In this feature, we’ll provide an overview of PTSD (Post Traumatic Stress Disorder) with real testimonials and concise, easy-to-read information and advice about treatment options. Whether you are suffering with PTSD, know somebody who is, or just looking to learn, we sincerely hope it helps.
“For months after the attack, I couldn’t close my eyes without envisioning the face of my attacker. I suffered horrific flashbacks and nightmares. For four years after the attack I was unable to sleep alone in my house. I obsessively checked windows, doors, and locks. By age 17, I’d suffered my first panic attack. Soon I became unable to leave my apartment for weeks at a time.”
What is PTSD?
PTSD stands for Post-Traumatic Stress Disorder. It is an anxiety disorder that occurs in cases where an individual has experienced (or been otherwise exposed to) stressful, frightening or distressing events. Although it is best known for affecting veterans and military personnel exposed to combat situations, PTSD can actually occur from a varied and diverse array of circumstances, including:
- Road accidents
- Burglary/Home invasion
- Serious health problems
- Experiences during childbirth
- Being kidnapped/held hostage
- Surviving a natural disaster
- Losing a loved one
- Any event in which a person fears for their life
In simple terms, PTSD occurs when a person’s mind is unable to integrate unwanted memories in the usual way. These memories (which can include emotional reactions and sensory experiences) can then intrude upon that person’s life in a variety of different ways, including flashbacks, nightmares, emotional outbursts and physical symptoms such as shaking or panic attacks. The condition is far more common than most people realize, as it develops in about 1 in 3 people who experience severe trauma.
What Causes PTSD?
We now know that trauma, of any kind, changes both the brain and the body. Every trauma-related neural pathway, even if it has lain dormant for a considerable period of time, has the potential to reactivate.
In the ‘Triune’ (or ‘three part’) brain model, the brain is separated into three parts, the reptilian or primal (responsible for instinctive and autonomic behavior), paleomammalian or emotional (which processes emotions and senses), and the neomammalian or rational brain (which controls cognitive learning, decision-making, learning and memory).
During a traumatic event, the primal brain takes over, mainly to facilitate a quick escape. You often hear survivors of natural disasters or terrorist attacks saying things like “I didn’t think, I just acted.” This is because the primal brain forcibly shuts down all non-essential body and mind processes. The sympathetic nervous system then releases all the ‘fight or flight’ hormones necessary to survive. This is called “reactive mode.” Once the person has survived, the parasympathetic nervous system begins to reassert control, reducing the stress hormones now that the threat has passed. This is called “responsive mode.” In some cases where PTSD develops, the transition from reactive to responsive mode never actually occurs. Instead, the primal brain maintains its grip on the individual, giving them a constant feeling of being under threat.
Imagine that your brain never stopped feeling like it did when that car almost hit you, or when that gang of big kids cornered you in childhood, or when somebody you loved was about to die and you were powerless to help them. Now imagine those feelings lasting years, even decades. That, in effect, is PTSD.
“Even after I moved to Germany, removing myself from the city and the country where the burglary occurred, the robbery stayed with me. It took weeks before I stopped having bad dreams or stopped eyeing strangers on the street near my house. The most valuable thing the burglars took was my sense of security.”
Generally speaking, PTSD symptoms fall into four main groups. These are:
- Intrusive thoughts (unwanted memories or flashbacks)
- Mood alterations (becoming excessively negative or irritable)
- Hyperarousal (being constantly ‘on edge’ and having an exaggerated startle response)
- Avoidance (going to great lengths to avoid anything that reminds the sufferer of the traumatic events)
PTSD may present via nightmares, flashbacks, mood swings, violent fits of rage, increased heart rate, pain, chest pains, panic/anxiety attacks, sweating, nausea, shaking, memory loss, forgetfulness, insomnia, shortness of breath, crying, emotional numbness, isolating oneself from friends, family and colleagues, low self-esteem, self-harm, self-destructive behavior and abuse of alcohol or drugs.
Some PTSD sufferers experience complex feelings of guilt or shame relating to their experiences. They can exhibit trust issues or feelings that nobody understands them. Some feel that they can never be safe. They may become suspicious, even paranoid. In some cases, PTSD sufferers have become completely unable to express affection for other people.
