I stood at the podium, in front of a room filled with strangers at a state summit in Michigan. I was there to speak about my trauma — my past. As I spoke, my legs shook uncontrollably, my palms were sweaty, and my heart raced. I shared my vulnerable story and my transition from victim to thriving survivor. My emotional pain was physically affecting me.
My speech ended and I stepped down from the podium. The event ended but I wanted to keep going. I decided that I must not let this trauma define me and that I must keep speaking. I began traveling and speaking at universities, replaying my nightmare that had become a reality. Each time, my mind and body raced. Physically, my body and back ached.
Survival Mode and the Sympathetic Nervous System
Studies have demonstrated a correlation between mental and physical health, where approximately 15% to 30% of patients with post-traumatic stress disorder also experience chronic pain. So what is trauma? Trauma is formally defined as “when our ability to respond to a perceived threat is overwhelming, which causes the nervous system to go into survival mode.” During survival mode, the body activates the sympathetic nervous system. Cortisol is constantly released, increasing in blood pressure and heart rate.
The sympathetic nervous system can remain activated for several days to months. When the sympathetic nervous system activates, it can cause somatic painThis is pain that a person experiences without an organic cause. Despite extensive lab testing and imaging, there is not a clear explanation for why a person experiences this type of pain.
Mental and Physical Pain Following Trauma
After trauma, the body experiences many physical and emotional changes. Evidence supports the following:
- Emotional turmoil and physical pain can feed off each other.Emotional pain from trauma can lead to an increase in somatic pain by 50%.
- The link between mind and body can influence pain responses. Chronic states of stress can lead to activation of the sympathetic nervous system, thus causing the body to create more pain.
- The association between pain and PTSD is complicated. PTSD is a state of heightened arousal, where the body is more prone to pain. Patients with PTSD have been known to display expectations of pain before the pain actually occurs.
Pain is Multidimensional
Pain is not always the result of physical injury. When treating pain, one should consider multiple factors by obtaining a thorough history. Therapies such as counseling, medication management, and physical therapy must be implemented to address pain non-physical pain.
As I stepped up to the podium in front of the audience, my voice quivered as I stated, “It was a long hard road, I lost myself but I found my voice.” I used my voice to speak up and find help through weekly therapy sessions, and, in turn, I have used my voice to advocate for others who’ve been through the same emotional pain as me.
Lauren Debski, FNP