Mental health struggles are as unique as the person dealing with them. How can help ourselves and loved ones?
Fear can change a person, inside and out. When dealing with a traumatic experience, people have different ways of coping. During an intense situation, the fight or flight response (which can be more accurately described as a series of responses such as freeze, flight, fight, fright, flag, and faint) is a well-documented reaction, that is innate to the human experience. When triggered, a person can experience an increased heart rate, rapid breathing, tense muscles, and other physiological changes. This response has value, as its function is to protect us in truly dangerous situations. However, it is all too common for a person’s nervous system to get stuck in protection mode, preventing them from healing and moving on from the trauma. When these nervous system responses continually occur in the absence of the stimulus of a traumatic event, it might be time to talk to a professional who is well-versed in PTSD.
PTSD symptoms may begin as early as one month after a traumatic event but could also take years before the first symptoms start to occur. When symptoms do begin, they often cause significant problems in day-to-day life, including social and work situations, relationships, and a person’s ability to accomplish normal tasks. According to the National Center for PTSD, post-traumatic stress disorder affects about 8 million Americans during any given year.
While it is incredibly normal to have unsettling memories, anxiety, or trouble sleeping after a traumatic event, these responses should begin to fade as time goes on. PTSD symptoms are generally grouped into four different types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Often movies and television will focus on the intrusive memories element of PTSD as a way to help the viewer see what PTSD might look like. Usually, the characters will have a flashback to the traumatic event where they are reliving the experience. While this does indeed happen, it is an oversimplification of a very complex reaction.
Sufferers of PTSD can experience additional symptoms that are incredibly disruptive to life, due to their body’s constant state of agitation. These can include:
As if this wouldn’t be a lot for anyone to deal with, PTSD sufferers often have negative changes in their thinking and relationships. Many PTSD sufferers deal with depression-like symptoms, and it is often difficult to determine where PTSD ends and depression begins. At bare minimum the two disease states are comorbid, meaning they both can be present at the same time. This means that on top of being easily agitated and irritable, sufferers might be having negative thoughts about themselves, lose hope in the future, or no longer be interested in things they once enjoyed. This combination of makes it very difficult to maintain close relationships, so sufferers can often isolate themselves as they begin to pull away from family members and close friends. This is clearly a dangerous combination, with as many as 27% of people diagnosed with PTSD having attempted suicide. What then, is to be done those struggling with the pain of PTSD?
It is important to understand what stage of PTSD the sufferer is in. The five states are:
This Emergency Phase occurs at the time of the traumatic event or immediately after the event. The brain will go into survival mode and a person often reacts purely on instinct. While this can aid in survival, it is important to understand that a person often is not acting rationally at this time. This phase can last for minutes or hours, and a person should not be expected to have fully processed or even understood what has just happened. Often times they may focus on securing their immediate safety and removing themselves from the traumatic experience.
This phase, just like the Impact stage, is geared around survival. Often, people suffering from PTSD will attempt to protect themselves through denial that the event ever occurred. By avoiding the reality of the situation, the mind is attempting to ensure it can’t be hurt by removing the high stress and anxiety associated with the event. Recovery cannot begin without acknowledging the reality of the trauma. The longer the brain stays in this phase the more harm it can cause. Without an outlet for the emotions of trauma, the mind and body are in constant duress and can experience a wide range of symptoms, including:
This stage is where the sufferer begins acknowledging their trauma. With the brain no longer able to deny the reality of the trauma, sufferers begin looking for ways to self-medicate in hopes of numbing the pain. This stage finds many sufferers engaging in self-destructive behaviors like drugs and alcohol, hoping to avoid the thoughts and emotions from the trauma. Additionally, they may have survivor’s guilt and have little regard for their own safety. Typically, this is the stage where family members and support people begin advocating for the sufferer to seek out help. It then is up to the sufferer to decide if they will do the work required for recovery or if they will continue in their acute suffering.
This stage is where the sufferer begins entering recovery. This includes gaining a new level of understanding and acceptance about how the trauma has impacted and affected their lives. With this recognition, coping mechanisms can be implemented with the aim of returning to a daily routine.
This stage is marked by a person’s ability to implement mechanisms and strategies in daily life. Coping strategies don’t always remain constant and may need to be adjusted as the sufferer enters new phases of life and encounters unexpected stressors. The recovery stage does not mean symptoms of PTSD are gone, rather it means the sufferer is able to manage symptoms. The ultimate goal is to allow sufferers the ability to take part in their lives with feelings of control, knowing they are capable of dealing with symptoms that can arise in different areas of life. Success in the recovery phase might look like the ability to go to work, maintain personal hygiene, and being an active participant in meaningful interpersonal situations.
Trauma-focused psychotherapies are typically the most recommended type of treatment. These treatments use different techniques to help a person process the trauma of the event. The treatment focuses on the memory of the event and its meaning. This can include visualizing, talking, or thinking about the traumatic memory, or focusing on changing unhelpful beliefs about the trauma. The trauma-focused psychotherapies with the most success include:
Medications can also be a helpful tool in treating some of the symptoms associated with PTSD. Antidepressants called SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) can help regulate the brain chemicals that affect mood. The antidepressant medications most commonly prescribed for PTSD are Sertraline (Zoloft), Paroxetine (Paxil), Fluoxetine (Prozac), and Venlafaxine (Effexor).
There are other options available that don’t have strong research yet, but they could be discussed if traditional treatment routes aren’t working. This could include hyperbaric oxygen therapy or an integrative medicine approach like acupuncture. The National Center for PTSD has a treatment guide with comparisons of different approaches that can be found here.
Few people will go through life without experiencing trauma of some kind. Whether this trauma comes via the death of loved ones, physical violence, sexual assault, military combat, an automobile accident, school or workplace violence, the ways a person can be exposed to trauma are extensive. Finding support groups, reaching out for help through medication or therapy, or practicing grounding techniques can all help in the fight against the effects of trauma. In the event that this trauma has a person in danger of self-harm or is a danger to others, call 911 or head to the nearest emergency room.
The following resources are also available 24 hours a day, 365 days a year:
National Suicide Hotline: (800) 273-TALK (8255)
Crisis Text Line: Text HOME to 741741
National Hopeline Network: (800) 442-HOPE (4673)