In young children, PTSD can present through bedwetting or other accidents, anxiety about being separated from a parent or trusted adult, or re-enactment of the trauma through play.
How to Tell if you Have PTSD
“The depression totally immobilizes me. I can’t even pick up a razor to shave, unable to look in the mirror; I question my existence. It becomes so intense that I have to go to bed for a couple of days and wait for it to pass.”
If you’ve experienced a traumatic event at any point (even during childhood), you may develop PTSD as a result. If you are experiencing any of the symptoms described above on any kind of a regular basis, you may already have PTSD. If you have doubts, you should consult your doctor.
A good idea would be to talk to a trusted friend, family member or partner. Ask them if you seem different or if your behavior has changed. Think back to a time before the traumatic event took place. Did you do anything differently? How has the event changed you? The answers may surprise you.
“Triggers can come from anywhere at any time… a smell, a look/glance, a vibe, a dream… how someone treats you. You are unable, as hard as you try, to turn it off.”
After a traumatic event has taken place, it is normal to experience feelings of anxiety, sadness or stress. Sometimes the event will play on your mind or stop you from sleeping, but these effects should only be temporary. It is also normal for some people who don’t have PTSD to exhibit some of the symptoms of PTSD. This does not necessarily mean that they have the disorder.
It is very common these days for people to look up their symptoms online and immediately assume the worst (headache = brain tumour) and this is as true for mental ailments as it is for physical ones. Many PTSD symptoms are also symptoms of stress, for example. The criteria for diagnosing PTSD consists of very specific points, which must be fulfilled by the patient in order to be formally diagnosed. However, only a medical professional can do this.
What Does a PTSD Diagnosis Mean?
“I was diagnosed by my GP with PTSD a few weeks after the death of my father who died very suddenly, following a family outing to the local pub for lunch. He collapsed in front of us and we had to administer CPR at the scene while waiting for the ambulance. He died on his way to hospital.”
If you have an unpleasant or frightening experience, it is normal for your emotional reaction (e.g. fear, panic, anger etc.) to outlast the event itself. Usually, these feelings will fade over time. However, if they do not, you could be experiencing PTSD.
Being diagnosed with PTSD (or any other psychiatric disorder, for that matter) does not make you ‘crazy’ – nor is it a sign of weakness. PTSD does not describe cowardice or even an ‘inability’ to deal with unpleasant events. It is the natural consequence of a human mind that is trying to process a traumatic experience.
Additionally, you don’t have to directly experience trauma in order to develop PTSD. If a person close to you experiences trauma of any kind, it is possible for you to develop PTSD from this. In some instances, police officers have developed PTSD after repeated exposure to the unpleasant details of cases, even though they were never physically present for any of the events described. This is called secondary trauma.
What Does PTSD Feel Like?
Living with PTSD can be a constant challenge. Some sufferers have described it as being similar to the feeling of anxiety or alertness after someone or something suddenly scares you, except that it never goes away. Others describe a feeling of being constantly on guard.
According to some descriptions, it is a feeling of being perpetually trapped in a terrible moment of time, for others, it is, quite literally, a waking nightmare.
“It’s like you’re tidying your house before a dinner party. But there’s this one item that’s just out of place. The doorbell rings. It’s your guests. You just shove that item into the closet and tell yourself you’ll deal with it later.
You start to do this every time. Filling the closest more and more. Saying to yourself that you’ll deal with it later. The closet becomes so full that it starts to creak. That’s your bodies way of saying ‘Hey! You got a lot of stuff to deal with! It’s time!’ But you keep thinking it’s fine.
Out of sight, out of mind. You ignore the closet. Until one day it’s too much. The closet bursts. And everything comes flying out in weird and wacky ways. Panic attacks. Dissociative episodes. Depression. Anxiety. Flashbacks. Intrusive thoughts. And then you’re left lying on the floor with all the items that were stuffed into the closet, splattered around you, forced to finally accept what happened. And forced to finally deal with it, forced to clean up the items around you and find appropriate places for each thing. And then over time, slowly, you learn what to do with each item, and how to deal with each thing, uniquely.”
