ph.D., author of Hardcore Self Help: F**k Anxiety., tells SELF. “On a broad scale, [talking about anxiety] is positive, but I don’t blame anyone for the confusion.”

Figuring out how serious your anxiety is can be tough because anxiety is a normal and essential part of being a human.

“Anxiety is a reaction to a situation we perceive as stressful or dangerous,” Monique Reynolds, Ph.D., licensed clinical psychologist at the Center for Anxiety & Behavioral Change in Rockville, Maryland, tells SELF. This produces a stress response in your body—specifically, your brain’s hypothalamus triggers your sympathetic nervous system to release norepinephrine (aka adrenaline) and cortisol (a stress hormone) to get you out of harm’s way.

This is actually a good thing when there is a real threat of danger present. “A major part of our brain’s job is to keep us alive, and fear and anxiety are a big part of that,” Reynolds says. For example, the anxiety you would feel at seeing a truck hurtling towards you would make you move from its way more quickly.

But if you have anxiety, that stress response can kick in when it shouldn’t. “You feel very much the way you do when in a dangerous situation…[but] there’s no real danger there,” Duff says. Instead of being helpful, this misfiring of your fight or flight reaction can hinder you.

While a little anxiety can also help you to perform at an optimal level under stress, giving you a burst of adrenaline and hyper-focus to finish a business proposal before deadline or nail that dance number at a performance, living in a constant heightened state of anxiety can be distracting at best and debilitating at worst. When anxious thoughts are interfering with your life and causing you significant distress, that isn’t something you should just chalk up to nerves and push through. That’s something you can get help with.

Anxiety is the most prevalent mental illness in the United States, and it comes in various forms.

Anxiety affects about 40 million American adults each year, according to the Anxiety and Depression Association of America (ADAA). But it’s not as cut-and-dry as saying that anxiety is simply when you feel nervous all the time. This mental health condition comes in many forms.

Generalized anxiety disorder (GAD) is characterized by having excessive worries and fears for months, according to the National Institute of Mental Health (NIMH). Per the ADAA, GAD affects 6.8 million U.S. adults each year. Panic disorder involves spontaneous bouts of debilitating fear known as panic attacks, along with intense worry about when the next attack will come, according to the NIMH. Per the ADAA, it affects 6 million American adults each year. Social anxiety disorder (also known as social phobia) happens when you have a marked fear of social situations in which you might be judged or rejected, as well as avoiding these situations or experiencing symptoms like nausea, trembling, or sweating as a result.

Then there are other issues that are closely related to anxiety, like obsessive-compulsive disorder, which involves intrusive thoughts and urges, and posttraumatic stress disorder, which happens when people have a prolonged stress response to harrowing situations.

These are just some of the various anxiety and anxiety-adjacent disorders out there. That these issues can present in myriad ways can make it even harder to know if what you’re experiencing is anxiety that could benefit from outside help.

“Some people feel they can control their anxiety, some feel it’s something they ‘should’ be able to manage, some feel shame, some fear they might be ‘crazy,’ and others downplay how much their anxiety is impacting them,” Reynolds says.

If anxiety interferes with your daily life—whatever that might look like to you—that’s reason enough to see a mental health professional.

“When your world starts to become limited because of anxiety, that is a good signal that it’s time to seek treatment,” Reynolds says. “What is it doing to your life, your relationships, your sleep, health, work, and ability to learn and pursue things that are important to you?”

This “functional impairment,” as Reynolds calls it, can show up in different ways in different people. Is anxiety making you avoid doing things with loved ones because you’re too nervous to go outside? Do you skip school or work out of fear of what people may think of you? Can you not get enough sleep because you’re up all night worrying about the next day? Is your anxiety over certain tasks, like paying bills, leading to procrastination so extreme it comes with consequences, like getting your lights turned off?

Keep tabs on whether you’re blowing up at people, too. Anger and irritability can sometimes be a sign of anxiety. “We often forget that fight or flight includes ‘fight,’” Reynolds says. “If you have a shorter fuse or are always on edge for triggers, it could be related to anxiety.”

So, too, could physical issues. “We think of ourselves as these disembodied heads floating around,” Reynolds says. “We forget that there is a big feedback loop between the nervous system and the body.” Every part of you, from your head to your stomach to your feet, has nerves to regulate important processes, which is why your sympathetic nervous system’s stress response can be so far-reaching. You even have an entire nervous system reserved for gastrointestinal function, known as your enteric nervous system, which may help explain why there’s such a strong link between issues like irritable bowel syndrome and anxiety.

