White knuckles, locked hands, and a cry for help
By Cristal Quijada
Master's student, Online MPH in Population and Health Sciences
This article was originally developed for PH510: Communication Fundamentals, in the Population Health Studies online MPH program. Learn more about the storytelling series from class instructor, William D. Lopez.
I remember the first time it happened: I was in my car, one of many on a long stretch of open highway, barely able to see through the blinding tears, my chest tightening with every breath I tried to take. My hands gripped the steering wheel tightly, turning my knuckles white. And while I wondered how this tension I was feeling in my body would affect everyone else on the road, I neglected to think about how it would affect me. I could feel the panic rising, building into something so overwhelming that I felt I might lose control of everything. I thought I was having a heart attack. In my early twenties, I was in the middle of navigating an abusive relationship, and I had no idea what was happening to my body. Was it possible the two were connected?
The more I struggled to breathe, the dizzier I became, with my vision narrowing, the world around me tilting like it was slipping out from under me. My breaths came in rapid, shallow gasps, and with every attempt to inhale, it felt like I was suffocating under an invisible weight. I veered off the main road into the first residential street I could find, the houses blurring past as I slowed to a stop at the first house I found that had a car in the driveway. I stumbled out of the car, hands beginning to curl in against my will. I didn't have a phone. I knocked on the door, desperate, my voice cracking as I asked the startled stranger to call 911. Within minutes, I was in the back of an ambulance, my body betraying me further as my fingers were locking in, forearms drawn tight, upper limbs curling inward like they were folding under pressure. The paramedics placed an oxygen mask over my face as they explained that the lack of oxygen was causing severe muscle contractures. I remember the panic still clawing at my chest, but also, for the first time, a sliver of understanding: something deeper was wrong, and it wasn't just in my head.
In the emergency room, the doctors couldn't find anything physically wrong with me; it was something far more profound, the culmination of years of emotional and psychological trauma. According to the National Institute of Mental Health, panic attacks often stem from trauma and emotional stress, which, for many individuals like me, can feel overwhelming and paralyzing. I later learned that the experience I had in the car that day is common among trauma survivors and must be addressed in public health.
Growing up in a home where domestic violence and emotional neglect were daily realities, I learned early that survival was my priority. My mind couldn't focus on school because I was too busy trying to escape the chaos at home. I didn't have the words to express the pain I felt, and no one seemed to notice or care. Like so many children living in similar conditions, I was left to suffer in silence. Research shows that children exposed to abuse or neglect are at greater risk of developing mental health conditions later in life, including anxiety, depression, and post-traumatic stress disorder. These children need not just love and care, but systems that recognize their pain and offer help.
As I grew older, my trauma only deepened. At 22, pregnant with my first child, I was still stuck in an abusive relationship and struggling with debilitating panic attacks. I was terrified of my own mind, of the constant feeling that I might collapse under the weight of everything. But it was at that darkest moment that I chose to change. I enrolled in an adult education program, and despite everything, I earned my GED. That moment marked the beginning of a journey that would ultimately lead me to become a public health nurse. However, I wasn't just pursuing a career. I was reclaiming my life.
As I found hope in my path of education, I recognized that many individuals who are affected by trauma, as I was, lack access to the essential resources for healing. Currently, the health systems that are supposed to help can be confusing, making them difficult to navigate, inaccessible, and intimidating. When I work with families that need help, I see the same hopelessness I once felt. Families living in poverty, struggling with mental health issues, and trying to navigate a fractured system will often find themselves falling through the cracks. The barriers are both financial and emotional. Asking for help feels like admitting defeat when you've been taught to survive on your own. And when you finally find the services you need, will you be able to pay for them?
Even when trauma survivors recognize they need help and find appropriate services, financial barriers often prevent them from actually accessing that care. It isn't just about access; it's about equity. Those most affected by trauma are frequently least able to pay for treatment. Evidence-based therapies like Eye Movement Desensitization and Reprocessing (EMDR) are rarely covered fully by insurance, leaving survivors to face high out-of-pocket costs or time-limited sessions as stipulated by insurance companies. The result? A system where the people who need help the most face the steepest barriers.
As public health professionals, this is where we need to step in. My work with Child Protective Services and Adult Protective Services has enabled me to support individuals in crisis in a holistic manner. But it's not enough to offer individual assistance, we need a system that actively breaks down barriers for people who have lived through trauma. We need more than just a collection of programs; we need a cohesive, compassionate approach that makes resources not only available but truly accessible.
That means creating a trauma-informed, integrated care system that meets people where they are emotionally, culturally, and materially. This includes affordable, coordinated services with built-in navigation support, culturally responsive providers, and environments designed to reduce stigma and promote healing and recovery. Access to care shouldn't feel like another trauma to survive.
That's why programs like those offered by the Health Resources and Services Administration (HRSA) are among the many powerful resources; they remove barriers and open doors to a wealth of knowledge. HRSA provided me with the opportunity to pursue a career in nursing, and I am confident that with more access to programs like this, many more people could transform their lives, just as I did. We must work together to create pathways to these resources and support systems, ensuring that everyone has the opportunity to recover and thrive.
The emotional toll of trauma is often invisible. It's the fear that rises in your chest, the thoughts that spin uncontrollably in your head, and the overwhelming desire to give up because nothing seems to work. It can also be the quiet strength that comes from asking for help, the courage to keep going, and the support that can make all the difference. I've learned that healing is possible. But we cannot expect those suffering to do it alone. Public health systems must prioritize mental health and create pathways for individuals to access the support they need. Everyone has the right to heal, and this begins by fostering an environment where support is readily available and care is compassionate and cohesive.
Today, I extend the same help that I once needed. I empathize and offer hope and support, reminding people that they are not alone. My journey is one of pain, but also of healing. I now witness firsthand how lives can transform when the right resources are available and people are given the space to heal without judgment or barriers. Public health professionals play a crucial role in ensuring that everyone has access to the support and resources needed to heal and thrive.
Lead image: Photo of the author at age 4 with neighborhood children, during a time when she was already experiencing adverse childhood experiences. Photo taken by a family member.
About the author
Cristal Quijada is a master's student in the online MPH program in Population and
Health Sciences at the University of Michigan School of Public Health. She currently
works as a Public Health Nurse in California, serving as a medical expert in the field
with Child and Adult Protective Services. In this role, she conducts assessments and
investigations related to trauma, neglect, and abuse. This work has deeply inspired
her to tackle the systemic roots of childhood maltreatment.
Her lived experiences and professional journey have fueled her passion for creating large-scale educational initiatives that empower communities to recognize and intervene in cases of trauma, particularly for those unable to speak for themselves. Cristal is currently contributing to the Healthy Brain Initiative campaign for the prevention of Alzheimer’s and dementia, and she is developing a proposal for the 41st Annual San Diego International Conference on Child and Family Maltreatment.
Originally drawn to nursing by her son’s disability, Cristal’s path led her beyond the hospital setting and into the heart of community public health, where she found her calling. Her long-term goal is to design and implement innovative programs that address childhood trauma and promote healing. Outside of her academic and professional life, she finds calm and strength through hot yoga, where the intensity of the practice helps restore balance and resilience.