How Long Does it Last?
“I found my therapist very easy to talk to, understanding, a good listener and very helpful. The treatment he provided definitely helped me get over this traumatic time in my life.”
There is no set duration for PTSD, but the good news is that it rarely lasts forever. Modern therapy has a high success rate and can at least lessen PTSD symptoms. Very often, PTSD can be completely overcome. It takes time and hard work, but the condition is actually very treatable. Symptoms are unlikely to go away by themselves, however. Treatment of some kind is most likely essential.
Factors that influence the duration of PTSD include the amount of times the trauma was experienced, whether it was accidental or intentional, whether or not the initial trauma was sexual in nature, prior experience of other mental conditions such as anxiety or depression, the level of social support a person has and their willingness to engage others for said support.
As stated earlier, each case is different, so there is no viable timetable.
“The thing that has been most helpful on this journey has been counseling. Friends and family can’t always understand what and why I feel the way I do, but counselors are always there to listen. I have been in therapy almost a year now, yet I do believe that you need to find a counselor you can click with. I tried a couple before I found the right one, but just knowing you can share with someone, who is not going to judge you and be there for you through dark times, has really helped me.”
PTSD can be treated, and even defeated. Many cases of PTSD are not lifelong and, even in cases where the condition persists, therapy can greatly reduce the symptoms.
Therapists pursue three main goals when treating a PTSD patient. The first is to improve the symptoms, the second is to teach the patient skills that can deal with the symptoms and the third is to restore the individual’s self-esteem.
The most common treatment technique used by PTSD sufferers is Cognitive Behavioral Therapy (CBT). CBT teaches methods by which the patient can ‘take back their mind’ as it were. Often, negative thought patterns continue unchallenged in the sufferer’s mind, even as she or he yearns desperately for peace. CBT teaches the patient to break these patterns, using techniques that have a very high success rate with PTSD patients. Stress Inoculation Training (SIT) is part of CBT, and teaches a number of stress reduction techniques (such as breathing to stimulate the vagus nerve). These techniques are proven to reduce anxiety.
Other forms of treatment available include support groups. Some group therapy can also be very useful, as it helps patients to talk with people that have experienced the same thing. Sometimes, simply understanding that their feelings aren’t unique to them and are, in fact, a normal human response to a perceived threat, can be a huge step on the road to recovery.
Cognitive Processing Therapy (CPT) is a 12-week program in which the patient is asked to talk through the traumatic event in detail and also to write their experiences down. This helps a therapist to highlight unhelpful ideas and thought patterns that are impeding the patient’s recovery.
Prolonged Exposure Therapy (PET) helps the patient to confront the event(s) and their feelings about it/them. This is mostly used in cases of avoidance. Patients are recorded describing their trauma and then listen to the recordings at home, this helps them face up to the past and put it behind them.
If you really don’t feel that you can talk about what happened (a lot of people can’t – this is a common PTSD symptom), you can receive Eye Movement Desensitization and Reprogramming (EMDR) treatment. For this therapy, the patient is asked to think about their trauma while a therapist encourages them to replace negative thoughts and attitudes with positive ones. It usually takes about three months to be effective.
Many of the anxiety reducing techniques mentioned here are available online, so even if you feel that you cannot face a therapist right now, you can work on reducing your anxiety this way until you can.
Remember also that therapy is confidential – and that there’s nothing you can tell a professional therapist that they haven’t heard before. Whatever you do, don’t feel that you can’t go through with therapy, or that you’re a ‘lost cause’ if one particular technique doesn’t yield results. You are much stronger than you think you are.
“I now understand why I behave the way I do. I believe it was a very important part of my recovery, as I have been given the tools to help myself and put them to use as soon as I could. I have learned to recognize certain feelings, which I’ve discovered are triggers, and stop any negative behavior.”
Often, PTSD arrives in the form of habits. Because the patient thinks about the event so often, they have a habitual way of relating to it and experiencing thoughts about it. Avoidance, too, can become habitual, as can low self-esteem, self-destructive behavior and many other PTSD symptoms. Over time, PTSD becomes a part of you, but it doesn’t have to stay that way.
