Post-traumatic stress disorder (PTSD):

 PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.

Who is affected?

PTSD is essentially a memory filing error caused by a traumatic event and can affect anyone who has been exposed to a traumatic event. The defining characteristic of a traumatic event is its capacity to provoke fear, helplessness, or horror in response to the threat of injury or death and therefore can affect anyone. Examples of traumatic events include:

  • bereavement
  • violent personal assault, such as a physical attack, sexual assault, robbery, or mugging
  • military combat
  • terrorist attack

Any exposure to traumatic event can cause PTSD, such as:

  • You experienced the traumatic event
  • You witnessed, in person, the traumatic event
  • You learned someone close to you experienced or was threatened by the traumatic event
  • You are repeatedly exposed to graphic details of traumatic events (for example, if you are a first responder to the scene of traumatic events)

Anyone can be diagnosed with PTSD, and it’s estimated that 1 in 10 people develop PTSD. 1 in 5 firefighters, 1 in 3 teenagers who have survived a horrific car crash, 70% of rape victims, 2 in 3 Prisoners of War, 40% of people who experienced a sudden death of a loved one, and an estimated 10,000 women a year following a traumatic childbirth, develop PTSD.

PTSD Symptoms

PTSD and trauma symptoms can vary in intensity over time. You may have more symptoms when you’re stressed in general, or when you run into reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.

People react to traumatic experiences in a variety of ways. Some may experience symptoms of trauma which dissipate after a number of weeks. However if symptoms of trauma continue for longer than a month, PTSD may be present.

Trauma symptoms vary from person to person, but some examples are:

Increased anxiety and emotional arousal

  • Intense physical reactions to reminders of the event (e.g. Pounding heart, nausea, muscle tension, sweating)
  • Irritability or outbursts of anger
  • Irrational and intense fear
  • Difficulty concentrating
  • Being easily moved to tears
  • Panic attacks/anxiety/depression/mood swings
  • Feeling jumpy and easily startled
  • Anger or aggressive behaviour
  • Tense muscles 

Avoidance and numbing

  • Work-related or relationship problems
  • Inability to remember important aspect of the trauma
  • Loss of interest in activities and life in general
  • Sense of a limited future
  • Feeling numb and empty
  • Feeling isolated
  • Frequent periods of withdrawal into oneself

Re-experiencing the traumatic event

  • Flashbacks (Acting or feeling like the event is happening again)
  • Nightmares (either of the event or of other frightening things)
  • Feelings of intense distress when reminded of the trauma

 Other common symptoms

  • Feeling suicidal
  • Self-harm and self-destructive tendencies
  • Guilt, Shame, embarrassment or self-blame
  • Misuse of alcohol/drugs/gambling and/or food
  • Seeking out high-risk/dangerous pursuits
  • Over-reactions to minor situations
  • Fear of being alone and fear of being in crowds

Individuals with PTSD almost always have altered cortisol levels, and a prolonged exposure to these increased hormones can cause some unexpected, and very inconvenient physical problems – you can read our blog post ’10 unexpected physical symptoms of PTSD’ here.

Symptoms of PTSD in children and adolescents

In children—especially those who are very young—the symptoms of PTSD can be different than the symptoms in adults. Symptoms in children include:

  • Fear of being separated from parent
  • Losing previously-acquired skills (such as toilet training)
  • Sombre, 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

Primary School-aged children 

These children may not have flashbacks or problems remembering parts of the trauma, the way adults with PTSD often do. Children, though, might put the events of the trauma in the wrong order. They might also think there were signs that the trauma was going to happen. As a result, they think that they will see these signs again, before another trauma happens. They think that if they pay attention, they can avoid future traumas.

Children of this age might also show signs of PTSD in their play. They might keep repeating a part of the trauma. These games do not make their worry and distress go away. For example, a child might always want to play shooting games after he sees a school shooting. Children may also fit parts of the trauma into their daily lives. For example, a child might carry a gun to school after seeing a school shooting.