Constant fatigue can also kick in if your anxiety is in overdrive. “The physical reaction to anxiety, by nature, is supposed to be short-term. The body is supposed to come back down to baseline,” Duff says. “But a prolonged period of anxiety depletes your resources and exhausts you.”

“If your anxiety is bothering you and you are suffering, you deserve to get help,” Duff says. That’s true whether or not you think your anxiety is serious, whether or not you think you meet diagnostic criteria you read online, and whether or not your friends and family treat your anxiety with the weight it deserves. And if your anxiety is getting to the point where you’re worried for your safety, call 9-1-1 or the National Suicide Prevention Lifeline (it’s available 24 hours a day, seven days a week at 1-800-273-8255), or go to the emergency room, Reynolds says.

Seeing a therapist can be anxiety-inducing on its own, but it’s worth it. Here are a few ways to make it easier.

Knowing what to expect at your first therapy session may make the experience less scary. Although every professional is different, you’re likely to get a lot of questions at the first visit. Ultimately, your psychologist or therapist’s goal is to learn what troubles you’re having so that they can create a plan to help you build the skills you need to address your anxiety.

They’ll also want to figure out which kind of therapy best matches your needs. Different forms, like cognitive behavioral therapy, which aims to help people change negative thought patterns, work for different people.

Since the cost of therapy can be prohibitive, know that there are resources to help you find affordable treatment, like the National Alliance on Mental Health’s HelpLine at 1-800-950-6264. The HelpLine is available Monday through Friday, from 10 A.M. to 6 P.M., and you can explain your specific situation to the staffer or volunteer who answers. They may be able to refer you to local organizations that offer more affordable treatment. You can also try the Substance Abuse and Mental Health Services Administration (SAMHSA) treatment locator tool, which can help you find mental health providers who take various forms of insurance, offer payment assistance, or use a sliding scale. Resources like GoodTherapy also allow you to limit search results to therapists who use sliding scales.

And don’t stress about meeting some arbitrary threshold of anxiety for your appointment to be worth the effort. “Somebody with anxiety [may] think there is a risk to seeing someone. ‘If I go and don’t have an anxiety disorder, there’s something bad about that,’” Duff says. “That’s not true. If you are suffering and seeing some of these signs, that’s enough.”

It may be that all you need is a few sessions, or you may meet weekly for months or years based on your goals. Your psychologist or therapist might decide medication would help you live your healthiest, happiest life, or just having someone to talk to might work for you. Also, if you decide you’re not really into the person you’re seeing but you still want help, there’s absolutely nothing wrong with trying someone else, Duff says.

Ask yourself what kind of life you want to live and what’s holding you back from achieving it, Reynolds says, adding, “If there’s anything related to fear and anxiety, it’s a great sign that maybe you need support around those things.”

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Don’t ‘suck it up’ but talk it out: Cops get help for trauma

Police officers have high rates of heart disease and suicide and shorter life expectancy. Some might also suffer from what researchers call ‘compassion fatigue.’

Plymouth police Sgt. Jeff Dorfsman remembers he was eating dinner when a homicide call came through dispatch in the typically quiet western Twin Cities suburb. He and other officers on duty rushed to the scene.

Some officers provided cover while Dorfmsan administered first aid to the gunshot victim. He died anyway. Dorfsman said officers always have the potential stress of these sort of calls in the back of their minds. These are the calls that can jar him.

“It could be a sick child or a terminally ill patient or car crashes, it could be violence, and sometimes it’s just things you can’t unsee,” Dorfsman said. “Over time, that can be a difficult thing for some officers to process.”

Police work can be stressful and unpredictable. An officer never knows when something routine like a traffic stop can escalate into something traumatic. It’s a side of the job that not many civilians see or think about.

There’s growing concern in law enforcement that responding to traumatic calls over and over without mental health support can take a toll on officers’ well-being, and that built-up trauma can make it more challenging for officers and community members to rebuild trust between them.

Coping with stress and trauma

Plymouth police officer Steve Thomas said cops traditionally have bottled up their feelings. After responding to calls about suicides, murders or child abuse, they’d be expected to suck it up and move on. But the Plymouth Police Department is at the forefront of providing support for officer wellness, and to giving officers tools to deal with that stress.

