Having PTSD takes a lot of energy. Those of us with that diagnoses know that we are “on point” 24/7. We monitor everything and know what’s going on around us all the time. Being hypervigilant is frustrating, to say the least, but it has become such a way of life, that we can’t even conceive of things being any other way.
Keeping track of all that’s going on is not an easy job, but it is part of who we are. Anxiety drives the hypervigilance, and our thoughts drive our anxiety. Learning to control our thoughts then is the first step in learning to manage our anxiety. Remember, our thoughts, feelings and behaviors are all connected.
Our thoughts are shaped by our life experiences, and while they may well have been right on target immediately following the traumatic event we experienced, as time goes by they may become less accurate. We may perceive something as a threat when it actually isn’t anymore.
There are four types of feelings we can experience connected with PTSD: fear, sadness, guilt and anger. Think about a feeling that’s bothering you. Now, weigh the pros and cons for why you feel the way you do. Weighing the pros and cons helps you decide if it’s worth holding on to those thoughts.
If keeping those thoughts outweigh letting them go, then you need to keep them for now. But, if it’s time to let them go, try looking realistically at what’s behind them.
If you decide it’s time to let them go, it’s the first step in changing your feelings. PTSD affects our thoughts, feelings and behaviors. But we can take back some of what we’ve lost so far. Take the time to identify what your feelings and thoughts are, and then weigh the pros and cons of keeping those thoughts. If the cons outweigh the pros, then it’s time to start changing your thoughts.
PTSD may result in our feelings flavoring our interactions with others. The result is that people avoid us because we treat them aggressively rather than assertively. If you are unsure about the difference between the two, assertiveness is:
- Knowing what you want or don’t want
- Considering your rights and the rights of the other person you’re speaking with
- Expressing your needs in a way that is respectful and clear enough to get the outcome you want.
Communicating assertively rather than aggressively is important because it allows you to get your message across without alienating others and increasing your isolation. The benefits of communicating assertively include:
- Helping develop your self-respect by giving your own needs the same importance as those of others
- Helping you get what you want
- Helping you handle stress better
There are five basic styles of communication behavior:
- Passive, where you let things happen without saying what you want or need. Passive people usually feel guilty for having their own wants and needs. The problem is that you aren’t likely to get what you want. Being passive with others causes them to feel resentful.
- Aggressive, where communications are basically hostile, demanding or threatening. Aggression ignores the other person’s rights and feelings. People often react by becoming defensive and angry, and by avoiding you.
- Passive-aggressive, where you resist requests from others by delaying, or active stubborn, or sullen. Passive-aggressive people often say one thing while meaning another. People respond by becoming angry and confused and they lose respect for you. You seldom get what you want this way.
- Manipulative, where you try to get your needs met by making others feel bad for you, or afraid and guilty. It allows you to play the victim in the hopes that others will give you what you want. Manipulating people causes them to become upset and to avoid you. They often resent and mistrust you too.
- Assertive, when you ask for what you want in a clear way, respectful of others. Being assertive increases the comfort level of the other person because you are clear about what you want. The other person feels respected and heard, and you’re more likely to get what you want using this style rather than any of the others.
Assertive communication is possible when you take the time to consider the position of the other person, then voice your own wants without running their position down. It can make interactions with other people easier, and remove the hostility that the other styles of communication elicit.
(This information was adapted from the VA’s PTSD Coach website: www.ptsd.va.gov/apps/PTSDCoachonline/default.htm).
One thing about PTSD I’ve realized, is that to a large extent, I can define whether it’s going to have a totally negative effect on me or not. While I wish I didn’t have this particular diagnosis, I’ve had to admit there is a legitimate reason I have PTSD, and that, having it does, to an extent, protect me. After all, being hypervigilant means that it is very rare for anyone to take me by surprise.
I’ve had one friend point out that I’m probably one of the safest people he knows just because I am so tuned in to what’s going on around me. When I get out of my car, I’m always aware of others in the area and I’m always evaluating whether they are a danger to me or not. While that doesn’t mean I won’t get hurt in the long run, it does mean that subconsciously I’m doing everything possible to ensure I won’t be stuck in another traumatic situation again.
Trying to view something in this manner is called reframing it. By acknowledging that my PTSD has a positive effect on my life in some way, makes it easier for me to live with it. PTSD is something I wish I didn’t have to live with. But, I have had to acknowledge that it’s possible to view things in a different light and recognize that there are silver linings to my clouds. PTSD is a way my mind has responded in order to keep me alive…and that can’t be all bad, can it?