Secondary Teenagers 

Teens are in between children and adults. Some PTSD symptoms in teens begin to look like those of adults. One difference is that teens are more likely than younger children or adults to show impulsive and aggressive behaviours.

Other effects of trauma on children

Besides PTSD, children and teens that have gone through trauma often have other types of problems. Much of what we know about the effects of trauma on children comes from the research on child sexual abuse. This research shows that sexually abused children often have problems with

  • Fear, worry, sadness, anger, feeling alone and apart from others, feeling as if people are looking down on them, low self-worth, and not being able to trust others
  • Behaviours such as aggression, out-of-place sexual behaviour, self-harm, and abuse of drugs or alcohol

If someone I care about has PTSD?

Many people, at some point in their lives, will experience a stressful or traumatic event which can affect their normal behaviour – for a time they may feel more stressed, angry or sad. These short term changes are common.

But longer-term, specific changes in behaviour, particularly following a trauma or multiple traumas, could be a sign that a person is developing, or has developed PTSD. These symptoms may manifest themselves over a short time, or over months, years or even decades.

Some of the common symptoms of PTSD are:

  • Intense physical reactions to reminders of the event (e.g. Pounding heart, nausea, muscle tension, sweating)
  • Irrational and intense fear
  • Panic attacks/anxiety/depression/mood swings
  • Feeling jumpy and easily startled
  • Anger or aggressive behaviour
  • Loss of interest in activities and life in general
  • Frequent periods of withdrawal into oneself
  • Flashbacks (Acting or feeling like the event is happening again)
  • Misuse of alcohol/drugs/gambling and/or food
  • Over-reactions to minor situations

 What can I do to help?

Be patient.

If you think your partner may have PTSD, it’s important to let them know you care and are there to listen when they are ready to talk. Broach the subject if you can, but without judgment. Often, those with PTSD may feel numb and distant from others. Relationship problems can develop as they are irritable, on guard, jumpy, worried, or nervous. They may also feel an increased need to protect their loved ones and so come across as tense or demanding. Try to understand how they may be feeling as much as possible.

The changes in you loved one, and the relationship you have, can understandably make you worried, and even perhaps angry, frustrated or hurt, so it’s important that you are patient with your loved one, and deal with this together – they may not have PTSD, but just need more time to process a trauma they went through. If they have PTSD, try to understand that they can’t ‘get over it’ or just ‘forget it happened’ – they are not choosing to relive the experience, or let it affect their life – they too will be equally frustrated and angry, and scared.

Take any conversations at their pace, and gently encourage them to help themselves by staying active, eating well and doing things they enjoy. Gather all the information you can about PTSD, educate yourself on what the symptoms are, and if the time seems right, guide them to our website to read a little more and see if they recognize any of the symptoms in themselves (they may be feeling other symptoms you haven’t noticed).

You don’t have all the answers, and that’s ok, just make it clear that you’re there to listen if they want to talk. You can hold your partner’s hand, offer hugs, and be present. One frustrating aspect of PTSD for sufferers is that it’s very difficult to articulate, or even know what will help – so your loved one may not be able to tell you what they need, or how they’re feeling. At times, a close hug might be what will help them, but the next minute, they may need to be alone. Try to keep communicating with each other about what will help at that moment in time, and don’t make assumptions that the same thing will help in a few days’ time.

When the time is right, you can look at getting help and a diagnosis, and treatment options (and therapies/activities that can help in the meantime whilst waiting for diagnosis or the treatment).  

How can I encourage my loved one to get help?

Acknowledging that you think you may have PTSD can be hard, and any changes in your relatives’ mental health may have felt quite gradual since a trauma, and so they might have not noticed any major issues (or put ‘two and two’ together). In the situation of PTSD, they may also feel that their symptoms are simply due to ‘dealing’ with a trauma that occurred.

If they’re willing, encourage them to see their GP as soon as possible, who will, if appropriate, refer them to their local mental health team for diagnosis and to discuss treatment options.

