What is Post Traumatic Stress Disorder (PTSD)?
Post Traumatic Stress Disorder (PTSD) When people experience or witness a traumatic event such as abuse, a natural disaster, or extreme violence, it is normal to be distressed and to feel “on edge” for some time after this experience. Some people who experience traumatic events have severe symptoms such as nightmares, flashbacks, being very easily startled or scared, or feeling numb/angry/irritable/distracted. Sometimes these symptoms last for weeks or even months after the event and are so severe that they make it difficult for a person to work, have loving relationships, or “return to normal.” This is when a person may be suffering from PTSD. Many people with PTSD have difficulty discussing their symptoms because they may be too embarrassed or scared to recall their trauma. This is common in victims of sexual abuse and in combat veterans.
PTSD has been referred to as "shell shock" or "battle fatigue" and was first brought to public attention by war Veterans. It is a complex and debilitating psychological disorder in which the affected person's memory, emotional responses, intellectual processes, and nervous system have all been disrupted by one or more traumatic experiences.
The primary cause of PTSD is suffering from a life-changing traumatic event. It is commonly seen in military personnel during wartime. Psychological, genetic, physical, and social factors are involved. PTSD changes the body's response to stress. It affects the stress hormones and chemicals that carry information between the nerves.
This disorder does not occur to any specific group of people, nor is it exclusive to men, women, or children. PTSD can occur in anyone. It can also occur in victims of natural disasters, rape, kidnapping, physical assaults, unexpected death of a loved one, terrorist attacks, car accidents, plane crashes, sexual abuse, childhood abuse or neglect, and other traumatic events.
STEPHEN COCHRAN "PIECES"
Song written from personal experience and living with PTSD
NOTE: PTSD is a serious mental health condition that often requires professional evaluation and treatment. PTSD Coach is not intended to replace needed professional care.
The questionnaire used in PTSD Coach, the PTSD Checklist (PCL), is a reliable and valid self-report measure used across VA, DoD, and in the community, but it is not intended to replace professional evaluation.
Providing you with facts and self-help skills based on research.
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Who created PTSD Coach?
PTSD Coach was created by the VA's National Center for PTSD in partnership with the Department of Defense's National Center for Telehealth and Technology.
Most common signs and symptoms of PTSD...
• Nightmares
• Intense anxiety and panic attacks
• Sudden mood changes
• Angry outbursts
• Avoidance of places, friends, and thoughts of the event
• Scary thoughts you can't control
• Lack of interest in activities
• Detachment from others
• Insomnia
• Jumpy or easily startled
• Depression
• Guilty feelings
Active coping skills for PTSD:
A National Center for PTSD Fact Sheet, By Joe Ruzek, Ph.D.
Because PTSD symptoms seldom disappear completely, it is usually a "continuing challenge" for
survivors of trauma to cope with PTSD symptoms and the problems they cause. Survivors often learn
through treatment how to cope more effectively.
Recovery from PTSD is an ongoing, daily, gradual process. It doesn't happen through sudden insight or
"cure." Healing doesn't mean that a survivor will forget war experiences or have no emotional pain when
remembering them. Some level of continuing reaction to memories is normal and reflects a normal body
and mind. Recovery may lead to fewer reactions and reactions that are less intense. It may also lead to a
greater ability to manage trauma-related emotions and to greater confidence in one's ability to cope and
even help others.
When a trauma survivor takes direct action to cope with problems, he or she often gains a sense of
personal power and control. Active coping means recognizing and accepting the impact of traumatic
experiences and then taking concrete action to improve things. Positive coping actions are those that help
to reduce anxiety and lessen other distressing reactions. Positive coping actions also improve the situation
in a way that does not harm the survivor further and in a way that lasts into the future.
Positive coping methods include:
Learning about trauma and PTSD: It is useful for trauma survivors to learn more about PTSD and how it
affects them. By learning that PTSD is common and that their problems are shared by hundreds of
thousands of others, survivors recognize that they are "not alone", weak, or crazy. When a survivor seeks
treatment and learns to recognize and understand what upsets him or her, he or she is in a better position
to cope with the symptoms of PTSD.
