As much as we don’t like anxiety or when our body goes into fight or flight mode, our body does those things for a reason. Anxiety says, “be careful! We don’t want that bad thing to happen.” Fight or flight mode is our body going into crisis mode to try to keep ourselves safe from serious harm or death.
The problem is sometimes our body goes into fight or flight mode when we’re not in imminent danger. Anyone who has had an anxiety or panic attack knows the feeling of your body screaming OMG WE’RE UNDER ATTACK when nothing is actually happening in the moment.
With Posttraumatic Stress Disorder (PTSD), something actually HAS happened. Something incredibly traumatic has happened where there was actual death or threats to someone’s life, severe injuries, or sexual violence. With PTSD, the person’s body goes into necessary fight or flight mode during the legitimately dangerous event in order to try to keep the person safe.
The problem? Sometimes the body and mind has a hard time going back into “okay, we’re safe now” mode. The mind can find potential threats or reminders of that original threat in everyday events. The body goes into WE’RE UNDER ATTACK mode whenever anything even remotely reminds it of that original danger because it is doing its best to keep you safe.
Unfortunately, once the original trauma is over, we generally ARE safe. But the body and mind is having trouble letting go of that protection from extreme danger mode.
WHAT DOES PTSD LOOK LIKE?
THE TRAUMATIC EVENT
When most people think of PTSD we think of veterans, people in horrible car accidents, people who were mugged at gunpoint, or were in a terrorist attack. Those events can result in PTSD, but so can ongoing physical abuse in childhood, sexual assault, serious injuries or sudden catastrophic medical events (like waking during surgery or going into anaphylactic shock).
It’s important to realize that some things may feel traumatic to someone, but not all traumatic events are the types of trauma that qualify for PTSD. With PTSD, the important thing is that during the event, the person is exposed to actual or threatened death, serious injury, or sexual violence to one’s self or other people.
SYMPTOMS OF PTSD
There are four major types of symptoms for PTSD: reliving the event, avoidance symptoms, mood and thought symptoms and arousal/reactivity symptoms.
When we think of reliving the traumatic event, we often think of PTSD flashbacks when we think of reliving events. But someone with PTSD can also have nightmares or intense thoughts and emotions that come up in response to things that “trigger” memories of the trauma, like sounds, images, words, thoughts, feelings, or interactions.
Avoidance symptoms include avoiding things that might be a trigger a person to relive the event, avoiding things that remind them of the event, or anything that brings up feelings, thoughts, memories, and associations with the event.
Mood and thought symptoms can be difficulty remembering things about the traumatic event, having negative/pessimistic/fearful thoughts about the world or themselves, depressive feelings, and struggling with feelings of guilt, shame, and thoughts of self-blame. The person might not be as interested in life or activities or doesn’t enjoy things like they used to. They might feel detached or numb or not care about themselves, their lives or other people.
Arousal and reactivity symptoms can be someone often being angry and irritable. Aggression and rage can be a huge part of PTSD symptoms, especially in men. Self-destructive or dangerous behavior can also be common. Difficulty concentrating, being hypervigilant for threats or danger, and increased startle responses are also arousal and reactivity symptoms. Folks with PTSD also often have difficulties with sleep, like struggling to fall asleep or stay asleep.
WHY DO ONLY SOME PEOPLE GET PTSD?
Having PTSD has nothing to do with being weak, whiny, selfish, careless, being a “pussy,” or too sensitive. There are a ton of neurobiological factors and environmental factors that go into someone having PTSD. Just like a heart attack: some people might have perfect diets and be in great fitness and have a heart attack while other people have horrible lifestyle habits and don’t get a heart attack. Remember, humans are complex, neurobiological organisms interfacing with complicated environmental factors.
Things that can impact whether or not someone has PTSD or how severe their symptoms are? The severity of the traumatic event, how long it lasted, how hurt or at risk the person was, social supports, getting treatment, how people treated them after the trauma, other additional life stress, coping mechanisms, ability to grieve, past trauma and difficulties, and countless neurobiological factors can all impact why someone might get PTSD. Notice how NONE of those factors were about the person being weak or bad or any other judgment that people might put on someone suffering from emotional distress.
Also, some people might have mild versions of PTSD symptoms after a traumatic event, but they’re not severe enough or don’t last long enough to meet the full requirements for actual PTSD. After a traumatic experience, instead of PTSD, some people might have difficulties with grief, depression, adjustment disorders, anxiety, or panic disorders.
No matter what symptoms you have or don’t have, no matter how bad or “no big deal” you think your experience was - anyone who has lived through trauma, severely dangerous or threatening situations, or intensely painful or harmful experiences can likely benefit from therapy to help manage any symptoms and to cope with the experiences they have lived through.
TREATMENT OF PTSD
PTSD is treatable. People can learn to manage their symptoms, re-establish a new sense of safety in the world, can live without PTSD destroying with their ability to function and accomplish their goals in life.
Crisis resources can be crucial for someone with PTSD to provide support during times where they are intensely reexperiencing the trauma, struggling with crushing guilt and shame, or trying to manage severe depressive, reactive, or other mood difficulties. Here is an international list of crisis hotlines Coco the Louder put together that people can use when in acute distress or having thoughts of ending their own life: https://goo.gl/1oCLe3
THERAPY, HOW DOES IT WORK?
Sometimes when people think of therapy for PTSD, they think of sitting in a chair and talking about the details of the traumatic event and how it made them feel. That can certainly be an important part of healing from PTSD, but therapy can do a ton of things to help manage PTSD. We can identify and manage any harmful, distorted thoughts that are pouring gasoline on the fire of trauma, fear, and depressive feelings. Therapists can help find ways of coping with the intense anxiety and emotional flashbacks that come when memories come up and the person is reliving the traumatic event. There are tools for cooling off panic, tools for managing triggers, tools for getting to sleep, making yourself feel safer, learning how to talk to loved ones about your symptoms, and more. CBT therapy can be fantastic for PTSD treatment – be sure to find a therapist with experience or specialization working with folks with PTSD!
A terrible way to treat PTSD? Self-medicating. DO NOT SELF-MEDICATE. Folks with PTSD might turn to drugs or alcohol as a means of trying to dampen the intensity of their symptoms. The problem? You gotta keep using the substance or drinking in order to cope – the symptoms aren’t just going to go away on their own. You’re throwing a rug on top of the problem, you’re not cleaning it up. If you close your eyes when there’s a fire in your kitchen, the fire doesn’t go out.
And what happens when you ignore a fire? It usually grows. And then you need even MORE substances and MORE alcohol and there we begin the road to addiction and dependency.
What’s the difference between self-medicating and a doctor giving you pills? The medications prescribed by your doctor have strong scientifically-supported evidence that they can help a person with PTSD cope with the trauma and symptoms, that they can manage the symptoms without being an unhealthy escape from the problem.
“But I saw a study once that said [insert non-prescription substance or drug here] was helpful for someone with depression.” Sure, there are a lot of smaller, pilot studies here and there on a lot of substances that show some promise, but that doesn’t mean that it is 100% proven, time to start prescribing this drug. There is a ton of research that needs to be done before prescribing medications for a disorder.
Also, when a doctor prescribes you medication for PTSD, they help ensure that you are using a safe and healthy dose, help monitor for negative side effects, and often recommend therapy to help you develop complementary tools and strategies to manage your symptoms. Most people on medication for mental health disorders also use many behavioral and cognitive strategies to manage their symptoms as well.