Some community mental health teams will accept self-referrals so you may be able to go directly to them. You can check this on your local mental health trust website.

Unfortunately, the time between the GP visit, diagnosis and treatment can take some time on the NHS. Once you have a diagnosis, you may wish to consider private treatment (if this is an option for you).

My loved one won’t get help. What can I do?

Your loved one might not want to visit their GP. They may not think they are unwell, not realise a GP can help, or feel too embarrassed or frightened to talk to a ‘stranger’ about how they’re feeling.

If your loved one won’t go to see their GP, and you feel it necessary, you can write to their GP (if you know who they are) to explain your concerns with as many facts and examples as possible. Some GPs feel that a person needs to approach them directly before they can offer any help.

However, some GPs will be willing to invite you to make an appointment to discuss your letter, contact your relative to invite them for a check-up, or to arrange for your loved one to be visited and assessed at home (although this is unlikely to happen without your relative’s consent).

It’s important to note that if your loved one is over the age of 18, they can’t be forced to have treatment they don’t want. They can only be forced to have treatment if they are detained under the Mental Health Act 1983.

If you need to more information about where to get treatment, what you are entitled to, or who to turn to to make a compliant in the NHS, you can do so with the help of the Patient Advice & Support Service in Scotland, the Patient Advice & Liason Service in England, the Patient Support and Advisory Service in Wales, or the Patient and Client council in Northern Ireland.

If the person you’re worried about expresses suicidal feelings, you or they should contact a GP or NHS 111. You can also contact Samaritans on 116 123 for confidential, 24-hour support or 999 if they are in immediate danger.

 Take care of yourself

During this process, it’s important to take care of yourself. When someone you care about suffers from PTSD it affects you too.

The symptoms of PTSD aren’t easy to live with, and the changes in your loved one can be downright terrifying. You worry that things won’t ever go back to the way they were before. At the same time, you may feel angry about what’s happening to your family, and hurt by your loved one’s distance and new emotions. It’s a stressful situation all around—one that can leave you feeling overwhelmed and confused.

The most important thing to know is that you aren’t helpless. Your support can make a huge difference in your partner, friend, or family member’s recovery. But as you do your best to care for someone with PTSD, you also need to take care of yourself.

Self-Care for carers and loved ones

Caring for someone with Post Traumatic Stress Disorder (PTSD) can be difficult and stressful. Your own mental health may slip further down your list of priorities, but it is vital to look after yourself in order to provide care and support.

Am I a carer?

Many carers don’t consider themselves to be “a carer”, because there is no clear boundary between being a carer and being a supportive partner, family member or friend.

Definitions of carers vary between different organisations, which can be confusing. For example, the UK benefits system has its own set of criteria for who can be considered a carer and therefore receive Carer’s Allowance. This may differ from the criteria which your Local Authority uses to assess whether you are entitled to additional support.

Mind and other organisations have a wider definition of what it means to be a carer. You are considered to be caring for someone if you provide practical and/or emotional support to help them cope with daily life. A range of tasks is included in this definition, such as preparing meals, managing medication and attending appointments.

How can being a carer affect my own mental health?

The responsibility of caring for someone with PTSD can cause a lot of stress. Witnessing their symptoms is often distressing and listening to how they feel, while helpful, can be upsetting. You may find it difficult to cope, which can cause symptoms associated with anxiety and depression. You may neglect your physical health, such as by not getting enough sleep or exercise, which can affect your mood and reduce your ability to deal with stress. The demands of being a carer can also make you feel alone and isolated.

Where can I get help and support?

Seeing your GP is essential when you are concerned about your wellbeing. You don’t need to be diagnosed with a mental illness yourself in order to receive support. GPs are aware of the issues involved in being a carer, so they can direct you to appropriate sources of help and support.

Counselling can be very valuable for carers, as it gives you the time and space to talk about your feelings without judgment. Some counselling is available on the NHS, but services and accessibility differ depending on where you live. Your GP can refer you to NHS counselling, if it is available, or to a private counsellor.

