Symptoms, Self-Help, and Treatment Alternatives
When you experience a threatening or traumatic event, your nervous system responds by triggering the fight, flight, or freeze response. After the danger passes, your body usually returns to normal. But if the upset doesn't fade and you feel stuck with painful memories and a constant sense of vulnerability, you may be suffering from post-traumatic stress disorder (PTSD). As upsetting and disabling as PTSD can be, it’s important to realize that you’re not helpless. There are plenty of things you can do to alleviate your PTSD symptoms, reduce anxiety and fear, and take back control of your life.
What is PTSD?
Post-traumatic stress disorder (PTSD) can develop following any event that makes you fear for your safety. Most people associate PTSD with rape or battle-scarred soldiers—and military combat is the most common cause in men—but any event, or series of events, that overwhelms you with feelings of hopelessness and helplessness and leaves you emotionally shattered can trigger PTSD, especially if the event feels unpredictable and uncontrollable.
PTSD can affect people who personally experience the threatening event, those who witness the event, or those who pick up the pieces afterwards, such as emergency workers. PTSD can also result from surgery performed on children too young to fully understand what's happening to them.
Traumatic events that can cause PTSD include:
- Natural disasters
- Car or plane crashes
- Terrorist attacks
- Sudden death of a loved one
- Sexual or physical abuse
- Childhood neglect
Common PTSD symptoms
PTSD develops differently from person to person because everyone's nervous system and tolerance for stress is a little different. While you’re most likely to develop symptoms of PTSD in the hours or days following a traumatic event, it can sometimes take weeks, months, or even years before they appear. There are three main types of symptoms:
Re-experiencing the traumatic event. You may experience upsetting memories, flashbacks, and nightmares, as well as feelings of distress or intense physical reactions when reminded of the event (sweating, pounding heart, nausea, for example).
Avoiding reminders of the trauma. You may try to avoid activities, places or thoughts that remind you of the trauma or be unable to remember important aspects of the event. You may feel detached from others and emotionally numb, or lose interest in activities and life in general, sensing only a limited future for yourself.
Increased anxiety and emotional arousal. You may experience trouble sleeping, irritability or outbursts of anger, have difficulty concentrating, be jumpy and easily startled, and feel hyper vigilant (on constant “red alert”).
Other common symptoms
- Guilt, shame, or self-blame
- Feelings of mistrust and betrayal
- Depression or hopelessness, including suicidal thoughts and feelings
- Substance abuse
- Physical aches and pains
Symptoms of PTSD in children
In children—especially very young children—the symptoms of PTSD can be different from adults and may include:
|PTSD symptoms in children|
Fear of being separated from parent
Losing previously-acquired skills (such as toilet training)
Sleep problems and nightmares
Somber, compulsive play in which themes or aspects of the trauma are repeated
New phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters)
Acting out the trauma through play, stories, or drawings
Aches and pains with no apparent cause
Irritability and aggression
How PTSD affects your nervous system
When your sense of safety is shattered by a traumatic event, it’s normal to have bad dreams, feel fearful, and find it difficult to stop thinking about what happened. For most people, these symptoms gradually lift over time. But this normal response to trauma becomes PTSD when the symptoms don’t ease up and your nervous system gets "stuck."
Your nervous system has two automatic or reflexive ways of responding to stressful events:
Mobilization, or fight-or-flight, occurs when you need to defend yourself or escape the danger of a traumatic event. Your heart pounds faster, your blood pressure rises, and your muscles tighten, increasing your strength and reaction speed. Once the danger has passed, your nervous system calms your body, lowering your heart rate and blood pressure, and winding back down to its normal balance.
Immobilization occurs when you’ve experienced an overwhelming amount of stress in a situation and, while the immediate danger has passed, you find yourself “stuck.” Your nervous system is unable to return to its normal state of balance and you’re unable to move on from the event. This is PTSD.
Self-help tip 1: Get moving
When you’re suffering from PTSD, exercise can do more than just release endorphins and improve your mood and outlook. By really focusing on your body and how it feels as you move, exercise can actually help your nervous system become “unstuck” and begin to move out of the immobilization stress response. Try:
Rhythmic exercise that engages both your arms and legs, such as walking, running, swimming, or dancing. Instead of focusing on your thoughts, focus on how your body feels. Notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin.
Rock climbing, boxing, weight training, or martial arts. These activities can make it easier to focus on your body movements—after all, if you don’t, you could get hurt.
Exercising for 30 minutes or more each day—or if it’s easier, three 10-minute spurts of exercise. The more you move, the better you’ll start to feel.
