Social Anxiety and PTSD

In my work with Veterans who have had a PTSD diagnosis, I’ve found that it is not uncommon for them to go to great lengths to avoid social interactions.  This is often the result of not feeling safe, or of feelings of panic at the thought of leaving the house.  In some cases, these vets do not have any significant contact with others at all in the course of their day, and it can go on for years.

This avoidance behavior is identified by mental health professionals as a social anxiety disorder, or a social phobia.  While social anxiety disorder may be caused by differing reasons in the general public, with PTSD, it is caused by an inability to feel safe anywhere but inside the home.  I have had it explained to me as a fear that “no one has your back.”  Social isolation can be a very difficult symptom to treat.

Panic attacks often accompany social anxiety disorder. This may include feelings of shortness of breath, or feeling overwhelmed and crowded by others. In order to prevent the anxiety from escalating, the veteran simply isolates him- or herself.

Overcoming social anxiety disorder can be difficult, but one of the primary points in healing is that you must be willing to move out of your comfort zone. I’ve had veterans tell me they desperately wanted to get over the disorder, but they absolutely refused to leave the house at all. That makes it very difficult to change the situation.

Despite being difficult to treat, social anxiety disorder can be cured!  By expanding your borders a little at a time and being willing to begin interacting with others socially a little at a time will facilitate the process.


Flashbacks and unwanted memories aren’t the only problems associated with PTSD.  Nightmares can leave you feeling confused and as if you are right back in the middle of your memories.  Waking night after night leaves you in a constant state of exhaustion.  You may even reach the point where you don’t want to go to sleep for fear you’ll drown in your terror.


Unfortunately, like so many other symptoms of PTSD, nightmares don’t affect just the person having them, but they may also have a terrible effect on family members.  Spouses may be afraid of waking you up for fear of how you’ll respond.  Children may be roused each time you wake too.  It’s not fun and games, that’s for sure.


A PTSD-trained dog can be taught to wake you when you have a nightmare.  The dog will prod you and then step back to allow you to wake up.  Sometimes being roused by a person can be very frightening.  Being roused by a dog doesn’t prompt a defensive reaction.  After the dog wakes you, once it feels secure, it will come close again to offer comfort and reorient you to the present.


As I approach the starting date to begin classes so I can train service animals, I will share with you what I am learning about these wonderful dogs.  There are quite a few types of service dogs available, including dogs that assist with balance, leader dogs for the blind, dogs trained to help with mobility, to pick things up that you’ve dropped, to alert you if you are about to have a seizure, or if your blood pressure is spiking, or dogs that assist people with a PTSD diagnosis.   That’s the one I’m most interested in learning to train.

The current official position of the VA is that dogs trained for PTSD have not been shown to provide any more benefit to someone with PTSD than a normal dog would.  I agree that an untrained dog can also enrich a veteran’s life, but PTSD dogs receive special training that, I believe, goes a step further than that.

For one thing, the dog is trained to respond to mood.  It may respond to sadness, signs of depression, crying, or other specific cues.  In this scenario, the dog would prompt the owner to pay attention to it, reorienting the individual to the present and showing positive acceptance.  That can be a strong prompter to remain in the present rather than falling into another flashback.

PTSD dogs are trained to “block” the owner.  By that, I mean that the animal will move in front of the handler, blocking others from approaching in a non-aggressive manner.  In working with individuals with severe PTSD, I find that the desire to keep others at enough of a distance to feel comfortable and secure is one of the strongest drivers of PTSD behavior.  Having a dog that allows one to feel comfortable in public is a tremendous achievement for those with PTSD.

PTSD service dogs do more than just bring emotional comfort to veterans.  As one veteran told me, “I could even go outside for a walk if I knew someone had my back!”

I am committed to learning as much as I can about PTSD service dogs over the next year.  My hope is that once I’ve completed the training, I will be able to take part in providing service dogs to veterans with PTSD and that these animals will enrich the quality of their owner’s lives.



By having your status as a veteran noted on your driver’s license, you can easily prove your Veteran status so you receive discounts from businesses.  The process involves submitting a veteran designation application at your local Secretary of State office or you can also do it when renewing your driver’s license through the mail.  If you are renewing your license or applying for an original, there is no charge for this designation.  If you add the designation at any other time, correction fees are assigned.

You are eligible if you have served in any branch of the U.S. armed forces and have an honorable or general discharge.  The designation will be noted in red on the front of the card, and there are many local businesses that allow discounts for veterans.  For more information, visit the Secretary of State website.




Sometimes moving ahead can be very difficult.  I know I need to move, but I’m stuck.  Although I want to achieve my goals, I don’t seem to be able to take that next step to get there.  I think everyone goes through times like this.  The trick is to not stay in one place too long.  Sounds easy, but it is not!

In the same way, we want to heal from PTSD, but healing means doing things we don’t want to do.  It may be going to the movies or dining out, or even driving down the road.  They are actions that we don’t want to take and forcing ourselves to take them can be so difficult.  But, if we want to get past the boundaries of our fear, we must change…and change is hard.  I mean, status quo is at least safe…isn’t it?

So, how do we get unstuck?  A friend of mine recently posed that question to me, and almost immediately answered it too.  “I guess it’s like the old adage of how do you eat an elephant?  One spoonful at a time!”

He was right.  Sometimes it can be so overwhelming to even consider challenging our “safeguards,” those beliefs that keep us stagnant.  But if we can’t swallow that entire elephant in one bite, we can at least try a spoonful.  Taking it one step at a time can make the unthinkable possible.