Citizens Advice in the various regions (England & Wales, Northern Ireland, Scotland) and The Carers Trust have information on local services which can offer support. They also have a lot of useful online resources.

If you feel you can’t cope and need immediate help, please contact Samaritans.

How can I take care of myself?

It is important to give yourself some respite on a regular basis. Spending time away from the person you are caring for may be difficult, in both practical and emotional terms, but it makes a huge difference.

Looking after your physical health has a big impact on your wellbeing. Try to ensure you get an adequate amount of sleep, eat healthy meals and do some exercise. When you neglect these basic self-care tasks, it is harder to cope with the demands of being a carer. Planning your activities and sticking to a routine is beneficial for both yourself and the person for whom you care. Use a planner or calendar to schedule events, appointments and tasks. Write a weekly to-do list and highlight the most important tasks as priorities. Staying organised helps you feel more in control and reduces stress.

If you feel you can’t do anything else the best thing you can do is connect with other carers, who will be able to share advice and coping strategies. By being in contact with people in similar situations, you will feel less isolated. Citizens Advice and your GP can put you in touch with local groups for carers, but also consider online support. Carers UK has an online forum and you can find other forums and groups on social media.

TRAUMA CAN BE “CONTAGIOUS”

Another reason why self-care is so important is because of the potential for secondary traumatization. What that means is that the spouses, partners, and family members of people with PTSD can develop their own symptoms. This can happen from listening to trauma stories or being exposed to scary symptoms like flashbacks. The more depleted and overwhelmed you feel, the greater the risk that you yourself may become traumatized.

Helping someone with PTSD

This page provides suggestions and help on how to help rebuild the trust and safety between you both, along with information on how to help deal with flashbacks or panic attacks and anger that may result from PTSD.

TIPS FOR REBUILDING TRUST AND SAFETY

Trauma alters the way a person sees the world, making it seem like a perpetually dangerous and frightening place. It also damages people’s ability to trust others and themselves.

Anything you can do to rebuild your loved one’s sense of security will contribute to recovery. This means cultivating a safe environment, acting in a dependable and reassuring way, and stepping in to help when needed. But it also means finding ways to empower the person. Smothering someone with PTSD or doing things for them that they’re capable of doing for themselves is counterproductive. Better to build their confidence and self-trust by giving them more choices and control.

THINGS YOU CAN DO TO INCREASE YOUR LOVED ONE’S SENSE OF SAFETY

  • Express your commitment to the relationship. Let the person know you’re here for the long haul.
  • Create routines. Structure and predictable schedules will enhance the person’s feelings of security. You can also help create a safe place.
  • Be aware of things that can make a person with PTSD feel unsafe, such as new places, crowds, confusion, or being physically constrained or ordered around.
  • Try to minimize stress at home and make sure your loved one has time alone for rest and relaxation.
  • Speak of the future and make plans. This can help counteract the common feeling among people with PTSD that their future is limited.
  • Keep your promises. Help rebuild trust by being trustworthy. Be consistent and follow through on the things you say you’re going to do.
  • Tell them you believe they are capable of recovery. Emphasize their strengths. Help them (and others) see their positive qualities and successes.

ENCOURAGING AND SUPPORTING TREATMENT

Despite the importance of your love and support, it isn’t always enough. Many people who have been traumatized need professional PTSD treatment. But bringing it up can be touchy. Think about how you’d feel if someone suggested that you needed therapy.

