Trauma + Stress = PTSD

[Assalamualaikum & salam sejahtera]


Seems to be one good equation but did you all know what’s that means?

Stress can define by everybody in the world. Believe it or not? Believe it! But how the professional explain about the stress that not everyone know about it. Today’s topic of my discussion is about stress and PTSD.

There are several definition of stress.

1. stress = tension: (psychology) a state of mental or emotional strain or suspense (wordnetweb.princeton)

2. Stress is a term in psychology and biology, refers to the consequence of the failure of an organism – human or animal – to respond appropriately to emotional or physical threats, whether actual or imagined. (The Stress of Life, Hans Selye, New York: McGraw-Hill, 1956 - wikipedia)

Thus, there are the definition of stress. There are many type of stress. In your mind, what stress means to you? Is it a bad thing? or Is it a good thing for you?211847_f260

Eustress is one of the helpful types of stress. What is the definition for eustress? It is the type of stress you experience right before you have the need to exert physical force. Eustress prepares the muscles, heart, and mind for the strength needed for whatever is about to occur.stress-main_full

Distress is one of the negative types of stress. This is one of the types of  stress that the mind and body undergoes when the normal routine is constantly adjusted and altered. The mind is not comfortable with this routine, and craves the familiarity of a common routine. There are actually two types of distress: acute stress and chronic stress.

Acute stress is the most common form of stress. It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future. Acute stress is thrilling and exciting in small doses, but too much is exhausting.

While acute stress can be thrilling and exciting, chronic stress is not. This is the grinding stress that wears people away day after day, year after year. Chronic stress destroys bodies, minds and lives. It wreaks havoc through long-term attrition. It's the stress of poverty, of dysfunctional families, of being trapped in an unhappy marriage or in a despised job or career. It's the stress that the never-ending "troubles".

Quadrant One: Chronic Eustress

Quadrant One is known as Chronic Eustress or long lasting, recurrent good stress. This is by far, the very best of the types of stress out there.

Words like fun, happiness, peace, joy, laughter, spirit, and love exist in this quadrant. When we are in a state of chronic eustress, our bodies have very high levels of the feel good hormones like Dopamine and Oxytocin. These hormones make it possible for us to have high levels of self-esteem and to have really strong relationships in all areas of your life, whether they be romantic, parental or work-related.


Quadrant Two: Acute Eustress

Quadrant Two is known as Acute Eustress or rapid onset, short, intense good stress. On a 'types of stress' scale of 1-10, with 1 being bad and 10 being good, this quadrant sits at about 6-7.

When you get some really fantastic news or you are engaged in a feel great workout or when something really wonderful happens to you, you experience this kind of stress. The body is temporarily, intensely and quickly flooded with feel good hormones like Dopamine and Oxytocin. This type of stress is desirable and it does a body good to experience this type of stress often.


Quadrant Three: Acute Distress

Quadrant Three is known as Acute Distress or rapid onset, short, intense bad stress. As far as types of stress go, this one is no fun but is not terribly dangerous and in fact it can save your life.

This type of stress happens when we feel shocked or threatened and our fight or flight stress response system kicks into gear. Our bodies are flooded with emergency response hormones such as adrenaline and cortisol. These hormones allow us to be alert and have increased strength, endurance and energy, thereby allowing us to respond to imminent danger.

This type of stress comes from things like a car accident or if you are attacked or if you feel extreme fear. While this type of stress is classified as a bad stress, it is not dangerous because it does not last a long time and the body will wash away these extra hormones when the danger or threat has passed. This stress helps us to survive.

Quadrant Four: Chronic Distress

Quadrant Four is known as Chronic Distress or long lasting, recurrent bad stress. This is by far the worst of the types of stress in our lives.

Chronic distress is the cause of most peoples' problems. With this kind of stress, your body is constantly flooded with emergency response hormones like Cortisol and Adrenaline. When your Endocrine System is over-used to this extent, things begin to malfunction.

Staying here will kill you and long before this quadrant gets around to that, it will more than steal your quality of life. So get out now, while you still can and stay out.

Now, when all of us already clear about stress, we’ll move on the main objective of it which is PTSD. Why I suddenly emerge this topic. In disaster, there are many combination stress. It can be a acute distress (when Merapi erupt) and chronic distress (as long as they don’t have works to do, as they live in refugee camp). Plus, there is trauma on the Merapi eruption. Thus, this lead to PTSD. Post Traumatic Stress Disorder.


PTSD is defined as a delayed reaction to an exceptionally stressful situation or a life threatening event. The delay can be as long as 6 months or even more. This disorder has gained significant attention during the past few years as more and more researches have commented on the short and long term effects of post traumatic stress disorder.

Many psychopathological conditions affecting adults and adolescents which were initially thought to be results of internal conflicts are now found to be due to a past stressful trauma. More researches are being done in this field.


The manifestations of the disorder are seen after a couple of months. The impact of the event is so much that the person who is affected, tries to avoid any stimuli reminding him of that past stressful event. In spite of it, if the person experiences the stimuli, the manifestations become more severe, with more anxiety and more arousal.

An affected person gets repeated recollection of the stressful event as Flashbacks or dreams. The person re-experiences the original trauma and gets affected both physiologically and psychologically and tries to avoid such stimuli. Repeated Re-experiences cause a behavioral change in the person.

Thus, when there is disaster especially deadly disaster like tsunami, earthquake or volcano eruption, psychological management cannot be left out at the first hand. Psychologist or psychiatrist has to collaborate to enhance the services to the victims. They are must one of the member of rapid response team during disaster management. The impact of PTSD is so huge till they can be suicide attempt. 

Wasior-Sassu Psychology Team of Palang Merah Indonesia in Wasior



1. American Psychological Association

2. stressfocus

3. Strictly Stress Management

-tHaNk yOu-


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Mohammad Fazrul bin Mohammad Basir, 4th year medical student of Faculty of Medicine, Gadjah Mada University, City of Student & Tourism, Yogyakarta, Indonesia. Being a medical student with an ambition to be director of government hospital later in my career, this blog is a good start. Enjoy yourself here!!

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