CATHERINE MUROMBEDZI
HEALTH CORRESPONDENT

Tuesday, September 10th, was a special day to observe. It marked World Suicide Prevention Day. Mental health disorders, such as depression, anxiety, and suicidal thoughts, are often shrouded in silence and invisibility.
Unlike physical illnesses, these conditions don’t manifest outwardly, making them difficult to detect and address. The absence of visible symptoms can lead to a lack of understanding, stigma, and delayed intervention.
As a result, individuals struggling with their mental health may suffer in silence, feeling isolated and unnoticed.
Trauma can lead to suicide contemplation.
It is high time to amplify the message of hope and support, acknowledging the invisible struggles that many face.
Dr Vivek Solanki, a medical specialist, encourages those affected to reach out for help.
He stressed the importance of listening. Together, we can break the silence and make a difference.

WHAT IS TRAUMA
Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being. (TIC, 2014)

“The long, silent shadow of mental, psychological, or psychosocial trauma can linger, growing over time. Like the tentacles of an octopus, trauma can wrap itself around our emotions, relationships, and sense of self. Its effects often remain hidden, only surfacing during life’s challenges.
“Many individuals are not fortunate enough to have their trauma addressed, leading to lasting consequences. Physical trauma can result in disability, while emotional trauma, if left unhealed, can manifest as psychological challenges,” said Dr Solanki.

TYPES OF TRAUMA
Trauma comes in many forms — three major categories of trauma are:
Acute trauma — results from a single unexpected, stressful event – causing distress immediately.
Chronic trauma – repeated or prolonged traumatic set of events, such as domestic violence or abuse
Complex trauma – the exposure to varied and multiple traumatic events, often differing types from which there is no possibility of escape, such as child abuse.
Others include:
Individual trauma – an event to one person – a mugging, rape, attack, etc.
Group trauma – experiences affecting a particular group of people
Community/cultural trauma – violence and atrocities undermining the safety within a community, neighbourhood, school, towns.

TYPICAL TRAUMA RESPONSES
Trauma responses from a reaction to a life-threatening situation can be a survival mechanism helping people react quickly.
These are known as the Four F’s – fight, flight, freeze, or fawn. These responses can become over-activated, leading to negative physical or mental consequences. The type of response mechanism a person takes is determined by factors such as background, experiences, and the current context.

KEY ASPECTS OF TRAUMA
Linger: Trauma can persist long after the initial event, affecting a person for years.
Grow: It can intensify and spread, impacting various areas of a person’s life.
Manifest: Trauma often reveals itself through symptoms, behaviors, or emotions, especially when triggered by stress or difficult situations.

UNDERSTANDING TRAUMA
Dr Solanki emphasizes the need for awareness and the importance of helping those affected to seek support. He explains that trauma comes in many forms, and all can be addressed with proper care.
“Trauma encompasses a wide range of experiences. It includes physical injuries from war, where survivors carry horrific memories or disfigurement. Witnessing violence, bombings, or losing loved ones in war leaves deep scars. Physical trauma can also result from accidents at home, on the road, or in sports, as well as violence or sexual abuse, which affect both the body and mind,” said Dr Solanki.

He also points to natural disasters, such as Cyclone Idai in 2018, and their lasting impact on survivors. “Disasters like fires, floods, and earthquakes leave not only physical destruction but emotional devastation. If not treated, these effects can linger for life,” he said.
“Survivors of near-drowning, attempted suicide, and severe illness can also experience trauma, often presenting with conditions like breathing difficulties or asthma attacks. Trauma can also stem from emotional or psychological distress, such as child abuse or sexual violence,” he added.

TRAUMA IN ZIMBABWE
“Fortunately, Zimbabwe does not experience the level of high crimes, such as gunshot wounds, seen in some neighboring countries,” Dr Solanki explains.
“The horrific injuries from trauma cause severe distress, but invisible trauma, such as emotional or psychological abuse, often goes untreated. Abusive relationships, neglect, bullying, and the loss of loved ones can lead to conditions like post-traumatic stress disorders (PTSD), anxiety, and depression.”
Dr Solanki underscores that untreated trauma can cause a range of physical symptoms, from hypertension and heart problems to breathing difficulties.
“Addressing trauma is essential, not just for the individual but for their loved ones too,” he stresses. It is important to seek professional help either from a healthcare provider or be referred to a therapist, counselor, support group, or other healthcare specialist to address the underlying suffering and develop coping mechanisms.

CYCLE OF VIOLENCE
Understanding of the ‘cycle of violence’ is necessary. A victim or survivor is abused by a perpetrator in the theoretical model of this cycle. This can then lead to a situation where the first victim starts abusing another victim; this cycle is likely to continue until support or treatment is obtained and dealt with.

THE IMPACT OF TRAUMA
Trauma can have significant and lasting impacts on an individual’s physical and mental health, including Chronic Stress Response, Hypervigilance, anxiety and Depression, sleep disturbances, substance abuse, and behavioral changes.

HEALING FROM TRAUMA
“Healing is not an event but a process,” said Dr Solanki. It takes time and is available in its different forms of treatment.
“By recognising the shadow of trauma, individuals can start the journey toward recovery, learning to overcome its lingering effects.”
The Trauma Centre offers trained staff who specialise in caring for predominantly physical trauma with a full backup of nurses, medics, administration staff, support staff, psychological support, ambulance services, supportive structures, systems with specialised personnel, equipment, and in-house facilities as well,” he said. Referrals to a specialised trauma counselor would be arranged for those requiring a higher level of sustained care.

“Through the Trauma Centre in 2020 to 2021, during the COVID-19 pandemic, over 3 000 healthcare workers were trained, free of charge. That is part of our corporate social responsibility.
We are currently offering MPox infection control, post COVID-19 post-traumatic stress disorders (PTSD), friends and family C.P.R, and C.P.R. for professionals, AHA B.L.S. for healthcare providers, first aid essentials for children, and baby basics.
This is a commitment to the well-being of us all as a nation,” said Dr Solanki.
In a shareable alert voice audio, he summarises the pointers of trauma.
“Lingering trauma can be devastating as it grows unnoticed. It can remain with a person for an extended period, even after the initial event has passed. Emotional trauma can grow and evolve, intensifying over time, affecting various aspects of a person’s life. It can then be seen when the effects are severe manifesting to become apparent through different symptoms, behaviours, or emotions, often when a person is faced with challenges or triggers,” he said.

Speaking in a World Health Organisation (WHO) media regional training on responsible reporting prior to World Suicide Prevention Day, Charles Tatenda Mako, who once considered suicide as an option, shared his journey as a way to help others facing similar challenges.
His story of resilience to refocus from the suicide ideation had his loving uncle standing with him when the rest of the extended family had washed their hands. Today, Charles is an advocate helping those in similar circumstances he once faced.

With the right support, the effects of trauma can be addressed, allowing individuals to heal and regain control of their lives.

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REFERENCES:
TIC (2014) Substance Abuse and Mental Health Services Administration. Trauma-Informed Care in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.