Trauma in Adults
Recognising Trauma in Adults by Debbie Admoni Psychologist
While adults frequently present with symptoms of anxiety and depression in some cases, these symptoms are linked to a history of trauma that may not be immediately obvious. Trauma can involve a single overwhelming event or, more commonly in complex trauma, a series of adverse experiences such as neglect, abuse, or disrupted attachment in early life.¹
Recent data suggest that between 57% and 75% of Australians will experience at least one potentially traumatic event in their lifetime. Around 11% will meet criteria for PTSD at some point.²
Clinical Presentation
Trauma is often masked by more common psychological symptoms. Patients may report low mood, generalised anxiety, disrupted sleep, and poor concentration. Individuals with a trauma history may appear dysregulated, hyperalert, or emotionally reactive. They may experience intense emotions such as fear, shame, or helplessness, and often report nightmares or intrusive thoughts linked to past experiences.
These symptoms can affect functioning at work, home, and in social relationships. Patients may not connect their current difficulties with past trauma, particularly if the events occurred in childhood or were long-standing.
For GPs, recognising trauma can be challenging. A history of repeated presentations for anxiety, depression, or physical symptoms that are unresponsive to standard interventions may suggest an underlying trauma component. It’s also useful to observe signs of dysregulation, such as chronic sleep disturbance, emotional lability, or exaggerated startle responses, especially where no clear cause is identified.
Working with Psychologists
Where trauma is suspected, referral to a psychologist can support a more detailed assessment. Psychologists will typically explore the patient’s developmental and mental health history, with a focus on exposure to potentially traumatic events. Tools such as the PCL-5 may be used to screen for PTSD.
Initial therapeutic work often targets stabilisation: helping patients establish daily structure, improve sleep, and reduce acute distress. Once a degree of regulation is achieved, treatment may progress to processing the traumatic memory. This may involve trauma-focused CBT or EMDR (Eye Movement Desensitization and Reprocessing), which helps the patient reprocess memories with attention to emotional, cognitive, and physiological responses. As treatment progresses, unhelpful beliefs formed during or after the trauma are addressed and reframed.
When trauma is identified and treated effectively, patients often show reduced symptoms of anxiety and depression, improved self-regulation, and better functioning across domains of life.
References
Rossman, 2002 & Mills et al., 2011 cited in Bendall et al., 2018
National Study of Mental Health and Wellbeing 2020–2022