The word “trauma” brings to mind negative events like the death of a loved one, sexual assault, or a terrible car accident. Mental health professionals think of trauma in much the same way. They’re concerned about how we respond to those events, both right away and long after they’ve happened.
While shock or even denial might come and go quickly, other reactions might linger.
Among other things, you may start to take risks, become reckless, and put yourself in danger. For example, you could:
- Binge on food or alcohol
- Use illegal drugs
- Have anonymous, unprotected sex
Not everyone who goes through trauma will do risky things. But in 2013, these reckless and self-destructive actions became part of a checklist doctors use to diagnose posttraumatic stress disorder (PTSD), a common mental health illness after a trauma.
“This is something that we’ve seen in clinical practice for years, and I think it was a very important addition,” says Luana Marques, PhD, director of research at the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital in Boston.
Who Starts Risk-Taking Behaviors?
The reasons someone does risky acts are as varied as the people who go through trauma.
One cause may be that a person with PTSD could both overestimate and underestimate danger. This could be the result of changes the trauma causes in the part of their brain that evaluates risky situations.
For example, an airplane crash survivor may not get on a plane again. But they may take up freestyle rock climbing. A sexual assault victim may have anonymous, risky sex but refuse to date appropriate partners.
“When someone has PTSD, they have a tough time distinguishing between real threats and those that can be ignored,” says Charles Marmar, MD, director of the PTSD Research Program at NYU Langone Health.
He adds that people can become afraid of something they did that caused their trauma, and not understand that something else they’re doing is just as risky.
Tough childhood experiences can also lead to risky behavior.
“Kids are very resilient, but they can also have it very rough after a trauma because they don’t have the resources to escape a bad situation,” says Niranjan Karnik, MD, PhD, associate professor of psychiatry at Rush Medical College in Chicago. “And in a lot of cases, the trauma is repeated daily.”
Some situations that can lead to risky behavior down the line include:
- Physical, sexual, or emotional abuse
- Physical or emotional neglect
- Violence between parents or guardians
- Seeing violence against their mother
- Substance misuse in the home
- Separation and divorce
- Mental illness in the home
- Having a loved one in jail
These things, especially if a child is exposed to them repeatedly, can lead not only to things like suicide attempts and dangerous sexual behavior, but also to problems like depressive disorders and sleep disturbances into adulthood.
A lot of trauma research has been done on veterans. One study says those who engaged in risky behavior raised their chances for worse PTSD symptoms.
But is being in war worse than being in an airline or car accident? Whether one trauma is more likely than another to lead to risky behavior is an almost impossible question to answer.
“It depends on how that person was affected,” Marmar says. “But there are certain situations that seem to affect people more than others and can lead to problems after that traumatic event.”
Some things that raise the odds for symptoms like risky behavior include:
- Getting hurt
- Seeing a dead person
- Feeling helpless or extremely fearful
- Little or no social support after the event
- A history of mental illness or substance abuse
Added stress after the event, like the pain or losing a loved one, your job, or your home.
What Can You Do?
If you or someone you love has gone through a trauma and you’re worried about aftereffects, see a professional. There is help.
“If my child or a friend or family member was in trouble, I would immediately move toward evidence-based care, which is cognitive behavioral therapy,” Marques says.
That includes things like:
Prolonged exposure therapy: This helps you gradually face situations you find frightening to help you confront fears so that everyday situations that may remind you of your traumatic event don’t stop you in your tracks.
Cognitive processing therapy: Treatment that helps you change negative thought patterns.
Dialectical behavior therapy (DBT): This approach can help you regulate emotions and control destructive behavior.
In some instances, medications like antidepressants may also help.
“There is always debate about trauma and behavior, but one thing we all agree on is that some people who have experienced trauma suffer greatly, and unfortunately developing reckless behaviors can do them so much more harm,” Karnick says.
“Getting help is vital.”