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Stress or Trauma? Understanding the Difference and What to Do Part 1 · Healthy Vitals

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  Scott Webb (Host): This is Healthy Vitals, a podcast from Summa Health.
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  I'm Scott Webb.
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  And right now in the United States, many everyday pressures
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  are weighing on people's minds and impacting overall mental health.
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  And joining us today is Dr.
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  Jennifer Knetig, a psychologist with Summa Health Behavioral Health Institute's
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  Traumatic Stress Center, to talk about the difference between stress and trauma
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  and how people can manage both while supporting their mental wellbeing.
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  Jennifer, it's nice to have you on today.
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  We're actually going to do two podcasts, so part one and part two.
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  So, today is part one, and we're talking about stress or trauma and really
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  understanding the difference between the two and what do we do once we
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  understand the difference between the two.
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  So, let's start there.
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  Like, when people say they're stressed or traumatized, what do those words actually
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  mean, and why does the difference matter?
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  Dr. Jennifer Knetig:
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  Thanks so much for having me, Scott.
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  So when we think about stress and trauma, while, you know, the experience certainly
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  is different for different people.
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  No one's experience is the same.
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  When people say they're feeling stressed, they're typically referring to feeling
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  overwhelmed or, like, stretched.
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  And people who feel stress are often, I would say,
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  experiencing a sense of urgency.
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  They're rushing from thing to thing, either in their lives or mentally in their
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  heads, and they may be feeling nervous.
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  I would say that people who've been traumatized, again, everyone's experience
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  is unique, but they tend to be feeling like they need to be more on guard.
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  They're looking to defend themselves, to protect themselves against threats.
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  Host: Yeah.
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  Dr. Jennifer Knetig:
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  And really, many things can feel threatening for people who've been
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  traumatized, even everyday things like going to the grocery store on Saturday or
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  being around family at a birthday party.
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  Scott Webb: Yeah, it's interesting, right?
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  Like, they may sort of manifest themselves in similar feelings
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  or emotions, but it's not a minor difference, I think, between the two.
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  Just learning from you a little bit already.
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  I'm wondering, is it possible for something to be very stressful but
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  not traumatic and maybe vice versa?
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  Dr. Jennifer Knetig:
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  Yes, definitely.
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  So, stress really happens when we are feeling stretched beyond what
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  is usual for us, beyond our limits.
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  And importantly, this can be positive, right?
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  Like a date with someone we're interested in or can be negative,
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  like paying bills on a fixed income.
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  I would say that things are traumatic when we are exposed to something
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  where we are afraid for our lives or the lives of somebody else.
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  So, this can look like a natural disaster, an accident, an assault,
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  and I would say that traumatic events are inherently stressful.
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  Host: Oh, that's so interesting, right?
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  That not all stressful moments are traumatic, but most traumatic
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  reactions or emotions are probably stressful for people, right?
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  Dr. Jennifer Knetig:
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  Well put.
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  Yes.
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  Host: Yeah.
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  That's interesting.
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  I got a lot to think about today . So then, let's talk about, let's say, a
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  normal stress reaction versus a trauma response, and maybe after an experience,
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  what are some common reactions that can be normal, in quotes, in the short term?
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  Dr. Jennifer Knetig:
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  Yeah.
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  So when you think about what is normal and again, kind of prefacing with,
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  you know, everyone's experience is different, but a normal stress reaction
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  can look just like a trauma response.
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  So, it can be hard for those of us on the outside knowing what is
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  actually going on with the person.
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  I would say that people having normal stress reaction can have
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  thoughts that just come up and bother them during the day, when maybe
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  they're engaged in something else.
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  They're at work with family.
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  They feel on edge and anxious.
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  They may have trouble sleeping.
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  They can feel cranky.
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  This can be part of a very normal stress or common stress reaction.
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  And comparing it with trauma, so trauma can look like that and often does look
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  like that, and the feelings that people have become so difficult to manage that
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  they have to learn new ways to cope, new ways to kind of change their lives, fit
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  this new experience, this new reality.
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  And I would say that it's that coping that often becomes a problem for people and
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  may be what brings them into treatment.
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  Host: Because I'm thinking about this as a person myself.
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  You're a person, I'm a person.
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  We're all people presumably listening to this.
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  There's no AI involved as far as I know.
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  So, maybe when those reactions, like I said, you know, short term, but maybe
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  what happens, like, if they don't fade and they start interfering with our daily
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  lives, is that what you're referring to sort of that coping and kind of sort of
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  living with the trauma and the stress?
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  Dr. Jennifer Knetig:
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  Yes.
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  Yes.
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  Like, it's a new reality.
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  People in that state, they become more distressed.
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  It can be harder for them to feel joy.
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  So it's not just I'm feeling stretched, I'm feeling
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  overwhelmed, but it gets deeper.
