How to Cope with Post-Traumatic Stress Disorder

Get an Accurate Diagnosis. The first step in managing PTSD is determining whether you truly suffer from this mental health disorder. PTSD is an anxiety disorder, and its symptoms often overlap with similar conditions.

• Consult a psychiatrist for a differential diagnosis and appropriate treatment. To be diagnosed with PTSD, you must have a history of experiencing a traumatic event that meets specific criteria.
• For example, over a certain period, you must exhibit symptoms from four categories: 1) nightmares, flashbacks, and intrusive memories; 2) avoiding thoughts, places, people, and objects associated with the trauma; 3) negative changes in cognition and mood – feeling detached from others, holding persistent negative beliefs about life, having difficulty recalling details of the event, etc.; and 4) changes in arousal responses, hypervigilance, sleep disturbances, etc.
• Anyone who has experienced a traumatic event can develop PTSD. Abused children, sexual assault victims, veterans, car accident survivors, and those who have survived natural disasters are at risk of developing this disorder.
• Acute stress disorder is a related anxiety disorder that can develop into PTSD. Acute stress disorder occurs within a month after a traumatic event and can last from 3 days to 4 weeks. If acute stress symptoms persist beyond a month, it is a sign that the condition may be evolving into PTSD.

Consult with a therapist experienced in working with trauma victims. While talking to family or friends can help you cope with the emotions following a traumatic event, therapists are specifically trained to assist individuals like you. Be open and detailed about your condition when speaking with a therapist! Even avoiding what may seem like small details can make the issue harder to resolve. Don't hesitate to cry if needed.

• Therapists can use cognitive therapies aimed at helping you identify and change your thoughts and beliefs about the traumatic event. Victims often blame themselves for what happened. Talking about the incident with a therapist can help you accept that it was difficult to control what occurred.
• Some treatment methods may include gradual or immediate exposure to places and situations related to the trauma. One diagnostic criterion is avoidance, which makes victims reluctant to talk or think about the event. However, discussing and processing the event with a therapist can aid recovery.
• Therapists may modify treatment plans to suit what works best for you. Each person recovers differently, and it's essential to choose the treatment approach that fits your specific situation.

Consult a psychiatrist for medication treatment. If PTSD symptoms affect your ability to function, such as causing insomnia or overwhelming anxiety that makes you afraid to go to work or school, a therapist may refer you to a psychiatrist for medication. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed drugs for treating PTSD, but antidepressants, mood stabilizers, and other medications can also be helpful. Keep in mind that each medication comes with its own set of side effects, which you should discuss with your doctor.

• Sertraline (Zoloft) helps improve serotonin deficiency in the amygdala by boosting serotonin production in the brain.
• Paroxetine (Paxil) increases serotonin levels in the brain.
• Sertraline and paroxetine are currently the only medications FDA-approved for PTSD treatment. Other drugs may also be used but are not FDA-approved for this purpose.
• Fluoxetine (Prozac) and Venlafaxine (Effexor) are sometimes used for PTSD. Fluoxetine is an SSRI, while venlafaxine is an SNRI (Serotonin-Norepinephrine Reuptake Inhibitor), meaning it increases both serotonin and norepinephrine levels.
• Mirtazapine affects serotonin and norepinephrine, which may be useful in treating PTSD.
• Prazosin helps reduce the frequency of nightmares in PTSD and is sometimes used as an “adjunct” therapy, meaning it's prescribed alongside other treatments like SSRIs and psychotherapy.
• Suicidal thoughts can be a side effect of SSRIs and SNRIs. Consult your doctor to understand the risks and how to manage them.

Join support groups. If you're struggling with the fear and anxiety associated with PTSD, joining a support group may be beneficial. While these groups don't directly treat the disorder, they provide a sense of connection and encouragement from others facing similar challenges.

• Adjusting to a diagnosis like PTSD can be difficult, and joining a group may help you reconnect with society.
• If your spouse or family members are struggling to cope with your condition, they can receive support and valuable advice by joining a recovery group for families of PTSD sufferers.
• The Anxiety and Depression Association of America offers a search tool to help you find a support group near you.
• If you're a veteran, consider reaching out to your local veterans' organization.

Care for your body and mind. Many people find that regular exercise, a diet full of healthy foods, and sufficient rest can significantly impact PTSD. Additionally, these practices have been proven effective in combating stress and anxiety, which often accompany PTSD.

• Making some lifestyle changes can help reduce symptoms or improve your ability to manage PTSD symptoms. When physical activity is combined with a healthy, whole-food diet, you may feel empowered to fight negative thoughts and cope with sudden panic attacks.
• Avoid alcohol and stimulants. Seek healthier ways to cope with stress and unwanted feelings, such as taking a walk outside, reading a novel, or calling friends for a chat.
• Understand that experiencing PTSD does not mean you are weak. PTSD can affect anyone. In fact, strong individuals may be pushed into situations that trigger this disorder, because they stand up for their beliefs, strive to help others, or overcome personal obstacles. If you developed PTSD after serving in the military, you showed bravery when joining the armed forces, and you are still courageous now as you face PTSD and seek treatment.

