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.