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  It's like family or my loved ones are starting to notice.
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  They may be impacted by it.
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  My work, you may see can be affected.
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  This is when it moves into this like longer term experience, physical
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  health can start to be affected.
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  Worst case scenario, people can get really depressed and think about suicide.
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  Host: Yeah, you used the word notice there, and I was thinking, "Okay, we might
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  notice or others might notice especially."
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  Like, are there some common emotional and physical reactions
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  that we or others might notice?
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  Dr. Jennifer Knetig:
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  Yes.
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  So, kind of when I talk to my clients or people I know, I'll explain
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  kind of these different groups of reactions that you're talking about.
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  That first group, we call it re-experiencing clinically.
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  But I like to think of it as really, you know, we're being
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  haunted by this experience.
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  So, it's like a recurring nightmare in a way.
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  And that can show up while you're awake.
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  You know, things just come out of nowhere.
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  You can't get your mind out of that mental space.
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  You can, you know, really struggle with nightmares.
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  I think that's a common response people can point to.
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  I think the other parts that we can see that tend to happen for folks
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  who've gone through trauma is that their bodies get put on high alert.
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  If you're being haunted by your own mind, you're going to be on guard.
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  It's going to show up—
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  Host: All the time.
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  Dr. Jennifer Knetig:
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  Yeah, right.
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  Like, day-to-day talking, you and I, like, it could be hard to
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  focus on a conversation like this.
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  It could be you may pick up on this person just doesn't seem present.
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  They're on edge.
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  They're really distracted.
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  They're more likely to get angry, and that shows up in their relationships.
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  Maybe they don't know why they're getting into, you know, driving too
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  fast and feeling more impulsive.
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  It can affect the body, that being on high alert state can really hurt your
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  body, because your body's cranking out chemicals you don't need, except if
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  you're running away from, you know, something scary or trying to fight it off.
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  And folks in this state, they don't need those chemicals, but it's happening.
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  So, it really has a potentially global effect.
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  And then, there's that group of reactions that we call avoidance clinically.
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  It's the ways people learn to cope that are not healthy, that actually
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  hurt them more than they help.
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  And then, finally, really depression.
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  So, for a lot of people who've gone through trauma, depression, really,
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  thinking about, you know, the ways that their experiences can really
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  alter their own views of themselves and the world can be more long-lasting.
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  Host: Yeah, a lot to unpack there.
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  Being haunted, I think we can all sort of identify with that fight or
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  flight and, as you say, those chemicals firing off that we really don't need,
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  that aren't really beneficial to us, especially in those situations
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  where we're not really "fighting."
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  Is that when it becomes clinical, right?
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  When it just becomes this thing that's just sort of overtaking our lives,
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  whether it manifests in itself in avoidance or being on edge or nightmares
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  or—you know, is that when we really need to talk to somebody, Jennifer,
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  when it just is just all too much?
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  Dr. Jennifer Knetig:
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  Yeah, I would agree with you that that's often a time when people are able,
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  they seek out help from a clinician.
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  I think that, it's at that point where people begin to notice,
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  just as you said, the avoidance.
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  The things that they've learned to do to try to make it better, they maybe
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  make it better in the short term.
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  They get temporary relief.
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  That's why we do those things.
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  But then as a long-term strategy, it actually makes it worse.
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  So, those things we learn to do to make it better, in the short
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  term, you know, it can help.
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  Like, 'I don't have to think about this."
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  Host: "I can just not think about this thing right now.
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  "Sure.
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  Dr. Jennifer Knetig:
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  Yeah.
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  Right.
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  "I don't have to feel this way.
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  I don't have to go back there."
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  And I think some common ways we do that, using substances, you know, drinking,
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  other drugs, for some people, they get to the point where there's a numbing
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  that happens where, you know, they've learned to kind of numb out the fear,
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  the guilt, shame, anger, whatever it is.
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  But, unfortunately, it's hard to numb out the negatives without
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  also numbing out the positives.
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  So, people who get to this point where maybe they, you know, they want to
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  bring a clinician in may share, you know, "I don't feel happy anymore.
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  I don't get the same satisfaction out of my work, my activities, family."
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  It can move into being more isolated.
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  And then, you know, we talk about dissociation in my field,
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  where, you don't really know
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  what's happening, but your body's there, your mind is not.
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  That's more serious.
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  Host: You know, I don't want to speak for everybody but myself, you know, I'm sure
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  I know that there have been times in my life where—and it wasn't just because I
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  was distracted by my phone or something, where there's something more serious
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  troubling me, be it stress or trauma and I'm there but I'm not really there, right?
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  Dr. Jennifer Knetig:
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  Yep.
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  I would agree.
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  And unfortunately, the people on the receiving end of that, they
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  don't know why you're not there.
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  Host: Right, right.
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  They're like, "What's wrong with him?"