  • Wait for the right time to raise your concerns. Don’t bring it up when you’re arguing or in the middle of a crisis. Also be careful with your language. Avoid anything that implies that he or she is “crazy.” Frame it in a positive, practical light: treatment is a way to learn new skills that can be used to handle a wide variety of PTSD-related challenges.
  • Emphasize the benefits. For example, therapy can help them become more independent and in control. Or it can help reduce the anxiety and avoidance that is keeping them from doing the things they want to do.
  • Focus on specific problems. If your partner shuts down when you talk about PTSD or counselling, focus instead on how treatment can help with specific issues like anger management, anxiety, or concentration and memory problems.
  • Acknowledge the hassles and limitations of therapy. For example, you could say, “I know that therapy isn’t a quick or magical cure, and it may take a while to find the right therapist. But even if it helps a little, it will be worth it.”
  • Enlist help from people your loved one respects and trusts. He or she may be more open to counselling if the idea comes from someone else. Suggest the person see a doctor or talk with his/her pastor, rabbi, or spiritual leader.
  • Encourage the person to join a support group. Getting involved with others who have gone through similar traumatic experiences can help your loved one feel less damaged and alone.
  • Remember that your meta-language (body language) conveys 90% of your message. Your words convey only 10% of your message. Convey positive messages, not degrading ones.

HOW TO HELP IN THE MIDDLE OF A FLASHBACK OR PANIC ATTACK

  • During a flashback, people often feel a sense of disassociation, as if they’re detached from their own body. Anything you can do to “ground” them will help.
  • Tell them they’re having a flashback and that even though it feels real, it’s not actually happening again
  • Help remind them of their surroundings (for example, ask them to look around the room and describe out loud what they see)
  • Encourage them to take deep, slow breaths (hyperventilating will increase feelings of panic)
  • Avoid sudden movements or anything that might startle them
  • Ask before you touch them. Touching or putting your arms around the person might make him or her feel trapped, which can lead to greater agitation and even violence

TIPS FOR COPING WITH PTSD IN THE FAMILY

  • Be patient. Getting better takes time, even when a person is committed to treatment for PTSD. Be patient with the pace of recovery. It’s a process that takes time and often involves setbacks. The important thing is to stay positive and keep at it.
  • Educate yourself about PTSD. The more you know about the symptoms, effects, and treatment options, the better equipped you’ll be to help your loved one, understand what he or she is going through, and keep things in perspective.
  • Don’t pressure your loved one into talking. It can be very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Instead of trying to force it, just let them know you’re willing to listen when they’re ready.
  • Take care of your emotional and physical health. As the saying goes, put on your own oxygen mask first. You won’t be any good to your loved one if you are burned out, sick, or exhausted.
  • Accept (and expect) mixed feelings. As you go through the emotional wringer, be prepared for a complicated mix of feelings—some of which you’ll never want to admit. Just remember, having negative feelings toward your family member doesn’t mean you don’t love them.
  • Be a good listener. While you shouldn’t push a person with PTSD to talk, you can let them know you’re available for them. If they do choose to share, try to listen without expectations or judgments. Make it clear that you’re interested and that you care, but don’t worry about giving advice. Leave that to the professionals. Instead, do your best to simply take in what they’re saying. Never underestimate how much the act of empathetic listening can help. A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Instead, offer to talk as many times as needed. And remember, it’s okay to dislike what you hear. Some of the things your loved one tells you might be very hard to listen to. But it’s important to respect their feelings and reactions. If you come across as disapproving, horrified, or judgmental, they are unlikely to open up to you again.

Help for Employees

Post-traumatic stress disorder can happen to anyone at any time. It doesn’t discriminate. Those experiencing PTSD can have traumatic flashback episodes, nightmares, feelings of intense stress, a pounding heartbeat, rapid breathing, muscle tension, sweating, sleep problems, hyper-vigilance, panic attacks, irritability, aggressive behaviour, difficulty concentrating, depression, and a sense of detachment from people and situations – among many other troublesome symptoms. While many associate PTSD with veterans and those fighting in wars, it can also happen after the death of a loved one, from childhood neglect, after a serious accident, from experiencing terrorist attacks or natural disasters, among other reasons.

As an employer, it can be difficult. Often those experiencing PTSD will not want to admit that they are suffering, and it may not always be straightforward in getting them to seek help or a diagnosis. For a while, even they may not realise why they feel the way they do and this can affect their work and home life. It is important to always ensure your workplace is a safe and secure place for people with mental health problems to feel that they can speak out, as well as know they won’t be discriminated against for doing so. The fear of losing your job can be as big a worry as the initial problem itself – and won’t help recovery.