Talking to another person for support: When survivors are able to talk about their problems with others,
something helpful often results. Of course, survivors must choose their support people carefully and clearly
ask for what they need. With support from others, survivors may feel less alone, feel supported or
understood, or receive concrete help with a problem situation. Often, it is best to talk to professional
counselors about issues related to the traumatic experience itself; they are more likely than friends or
family to understand trauma and its effects. It is also helpful to seek support from a support group. Being
in a group with others give the opportunity to contribute to the recovery of other survivors of trauma.
Reaching out and asking for assistance:
Talking to your doctor about trauma and PTSD is part of taking care of yourself. Your doctor can take care
of your physical health better if he or she knows what it is that you are going through. Your doctors can
often refer you to more specialized and expert help.
Practicing relaxation methods: These can include muscular relaxation exercises, breathing exercises,
meditation, swimming, stretching, yoga, prayer, listening to quiet music, spending time in nature, and so
on. While relaxation techniques can be helpful, they can sometimes increase distress by focusing attention
on disturbing physical sensations or by reducing contact with the external environment. Be aware
that while uncomfortable physical sensations may become more apparent when you are relaxed, in the
long run, continuing with relaxation in a way that is tolerable (i.e., interspersed with music, walking,
or other activities) helps reduce negative reactions to thoughts, feelings, and perceptions.
Increasing positive distracting activities: Positive recreational or work activities help distract people from
his or her memories and reactions. Artistic endeavors have also been a way for many trauma survivors
to express their feelings in a positive, creative way. This can improve your mood, limit the harm
caused by PTSD, and help you rebuild your life. It is important to emphasize that distraction alone is
unlikely to facilitate recovery; active, direct coping with traumatic events and their impact is also important.
Taking prescribed medications to tackle PTSD: One tool that many with PTSD have found helpful is
medication treatment. By taking medications, some survivors of trauma are able to improve their sleep,
anxiety, irritability, anger, and urges to drink or use drugs.
Sometimes PTSD symptoms worsen and ordinary efforts at coping don't seem to work. Survivors may feel
fearful or depressed. At these times, it is important to reach out and telephone a counselor, who can help
turn things around. If you don't ask them, they won't know what you need.
VERY IMPORTANT: Negative coping actions help to perpetuate problems. They may reduce distress
immediately but short-circuit more permanent change. Some actions that may be immediately effective may
also cause later problems, like smoking or drug use. These habits can become difficult to change. Negative
coping methods can include isolation, use of drugs or alcohol, workaholism, violent behavior, angry
intimidation of others, unhealthy eating, and different types of self-destructive behavior (e.g., attempting
suicide). Before learning more effective and healthy coping methods, most people with PTSD try to cope with
their distress and other reactions in ways that lead to more problems.
The following areas show negative coping actions (scratch the negative):
Use of alcohol or drugs: This may help wash away memories, increase social confidence, or induce sleep, but
it causes more problems than it cures. Using alcohol or drugs can create a dependence on alcohol, harm
one's judgment, harm one's mental abilities, cause problems in relationships with family and friends, and
sometimes place a person at risk for suicide, violence, or accidents.
Social isolation: By reducing contact with the outside world, a trauma survivor may avoid many situations that
cause him or her to feel afraid, irritable, or angry. However, isolation will also cause major problems. It will result in
the loss of social support, friendships, and intimacy. It may breed further depression and fear. Less participation in
positive activities leads to fewer opportunities for positive emotions and achievements.
Anger-Like isolation: Anger can get rid of many upsetting situations by keeping people away. However, it also
keeps away positive connections and help, and it can gradually drive away the important people in a person's life. It
may lead to job problems, marital or relationship problems, and the loss of friendships.
Continuous avoidance: If you avoid thinking about the trauma or if you avoid seeking help, you may keep distress
at bay, but this behavior also prevents you from making progress in how you cope with trauma and its
consequences.
Recommended Lifestyle Changes: Taking Control - Those with PTSD need to take active steps to deal with their
PTSD symptoms. Often, these steps involve making a series of thoughtful changes in one's lifestyle to reduce
symptoms and improve quality of life.
Positive lifestyle changes include:
Calling about treatment and joining a PTSD support group: It may be difficult to take the first step and join a PTSD
treatment group. Survivors say to themselves, "What will happen there? Nobody can help me anyway." In addition,
people with PTSD find it hard to meet new people and trust them enough to open up. However, it can also be a
great relief to feel that you have taken positive action. You may also be able to eventually develop a friendship with
another survivor.