Thomas, who is one of the department’s designated wellness officers, said it’s typical now in Plymouth for officers to work through these calls after they happen.

“If there’s a traumatic incident, we always have debriefings of just the people involved in that incident. Nobody else can come in,” Thomas said. “Just so they can decompress and talk.”

Plymouth Police Chief Mike Goldstein remembers the first experience as a cop that really stuck with him. It was three decades ago, late in the afternoon. He was a rookie cop, patrolling alone for one of the first times, when he got a medical call.

Goldstein was the first to arrive at the home, which he says he can still pick out on the street.

“I was led to the crib and I started to try to resuscitate the infant,” Golstein said. “Then I felt a tap on my shoulder from a senior officer who, you know, was shaking his head. It was obvious that the child had passed.”

It was because of these sort of incidents, and the strain they put on career officers, that spurred Goldstein to launch the department’s officer wellness programs in 2012. The department now has four police trained as wellness officers and a part-time officer who’s a physician who mentors other officers. They’ve even got an in-house chaplain.

”We’ve done a lot to look at physical health, to look at behavioral health and to look at spiritual health,” Goldstein said. “We have programs from the time you walk into this department as a brand-new officer to the time you choose to retire.”

The department also now requires officers to meet with a behavioral health counselor at least once a year. Goldstein made that change after some officers had to take leaves of absence because of post-traumatic stress disorder.

“I really don’t care when you go in to talk to the provider what you discuss. You could stare at them for an hour, you could talk about the Minnesota Twins,” Goldstein said. “I just want them to establish a connection so that if something does trigger an emotional response and they need to talk to someone, they have a comfort level going in and they’re not starting from scratch.”

Before becoming a police officer, Mitch Martinson served in the military, where these sort of wellness services have been long established to help soldiers cope with trauma. He said the programs have helped his fellow officers understand that talking about trauma isn’t a sign of weakness.

“We would urge each other to seek help if needed,” Martinson said.

Wellness isn’t just about mental health. In recent years, the department has also built out a free gym for officers to use in the basement of the police station.

Plymouth police Detective Amy Goodwin was in the gym dead-lifting 205 pounds on a recent afternoon. She said the on-site gym gives officers an opportunity to blow off steam and talk about things other than their police work.

“It’s just a great way for officers to come down here, relieve stress and to be able to take the uniform off for a while,” Goodwin said. “We all do workouts together, so it also builds that team-building for us down here.”

This is something Goldstein emphasizes, too: Officers need to interact with people outside the profession and outside the sometimes stressful 911 calls.

“Try not to live, breathe, sleep and eat law enforcement. It’s unhealthy,” he said. “Remember: Most people are good.”

But not everyone was on board with the wellness programs right away. There was skepticism from older officers and the police union, Goldstein said. But over time, the wellness programs have become part of the culture of the department.

”They know it’s not going away. They know that it’s a benefit to them. If they don’t see it, their families do,” Goldstein said. “And I just want to promote it as effectively as we can so that it becomes contagious.”

Some observers, including Goldstein, see an explosion of interest in police officer wellness programs in Minnesota and across the country. Both the International Association of Chiefs of Police and the Department of Justice COPS program have launched programs promoting officer wellness in recent years.

At a time when fewer young people are being drawn to work in law enforcement, Goldstein, who’s 52, sees the wellness programs as a perk that may help recruit a younger generation of officers who have different expectations and fewer stigmas around issues of mental health.

“The curmudgeons that are out there, the crusty old guys,” Goldstein said, “I think that if they had an honest conversation, they would say, ‘I really wish we were doing this stuff 30 years ago because I would have benefited from it.’”

Avoiding compassion fatigue

Researchers have found that police officers’ health is worse than many other professions. They have high rates of heart disease and suicide and a shorter life expectancy.

That’s partly due to the routine stresses of the job, said Daniel Blumberg, a professor of psychology at Alliant International University

“Some officers never even draw their weapon,” Blumberg said. “But all officers are going to be going to child abuse, domestic violence, fatal traffic accidents and just seeing some of the challenges of society.”

It’s not uncommon for large departments to have counseling available for officers. Blumberg said it’s about more than just supporting traumatized officers — but about city leaders appointing chiefs who put wellness at the core of their missions.