Ultimately, it is for the employee to notify you, the employer, of their problem. Some may be signed off from work long term, while others will want to keep working and retain a sense of ‘normality’. In these events, it is key that you or your HR team sit down with the individual and discuss ways to help them in their work.

Seating location

This might involve giving employees an option to choose where they sit – some may find it easier to be able to see an access door or window and without having their back to the room, especially if they suffer from hypervigilance. It may help if they can see the whole office so they don’t panic if someone comes up behind them unannounced.

Noise

Additionally, they may prefer to sit somewhere where noise is kept to a minimum – perhaps even a private office, where they have some space to breathe without feeling claustrophobic. Having soft ambient music may help, either through a CD player or by allowing them to wear earphones (if they feel comfortable with this). It can also help them to stay focused on the task at hand.

Employees should also be aware of making sudden loud noises, which could trigger a flashback for some sufferers. However, the privacy of the individual and their health concerns should always be paramount before speaking to other staff about recommendations. It should be at the approval of those with PTSD whether others are notified.

Flexible working hours

For many people, having a flexible working option (where appropriate), is particularly beneficial. If an employee has had a particularly bad night’s sleep, for example, look at options for them to come to work late, alternate their hours or work from home.

Task Management

If they are struggling to concentrate, try breaking their tasks down into smaller chunks and giving them a clear, manageable job list to work from. They should also be given additional time for each task without the pressure of looming deadlines, which can paralyse some people. Scheduling apps and software can help the PTSD sufferer stay on top of their organisation without becoming overwhelmed.

Specific Requirements

Specific requirements should also be considered based on the trauma that has caused the PTSD. For example, if the initial trauma was a car accident, don’t expect your employee to travel to meetings in a car (or back of a car, if that is their issue) as this may cause them to panic or feel anxious. Additionally, don’t expect an employee to travel alone to another city late at night if they were assaulted, for example. Provisions should be made to help them feel safe and secure, and anything that requires them getting back to a sense of ‘normal’ should be done with assistance from their doctor or mental health practitioner, and in their own time.

Just showing you care, and understand how they may be feeling can be a huge help to someone suffering PTSD

I’ve been diagnosed with PTSD. What do I do?

If you have recently been told you have post-traumatic stress disorder (or PTSD) then you might feel worried or frightened by what this diagnosis means. Perhaps having a name for how you have been feeling up until now has given you some comfort. No matter how you feel, the biggest thing to know is that you aren’t alone. We’re right here beside you – as are many other people and organisations.

In the UK, it is estimated that one in four people experience a mental health problem each year, with 4.4 in 100 being diagnosed with PTSD. According to the NHS, post-traumatic stress disorder affects 1 in 3 people who have a traumatic experience, such as a car crash, be sexually abused, physical assault, near death involvement, time in military combat, witnessing a serious event, being involved in a natural disaster, or many other types of events.

In order to help you cope with your post-traumatic stress disorder, there are many hugely beneficial organisations set up to work with you and offer support, both emotionally and physically. From the NHS to SAMH and Mind, PTSD UK (that’s us!) to the Samaritans – whoever it is you need, you’ll hopefully feel supported through your diagnosis towards a pathway of rehabilitation and recovery.

Your Emotions

After your initial diagnosis, it is completely normal to feel a wave of emotions; from relief that your problem has a name and you know why you’re not feeling yourself, to hope that you might be able to find a way of coping with your symptoms, to fear of what your diagnosis means and how it might affect your life, to shock and denial about the fact it is happening to you – there’s a lot to process. Perhaps you feel ashamed or confused, angry about why it has happened to you or a sense of being out of control. It may be that you feel guilty it has happened or a sense of grief for your old life.

Keep talking

No matter how you feel, the best thing to do is stay open with your communication. Share how you are feeling with loved ones, friends, family or a trained professional such as your therapist or doctor. Whoever you choose to talk with it about, you need to be able to trust them. It might also be worth having a confidential chat with your work so they understand what you are going through and can give you any time off you may require. They may also be able to make accommodations for you, such as giving you a quiet office space or moving your desk so you don’t have your back to people.

