Hidden beneath the scars: Surviving a mental disorder

By Lindsay Blair

When 11 year old Amanda Smith was in a serious car accident, the injuries she received were more than just on the surface, the true effect of which would not show until much later.

The effect of Smith’s accident was not immediately clear to her. She said that her family was reassuring her that everything was going to be OK, but for Smith even at a young age, she knew that things were not going to be fine.

“(In the hospital I remember) I went to the bathroom finally and there was a mirror and I looked in the mirror and I was like ‘Holy shit,’ that’s pretty bad,” she said, “My mom was in the bathroom with me and she tried to reassure me, but when someone is trying to reassure you about stuff like that, it’s like ‘shut up’.”

Before seeing the extent of her facial injuries, Smith told herself that whatever happened did not matter and that she did not care what she looked like. “I just had to tell myself that it didn’t matter,” she said. In the accident, she suffered severe cuts to her face and chin and also a severed knee.

When Smith saw the real extent of her injuries, despite telling herself that it didn’t matter, she said that they “pretty gruesome” and that she was shocked because the injuries on her face “looked gross”.

When Smith returned to school after the Christmas break, she was met with stares and sneers. Talk of getting a school sponsored ‘protector’ circulated, but that did not stop some of her peers commenting on her appearance. Smith vividly remembers the aftermath of the accident, particularly reminiscing about the influences of other people, which she said still affect her today.

“I have thought about this for a long time, when I got older I started to become more reserved. Before that I was always very outgoing,” Smith said, “I kept my head down, I didn’t really talk to anybody. I was never really the type of person to make friends after that whereas before I was,”

“I am still the same way. I am still reserved, I don’t really like to talk to people unless they come and talk to me, it’s the only time I really talk to people, I am very insecure,” Smith said, “My reactions to things are different now.”

Smith describes the effects of the accident when she was 11-years-old as a “snowball effect”. She said that when a person is affected by a traumatic event and then bullied, people often get down on themselves. Smith has had problems in the past with people telling her that she thinks too negatively about things and this has led to her losing some of her friends.

“Honestly, I have had so many points, low points, breaking points, whatever you want to call them. I have had so many points in my life where I have had somewhat of a crisis, I guess you could say,” she said.

Many people affected by trauma, suffer from psychological disorders. Smith was last year diagnosed with social anxiety disorder, a disorder which affects as many as 15 million Americans each year, according to socialphobia.org, a site dedicated to aiding the socially anxious.

According to the report, ‘Post Traumatic Stress Disorder,’ written by Psychologist Thomas A. Richards, even when they're around familiar people, a person with social anxiety may feel overwhelmed and have the feeling that others are noticing their every movement and critiquing their every thought. They feel like they are being observed critically and that other people are making negative judgments about them.

Richards said in the report, “Unlike some other psychological problems, social anxiety is not well understood by the general public or by medical and mental health care professionals,”

Cognitive behavioral therapy encourages anxiety sufferers to think about things in a different way said Richards. Sufferers are advised to take negative comments and think about them in a positive way.

“You have to do the opposite of what your initial reaction is,” Smith said, who has found this type of treatment the most effective.

Although the condition, the effects of which are not completely understood, psychologists say social anxiety is best treated with cognitive behavioral therapy.

“I go once a week. I am a very self-aware person so I notice a lot of things within myself and others’ reactions it makes it a lot better and faster to notice these things (and treat them) because that is basically my problem. (For me) what everything stems from is having social anxiety,” Smith said.

People who suffer trauma in their lives can be affected in many ways and this can sometimes remain undetected. Post Traumatic Stress Disorder (PTSD) is a condition which affects one in ten Americans, according to a report by Stephen R Paige, which was published on the medical reference web site emedicinehealth.com. Acute stress disorder is usually a short term condition which occurs immediately after a traumatic experience.

The traumatic event (such as car or airplane accidents and also sexual assault and domestic violence) causes a cascade of psychological and biological changes known as post-traumatic stress disorder, the report said.

Paige, Visiting Professor of Psychology at the University of Nebraska in Omaha, said in his report, “The worse the trauma, the more likely a person will develop PTSD, and the worse the symptoms (will be). The most severely affected are unable to work, have trouble with relationships, and have great difficulty parenting their children.”

Former PTSD sufferer, teacher and police officer, David Kinchin, from Manchester, England is now an author of help books for sufferers of the disorder.

Kinchin helps sufferers of PTSD and holds workshops on the subject. He is not a counselor, but his book ‘Post Traumatic Stress Disorder: the invisible injury’, released in 2005, has helped many sufferers.

Kinchin said, “I think that if there was an element of blame attached to the event then there are links to PTSD,”

“From dealing with people, if they hold a grudge or they have an axe to grind then there seems to be a stronger link between trauma and PTSD,” he said, when questioned about the effects of trauma on a person’s mind.

In a follow up email, Kinchin said self esteem is a real issue with some of the symptoms of PTSD and is also important with regards to the whole thought that “I am a weak person and that is why I have PTSD”.

There are many symptoms of PTSD that can be associated with lack of self esteem, such as lack of concentration, loss of memory and being frightened of shadows, according to Kinchin. They (PTSD sufferers) think they are going mad and that people think that they can’t cope.

Kinchin said that mental disorders can affect many people and can stem from many situations, but trauma in particular, such as accidents or even warzones.

Although PTSD can be treated with drugs, therapy methods similar to those used to treat social anxiety are also successful. With medication or counseling and usually both, the movie inside a person’s head stops playing and fades with time, said Richards in his report.

Knowledge is one of the best ways to cope with post-traumatic stress disorder said the report, that’s why grief counselling works if the counsellor concentrates on talking things through.

As a sufferer Smith, although still suffering from the effects of her accident, has seen improvements in her attitude, behavior and the way she reacts to situations.

“Therapy is slow but it helps,” Smith said, “I try to set goals for myself and I try to keep positive,”

“I am fine, well I’m not but I understand.”