Saludos Psychology Group

Dr. Kimberly Fitzgerald González

Florida Licensed Clinical Psychologist · License #PY10967 · Clinical and Forensic Psychology · Telehealth across Florida

Trauma & Stress-Related Disorders | SaludosPsych

Mental Health Education

When the Past Won't Stay in the Past

Trauma leaves a mark — not just as a memory, but in the body, the nervous system, and the way we move through the world. This guide explains trauma and stress-related disorders in plain language, for people who are living with them or trying to understand someone who is.

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Trauma & Stress-Related Disorders

Conditions rooted in exposure to traumatic or overwhelming stress

Trauma & Stress-Related Disorders

Post-Traumatic Stress Disorder

Commonly known as: PTSD

Most people have heard of PTSD in the context of war veterans. But PTSD can follow any experience in which a person's sense of safety was fundamentally shattered — a car accident, a sexual assault, a natural disaster, childhood abuse, witnessing violence, or a sudden loss. Trauma is not defined by what happened; it's defined by what it did to the person who experienced it.

What makes PTSD different from ordinary grief or stress is that the traumatic event doesn't feel like it's over. The past intrudes on the present — through flashbacks, nightmares, or sudden overwhelming sensations that make the body feel like the danger is happening right now. A smell, a sound, a particular time of year can pull a person back into the experience with startling force.

"I knew I was safe. But my body didn't. Every time a car backfired, I was back there."

People with PTSD often develop ways of managing these intrusions — avoiding anything that might trigger a memory, staying hypervigilant and on edge, or emotionally numbing themselves to get through the day. These strategies make sense as survival responses, but over time they can cut people off from their own lives. PTSD is not a sign of weakness. It is the nervous system doing exactly what it was designed to do — protect — and getting stuck. With the right treatment, recovery is absolutely possible.

Common experiences people describe

  • Flashbacks — vivid, involuntary reliving of the traumatic event
  • Nightmares related to the trauma
  • Intense distress when reminded of the event
  • Avoiding people, places, thoughts, or feelings connected to the trauma
  • Feeling detached from others or emotionally numb
  • Persistent negative beliefs about oneself or the world
  • Hypervigilance — feeling constantly on guard or easily startled
  • Difficulty sleeping or concentrating
  • Irritability or angry outbursts that feel out of proportion

Trauma & Stress-Related Disorders

Unspecified Trauma- and Stressor-Related Disorder

When something is clearly wrong — but doesn't fit neatly into a category

Trauma doesn't always arrive in forms that fit cleanly into a diagnostic checklist. Some people experience significant distress and impairment following traumatic or stressful events, but their symptoms don't fully meet the criteria for PTSD, Acute Stress Disorder, or any other specific diagnosis in this category. That doesn't mean their suffering is any less real — it means the human experience of trauma is more varied than any manual can fully capture.

The Unspecified Trauma- and Stressor-Related Disorder designation exists precisely for these situations. A clinician may use this diagnosis when there is not enough information to be more specific — for example, in an emergency setting — or when a person's presentation is genuine and clinically significant but doesn't check every required box for another diagnosis.

"My therapist said I didn't technically have PTSD. But something was very wrong, and I needed help. That felt like enough."

For people who receive this diagnosis, it can feel unsatisfying — like being told you have "something" without being told exactly what. It helps to know that the label is not the point. What matters is that your experience is being taken seriously, and that effective, trauma-informed care doesn't require a perfect diagnostic match to begin.

When this diagnosis might apply

  • Significant distress or impairment following a traumatic or stressful event
  • Symptoms that resemble PTSD or another trauma disorder but don't fully meet criteria
  • Presentations that are atypical, mixed, or difficult to categorize
  • Situations where a clinician needs more time or information before specifying a diagnosis
  • Cultural expressions of distress following trauma that don't map neatly to Western diagnostic categories

Trauma & Stress-Related Disorders

Acute Stress Disorder

The immediate window after trauma

In the days and weeks immediately following a traumatic event, it is normal — and expected — to feel shaken, disoriented, and unlike yourself. Acute Stress Disorder describes a cluster of distressing symptoms that emerge within the first month after trauma.

People with Acute Stress Disorder often describe a feeling of unreality — as if they are watching themselves from outside their body, or as if the world around them has become strange and dreamlike. This is called dissociation, and it is the mind's way of creating distance from an experience that is too overwhelming to process all at once.

"I felt like I was watching my own life through glass. I knew I was there but I couldn't feel anything."

Acute Stress Disorder occurs in the first month after trauma. For many people, symptoms resolve on their own as the nervous system gradually settles. For others, the distress persists and evolves into PTSD. Early support — talking to someone, grounding techniques, and trauma-informed care — can make a meaningful difference in how the weeks ahead unfold.

Common experiences people describe

  • Feeling detached from your own body or emotions
  • A sense that the world is unreal or dreamlike
  • Inability to remember important parts of the traumatic event
  • Intrusive memories, images, or flashbacks
  • Avoiding reminders of what happened
  • Sleep disturbance, irritability, or difficulty concentrating
  • Persistent inability to feel positive emotions

Trauma & Stress-Related Disorders

Adjustment Disorders

When life changes become too much to carry

Not all stress comes from catastrophic events. Sometimes what breaks us open is something that looks manageable from the outside — a divorce, a job loss, a move to a new city, a serious illness, the end of a relationship. Adjustment disorder is what happens when the emotional response to a stressor becomes more intense or more prolonged than expected, and begins to interfere with daily life.

