PTSD, or post traumatic stress syndrome, is seen as a mental health problem. It can develop after experiencing - or witnessing - a life-threatening event like a natural disaster, a shooting, a car accident or sexual assault.
The fall out for experiencing such a stressful event may be instant but in the case of PTSD sufferers, can also be delayed for weeks, months or even years.
When symptoms of PTSD emerge well after the event, this is described as delayed-onset of PTSD. Delayed-onset PTSD has been observed among older people, who may have developed PTSD over an event that occurred when they were much younger.
Why Are The Symptoms Delayed?
It appears, from research on war veterans, that our psyche may delay the onset of PTSD in order to contain the trauma so’s to cope better in the present moment. However, if life stressors get on top of us, this can increase the likelihood of traumatic symptoms emerging. Memories of the trauma can be stored for years only developing when other stressful life events come into play.
The experience of additional life stresses can then tax our ability to cope with a previous traumatic event, increasing the probability that existing sub-threshold PTSD symptoms become more severe.
It's Not Just War Veterans Who Suffer From PTSD
My field is in helping people recover from being raised in a dysfunctional family. Although it’s not highly recognised, being raised in this type of environment can result in suffering PTSD long after we’ve grown up.
I was raised in a dysfunctional family and, as a result, suffered from some pretty horrific mental health issues for many years.
For anyone raised in a dysfunctional family, problems can include:
Feeling very isolated
Fearing people and especially authority figures
Always seeking approval from others
Frightened of angry people
Frightened of being criticised
Feeling like one of life’s victims
Feeling responsible for everyone else’s feelings
Concerned more with others’ problems than our own
Feeling guilty when standing up for oneself
Confusing love with pity
"Loving" people who needed rescuing
Stuffing feelings and losing the ability to express them
Having low self-esteem
Judging ourselves viciously
Terrified of being abandoned
Doing anything to hold on to a relationship
Suffering these traits can be debilitating. One way to deal with them is to run away from them but eventually things catch up with us. This leaves us prone to poor mental health, depression and anxiety.
The Beauty Of Denial
Suffering from PTSD is a key driver in our lives, even if we’re not aware of it.
However, being unaware of it has its problems and none more so than living with feelings of deep unease and anxiety but not understanding why.
This is when denial steps in. Denial simply means we reject the notion we have a problem and need help.
Denial may seem from the outside like an ignorant state in which to live, but it is a very practical way of keeping a problem at bay. It’s is a form of survival.
People who are denying their own trauma need to be left alone until they are ready to come out of hiding on their own terms.
Many addictions are created to assist the individual to deny his/her problems. Although this may seem self-destructive, it has to be recognized that the addiction is, conversely, a form of survival.
It is about surviving the trauma by burying the painful feelings that go along with the experience.
It’s a double-edged sword: the denial helps protect us from chronic despair and associated low esteem; it also stops us from thinking there was anything wrong with us.
Unfortunately, denial only lasts so long until the trauma catches up with us.
If we’re inadvertently running away from something, eventually our life will feel like a car crash. It’s not until we’re on our knees that we look for help.
At the same time we don’t want it because that will expose our weaknesses.
Once we can’t manage our accumulated problems isolation, the denial begins to lift. It’s at this point we may begin to suffer severe PTSD symptoms.
PTSD symptoms can manifest as:
Suffering flashbacks and re-experiencing the original trauma through intrusive memories and nightmares.
Suffering emotional numbness; avoiding places and people that reminded us of past trauma.
Always feeling on edge feeling jumpy, and being easily irritated and angered.
PTSD is diagnosed after we experience symptoms for at least one month following a traumatic event. However symptoms may not appear until several months or even years later.
When they do arrived however, there’s no way our inbuilt denial can protect us any longer. We have to do something about the PTSD symptoms because they have the power to literally kill us.
But What Can We Do To Recover From PTSD?
Recovery from PTSD is lengthy and it can seem as if we get better at a snail’s pace. We have to give ourselves breathing space and be gentle on ourselves. After all, how long did it take for the trauma to weave itself into our psyche? It’s certainly not going to leave us in a couple of days.
We need to feel safe to gradually allow the reality of what happened to come into view. Then we can reassess how we coped and the way it affects us today.