Spend time in nature
Pursuing outdoor activities like hiking, camping, mountain biking, rock climbing, whitewater rafting, and skiing helps veterans cope with PTSD symptoms and transition back into civilian life. Anyone with PTSD can benefit from the relaxation, seclusion, and peace that come with being out in nature. Seek out local organizations that offer outdoor recreation or teambuilding opportunities.
Tip 2: Self-regulate your nervous system
PTSD can leave you feeling vulnerable and powerless over your symptoms. But by learning that you can change your arousal system and calm yourself when you start to feel overwhelmed, you can directly challenge this sense of helplessness and start to feel in control again.
Mindful breathing is a quick way to calm yourself. Simply take 60 breaths, focusing your attention on each out breath.
Sensory input. Just as specific sights, noises, or smells can instantly transport you back to the traumatic event, so too can sensory input quickly calm you down. The key is to find the sensory input that works for you. Does listening to an uplifting song make you feel calm? Or smelling ground coffee or a certain brand of cologne? Or maybe petting an animal works quickly to make you feel at ease? Everyone responds to sensory input a little differently, so experiment to find what works best for you.
Reconnecting to uncomfortable emotions without becoming overwhelmed can make a huge difference in your ability to manage stress, balance your moods, and take back control of your life. See our Emotional Intelligence Toolkit.
Tip 3: Connect with others
Once the fight or flight reflex has been triggered, face-to-face connection with a person who makes you feel safe and valued is the quickest, most effective way of bringing your nervous system back into balance. You don’t have to talk about the trauma if you don’t want to but the caring support and companionship of others is vital to your recovery. Reach out to someone you can connect with for an uninterrupted period of time, someone who will listen when you want to talk without judging, criticizing, or continually being distracted. That person may be your significant other, a family member, a friend, or professional therapist. Or you could try:
Volunteering your time or reaching out to a friend in need. This is not only a great way to connect to others, but can also help you reclaim your sense of control.
Joining a PTSD support group. This can help you feel less isolated and alone and also provide invaluable information on how to cope with symptoms and work towards recovery.
If connecting with others is difficult
No matter how close you are to someone, or how helpful they try to be, the symptoms of PTSD that leave your nervous system feeling “stuck” can also make it difficult to connect to others. If you still don’t feel any better after talking to others, there are ways to help the process along.
Exercise or move. Before chatting with a friend, either exercise or move around. Jump up and down, swing your arms and legs, or just flail around. Your head will feel clearer and you’ll find it easier to connect.
Vocal toning. As strange as it sounds, vocal toning is a great way to open up your nervous system to social engagement—even if you can’t sing or consider yourself tone-deaf. Sit up straight and with your lips together and teeth slightly apart, simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face. Practice for a few minutes and notice if the vibration spreads to your heart and stomach.
Tip 4: Make healthy lifestyle changes
The symptoms of PTSD can be hard on your body so it’s important to take care of yourself and develop some healthy lifestyle habits.
Take time to relax. Relaxation techniques such as meditation, deep breathing, massage, or yoga can activate the body’s relaxation response and ease symptoms of PTSD.
Avoid alcohol and drugs. When you’re struggling with difficult emotions and traumatic memories, you may be tempted to self-medicate with alcohol or drugs. But substance use worsens many symptoms of PTSD, interferes with treatment, and can add to problems in your relationships.
Eat a healthy diet. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day. Omega-3s play a vital role in emotional health so incorporate foods such as fatty fish, flaxseed, and walnuts into your diet. Limit processed food, fried food, refined starches, and sugars, which can exacerbate mood swings and cause fluctuations in your energy.
Get enough sleep. Sleep deprivation can trigger anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night. Develop a relaxing bedtime ritual (listen to calming music, watch a funny show, or read something light) and make your bedroom as quiet, dark, and soothing as possible.
Helping a loved one with PTSD
When a loved one has PTSD, it takes a heavy toll on your relationship and family life. You may have to take on a bigger share of household tasks, deal with the frustration of a loved one who won’t open up, or even deal with anger or disturbing behavior. Your loved one’s PTSD symptoms can also result in job loss, substance abuse, and other stressful problems.
Don’t pressure your loved one into talking. It is often very difficult for people with PTSD to talk about their trauma. For some, it can even make things worse. Never try to force your loved one to open up. Comfort often comes from your companionship and acceptance, rather than from talking.
Let your loved one take the lead, rather than telling him or her what to do. Take cues from your loved one as to how you can best provide support and companionship—that may involve talking about the traumatic event over and over again, or it may involve simply hanging out together.
Manage your own stress. The more calm, relaxed, and focused you are, the better you’ll be able to help your loved one with PTSD.
Try to prepare for PTSD triggers. Common triggers include anniversary dates; people or places associated with the trauma; and certain sights, sounds, or smells. If you are aware of the triggers that may cause an upsetting reaction, you’ll be in a better position to help your loved one calm down.