”It’s about everything from who you’re hiring, to how you train, to how you supervise implementing preventive measures,” Blumberg said.

The personal impact of stress on officers is well established. But there may also be a broader public interest in ensuring that officers mental health is taken care of. Blumberg said another thing clinicians see in police officers is what they refer to as “compassion fatigue,” which can also affect other first responders.

“It’s essentially the emotional toll taken by routinely trying to assist victims of trauma, and additionally for police officers, the futility that they often feel when it comes to preventing a crime or stopping criminals from hurting people,” Blumberg said.

“Compassion fatigue” can happen to police officers partly because of the demands of the job. Imagine an officer going from a call where a child was brutalized to a call where someone’s bike was stolen, he said.

”When you’re suffering significantly from compassion fatigue, the last thing that you want to do is connect with someone who’s in a lot of emotional pain,” Blumberg said. “So, that person comes to the scene, and is not being as helpful or supportive as that victim may need in the moment.”

Police and community relations are in the headlines all the time. Protests broke out across the country in recent years after police officers shot and killed civilians on the job.

That’s led to a climate where officers can feel like their actions are being closely scrutinized, said Jillian Peterson, a professor of criminology and criminal justice at Hamline University. She said providing mental and physical support for officers could be one way to start to rebuild trust between police and the communities they serve.

“We talk a lot about trauma that is sometimes caused by police interaction, which is a really important conversation. But I think we don’t talk as much about the trauma that police are being exposed to and how that’s impacting every interaction that they have,” Peterson said. “It’s to the public’s benefit, I think, to have these conversations.”

Mike Goldstein, the Plymouth police chief, said his goal is to make sure his officers stay healthy, so they can do a good job for their citizens.

“If I give them everything they need, they’re the ones that are then going to serve the community, they’re going to carry out our mission, and then everybody wins,” Goldstein said. “But if they’re broken, if they’re sick, if they’re not focused, if they’re stressed, then nobody wins.”

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Smiling Depression: What You Need to Know

What are the symptoms of smiling depression?

Someone experiencing smiling depression would — from the outside —appear happy or content to others. On the inside however, they would be experiencing the distressful symptoms of depression.

Depression affects everyone differently and has a variety of symptoms, the most distinguished being deep, prolonged sadness. Other classic symptoms include:

  • changes in appetite, weight, and sleeping
  • fatigue or lethargy
  • feelings of hopelessness, lack of self-esteem, and low self-worth
  • loss of interest or pleasure in doing things that were once enjoyed

Someone with smiling depression may experience some or all of the above, but in public, these symptoms would be mostly — if not completely — absent. To someone looking from the outside, a person with smiling depression might look like:

  • an active, high-functioning individual
  • someone holding down a steady job, with a healthy family and social life
  • a person appearing to be cheerful, optimistic, and generally happy

If you’re experiencing depression yet continue to smile and put on a façade, you may feel:

  • like showing signs of depression would be a sign of weakness
  • like you would burden anyone by expressing your true feelings
  • that you don’t have depression at all, because you’re “fine”
  • that others have it worse, so what do you have to complain about?
  • that the world would be better off without you

A typical depressive symptom is having incredibly low energy and finding it hard to even make it out of bed in the morning. In smiling depression, energy levels may not be affected (except when a person is alone).

Because of this, the risk of suicide may be higher. People with major depression sometimes feel suicidal but many don’t have the energy to act on these thoughts. But someone with smiling depression might have the energy and motivation to follow through.

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7 Tips for Disciplining a Depressed Child

Depression doesn’t just affect adults, it also affects millions of children and adolescents.

Some of the symptoms that accompany childhood depression include irritability, social withdrawal, and low energy. Children with depression may also struggle to manage their behavior.

In 2013, 11 percent of 12- to 17-year-olds experienced a major depressive episode. Many younger children are also diagnosed with depressive disorders, such as persistent depressive disorder or disruptive mood dysregulation disorder, every year.

Children with depression may require a slightly different approach to discipline. Here are seven tips for disciplining a depressed child.

Work With Your Child’s Treatment Team

If you suspect your child has depression, speak to his pediatrician or a mental health professional. Depression is treatable, but without appropriate intervention, it may get worse. Treatment may include therapy, parent training, or medication.