What Are PTSD Triggers?
A PTSD trigger is something that activates a memory, or flashback, transporting us back to the original event, which left us with the original trauma. Often we react to the flashback trigger with similar emotions to that at the time of the trauma.
One of the things that can take sufferers by surprise is when a trigger suddenly appears out of nowhere. When this happens it can take us right back to the moment we suffered the trauma.
How To Identify Our PTSD Triggers
PTSD triggers may be all around us and, seemingly come out of nowhere. However, even though it may sometimes feel like the symptoms come out the blue, they are rarely spontaneous.
Instead, whether we’re aware of it or not, symptoms of PTSD are often caused two ways:
Either by something internally like something that happens within our body i.e. thoughts or feelings
Or by something externally like something that happens outside your body e.g. a stressful situation
Because certain thoughts, feelings, or situations can bring up uncomfortable PTSD symptoms e.g. memories or unexplained anxiety, a way of coping with the symptoms is by increasing our awareness of the triggers.
We can lessen the effect of certain PTSD symptoms by recognizing what specific types of thoughts, feelings, and situations trigger them. Then we can take steps to limit their incidence or the impact of the triggers.
Recognizing Our PTSD Triggers
The two types of triggers fall into Internal Triggers and External Triggers.
It’s easy to identify Internal triggers because they are things that we feel or experience inside our bodies like thoughts, memories, emotions, and bodily sensations.
Thoughts of the past
Feeling out of control
External Triggers are circumstances, people or places that we may encounter throughout our day or things that happen outside our body.
Seeing a car, or other vehicle, accident
Seeing a news article that reminds you of your traumatic event
Being in specific place
Watching a film or television show that reminds you of your traumatic event
Seeing an argument
The end of a relationship
Seeing someone who reminds you of a person linked with the trauma
Identifying Your Triggers
Now we’ve looked at the triggers, it helps to identify what your triggers are. This helps to manage anxiety as well as PTSD.
Make a note of as many internal and external triggers as you can and try to evaluate when your PTSD symptoms usually come up.
What is happening around you?
What kind of emotions are you having?
What type of situation are you in?
What thoughts are you experiencing?
What does your body feel like?
PTSD What To Do When You Are Triggered
Of course, the best way of coping with triggers is to avoid them.
However, this is virtually impossible to do because we can’t really avoid thoughts, emotions and bodily sensations. These are, generally, out of our control.
However, we can take some steps to cope with our environment (for example, not going to certain places that we know will trigger us) so we can manage our external triggers.
We need to stay realistic because but we can’t control everything that happens to us. We might, for example, unintentionally come into contact with a news story or conversation that reminds us of our traumatic event.
I know for me, when I see a story on TV about someone who’s been reunited with their long lost parent, I fall apart.
So we often cannot avoid triggers and for this reason it’s important to find ways of coping with them.
Healthy and effective coping strategies for lessening the impact of triggers include:
Setting firm boundaries i.e. learning to say ‘no’
Leaning on social support
The more coping mechanisms we have available to us, the better off we will be in managing our triggers. Plus, the more coping strategies we have, the more likely we will be able to prevent the development of unhealthy coping strategies like overeating, alcohol and drug use.
Additionally, simply being more aware of our triggers can be beneficial. As a result of this increased awareness, our emotional reactions may begin to feel more understandable, valid, predictable and less out of control. This can definitely positively impact our mood and overall well-being.
Have a Safety Plan in Place
Although it is important to increase our awareness of our triggers, doing so can cause some distress. Trying to identify their triggers might actually trigger some people. Therefore, before we take steps to identify our triggers, it’s important to have a safety plan in place in case we experience distress.
An Example Safety Plan
1. Think Ahead
Before you go anywhere, think about whether or not you may encounter some triggers for your PTSD symptoms. Classify them and maybe how you can avoid them.
2. Have Some Emergency Numbers
We all need support and can be an excellent way of coping with PTSD symptoms. We need to be able to get in touch with someone when you are in need. Therefore, we can make a list of people we can call should we be in a situation where we need help.
3. Always Making Sure We Have The Right Medication With You
We must ensure we have the correct medication available so that we don't run into any risk of missing a dose. Or in a situation where we need it to manage our symptoms.