Increasing contact with other survivors of trauma: Other survivors of trauma are probably the best source of
understanding and support. By joining a survivors organization (e.g., veterans may want to join a Veteran's
organization) or by otherwise increasing contact with other survivors, it is possible to reverse the process of
isolation and distrust of others.
Reinvesting in personal relationships with family and friends: Most survivors of trauma have some kind of a
relationship with a son or daughter, a wife or partner, or an old friend or work acquaintance. If you make the effort
to re-establish or increase contact with that person, it can help you reconnect with others.
Changing neighborhoods: Survivors with PTSD usually feel that the world is a very dangerous place and that it is
likely that they will be harmed again. It is not a good idea for people with PTSD to live in a high-crime area because
it only makes those feelings worse and confirms their beliefs. If it is possible to move to a safer neighborhood, it is
likely that fewer things will set off traumatic memories. This will allow the person to reconsider his or her personal
beliefs about danger.
Refraining from alcohol and drug abuse: Many trauma survivors turn to alcohol and drugs to help them cope
with PTSD. Although these substances may distract a person from his or her painful feelings and, therefore,
may appear to help deal with symptoms, relying on alcohol and drugs always makes things worse in the end.
These substances often hinder PTSD treatment and recovery. Rather than trying to beat an addiction by yourself, it
is often easier to deal with addictions by joining a treatment program where you can be around others who are
working on similar issues.
Starting an exercise program: It is important to see a doctor before starting to exercise. However, if the physician
gives the OK, exercise in moderation can benefit those with PTSD. Walking, jogging, swimming, weight lifting, and
other forms of exercise may reduce physical tension. They may distract the person from painful memories or
worries and give him or her a break from difficult emotions. Perhaps most important, exercise can improve self
esteem and create feelings of personal control.
Starting to volunteer in the community: It is important to feel as though you are contributing to your community.
When you are not working, you may not feel you have anything to offer others. One way survivors can reconnect
with their communities is to volunteer. You can help with youth programs, medical services, literacy programs,
community sporting activities, etc.
Ways you can help...
• Learn as much as you can about PTSD. Knowing how PTSD affects people may help you understand what your
loved one is going through. The more you know, the better you and your friend or family can handle PTSD.
• Tell your loved one you want to listen and that you also understand if he or she doesn't feel like talking.
Plan activities together, like having dinner or going to a movie or something of their choosing.
• Take a walk, go for a bike ride, or do some other physical activity together. Exercise is crucial for their health and
it helps to clear the mind.
• Offer to go to doctor visits with your loved one. You can help keep track of medicine and therapy, and you can
be there for support.
• Your loved one may not want your help. This may happen often and when it does, keep in mind that withdrawal
can be a symptom of PTSD.
• A person who withdraws may not feel like talking, taking part in couple or group activities, or being around
others. Give him/her space, but let them know that you "will" always be ready to help.
PTSD Coach has now been downloaded over
100,000 times in 74 countries around the world.
The PTSD Coach app can help you learn about and manage
symptoms that commonly occur after trauma.
Features include:
• Reliable information on PTSD and treatments that work.
• Tools for screening and tracking your symptoms.
• Convenient, easy-to-use skills to help you handle stress symptoms.
• Direct links to support and help.
• Always with you when you need it.
Download the mobile app:
PTSD Coach - US Department of Veterans Affairs (VA)
Free PTSD Coach download from:
iTunes (iOS)* and Google Play (Android)*
How to use PTSD Coach
Together with professional medical treatment, PTSD Coach provides you dependable resources you can trust. If you have, or think you might have PTSD, this app is for you. Family and friends can also learn from this app.
PTSD Coach was created by the VA's National Center for PTSD and the DoD's National Center for Telehealth and Technology.
People with PTSD commonly avoid stimuli and situations that remind them of the traumatic event because they trigger symptoms. Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. A person experiencing flashbacks due to PTSD may quickly and easily become upset. To the person without PTSD, these experiences of distress or anxiety may appear to come completely "out of the blue."
How can we communicate better?