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  Dr. Jennifer Knetig:
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  Right.
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  And then, they may blame themselves and think there's something wrong with them.
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  And I think you raise a good point that often a common outcome for
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  people who've gone through trauma is the effects on relationships
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  Host: Yeah, I wanted to ask you about that because I'm thinking about where the
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  sort of venues, if you will, like does stress and/or trauma manifest differently
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  at work versus home or in relationships?
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  It seems like it may not always sort of, you know, be the same in
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  each of those areas of our lives.
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  Dr. Jennifer Knetig:
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  Right.
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  Yeah, I would say that some kind of concrete examples of this, people who've
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  been through trauma are more likely to call off, you know, from work, be late,
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  have a hard time holding a job, and as a result, they struggle financially.
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  There's the struggle in relationships.
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  You describe this experience, if I'm checked out, you know, I don't feel
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  present, you know, to my loved ones and, they may not know why, because
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  part of this for a lot of people is shame and hiding actually what happened.
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  I think kind of the worst kind of like most extreme levels of relationship
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  impact are intimate partner violence.
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  People with PTSD are more vulnerable to experiencing violence in relationships
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  and to struggling with their own anger.
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  I think when we think about family impact, trauma survivors are more likely
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  to be like these helicopter parents who are more, more anxious and controlling.
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  It's coming from a place of protection, their kids don't feel that.
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  And they feel like I'm being controlled, and sometimes intimate partners
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  can have like—it'll be a similar dynamic, you know, where they're
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  experiencing this control, but the survivor is just trying to protect.
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  I would argue that is not always the case, but that's the motivation.
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  And I think kind of extending that out to like loss, we talked earlier
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  about numbing out numbs out the good and the bad for a lot of people.
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  So, losing interest in sex, having sexual dysfunction.
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  So again, going back to if you're in a relationship, you know, the
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  other person may not know why their partner's pulled away and can
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  cause real conflict and sadness.
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  Host: Yeah.
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  You know, as I mentioned, as we got rolling here, we're going
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  to have a part two of this episode, so a lot more to get to.
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  So, I don't have to feel like I have to squeeze it all in today.
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  But just want to finish up, if someone realizes like, "Okay, this
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  is more than everyday stress," right?
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  What are some maybe helpful first steps they can take right away?
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  Like, what can we do to help ourselves before we meet with a clinician?
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  Dr. Jennifer Knetig:
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  So right away, I want to tell listeners, you know, don't judge yourself.
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  But that's easier said than done.
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  I would say that survivors often do that.
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  So, I would encourage people, try to catch any judgments that
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  you have for yourself, like, I'm overreacting," or, "Why am I so upset?"
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  Or, you know, "Something must be wrong with me.
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  Just get over it."
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  I would say that doing those things and validating how you feel, how you
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  think, is the opposite of what you need.
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  What people need, number one, in my opinion, and just me, is gentleness, is
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  self-compassion, is really striving to understand what's going on that I'm so
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  angry, that I keep thinking about this.
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  What's going on that I've pulled away from my family?
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  So really, you know, just approaching with curiosity.
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  It's important for listeners to know that the more we try to block these
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  things out and just get over it, stop thoughts, stop feelings, the longer
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  they stay and the stronger they come.
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  Host: Yeah.
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  Yeah, the word that came to mind listening to you there was grace.
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  Just allowing ourselves some grace and to just work on, you know,
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  trying to understand what is this and where is this coming from?
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  And, you know, as you say, the approach of get over it, that
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  doesn't work in the long term.
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  That's a short-term thing.
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  You know, "Rub some dirt on it, you'll be fine."
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  Yeah, maybe today I'll be fine.
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  In this moment, I'll be fine, but I'm not fine, right?
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  Dr. Jennifer Knetig:
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  That's right.
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  That's right.
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  And finding people, if you have that luxury of having a safe person who isn't
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  there to judge you, they will can just sit with you and be with you, witness
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  this, you know just be present can help you, I think, get to that place of
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  more compassion and grace, as you say.
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  Host: Right.
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  Well, I'm looking forward to part two.
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  The thing about podcasts which is great is we can listen to things
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  and we can replay them over and over and over and refer back to them.
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  So, I hope that folks do.
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  But I know we're going to talk again soon, and I look forward to it.
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  Thanks so much.
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  Dr. Jennifer Knetig:
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  Thank you.
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  Host: And to learn more about Summa Health Behavioral Health Services,
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  visit summahealth.org/behavioral
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  or call 234-475-HELP.
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  That's 4357.
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  That's 234-475-HELP, 4357.
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  And if you enjoyed this episode of Healthy Vitals, we'd love
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  it if you'd leave us a review.
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  Your review helps others find our educational content.
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  I'm Scott Webb.
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  Thanks for listening, and we'll talk again next time.