Coping with PTSD and Recommended Lifestyle Changes for PTSD
Patients
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
Actions 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
Negative 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.