If you have PTSD, chances are fairly good that you are also having nightmares. Add a little depression or anxiety in with your PTSD, and it increases your likelihood of having nightmares. Nightmares are difficult to deal with because they increase your fear, anxiety, feelings of helplessness, panic, and screaming or crying in your sleep. Absolutely no fun. But the negative effects of having these nightmares continue even after you wake. PTSD nightmares can result in a higher increase in REM sleep than normal, an increase in night-time awakenings and extended periods of being awake, decreased amounts of deep, restorative sleep, decreased sleep time, and problems functioning the day after due to exhaustion.
The negative effects don’t stop there either. PTSD nightmares keep you in your traumatic “flight or fight” mode of heightened arousal. You may find you avoid going to bed at a reasonable time because you are apprehensive about having more nightmares. PTSD nightmares may even prompt you to turn to using drugs in an attempt to prevent additional nightmares. PTSD nightmares have a negative impact on your quality of life.
Treatment for PTSD nightmares is often an arduous journey, slow and frustrating, but treatment can help. Stress reduction and relaxation techniques can help calm you before sleep. Image Rehearsal Therapy (IRT) is a cognitive-behavioral therapy where you focus on a different ending for your nightmares, replaying the scenario over and over so eventually the new ending will replace the nightmare ending. There has also been some success using orientation techniques to ground you in the present moment following a nightmare.
There are several other considerations those with PTSD nightmares should keep in mind. Recent research indicates that many people who have PTSD nightmares also have sleep apnea. This research indicates that restricted oxygen intake keeps the brain from its normal attempts to sooth itself, and this makes the nightmares worse. Treating the sleep problems may well resolve the nightmare issue.
Other possible treatments include somatic therapy where you focus on movement and sensations to work through the physical and emotional aspects of the trauma, and EMDR or Eye Movement Desensitization Reprocessing therapy.
Whatever form of treatment you try, remember that PTSD nightmares do respond to treatment and life can get better. You deserve a calm, peaceful life. Don’t let PTSD nightmares keep you from it!
PTSD and depression can occur simultaneously, with symptoms that often mimic each other. While depression happens to all of us at one time or another, clinical depression lasts for an extended period of time, usually three months or longer. It flavors everything going on in your life and makes it difficult to get up in the morning and keep going throughout the day. PTSD can have the same effect.
It’s not unusual to experience depression following exposure to trauma. If you have PTSD, depression is 3 to 5 times more likely to occur than if you don’t have PTSD. We may struggle as we process traumatic experiences and that can lead to depression. In addition, the trauma may have affected others around us leading to survivor guilt or grieving. The lack of trust we feel when we have PTSD can cause depression too.
Many of the symptoms of PTSD and depression overlap, such as sleep difficulties and concentration. In fact, you may not know which condition is affecting you. Both can lead to isolation and irritability. Fortunately, both can often respond to the same treatment too.
Milder forms of depression can be treated with counseling or talk therapy. More severe forms may involve medications. If you are suffering with PTSD and/or depression, talk with your healthcare provider. Treatments for both work!
One of the more frustrating symptoms of PTSD is being able to sleep soundly. I’ve had years of fighting to get to sleep and then to stay asleep. I think I’ve tried every solution listed for managing my sleeplessness! I’ve made a habit of going to bed at the same time every night. I keep my bedroom cool and dark. I don’t drink any caffeinated beverages in the evenings, or eat before bed. I don’t exercise late in the day or drink alcoholic beverages before bed. Nothing worked successfully for me.
It was only as I got older and stopped fighting it that things got better. I know that sounds impossible, but I believe when I stopped getting angry over not being able to sleep, I slept better! I used to be furious knowing that the next day I was going to be struggling to stay awake at work. Now I keep a book and some crossword puzzles by the bed, and when I wake in the night and can’t get back to sleep, I don’t get mad about it at all. I just quietly turn on a low light and do a bit of reading or work a puzzle and soon I’m dozing off again.