Work with treatment providers to learn about the steps you can take to best support your child’s mental health. Inquire about the specific strategies you should use to address behavior problems like non-compliance and disrespect.

Establish Healthy Rules

All kids need rules, but children with depression sometimes require specific rules that support a healthy lifestyle. A depressed child may want to stay up late and sleep all day, or he may want to spend all of his time playing video games because he lacks the energy to play outside.

Set limits on electronics and discourage your child from sleeping during the day. You may also need to create rules about personal hygiene as children with depression sometimes don’t want to shower or change their clothes. Keep your household rules simple, and emphasize the importance of being healthy.

Provide Structure to Your Child’s Day

Kids with depression often struggle to fill their time with meaningful activities. For example, a child may sit in his room all day, or he may put off doing his chores as long as possible.

Create a simple schedule that provides structure to your child’s day. Set aside time for homework, chores, and other responsibilities and allow him to have limited electronics time once his work is done. Children with depression sometimes struggle with sleep issues, so it’s important to establish a healthy bedtime routine as well.

Catch Your Child Being Good

Positive discipline is most effective for children with depression. Look for opportunities to praise your child by saying things like, “You did a great job cleaning your room today,” or, “Thank you for helping me clean up after dinner.” Praise will encourage your child to keep up the good work.

Create a Reward System

Rather than focus on taking away privileges for misbehavior, emphasize to your child that he can earn rewards for good behavior. A behavior chart or a token economy system can motivate depressed kids.

Choose one or two behaviors to work on first—like taking a shower before 7 p.m. If he follows through, let him earn a token or sticker that can be exchanged for bigger rewards, like a trip to the park. Or, provide small, immediate rewards for compliance, like 15 minutes to play on the computer.

Separate Your Child’s Emotion from the Behavior

Discipline your child’s child’s behavior, not his emotions. Don’t scold him for being angry or lecture him about being in a bad mood. Instead, send the message that emotions are OK, it’s what he chooses to do with those emotions that matters. Teach him healthy coping strategies so he can deal with uncomfortable feelings, like anger, frustration, embarrassment, or sadness.

Consider the Implications of Negative Consequences

Children with depression need negative consequences for breaking the rules, but you should choose those consequences carefully. Taking away your child’s ability to socialize with friends, for example, could make his depression worse.

Short-term consequences, like time-out, can be very effective for younger children with depression. Consequences that take place over several days, like being grounded for a week, can backfire because children with depression may lose their motivation to earn their privileges back.

The Healing Power of Telling Your Trauma Story

When we’ve survived an extremely upsetting event, it can be painful to revisit the memory. Many of us would prefer not to talk about it, whether it was a car accident, fire, assault, medical emergency, or something else.

However, our trauma memories can continue to haunt us, even — or especially — if we try to avoid them. The more we push away the memory, the more the thoughts tend to intrude on our minds, as many research studies have shown.

If and how we decide to share our trauma memories is a very personal choice, and we have to choose carefully those we entrust with this part of ourselves. When we do choose to tell our story to someone we trust, the following benefits may await. (Please note that additional considerations are often necessary for those with severe and prolonged experiences of trauma or abuse, as noted below.)

1. Feelings of shame subside. 

Keeping trauma a secret can reinforce the feeling that there’s something shameful about what happened — or even about oneself on a more fundamental level. We might believe that others will think less of us if we tell them about our traumatic experience.

When we tell our story and find support instead of shame or criticism, we discover we have nothing to hide. You might even notice a shift in your posture over time — that thinking about or describing your trauma no longer makes you feel like cowering physically and emotionally. Instead, you can hold your head high, both literally and figuratively.

2. Unhelpful beliefs about the event are corrected.

Many people experience shifts in their beliefs about themselves, other people, and the world following a traumatic event. For example, a person might think they’re weak because of what happened, or that other people can never be trusted. When we keep the story inside, we tend to focus on the parts that are most frightening or that make us feel self-critical.

I’ve often been struck during my work with trauma survivors by the power of simply telling one’s story to shift these unhelpful beliefs. These shifts typically don’t require heavy lifting by the therapist to help the trauma survivor recognize the distorted beliefs. Instead, there’s something about opening the book of one’s trauma memory and reading it aloud, “from cover to cover,” that exposes false beliefs.