Don’t take the symptoms of PTSD personally. If your loved one seems distant, irritable, angry, or closed off, remember that this may not have anything to do with you or your relationship.
Educate yourself about PTSD. The more you know about the symptoms, effects, and treatment, the better equipped you'll be to help your loved one, understand what he or she is going through, and keep things in perspective.
Take care of yourself. Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. You need to take care of yourself in order to take care of your loved one.
Professional treatment for PTSD
Treatment for PTSD can relieve symptoms by helping you deal with the trauma you’ve experienced. A doctor or therapist will encourage you to recall and process the emotions you felt during the original event in order to reduce the powerful hold the memory has on your life.
- Explore your thoughts and feelings about the trauma
- Work through feelings of guilt and mistrust
- Learn how to cope with intrusive memories
- Address problems PTSD has caused in your life and relationships
Types of treatment for PTSD
Trauma-focused cognitive-behavioral therapy involves gradually "exposing" yourself to feelings and situations that remind you of the trauma, and replacing distorted and irrational thoughts about the trauma with a more balanced picture.
Family therapy can help your loved ones understand what you’re going through and help the family work through relationship problems.
Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety, although they do not treat the causes of PTSD.
EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. These techniques work by "unfreezing" the brain’s information processing system, which is interrupted in times of extreme stress.
Finding a therapist for PTSD treatment
When looking for a therapist, seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can ask your doctor or other trauma survivors for a referral, call a local mental health clinic, psychiatric hospital, or counseling center, or see the Resources and References section below.
Beyond credentials and experience, it’s important to find a PTSD therapist who makes you feel comfortable and safe. Trust your gut; if a therapist doesn’t feel right, look for someone else. For therapy to work, you need to feel comfortable and understood.
Resources and references
General information about PTSD
Post-Traumatic Stress Disorder News & Research – Overview of the latest research on PTSD, including its causes, risk factors, and promising new treatments. (National Institute of Mental Health)
Myths and Facts About PTSD – Learn the truth behind common misconceptions about PTSD. (Sidran Institute)
Understanding PTSD Treatment (PDF) – Explore proven treatment and therapy options for PTSD, hear success stories, and debunk common treatment myths. (National Center for PTSD)
Signs and symptoms
Post-Traumatic Stress Disorder Self-Test – Online self-test for PTSD to help you evaluate your symptoms. (Anxiety Disorders Association of America)
The Symptoms of Post-Traumatic Stress Disorder: Chronic and/or Delayed – Description of PTSD’s many symptoms, including withdrawal, avoidance, isolation, and flashbacks. (PTSD Support Services)
Common Reactions After Trauma – Find information on some common reactions to trauma, including anger, nightmares, sleep problems, avoidance, and depression. (National Center for PTSD)
Treatment and self-help
Treatment of PTSD – Guide to the treatments for PTSD, including cognitive therapy, exposure therapy, and EMDR. (National Center for PTSD)
Self-Help and Coping – Series of articles on how to cope with PTSD in healthy ways that promote healing and recovery. (National Center for PTSD)
Four Concrete Steps for Working with Trauma - Trauma specialist Bessel van der Kolk discusses four steps for working with trauma. (NYAPRS)
Helping a loved one with PTSD
Returning from the War Zone: A Guide – Advice for service members and their families on what to expect and how to adapt after returning home from war. (National Center for PTSD)
Partners with PTSD – Article for the friends and family members of people with PTSD. Includes an explanation of symptoms and what you can do to help. (Gift from Within)
Find PTSD treatment and support groups in the U.S.
Find Support – Call the NAMI helpline at 1-800-950-NAMI to find a support group near you. (National Alliance on Mental Illness)
Trauma Treatment Programs (PDF) – Directory of trauma resources listed by state. (Sidran Institute)
Find PTSD treatment and support groups in other countries
Where to Get Help – Find different treatment and support options in the UK. (PTSD UK)
Find Help – Find PTSD recovery resources in Australia. (Phoenix Australia)
Find Your Local CMHA – Contact your local CMHA division to find support and treatment options in Canada. (Canadian Mental Health Association)
Help for veterans with PTSD in the U.S.
PTSD Program Locator – Find specialized VA PTSD treatment programs near you. (U.S. Department of Veteran Affairs)
Veteran Combat Call Center – A 24/7 hotline where you can talk with another combat veteran: 1-877-WAR-VETS (1-800-927-8387)
Help for veterans with PTSD in other countries
Canadian veterans: visit Operational tress Injury Social Support (OSISS)
UK veterans: visit Combat Stress or call the 24-hour helpline 0800 138 1619.
Australian veterans: visit Veterans and Veterans Families Counselling Services (VVCS) or call 1800 011 046.
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