Keep a personal journal. Write down anything that bothers you during the day, as those situations or objects may trigger nightmares or flashbacks. Also, note how you're feeling and whether any symptoms you experienced were normal or unusually bad.

• This helps track your progress and allows your therapist to see changes in your symptoms over time.

Lean on family and friends. Try to avoid falling into the trap of isolation. While you may feel relief by distancing yourself from others, this actually exacerbates your symptoms. Social support can help reduce both anxiety and depression associated with PTSD.

• Pay attention to when your symptoms worsen and make an effort to spend time with loved ones who bring you comfort and smiles.
• You can also find support through peer groups and connect with others who are dealing with PTSD.

Advocate for others. As you learn to manage the severity of PTSD, helping others in similar situations can accelerate your recovery. Supporting mental health policies and accessing services can empower you on your journey to healing from PTSD.

• Raising awareness of the mental health condition you’re experiencing will help both you and others in the recovery process. Your advocacy will empower you to transform a traumatic event into a positive message for healthcare providers, policymakers, and others affected by mental illness.

Recognizing the signs of an impending panic attack. Persistent fear is a hidden aspect of PTSD. Excessive stress or fear can trigger a panic attack, which often occurs simultaneously with PTSD. These attacks can last anywhere from 5 minutes to an hour or more. Sometimes, a severe panic attack can begin without any obvious warning signs. Every time you respond positively, you are helping to reduce the occurrence of anxiety or panic attacks. Regular practice will make it easier to cope. Common signs of a panic attack include:

• Chest pain
• Shortness of breath or a feeling of breathlessness
• Sweating
• Feeling of choking
• Trembling
• Nausea
• Dizziness, lightheadedness, or faintness
• Feeling hot or cold
• Feeling numb or tingling
• Distorted sense of reality (feeling detached from the present) or depersonalization (feeling outside of your body)
• Fear of losing control or “going crazy”
• Fear of dying
• A feeling of collapse

Practice deep breathing.. This technique can be helpful in reducing anxiety, fear, and even alleviating uncomfortable pain. The mind, body, and breath are interconnected, so taking a few minutes to practice intentional breathing can offer numerous benefits, including lowering blood pressure, relaxing muscles, and boosting energy levels.

• A typical deep breathing technique involves inhaling for a count of 5 to 8, holding the breath briefly, and then exhaling for the same amount of time. This action shifts your “fight or flight” response into a calmer state.

Try progressive muscle relaxation. Another anxiety-reducing technique involves slowly tensing and relaxing each muscle group systematically. This method can relieve stress and improve conditions beyond anxiety, such as insomnia and chronic pain. Progressive muscle relaxation also enhances the effectiveness of deep breathing techniques.

• Start at your toes and gradually move upward through your body. Inhale for a count of 5 to 10, simultaneously tightening the muscles in your feet and holding the position. When exhaling for the same count, suddenly release those muscles and focus on the sensation once the tension dissipates.

Meditation. This relaxation method can be difficult to practice when you're in the midst of a panic attack. However, meditation can be quite effective in preventing panic attacks from starting in the first place.

• If you're new to meditation, start gradually with 5 minutes each day and work your way up to longer sessions. Choose a quiet, comfortable place with as few distractions as possible. Sit up straight with your legs crossed on the floor, on a cushion, or in a chair. Close your eyes and begin slow, deep breaths—inhale through your nose and exhale through your mouth. Focus solely on your breath, and try to refocus whenever your mind wanders. Continue this practice for as long as you like.
• A study was conducted with 16 participants in a mindfulness-based stress reduction program, meditating for 27 minutes daily. At the end of the trial, MRI results revealed structural changes in the brains of participants, including increased compassion, self-awareness, and introspection, alongside a reduction in anxiety and stress.

Try to limit anxiety. Constant worry about panic attacks can actually trigger them. Keep yourself busy and distracted to avoid excessively stressing over future episodes.

• Develop some positive self-talk strategies when you notice you're persistently anxious. These might include telling yourself, "I’ll be okay," or, "This too shall pass." Reminding yourself that you've been through this before and survived can make the panic attack less frightening and even help prevent them from happening.
• When you find yourself anxious about the future, try to focus on the present. Write down things you're grateful for or positive qualities about yourself, such as "I am strong." This can help you manage your anxiety and remind you that your life isn't just filled with frightening things that contribute to panic.

• If you don't feel better during treatment, be patient and give it time. Some forms of therapy require time before you notice improvement. Persistence is key.
• You might feel uncomfortable discussing your traumatic experience with others. Try your best to open up to someone, particularly your therapist, as this can help you address any feelings of shame or guilt related to PTSD.

• People with post-traumatic stress disorder may experience terrifying thoughts, deep sadness, or even suicidal or homicidal thoughts. Call the crisis hotline or reach out to a local doctor if you ever have thoughts of ending your life or someone else's.