It never seems to matter which holiday it is. When you have PTSD, no holiday feels like a celebration. Feeling uncomfortable in crowds makes July 4th one of the worst. The kids all love to go to the parade, but that’s the last place I want to go! And then there are the barbecues, the relatives, and all the other traditions that make holidays one big pain in the neck. But it doesn’t have to be that way.
If we bow to the fear that comes with having PTSD and worrying that something else horrible is going to happen to us, then we miss out on all the good things that can happen too. And, I really believe there are a lot more good things out there than there are bad. Sometimes it’s good to visit with family you haven’t seen in a while. And barbecues can be fun if they aren’t too big and too much work.
It’s up to you how much celebrating you want to do on any holiday and how much effort you want to expend in entertaining. While you may never want to go to a parade, or have your relatives all over for dinner, or host the neighborhood block party, find the boundaries of your comfort zone and do some celebrating within them. Don’t let the fear win! If you can’t manage the parade, then take part in a cook-out with your family. If you can’t go to the movies, then treat the kids to a special video and popcorn in your home. Don’t give up on all celebrations. Find ways to participate in the joy of the season.
After having a particularly stressful day, I got to thinking about PTSD effects our stress levels. I believe that if it’s a stressful day, my baseline increases dramatically due to my PTSD. My sister will tell you my temper has a hair trigger, and that used to be very true. I’d like to think it’s not the case so much now, but, it is what it is. I know that I react to everyday frustrations very quickly, and it’s something I have to keep at the top of my consciousness and work to control every day.
It used to be that I did not realize I was so stressed until I had an emotional melt down. I don’t like myself very much when that happens, so I try to ensure that I’m paying attention enough now to stop it before things get out of hand. Sometimes that means stepping aside for a voluntary “time out.” That means I disconnect from whatever is stressing me and focus intently on something enjoyable. Often I’ll use music to regroup, or maybe I’ll sit down at the computer to play a game or two, or take a ten minute ride in the car. Basically, it means I’ve had enough stress for the moment and I need to disconnect in order to allow myself a cooling off period. I really don’t think my family realizes how necessary this is for me, but it is something I feel I have to do for myself to maintain my mental health.
Try monitoring your stress levels throughout the day. If you practice doing this on a daily basis, it will become easier as you go. Intervening before your stress takes over allows you to stop the cycle of “blowing up” and taking it out on everyone else in the vicinity. I know I don’t like being known as the person with a temper that explodes on a hair trigger. Even if others around you don’t understand what you’re doing when you refocus, it’s better for them and you to not let stress push you into the danger zone.
Telemedicine is the newest trend in treating PTSD. Video teleconferencing (VTC) allows a single person or group of individuals in one location and a clinician in a different location to see and hear each other in real time.
Telemedicine allows veterans living in remote areas to access treatment services they otherwise would have to travel miles to reach. Telemedicine services may include clinical assessment, individual or group psychotherapy, educational interventions, cognitive testing, and general psychiatry. The major benefit is that these services eliminate travel expense that may be disruptive or overly expensive.
Research comparing VTC and real-time methods of PTSD assessment has shown the methods yield comparable results. While providing treatment using telemedicine may need more research, it does provide an alternative for individuals who have difficulty accessing treatment even though they live in remote areas.
Telemedicine appears to offer a more convenient and economical way to provide or supplement PTSD care services. For patients that live remote distances from VA Med Centers, this is one way to make treatment for PTSD accessible.
The thing about PTSD is that it is a normal reaction to trauma. You can actually think of it as a normal reaction to an abnormal event. So why do we call it a disorder? . Although we may be changed by what we’ve been through, we can and usually do get better over time. While we may never be the same, for many people the symptoms lessen or disappear altogether.
PTSD treatment works. There are different options you can try to treat PTSD. The thing is, if you don’t get into treatment, your PTSD may get worse. It’s never too late to get into treatment; the sooner treatment starts, the sooner you can start to feel better!
There are a variety of treatments available for treating PTSD:
- Talk Therapy involves discussing what you went through with a therapist.
- With Prolonged Exposure Therapy, you’ll discuss your experience with a therapist who will ask you to review the situation multiple times. Reliving the experience helps reduce the intensity of the memory.
- Cognitive Processing Therapy helps you change your thoughts about the event which helps change how you feel too.
- Eye Movement Desensitization and Reprocessing involves having you think about the event while listening to a sound such as a beeping tone, or being exposed to a blinking light. For some reason, this helps your brain reprocess your feelings about the event.
- Stress Inoculation Training teaches you the skills you need to handle stress.
- Medications may be used to increase certain chemicals in your brain that help you manage stress.
PTSD is a normal reaction to an abnormally stressful situation. It is treatable, and treatment can result in reduction or elimination of symptoms.