Sleeplessness followed me around like a grumpy bear for years making my life miserable. When I stopped fighting it and simply waited for it to pass, I got a handle on it and found a way to live with it.
PTSD Coach Online suggests journaling about your problems as a way of coping with them. Seems pretty lame on the surface. I know what my problems are, why would writing about them make a difference? But, in the name of trying everything, I went ahead and took 20 minutes out of my life to write about the most pressing issues I’m dealing with.
You see, I’m struggling to make sense out of a senseless event. One single trauma that has burned me to the bone. I know I won’t fully recover from it, but I have to learn to live with it or it’s going to kill me.
Much to my surprise, I found I did learn something from writing about the traumatic event. I was able to get a better, I believe more realistic, perspective on what happened seeing it on paper in front of me, and I was able to better evaluate my feelings. Maybe that’s not moving mountains, but it is a start to understanding the size of my problems and, perhaps, how to view them in a different light.
Sometimes opening the wound is the only way to get a clear picture of how deep it is and why it won’t heal. When we stop running and face our issues, we start to recognize how much of the problem isn’t just the initial trauma we experienced, but how we allow it to grow and fester in our minds. I don’t know if I will come out on the other side of my problems whole and healed, but I’m sleeping better and I’m not as stressed out as I was. That’s something good.
If you have PTSD, you likely also have sleep problems. Nine out of ten Veterans who have PTSD have difficulty sleeping. Four out of ten Veterans have insomnia.
PTSD sleep problems include:
- Intrusive memories
- Excessive worrying
- Nightmares that disrupt sleep
The #1 recommended treatment for PTSD-related insomnia is not sleep medication. It is Cognitive Behavioral Therapy (CBT). CBT for insomnia is a talk-therapy, proven to work. CBT helps you learn to modify the thoughts and habits that affect your sleep. 70% to 80% of those treated achieve better sleep.
Sleep problems often go hand-in-hand with PTSD, but Cognitive Behavioral Therapy works!
(Adapted from http://www.PTSD.va.gov)
When you have PTSD, you are in a heightened state of arousal; this is part of the “fight or flight” response to danger. With PTSD, fight or flight doesn’t go away when the danger is gone. It hangs around leaving us in a constant state of alertness. This arousal can affect our sleep, irritability and hypervigilance.
This heightened state of arousal can lead to excessive anger. When that anger gets out of control, it can affect your relationships and you may become aggressive toward others or develop self-destructive behaviors. Substance abuse may be a part of your response, or you may find you want to hurt yourself.
If you are experiencing intense anger, learn to use anger management techniques. You may want to try mindfulness, or talking through your anger with someone you respect. Deep breathing exercises can calm your body. Focusing on something other than your anger can help too. Developing ways to manage your anxiety may also be helpful as intense anger and anxiety are similar emotions that are involved in the fight or flight response.
PTSD intensifies anger. Learning to manage your rage can improve relationships and self-esteem. Take the time to learn ways you can try to manage your anger. Not all of them may work for you, but don’t give up! There are many ways to cope with the anger in PTSD and it’s worthwhile finding them.
When you have PTSD, you may find it affects your ability to learn. It is not unusual for individuals with PTSD to have trouble paying attention to what is going on around them. They may find that it is hard to recall words, facts such as appointments, or specific details of past events. They may also find it difficult to concentrate.
One of the main reasons PTSD has such an effect on learning and remembering is related to the level of anxiety you are experiencing. It’s not just that you aren’t paying as close attention to detail as you might, but your brain actually encodes information into your memory differently when you have PTSD. If you are depressed, or if you use drugs to cope with your emotional pain, you may find that it is even more likely you will have problems with memory and attention.
Sleep disturbances may also be a problem for those with PTSD. When we are tired, we are less alert. That makes it even harder for us to remember details and focus effectively on what’s going on around us.
PTSD can make learning more difficult. Concentration, recall and focusing are all harder and may require treatment to overcome. Fortunately, effective treatments are available. Mindfulness can help calm your anxiety making it easier to concentrate and focus, and other treatments for PTSD can help too.