PTSD: Relapsing

Post-traumatic stress disorder (PTSD) is an anxiety disorder that occurs as the result of witnessing or experiencing a terrifying event. PTSD is the result of a change to the body’s "fight-or-flight" response; feelings of anxiety persist in the absence of immediate danger. While most people feel some type of stress following a traumatic event, PTSD can interfere with a person’s daily functioning, and symptoms are felt over a long period of time.

If you have been diagnosed with PTSD, you will be familiar with some, if not all, of these symptoms:

Reliving the event: Nightmares, flashbacks, intense reactions to triggers (objects, people, or places that remind you of the event)

  • Avoidance: Feeling guilt, depression, worry, numbness, or hopelessness; avoiding activities that were once enjoyable; withdrawing from relationships; avoiding thinking about or having trouble remembering the traumatic event
  • Hyper-arousal: Trouble sleeping or concentrating, startling easily, angry outbursts or irritability, feeling "on guard"
  • You may also experience physical symptoms of anxiety, such as headache, racing heartbeat, or dizziness/faintness.

PTSD symptoms can come and go over many years. A relapse is the return of enough symptoms to meet the criteria for diagnosis with PTSD. Though you might not have a full relapse, you may find yourself slipping into old patterns of thought or behavior. You should be aware of the warning signs so that you can intervene early with healthy coping strategies.

Early Warning Signs

PTSD symptoms can return or worsen due to unexpected triggers, the anniversary of a traumatic event, or unavoidable life events such as the release of an incarcerated offender. It is important to learn the early warning signs so you can take control before your symptoms start to feel unmanageable. Early warning signs signal a return to old behaviors or thought processes. Here are some examples of things to watch out for:

  • Changes in sleeping patterns (too much or too little, nightmares)
  • Frequent crying
  • Angry outbursts
  • Panic attacks
  • Avoiding people, places, or activities you once found enjoyable
  • Slipping into unhealthy coping behaviors such as substance abuse or deliberate self-harm
  • Feeling hopeless
  • PTSD is a personal experience, and your warning signs will be unique to you. You should look for recurrent negative changes in behavior, thoughts, or feelings and commit yourself to using healthy coping strategies at the first sign of trouble.

Healthy Coping

You can empower yourself by practicing healthy coping habits. Actively coping will help you to feel a sense of control over your health and your circumstances. Hopefully you have already incorporated some of these strategies into your everyday life. If not, you should think about turning some of these skills into habits so that you can be prepared for stressful times.

Work on regulating your sleeping. Poor sleep has a negative impact on both emotional and physical health. There are many ways that you can combat sleeping problems. Exercise during the day. Avoid working out within three hours of bedtime, since exercise temporarily stimulates your heart, muscles, and brain. Avoid heavy meals, nicotine, caffeine, and alcohol in the evening. Try to make it through the day without napping. Make changes to your sleeping space to make it more comfortable. Reduce light from alarm clocks and other electronic devices, and set the temperature at a comfortable level. You can also practice relaxation techniques such as meditation or progressive muscle relaxation. If you are still having trouble falling asleep, go into another room and engage in a quiet activity until you feel tired. Avoid using backlit electronic devices such as laptops, tablets, and cell phones. Research has found that the light emitted by these products interferes with the body’s sleep regulating system.

Utilize your support system. Talk to your doctor or a mental health provider about your symptoms. Medicine may be helpful in reducing feelings of depression or anxiety. A therapist can help you to develop coping skills and provide support if you feel disconnected from your loved ones. Health care providers can also help you conquer any bad coping habits that you may have picked up, such as smoking or alcohol abuse. You should also consider reaching out to trusted family and friends. Talking about your feelings can keep you from feeling isolated. You may prefer to join a support group and exchange your story with other survivors so that you know you are not alone.

Get involved in activities. You may find yourself avoiding social functions or other activities that you used to enjoy. Staying active can be a positive distraction, improving your mood and reducing your stress levels. Setting weekly goals can encourage you to get moving. Personalize your goals so that they reflect your interests. This can mean completing an art project, taking your dog to the park, or meeting up with a friend for coffee. After you meet your goals, treat yourself to a reward. This will reinforce the positive nature of your activities.

PTSD is a normal response to an abnormal event. Remember, you are a survivor, and you are not alone. There are many resources available to those who seek them. By actively participating in your recovery, you can take control of your life and arm yourself with tools for the future.

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