Coping with PTSD and Recommended Lifestyle Changes for PTSD Patients
A National Center for PTSD Fact Sheet
By Joe Ruzek, Ph.D.
Coping with PTSD
Because PTSD symptoms seldom disappear completely, it is usually a
continuing challenge for survivors of trauma to cope with PTSD symptoms and the
problems they cause. Survivors often learn through treatment how to cope more
effectively.
Recovery from PTSD is an ongoing, daily, gradual process. It doesn't happen
through sudden insight or "cure." Healing doesn't mean that a
survivor will forget war experiences or have no emotional pain when remembering
them. Some level of continuing reaction to memories is normal and reflects a
normal body and mind. Recovery may lead to fewer reactions and reactions that
are less intense. It may also lead to a greater ability to manage
trauma-related emotions and to greater confidence in one's ability to cope.
When a trauma survivor takes direct action to cope with problems, he or she
often gains a sense of personal power and control. Active coping means
recognizing and accepting the impact of traumatic experiences and then taking
concrete action to improve things.
Positive coping actions are those
that help to reduce anxiety and lessen other distressing reactions. Positive coping actions also improve the
situation in a way that does not harm the survivor further and in a way that
lasts into the future. Positive coping methods include:
Learning about trauma and PTSD-It
is useful for trauma survivors to learn more about PTSD and how it affects
them. By learning that PTSD is common and that their problems are shared by
hundreds of thousands of others, survivors recognize that they are not alone,
weak, or crazy. When a survivor seeks treatment and learns to recognize and
understand what upsets him or her, he or she is in a better position to cope
with the symptoms of PTSD.
Talking to another person for support-When
survivors are able to talk about their problems with others, something helpful
often results. Of course, survivors must choose their support people carefully
and clearly ask for what they need. With support from others, survivors may
feel less alone, feel supported or understood, or receive concrete help with a
problem situation. Often, it is best to talk to professional counselors about
issues related to the traumatic experience itself; they are more likely than
friends or family to understand trauma and its effects. It is also helpful to
seek support from a support group. Being in a group with others who have PTSD
may help reduce one's sense of isolation, rebuild trust in others, and provide
an important opportunity to contribute to the recovery of other survivors of
trauma.
Talking to your doctor about trauma
and PTSD-Part of taking care of yourself means mobilizing the helping
resources around you. Your doctor can take care of your physical health better
if he or she knows about your PTSD, and doctors can often refer you to more
specialized and expert help.
Practicing relaxation methods-These
can include muscular relaxation exercises, breathing exercises, meditation,
swimming, stretching, yoga, prayer, listening to quiet music, spending time in
nature, and so on. While relaxation techniques can be helpful, they can
sometimes increase distress by focusing attention on disturbing physical
sensations or by reducing contact with the external environment. Be aware that
while uncomfortable physical sensations may become more apparent when you are
relaxed, in the long run, continuing with relaxation in a way that is tolerable
(i.e., interspersed with music, walking, or other activities) helps reduce
negative reactions to thoughts, feelings, and perceptions.
Increasing positive distracting
activities-Positive recreational or work activities help distract a person
from his or her memories and reactions. Artistic endeavors have also been a way
for many trauma survivors to express their feelings in a positive, creative
way. This can improve your mood, limit the harm caused by PTSD, and help you
rebuild your life. It is important to emphasize that distraction alone is
unlikely to facilitate recovery; active, direct coping with traumatic events
and their impact is also important.
Calling a counselor for help-Sometimes
PTSD symptoms worsen and ordinary efforts at coping don't seem to work. Survivors
may feel fearful or depressed. At these times, it is important to reach out and
telephone a counselor, who can help turn things around.
Taking prescribed medications to
tackle PTSD-One tool that many with PTSD have found helpful is medication
treatment. By taking medications, some survivors of trauma are able to improve
their sleep, anxiety, irritability, anger, and urges to drink or use drugs.
Negative coping actions help to
perpetuate problems. They may reduce distress immediately but short-circuit more
permanent change. Some actions that may be immediately effective may also cause
later problems, like smoking or drug use. These habits can become difficult to
change. Negative coping methods can include isolation, use of drugs or alcohol,
workaholism, violent behavior, angry intimidation of others, unhealthy eating,
and different types of self-destructive behavior (e.g., attempting suicide).
