We expect the broken bones. The stitches. The scans. The surgeries.
We don’t expect the way our heart races at a left turn.
We don’t talk about why the hallway feels too quiet, why the door slams and we flinch, and why it’s been months and we still can’t sleep at night.
But trauma doesn’t end when the bleeding stops.
And emotional trauma is not an exception—it’s often what comes next.

This month is Mental Health Month and therefore the perfect time to talk about what’s often missing in trauma care (or at least physical trauma care).

Unlike what we may know from popular culture, there are actually many forms of emotional trauma that can happen after a physical injury, as outlined in the DSM-5 – the diagnostic manual used by mental health professionals.

The first is acute stress disorder (ASD). It’s the days or weeks after the accident. Maybe the memories come back at the strangest times. Maybe you can’t sleep. Maybe your heart races and you avoid that intersection where the car crashed or that street corner where the assault happened. Maybe it feels like you’re overreacting to everything. It may feel like PTSD – but it’s not, at least not yet. What you’re experiencing is most likely ASD: your brain’s and body’s immediate response to trauma.

However, when those symptoms linger for over a month, they may meet the criteria for post-traumatic stress disorder (PTSD), meaning the symptoms have persisted, they interfere with daily functioning, and it’s time to seek help. (Seeking help when it’s ASD is also encouraged!) Originally termed “shell shock” in the aftermath of World War I, PTSD was first diagnosed in veterans – but we now know that anyone exposed to trauma, even secondary trauma like we experience as healthcare providers, can be affected.

So what then? What if you – or a patient – has ASD or PTSD? All is not lost. There are multiple therapies that can help reduce symptoms significantly. If someone isn’t quite ready for therapy, even tracking symptoms and triggers through an app like PTSD Coach (sponsored by the National Center for PTSD) can help tremendously. There’s also PTSD Family Coach, an app designed to support loved ones in understanding and responding to trauma symptoms.

Across Maryland, trauma patients leave our hospitals with more than just discharge papers. They carry memories, fears, and sometimes, wounds no scan can show. Emotional trauma may not be visible – but it is real, and it deserves our attention.

This Mental Health Month, let’s remember: recovery doesn’t end at survival. As trauma professionals, advocates, and community members, we have an opportunity to support healing that goes beyond the physical – right here in our state, and in every trauma center we serve.

Because trauma doesn’t end when the bleeding stops.
And healing isn’t complete without the mind.

Amanda Kern, LCSW-C, began her career at the R Adams Cowley Shock Trauma Center as a unit social worker and now serves as the Trauma Survivors Network Coordinator there. Since stepping into this role in late 2024, she has focused on advancing trauma-informed care, supporting survivors, and promoting emotional healing after injury.

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Amanda Kern, MSW, LCSW-C
Trauma Survivors Network Coordinator
UM R Adams Cowley Shock Trauma Center
University of Maryland Medical System