Treatments and help

Hopefully by now you will have been told about the many available recommended treatments such as EMDR and CBT. There are a lot of medical and natural options, including some less discussed options, including kundalini yogaequine therapyketogenic dietrunning, and ocean and surf therapy. You might want to give some of these ago while you wait for the next stages of your treatment to begin. You can take a look on the PTSD UK blog to find out more about the multitude of ways for reducing your symptoms and dealing with your diagnosis – and we even have some practical help with hypervigilance from PTSD. There’s also a lot of other information available to educate you about post-traumatic stress disorder. Knowledge is power and it can help you to feel more in control.

The good news is that with the right treatment and support, PTSD is entirely treatable, and you will eventually start to feel better. It might feel like a long road ahead, and there will potentially be pot-holes for you in that journey, but the good news is that you are on the right path for where you want to be; and we’re here, with you, for the long haul.

Understanding the recovery process of PTSD

PTSD is entirely possible to recover from, however, it’s not always straightforward or simple.

Sometimes you may be putting obstacles in the way of your recovery. Understanding the blockers you’re putting in place (usually unconsciously) is the first step to eliminating them.

  • You feel unworthy: No matter what anyone says, your feelings are valid. Don’t listen to those ignorant of PTSD, or those voices in your head saying ‘it won’t work’- it can, and with belief, it will.
  • You’re moving too fast: Your brain, emotions and mind need to work together, so don’t rush the recovery process. Take the time you need.
  • You’ve lost your way: You may have approached one element of recovery which has taken you further away from the main trauma you needed to address – this may happen more with those with C-PTSD, but take time to recognise this feeling for what it is, and don’t lose motivation towards the end goal of full recovery.
  • Control: It’s normal to use control as a way of ‘staying safe’ however, in order for recovery to work fully, you need a free and open environment to work with. Trust that things can, and will, get better.
  • You’re overwhelmed: Going through treatment for PTSD can seem a daunting task – you feel lower than you’ve ever felt before, and so recovery seems like a long road ahead. Knowledge is power with PTSD – knowing what is involved in treatment can be a big comfort.
  • The emotional and physical cost: Your PTSD-led thoughts can make recovery seem like a costly process in terms of your feelings, relationships, money and time – understanding that you can return to the ‘old you’ will hopefully make it seems worthwhile.
  • Self-trust: You may not feel confident enough to take the right path of recovery, to choose the right treatment or to do what’s necessary to rid you of PTSD. Just follow the advice of the professionals, and trust yourself when it comes to you well-being.
  • Recovery isn’t balanced: If you concentrate too much on recovery, and don’t give yourself the space to breathe, it can be detrimental to treatment. Similarly, if you don’t focus enough on recovery, it may stop the progress. Make sure you give yourself the right time that you need.
  • Commitment: You need to emotionally ‘buy into’ your treatment and the recovery – without this, you’re disconnected from the purpose and can negatively affect the process – be dedicated to trusting that the treatment can be successful. It’s important you get the most from your therapist that you can.
  • Self-trust: You may not feel confident enough to take the right path of recovery, to choose the right treatment or to do what’s necessary to rid you of PTSD. Just follow the advice of the professionals, and trust yourself when it comes to you well-being.

If you recognise any of these feelings in yourself, sometimes it’s best stop trying to move forward and instead resolve the conflict of the obstacle in your way, then allowing your recovery process to move forward once more.

WHY SOMEONE WITH PTSD MIGHT BE RELUCTANT TO SEEK SUPPORT

“For a long time I’d resisted professional help because I didn’t want to talk, period? 

The craziness in my head, the pain in my body, the fear in my soul, I saw it all as my personal burden and something that would destroy me if I tried to actually work with it.”