This diagnosis is sometimes dismissed as "not serious enough." That is a mistake. Pain doesn't need to be caused by the worst possible thing to be real. People with adjustment disorders are genuinely struggling — they just haven't been through a capital-T trauma.

"Everyone kept saying it was just a job. But I couldn't get out of bed. I couldn't stop crying. I didn't understand what was happening to me."

Symptoms typically begin within three months of the stressor and resolve within six months once the stressor ends — but that window can feel like a very long time to live through without support.

Common experiences people describe

  • Emotional distress that feels disproportionate to the situation
  • Significant difficulty functioning at work, school, or in relationships
  • Low mood, tearfulness, or hopelessness following a life change
  • Anxiety, worry, or nervousness that won't settle
  • Feeling overwhelmed by something others seem to handle with ease
  • Withdrawal from social activities or responsibilities
  • In some cases, reckless or impulsive behavior as a way of coping

Trauma & Stress-Related Disorders · Children

Reactive Attachment Disorder

When early caregiving leaves children unable to connect

From the moment we are born, we are wired to attach — to seek comfort, safety, and connection from the people who care for us. When those early caregiving relationships are severely neglectful or absent, something fundamental in a child's development is disrupted. Reactive Attachment Disorder (RAD) is the result.

Children with RAD have learned, through painful early experience, that the adults in their world cannot be relied upon for comfort or safety. So they stop seeking it. They may appear emotionally withdrawn, unresponsive to affection, and disconnected — even from caregivers who genuinely love them and are trying to help. This is not defiance or coldness. It is a child who learned that reaching out doesn't work.

"She'd fall and hurt herself and just sit there quietly. She never cried for me. It broke my heart every single time."

RAD is seen most often in children who experienced early institutional care, repeated changes in caregivers, or severe neglect. Healing is possible — but it requires patience, consistency, and specialized therapeutic support. A child with RAD is not broken. They are a child who learned to survive in conditions that no child should have to navigate.

Common experiences caregivers describe

  • Child rarely seeks comfort when distressed
  • Minimal response to comfort when offered
  • Limited positive emotional expression
  • Unexplained episodes of irritability, sadness, or fearfulness
  • Emotional withdrawal even with familiar, safe adults
  • History of neglect, institutional care, or multiple caregiver changes

Trauma & Stress-Related Disorders · Children

Disinhibited Social Engagement Disorder

Also known as: DSED

Where RAD is marked by withdrawal, DSED looks almost like the opposite — and that can make it harder to recognize. Children with DSED will approach and interact with unfamiliar adults with very little hesitation. They may wander off with strangers, be overly physically affectionate with people they've just met, or show no wariness in situations where caution would be expected.

From the outside, this can look like friendliness or outgoing personality. But there is an important difference between a warm child and a child who has no sense of who is safe. DSED reflects an early failure in selective attachment — the child never fully developed the ability to distinguish between familiar, trusted caregivers and strangers.

"She'd hold a stranger's hand at the grocery store like she'd known them her whole life. I was terrified for her."

Like RAD, DSED is associated with early neglect or unstable caregiving. With the right therapeutic environment and stable, loving caregiving over time, children with DSED can develop healthier patterns of relating — but the process takes time and specialized support.

Common experiences caregivers describe

  • Approaching and engaging with unfamiliar adults without hesitation
  • Willingness to leave with strangers or wander away from caregivers
  • Overly familiar physical contact with people the child barely knows
  • Asking personal questions of strangers that feel intrusive for their age
  • Reduced or absent checking back with caregiver in unfamiliar situations
  • History of early neglect, institutionalization, or repeated caregiver changes

Clinical Expertise

Why Dr. Fitzgerald González's expertise matters

51,000 hours of clinical and research experience across trauma populations

Dr. Fitzgerald González has assessed and treated trauma across the full range of clinical severity — from acute crisis presentations in forensic and correctional settings to complex, chronic trauma in outpatient care. Her training spans the settings where trauma is most concentrated and most clinically complex: state correctional systems with high rates of trauma history, forensic psychiatric units, and acute inpatient settings where trauma underlies the majority of presentations.

Trauma presentations are rarely straightforward. PTSD co-occurs with depression, substance use disorders, personality pathology, and dissociative conditions in ways that require careful differential diagnosis and integrated treatment. Getting the full clinical picture right — not just identifying trauma, but understanding how it interacts with everything else — is what determines whether treatment actually works.

That breadth of clinical experience carries directly into every trauma-related evaluation and treatment at Saludos — including those that take place in the very different context of outpatient telehealth.

Clinical Relevance

Why it matters for you

The right treatment changes everything that follows

If you have been carrying the weight of something that happened — if the past keeps intruding on the present in ways you don't fully understand — accurate assessment of what you are experiencing is the foundation of treatment that actually helps.

Trauma-informed care begins with understanding the full picture: what happened, when, what it did to your nervous system, how it has shaped your patterns of relating and coping, and what evidence-based approaches are most likely to produce real change for your specific presentation.

An accurate diagnosis and evidence-based treatment changes everything.

Saludos Psychology Group provides services via telehealth. Schedule directly with Dr. Fitzgerald González — no referral required.

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This page is for educational purposes only. It is not a substitute for professional mental health assessment, diagnosis, or treatment. If you are in crisis, please immediately call or text 988 or go to the nearest emergency room.