Post-traumatic Stress Disorder

PTSD symptoms most often start within three months of the event. But in some cases, they don’t begin until months or years later. PTSD symptoms vary in intensity, and they may come and go throughout many years. Symptoms that last more than four weeks, cause you great distress or interfere with your daily life may be an indication that you have PTSD.

There are four primary types of PTSD symptoms:

• Reliving the event, or re-experiencing symptoms. Thoughts and memories of the event may resurface through flashbacks, hallucinations or nightmares. Certain triggers, like the anniversary date of the event, may also cause you to relive the event.
• Avoiding situations that remind you of the event. You may avoid people, places, thoughts or situations that remind you of the event. Crowds might now feel dangerous, or you might now overschedule yourself so you don’t have to think about the event. This can lead to feelings of detachment and isolation from close family and friends.
• Experiencing negative changes in beliefs and feelings. You may think of yourself, or others, differently because of the event. For example, you may not have positive or loving feelings toward other people who were once very close to you, and you may avoid relationships. You may also feel emotionally numb, lose interest in activities you once loved or have difficulty remembering certain aspect of the event.
• Feeling hyper-aroused. You might experience heightened emotions; difficulty relating to others, including feeling or showing affection; problems falling or staying asleep; outbursts of anger or irritability; or difficulty concentrating. You might also have physical symptoms like an increased blood pressure or heart rate, rapid breathing, muscle tension or nausea.

Other symptoms may include:

• Panic attacks
• Chronic pain or headaches
• Difficulty functioning in school or at work
• Substance abuse
• Depression
• Persistent thoughts of suicide

PTSD is a serious mental health condition that’s triggered by traumatic events like:

• Combat
• Childhood neglect or physical abuse
• Sexual or physical assault
• Unexpected death of a loved one
• Serious accidents
• Natural disasters (fire, tornado, hurricane, floor or earthquake)

You might already know that everyone reacts to these traumatic events differently. Your ability to manage fear and stress, and to cope with the threat posed by a traumatic event or situation, is unique to you.

Whether you develop PTSD depends on a number of factors:

• Intensity and duration of the event
• Your proximity to the event
• Strength of your reaction to the event
• Whether you felt a sense of control during the event
• How much support you received following the event

Coping with PTSD requires action – action that might seem daunting or overwhelming at first. But if you reward yourself for each small step forward, you’ll notice significant, positive changes in yourself over time. You’ll reduce your symptoms and improve your quality of life.

Try starting with these suggestions:

• Connect with trusted friends and family members. It’s easy to feel alone after you’ve experienced a traumatic event and aren’t feeling well. But isolation can make you feel worse. Staying connected to your loved ones can provide you with the support you need. You don’t necessarily have to talk about what happened. Simply sharing time with trusted friends and family members can offer healing and comfort.
• Break the cycle with regular exercise. When PTSD symptoms begin to present themselves, try exercising, even if it’s for just 20 minutes. Regular daily exercise can help reduce stress, anxiety and muscle tensions, and it improves your mood for up to 12 hours. Starting small is OK, too. Even short 10-minute bursts of activity like taking a brisk walk can have positive effects on your mood and well-being.
• Avoid self-medication. Turning to drugs or alcohol to numb your feelings will only worsen PTSD symptoms, even though it might be a tempting way to cope. Self-medication can lead to more health concerns, and it can prevent real healing.
• Take care of yourself. This means aiming for eight hours of sleep each night. Getting enough sleep each night can help you cope with difficult emotions related to the event, and it can help you recover from daily stresses. Taking care of yourself also means adopting healthy eating habits. Eating a well-balanced diet rich in complex carbohydrates (whole grains, beans, fruits and veggies) and omega 3 fatty acids (salmon, mackerel, canola and walnuts) do your body and brain good. They can help combat feelings of stress, anxiety and irritability, as well as body aches and headaches.
• Keep a journal. Writing down your thoughts, feelings and emotions can be an effective way to cope with PTSD. Research shows that writing about painful events can help reduce stress and improve health and well-being.
• Practice mindfulness. Mindfulness is a way of thinking and focusing that can help you become more aware of your present experiences, thoughts and feelings. You might have daily, routine activities that you don’t even think about like brushing your teeth or tying your shoes. Mindfulness involves paying attention to the feelings and sensations of these experiences.
  