Imagine a person that is in the habit of eating junk food at all times of the day or night, they will gain weight and suffer the associated health problems from this habit. However, if they can instead change their habits to mainly eating healthy food and at set times in the day, they will lose weight and suffer less as a result. Your mind works in basically the same way. The traumatic event is in the past; it now exists only as a memory. Change the habitual way you think about the event – and you can change what the memory means to you.
If you are experiencing regular flashbacks, it helps to learn some breathing exercises. It also helps to carry an object that reminds you of the present. Use it to remind yourself that you are somewhere else now, not still experiencing past trauma. Assure yourself that you are safe and (if you can) take comfort in something that soothes you. Try also to focus on your surroundings, or even describe them out loud. Stay safe in the moment and try not to let your mind drift from the present. It may also help to keep a diary because this will help you to identify your triggers.
Knowing your triggers is very important. A trigger is something that brings about your PTSD symptoms (often in the form of flashbacks). It could be anything, from an anniversary that reminds you of the event, to a smell, or even a song on the radio. Once you identify these triggers, you have taken a major step forward. Not only can these triggers be better avoided once you understand them, but it will also now be easier for a therapist to understand and help treat your symptoms.
Developing a routine for sleep and preparing your mind and body for bed each night can also help. Sleep is enormously beneficial to the body and mind. This will be difficult at first, but keep in mind that all things are possible with practice.
It will also help if you can confide in someone. This could be a therapist or a support group, but these things work particularly well when balanced against the support of a trusted friend, partner or family member.
You might also consider the practice of gratitude. Gratitude, as they say, is a habit that becomes a way of life. To start off, simply spend 5 – 15 minutes each day mentally or verbally listing things you are grateful for. Eventually, this process internalizes and sees you focusing more on what works in your life than what doesn’t. You need not add any kind of religious or spiritual element, simply be grateful and happy to be alive. It sounds a bit mad, but trust us – it works. Meditation can also be greatly beneficial.
Avoid abusing alcohol and/or drugs. These things may feel as if they help, but they really don’t, especially over the long term. As a PTSD sufferer, you are in a precarious place – and these substances can worsen your situation very quickly.
Try also to improve your diet and, where possible, get more exercise (running can be especially useful). These things affect the body in several key ways – and actually contribute to a person’s happiness and positive mental state in some surprising ways.
Above all, be patient. Developing mental habits deliberately takes both time and effort. You will slip up, you will have bad days – and it is difficult at first, but stick with it. Have faith in yourself and hope for the future and you’ll rarely be disappointed.
How to Support Someone who has PTSD
“Being the partner of someone who has PTSD can be challenging — and frustrating — for many reasons. You want to take away their pain, but you’re also dealing with your own guilt at needing to care for yourself, too.”
PTSD can – and has – torn families, relationships and entire lives apart. Even today, it is still a very misunderstood disorder. In many circles, mental health is still a taboo subject and is very difficult for people to talk about.
Caring for someone with PTSD can be very difficult. First of all, keep in mind that it is neither your job, nor your duty to cure or fix the person. Your job is to provide social support and help, nothing more. Do not pressure the person into talking. If they are reluctant or unwilling, this will likely cause more problems than it solves.
Encourage normalcy in their life. Remind them if they haven’t indulged their hobbies in a while and gently encourage them to socialize with others. It may also help to find regular activities you can do together, such as fitness classes, art classes or regular shopping trips – whatever you both enjoy. If you don’t have the money, try walking or having ‘movie nights’ at home.
Be patient with them. You may have to endure some difficult behavior – just keep in mind that by not reacting negatively, you’re doing them a favor. Don’t let yourself be pushed around or abused in any way, but equally don’t go on the offensive. Simply remove yourself if the situation becomes too negative, but always keep the lines of communication open when you do. It helps to understand and anticipate their triggers and watch for signs of anger, stress or discomfort.
Listen to them, but don’t give them instructions on how to cope. Everyone is different. Don’t blame all their/your problems on PTSD. The condition may contribute to the problems, but it won’t be the entirety of them. Don’t turn the conversation around to your own experiences; even if they are the same as the other person’s. Everyone is unique, including the way we relate to and process trauma.