You and your loved one may have trouble talking about feelings, worries, and everyday problems.
Here are some ways to communicate better:
• Be clear and to the point.
• Be positive. Blame and negative talk won't help the situation.
• Be a good listener. Don't argue or interrupt. Repeat what you hear to make sure 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 are clear
about your feelings.
• Help your loved one put feelings into words. Ask, "Are you feeling angry? Sad? Worried?"
• Ask how you can help.
• Don't give advice unless you are asked.
• If your loved one is having a lot of trouble talking things over, consider trying therapy. Therapy is a
type of counseling that involves more than one. Therapy can consist of two people or a whole family.
therapist helps you and your loved ones communicate, maintain good relationships, and cope with tough
emotions.
• During therapy, each person can talk about how a problem is affecting the other and/or the family as a
whole. Family therapy can help family members understand and cope with PTSD.
• Your health professional or a religious or social services organization can help you find a therapist who
specializes in PTSD.
Family members and friends may also feel as though their loved one with PTSD is emotionally cut-off or distant. This is not a personal choice on the part of the person with PTSD. People with PTSD have been found to experience something called emotional numbing. They can become completely withdrawn from people they were once close to.
As the name implies, emotional numbing refers to the inability to have certain emotions. Emotional numbing may interfere with a person's ability to experience love and joy.
How do we deal with anger or violent behavior?
• Your loved one may feel angry about many things. Anger is
a normal reaction to trauma, but it can hurt relationships
and make it hard to think clearly. Anger also can be
frightening.
• If anger leads to violent behavior or abuse, it's dangerous.
Go to a safe place and call for help right away. Make sure
children are in a safe place as well.
• It's hard to talk to someone who is angry. One thing you
can do is set up a time-out system. This helps you find a
way to talk even while angry.
Here's one way to do this:
- Agree that either of you can call a time-out at any time.
- Agree that when someone calls a time-out, the discussion must stop right then.
- Decide on a signal you will use to call a time-out. The signal can be a word that you say
or a hand signal.
- Agree to tell each other where you will be and what you will be doing during the time-out.
- Tell each other what time you will come back.
After you come back:
• While you are taking a time-out, don't focus on how angry you feel. Instead, think calmly about how you
will talk things over and solve the problem.
• Take turns talking about solutions to the problem. Listen without interrupting.
• Use statements starting with "I," such as "I think" or "I feel." Using "you" statements can
sound accusing.
• Be open to each other's ideas. Don't criticize each other.
• Focus on things you both think will work. It's likely you will both have good ideas.
• Together, agree which solutions you will use.
Helping a person with PTSD can be hard on you. You may have your own feelings of fear and anger about the trauma. You may feel guilty because you wish your family member would just forget his or her problems and get on with life. You may feel confused or frustrated because your loved one has changed, and as if they may never return to normal.
All of this can drain you. It can affect your health and make it hard for you to help your loved one. If you're not careful, you may get sick yourself, become depressed, or burn out and stop helping your loved one.
How can I take care of myself:
• Don't feel guilty or feel that you have to know it all. Remind yourself that nobody has all the answers. It's
normal to feel helpless at times.
• Don't feel bad if things change slowly. You cannot change anyone. People have to change themselves.
• Take care of your physical and mental health. If you feel yourself getting sick or often feel sad and hopeless,
see your doctor.
• Don't give up your outside life. Make time for activities and hobbies you enjoy. Continue to see your friends.
• Take time to be by yourself. Find a quiet place to gather your thoughts and "recharge."
• Get regular exercise, even just a few minutes a day. Exercise is a healthy way to deal with stress.
• Eat healthy foods. When you are busy, it may seem easier to eat fast food than to prepare healthy meals.
But healthy foods will give you more energy to carry you through the day.
• Remember the good things. It's easy to get weighed down by worry and stress. But don't forget to see and
celebrate the good things that happen to you and your family.
Get help:
During difficult times, it is important to have people in your life who you can depend on. These people are your support network. They can help you with everyday jobs, like taking a child to school, or by giving you love and understanding.
You may get support from:
• Family members.
• Friends, coworkers, and neighbors.
• Members of your religious or spiritual group.
• Support groups.
• Doctors and other health professionals
Source - Department of Veteran Affairs, National Center for PTSD
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