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Think trauma only affects people who have been in war or a serious accident? Nope, it’s more than that. Traumatic events can include systemic racism, abuse or assault, death of a loved one, a house fire, and even natural disasters. Yetunde Akins, MD, DFAPA, a psychiatrist at Sky Lakes Medical Center, says between 60 and 70% of adults have experienced at least one traumatic event in their lives. Trauma is linked to PTSD, substance use, and suicide risk, as well as to heart disease, obesity, and other chronic physical conditions. It shapes how people see themselves, how much they trust others, and how they respond to care.
Trauma-informed care is an approach to medicine and mental health that takes all of that into account. Akins says instead of asking “What is wrong with you?” the question becomes “What happened to you?”
What Trauma-Informed Care Means
Trauma-informed care is built on a few core principles: safety, transparency, choice, collaboration, and especially cultural humility. Different cultures express distress in different ways: some through physical symptoms, some through spiritual explanations, some through emotional restraint. A provider who doesn’t understand that context may misread what they’re seeing.
“Care is done with the patient, not to the patient,” Akins says. “Allowing the patient to participate in treatment decisions, focusing on strengths, resilience, and recovery — that’s what trauma-informed care looks like.”
Sometimes Depression Is Actually Trauma
One of the most important things to know is that what looks like treatment-resistant depression is sometimes unresolved trauma in disguise. Social withdrawal that seems like depression could be someone avoiding triggers. Akins explains that low self-esteem that looks like a depressive symptom could be a trauma-shaped belief, such as “I am worthless” or “people will hurt me.” Loss of interest in things could be emotional numbing from trauma, rather than a chemical imbalance.
If the real problem is unresolved trauma, antidepressants alone won’t fix it. The evidence points to specific therapies instead: trauma-focused cognitive behavioral therapy (TF-CBT), prolonged exposure therapy, and EMDR (eye movement desensitization and reprocessing). When trauma is treated directly, many people who seemed treatment-resistant begin to improve.
How Healthcare Can Accidentally Make Things Worse
Akins explains how healthcare settings can unintentionally recreate the conditions of trauma: lack of control, feeling unheard, being rushed or dismissed. Small things matter more than providers often realize, for example, knocking before entering a room, asking permission before touching a patient, and not making someone retell their entire history at every new appointment. Using language carefully — calling hypervigilance “paranoia,” for example, carries a very different and stigmatizing meaning.
Dismissive responses are damaging, too. When someone shares a difficult experience and a provider says “you’re overreacting” or “it’s just anxiety,” the message the patient receives is that their experience doesn’t matter and no one believes them. Trauma-informed care means validating the experience and listening without judgment.
Your Voice Matters in Your Own Care
Trauma-informed care also means patients have rights in the exam room. You have the right to ask questions, understand your treatment options, and share the life experiences that shape your health. You can ask why you were prescribed a specific medication, what the side effects are, and whether there are other options. You can also get a second opinion.
“The best outcomes happen when care becomes a partnership between the patient and the clinician,” Akins says. “Their stories, their experiences, their concerns matter.”
Trauma-informed care is about personalized care — understanding who you are, where you come from, what you fear, and how a provider can be a genuine partner in getting you somewhere better. Know that you are empowered to fully participate in your care.
Yetunde Akins, MD, DFAPA
Dr. Akins practices psychiatry at Sky Lakes Psychiatry and Mental Health Clinic.