  • Being afraid of losing control
  • Feeling weak or ashamed
  • Not wanting to burden others
  • Feeling they may dishonour or forget about those they’ve lost through the trauma
  • Believing that others won’t understand
  • Wanting to avoid thinking about what happened
  • Fear that others will judge or pity them

Getting the most from your PTSD treatment

CHOOSING A THERAPIST OR PRACTITIONER

If you are receiving treatment through the NHS, you may be unable to ‘choose’ your therapist, but if you are looking for private treatment, choosing the right therapist for you is really important.

Beyond credentials and experience, it’s important to find a PTSD therapist who makes you feel comfortable and safe, so there is no additional fear or anxiety about the treatment itself –  this will set you on the path to recovery that is focused, appropriate and geared toward the sensitive issues that are unique to PTSD healing.

Some things to bear in mind are:

  • Trust your gut: If a therapist doesn’t feel right, look for someone else. For therapy to work, you need to feel respected and understood.
  • Find a therapist who is specifically trauma-trained: PTSD treatment and recovery is a complex process that is best undertaken under the direction of someone who truly understands the science behind the symptoms of PTSD, plus the most important components of healing. Look for a psychologist or therapist who holds qualifications in trauma treatment and approach methods that are documented for PTSD.
  • Interview or have a trial session where possible: You have the right to ask any questions you feel you need answers to. It can help to make a list of questions to take with you, perhaps about their training, work history, and success with other PTSD clients.

HOW DO I MAKE THE MOST OF THERAPY AND REACH TOWARDS RECOVERY?

To get the most from your therapist and embrace the healing process from PTSD, follow these tips:

  • Believe: If you don’t believe you can make a full recovery, you won’t. Trust that you can recover from PTSD and know that tomorrow can be a new day.
  • Set goals: It’s all very well saying ‘I want to feel better’ but it’s quite vague and difficult to measure. Start your recovery process clearly with goals such as ‘I want to be able to go out alone’ or ‘I want to be able to sleep a whole night through’ and you can measure these successes as they come along.
  • Get involved: Ask as many questions as you need, understand the process, talk things through. The therapist is there to guide you through recovery and the treatment, but ultimately, you need to do the hard work.
  • Take Action: Recovery only happens because you happen. If you remain passive and static, so will your recovery. Taking actions toward each goal is so important and helps build momentum. 
  • Give yourself some ‘me’ time: Recovery can be tough and tiring process, so make sure to give yourself some time off and love.
  • Be open: There are lots of approaches to recovery and reducing PTSD symptoms, so be open to things which can augment your treatment, or help you keep motivated to healing.
  • Build your confidence: PTSD can knock your confidence, so help your recovery process by doing things to build your self-esteem and worth.
  • Get Support: As you probably know, PTSD can be very isolating, so try to find one person you can trust and talk things over with during your recovery. If you have no-one, you can call Samaritans on 116 123 for a friendly chat.
  • Work between your session where required: For some therapies like EMDR, you’re best to relax, but for some therapies and processes, there may be ‘work’ to do – speak to your therapist for the best course of action.

If you feel that your recovery isn’t progressing as you’d hoped, it’s important to understand the recovery process to ensure that you’re not putting any blockers in place of your healing.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a type of therapy that aims to help you manage your problems by changing how you think and act.

Trauma-focused CBT uses a range of psychological treatment techniques to help you come to terms with the traumatic event.

For example, your therapist may ask you to confront your traumatic memories by thinking about your experience in detail. During this process your therapist will help you cope with any distress you feel, while identifying any unhelpful thoughts or misrepresentations you have about the experience.

By doing this, your therapist can help you gain control of your fear and distress by changing the negative way you think about your experience, such as feeling that you are to blame for what happened or fear that it may happen again.

You may also be encouraged to gradually restart any activities you have avoided since your experience, such as driving a car if you had an accident.

You will usually have 8-12 weekly sessions of trauma-focused CBT, although fewer may be needed if the treatment starts within one month of the traumatic event.

Sessions where the trauma is discussed will usually last for around 90 minutes.

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