  Mindfulness can help enhance your ability to cope with fearfulness, anxiety, stress and depression. Continually practicing mindfulness can help you become more focused and aware of the present moment, while becoming more willing to experience difficult emotions that sometimes surface after a traumatic event. Practicing mindfulness can help you become more aware of your thoughts and feelings, then easily let them go without labeling them as “good” or “bad,” and without acting on them by avoiding or behaving impulsively.
• Help others through volunteerism. By volunteering, you can make a positive impact on the health and well-being of your community – as well as your own. Research shows that volunteering helps build social networks, improve self-esteem and provide a sense of purpose and achievement. You can collect tickets at a performing arts event, or help your local animal shelter care for four-legged friends, for example. Make your volunteer experience an enjoyable one by choosing something that can bring you comfort and happiness.

Your loved one may seem like a different person than you knew before the traumatic event – he or she may be angry and irritable, or withdrawn and depressed. When your loved one struggles with PTSD, it can significantly strain your emotional and mental health. You might feel scared and frustrated about the changes you see in your loved one, or you may wonder if things will ever “go back to normal.” These feelings and worries are common.

It’s important for you to learn about PTSD so you can understand how it occurs, how it’s treated and what you can do to help. You may feel helpless, but there are many things you can do to support your loved one:

• Make your own health a priority. Changes in family life are stressful, but making your own health a priority will make it easier to cope. Make sure you eat well, exercise regularly and get plenty of rest. Staying connected to close friends, and maintain hobbies or activities that bring you joy, can help you recharge.
• Understand that withdrawal is part of the disorder. Your loved one might resist you help. Be prepared for this, and allow your loved one some space. Just make sure he or she knows you’ll be there when they’re ready to accept your help and support.
• Offer to attend doctor’s visits. If your loved one is willing, attending doctor’s visits can help you understand, and assist with, the treatment. It’s also an opportunity for you to show your love and support.
• Be willing to listen. Your loved one may not be ready, or may not want, to talk about the event, and it’s important to allow him or her this freedom. But make sure he or she knows you’re willing to listen whenever they’re ready to talk.
• Encourage and plan family activities. Taking a walk outside, watching a favorite family movie or simply eating dinner together can help your loved one feel connected, and it can help prevent feelings of isolation. You can also celebrate good events.
• Communicate, communicate, communicate. You and your family may have trouble talking about feelings, worries and everyday problems. It’s important to clearly communicate these feelings and worries in a positive manner – blame and negative talk will further complicate the situation. Here are some ways to practice clear communication:
  • Repeat what you hear to make certain you understand, and ask questions if you need to know more.
  • Put your feelings into words. Your loved one may not know you are sad or frustrated unless you’re clear about your feelings.
  • Help your loved one put feelings into words. For example, you can ask, “Are you feeling angry? Sad? Worried?”
  • Ask your loved one how you can help.
• Establish a time-out system. Your loved one may feel angry about many things. Anger is a normal reaction to traumatic events, but it can hurt relationships and make it difficult to think clearly. You can establish a time-out system for when your loved one’s anger becomes overwhelming for him or her – or you.
  • Before the time-out:
    • Decide on a time-out signal.
    • Agree that a time-out can be called at any time.
    • Agree to tell each other where you’ll be and what you’ll be doing during the time-out.
    • During the time-out, don’t focus on negative feelings. Instead, think calmly about how you’ll talk things over and solve the problem.
  • When you come back from the time-out:
    • Take turns talking about solutions to the problem, and listen to each other without interrupting.
    • Try to avoid using “you” statements because they can sound accusing. Instead, use “I” statements like “I think,” or “I feel.”
    • Be open to each other’s ideas, and don’t criticize.
    • Together, agree what solution you’ll use.