For example, a person who was assaulted might believe they were targeted, because they look like easy prey; through recounting what actually happened, they may come to see that it was due to situational factors (“wrong place, wrong time”), rather than something personal and enduring about themselves.

Telling the trauma story to a supportive therapist is one of the key components of Cognitive Behavioral Therapy (CBT), which is one of the most effective treatments for post-traumatic stress disorder (PTSD). I recently explored the latest findings on PTSD treatment research with psychologist Dr. Mark Powers, Director of Trauma Research at Baylor Scott and White Health. As we discussed, effective CBT typically doesn’t require an intensive examination of the survivor’s beliefs and evidence for those beliefs, as is often done in CBT for other conditions. Instead, insights about the truth of what happened emerge just through talking about what happened and what it means.

3. The memory becomes less triggering. 

Revisiting a trauma memory can be very upsetting, triggering strong emotional and physical reactions and even flashbacks to the event. Those reactions can stay in place for years if we have unprocessed trauma memories, especially when we’re trying to avoid thinking about the trauma.

Through retelling the story of what happened, we find that our distress about it goes down. The first time, it’s likely to be very upsetting, even overwhelming, and we might think we’ll never be able to tolerate the memory. With repeated retelling to people who love and care about us, though, we find the opposite — that the memory no longer grips us. As Dr. Powers noted, we find that the memory no longer controls us. It will never be a pleasant memory, of course, but it won’t have the same raw intensity that it once had.

4. You find a sense of mastery.

As we talk about our trauma, we find that we’re not broken. In fact, as Dr. Powers pointed out, we can come to see that our reactions to trauma actually make sense. For example, it’s understandable that our nervous systems are on high alert, since they’re working to protect us from similar danger in the future.

Many trauma survivors I’ve worked with described the strength they found as they faced their trauma and told their story. They said they felt like they could face anything, as they saw their fear lessen and found greater freedom in their lives. It takes courage to tell your story, and witnessing your own courage shows you that you’re not only strong, but also whole.  

5. The trauma memory becomes more organized.

Trauma memories tends to be somewhat disorganized compared to other types of memories. They’re often stored in fragments, disconnected from a clear narrative and a broader context. Existing research suggests that these differences are detectable in the brain, with unprocessed trauma memories showing less involvement of areas like the hippocampus that provide context to our experience.

Recounting the trauma begins to organize the memory into a story of what happened. We can see that it has a beginning, a middle, and an end, and that it happened at a specific place and a specific time. We can better understand the events that led up to it, and our own reactions at the time and in the aftermath. By putting a narrative frame around it, the memory can become more manageable and less threatening.

6. You begin to make sense of the trauma.

The biggest benefit from sharing our trauma stories may come from starting to make sense of a senseless event. “As humans we gravitate toward processing and trying to make sense of our experience,” Dr. Powers said, and that need is especially pronounced following a trauma. “That’s why treatment is often geared toward finding a sense of meaning.”

While PTSD treatment shares elements with the treatment of anxiety, such as phobias, Dr. Powers pointed out that it focuses more on meaning than does treatment for anxiety. “We don’t see the same type of drive to make sense of one’s fear in panic disorder or spider phobia,” he said. “The person doesn’t tend to say, ‘I really need to understand my fear of spiders.’ But that does seem to happen in PTSD, that our brains need to process what happened.”

Accordingly, effective therapy for PTSD includes not only revisiting the trauma memory, but also exploring its possible meanings. The meaning doesn’t come “off the shelf,” of course, but can only be arrived at by each individual. According to Dr. Powers, “At best we can help guide them through that discovery process.”

Important Considerations

It probably goes without saying that not everyone is the ideal person to share your trauma with. Some people may have a hard time hearing it based on their own trauma history. Others might respond with blame or criticism, or other non-validating responses. Choose carefully so that the person is likely to meet your story with understanding and compassion.

Timing is also important. It may take time before you’re at the point where you’re able to put the trauma into words. Be patient with yourself, recognizing that “not now” doesn’t have to mean “never.” Again, you get to decide when, where, and how you tell your story, which is a crucial part of owning the events of your life.

A Note About Complex PTSD

As noted above, the points raised here are based for the most part on work with discrete types of trauma — for example, a one-time car accident or violent assault. Other considerations may be necessary for those experiencing more complex forms of PTSD, such as those with a history of severe childhood maltreatment. The National Center for PTSD provides additional information on complex PTSD.

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