Before learning more effective and healthy coping methods, most people with
PTSD try to cope with their distress and other reactions in ways that lead to
more problems. The following are negative coping actions:
Use of alcohol or drugs-This may
help wash away memories, increase social confidence, or induce sleep, but it
causes more problems than it cures.
Using alcohol or drugs can create a dependence on alcohol, harm one's
judgment, harm one's mental abilities, cause problems in relationships with
family and friends, and sometimes place a person at risk for suicide, violence,
or accidents.
Social isolation-By reducing
contact with the outside world, a trauma survivor may avoid many situations
that cause him or her to feel afraid, irritable, or angry. However, isolation
will also cause major problems. It will result in the loss of social support,
friendships, and intimacy. It may breed further depression and fear. Less
participation in positive activities leads to fewer opportunities for positive
emotions and achievements.
Anger-Like isolation, anger can
get rid of many upsetting situations by keeping people away. However, it also
keeps away positive connections and help, and it can gradually drive away the
important people in a person's life. It may lead to job problems, marital or
relationship problems, and the loss of friendships.
Continuous avoidance-If you avoid
thinking about the trauma or if you avoid seeking help, you may keep distress
at bay, but this behavior also prevents you from making progress in how you
cope with trauma and its consequences.
Recommended Lifestyle Changes – Taking Control
Those with PTSD need to take active steps to deal with their PTSD symptoms.
Often, these steps involve making a series of thoughtful changes in one's
lifestyle to reduce symptoms and improve quality of life. Positive lifestyle
changes include:
Calling about treatment and joining a PTSD support group-It may be
difficult to take the first step and join a PTSD treatment group. Survivors say
to themselves, "What will happen there? Nobody can help me anyway."
In addition, people with PTSD find it hard to meet new people and trust them
enough to open up. However, it can also be a great relief to feel that you have
taken positive action. You may also be able to eventually develop a friendship
with another survivor.
Increasing contact with other survivors of trauma-Other survivors of
trauma are probably the best source of understanding and support. By joining a
survivors organization (e.g., veterans may want to join a veteran's
organization) or by otherwise increasing contact with other survivors, it is
possible to reverse the process of isolation and distrust of others.
Reinvesting in personal relationships with family and friends-Most
survivors of trauma have some kind of a relationship with a son or daughter, a
wife or partner, or an old friend or work acquaintance. If you make the effort
to reestablish or increase contact with that person, it can help you reconnect
with others.
Changing neighborhoods-Survivors with PTSD usually feel that the
world is a very dangerous place and that it is likely that they will be harmed
again. It is not a good idea for people with PTSD to live in a high-crime area
because it only makes those feelings worse and confirms their beliefs. If it is
possible to move to a safer neighborhood, it is likely that fewer things will
set off traumatic memories. This will
allow the person to reconsider his or her personal beliefs about danger.
Refraining from alcohol and drug abuse-Many trauma survivors turn to
alcohol and drugs to help them cope with PTSD.
Although these substances may distract a person from his or her painful
feelings and, therefore, may appear to help deal with symptoms, relying on
alcohol and drugs always makes things worse in the end. These substances often hinder PTSD treatment
and recovery. Rather than trying to
beat an addiction by yourself, it is often easier to deal with addictions by
joining a treatment program where you can be around others who are working on
similar issues.
Starting an exercise program-It is important to see a doctor before
starting to exercise. However, if the physician gives the OK, exercise in
moderation can benefit those with PTSD. Walking, jogging, swimming, weight
lifting, and other forms of exercise may reduce physical tension. They may
distract the person from painful memories or worries and give him or her a
break from difficult emotions. Perhaps most important, exercise can improve
self-esteem and create feelings of personal control.
Starting to volunteer in the community-It is important to feel as though
you are contributing to your community. When you are not working, you may not
feel you have anything to offer others. One way survivors can reconnect with
their communities is to volunteer. You can help with youth programs, medical
services, literacy programs, community sporting activities, etc.
Related Fact Sheets
Managing
stress
A brief guide to recognizing the symptoms of stress and managing traumatic
stress
Self
care following disasters
Answers questions about what people can do to cope with PTSD and where one
can go to get help
Discussing PTSD
with your doctor
A useful checklist to help discuss traumatic stress symptoms with primary care
physicians
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