Above all, take time for yourself and look after yourself. Your life is just as important as anybody else’s. You may feel duty-bound to care for the person every waking minute, but you will soon burn out if you try to – and you could end up invoking feelings of guilt in the other person if you do. Keep yourself as fit and rested as possible, remain engaged with your hobbies and interests, take time for yourself. Keep empathy and compassion at the core of everything you do.
Who’s at Risk?
Anybody can experience post-traumatic stress disorder. On average, women are exposed to more ‘high impact’ trauma from a younger age than men, which explains why women experience more PTSD. According to the latest research, men are most likely to develop PTSD symptoms between the ages of 41 and 45, whereas women are more likely to do so between 51 and 55. Common causes of PTSD include car accidents, assaults, bullying, muggings, home invasion, seeing others being hurt or killed, or a painful bereavement.
You are at a greater risk of developing PTSD if you:
- Experience the trauma repeatedly instead of just once
- Are physically hurt as a result of the trauma
- Push family, friends and therapists away, isolating yourself
- Are dealing with extra stress at the time the trauma occurs (e.g. money worries, a break-up or a bereavement)
- Have previously suffered with anxiety or depression
What is Complex PTSD?
“Particularly abusive parents deepen the abandonment trauma by linking corporal punishment with contempt. Slaveholders and prison guards typically use contempt and scorn to destroy their victims’ self-esteem. Slaves, prisoners, and children who are made to feel worthless and powerless devolve into learned helplessness and can be controlled with far less energy and attention. Cult leaders also use contempt to shrink their followers into absolute submission after luring them in with brief phases of fake unconditional love.” – Excerpt from the book ‘Complex PTSD: From Surviving to Thinking’ by Pete Walker.
Complex PTSD (CPTSD) usually occurs when a person has repeatedly experienced traumatic events over an extended period of time. This is especially the case if the trauma occurred during the person’s childhood. However CPTSD is not limited to instances of childhood trauma.
In cases of child abuse, neglect or abandonment, CPTSD can be worse if a parent or carer inflicted the trauma upon the child and if that child was otherwise alone when the trauma occurred. It can be especially damaging if the person is still in contact with those responsible for the trauma.
CPTSD manifests in much the same way as ‘standard’ PTSD (if such a thing exists), but can be more difficult to manage and treat due to the repeated nature of the trauma that caused it.
Some symptoms of CPTSD include:
- Physical symptoms, such as headaches, dizziness or nausea
- Avoiding friends and family
- Feelings of hostility or distrust towards the world
- Feeling that nobody can understand your experience
- Being easily distracted
- Difficulty controlling emotions
- Feelings of worthlessness
- Depersonalization or other dissociative feelings
- Suicidal thoughts and feelings
Many people with CPTSD suffer from profound trust issues stemming from their negative encounters with other people. This can make them slightly harder for a therapist to treat. However, even in the most extreme cases, CPTSD can still be treated and the patient’s quality of life can almost always be improved.
It’s Not Too Late
“I was diagnosed with post-traumatic stress disorder earlier this year. I realize now that I’ve been ignoring the symptoms for a long time. I was partly in denial and partly worried about telling people because of their reaction. I refused to tell work what was going on until I ended up in hospital. I was aware of the stigma around mental health at my workplace and kept everything a secret.”
Information available here should only be used as a starting point. Forums and social media groups can be supportive and useful, of course, but they will be very unlikely to provide you with the ability to treat yourself. Sooner or later, you will need to see a therapist. Remember, it is never too late to seek help. You are more supported, loved and respected than you probably think. Never be afraid to let people surprise you.
If you feel you are in crisis, please call the National Suicide Prevention Lifeline now at 1.800.273.TALK (8255), or contact the Crisis Text Line by texting “HOME” to 741741 in the US (686868 in Canada). If you are in an emergency, call 911 or go to your nearest emergency room.
This post is an adaptation of an article on WorkingTheDoors.co.uk. Clickhere to view the author’s original work.