Reviewed by Melinda (Santa) Gladden, LCSW
Post-traumatic stress disorder, or PTSD, is a psychiatric illness that happens to those who have experienced some kind of traumatic incidents like a violent attack, natural disaster, or combat in the military service. It is also common in those who are victims of ongoing emotional, sexual, or physical abuse. It affects more than 3.5% of adults in the United States with women being twice as likely to develop the disorder.
Those with PTSD experience disturbing feelings and thoughts that are related to the traumatic incident. It may happen right away, or it could be months or years after the incident. One of the reasons why it is hard to diagnose is because of this delay in the onset of symptoms.
What Are the Symptoms of PTSD?
So, how do you know if you have PTSD? There are several PTSD tests you can take online that will help you figure it out. However, the symptoms are grouped into four different categories including alterations in reactivity and arousal, mood and cognitive alterations, avoidance, and intrusive thought and feelings.
Alterations in reactivity and arousal includes:
- Being more irritable and angry
- Having outbursts of aggression
- Self-destructive actions like alcohol or drug abuse
- Trouble falling asleep and/or staying asleep
- Increased startle responses
- Feelings of paranoia
Mood and cognitive alterations include:
- Trouble making decisions or focusing
- Negative thoughts and feelings about your future
- Distorted beliefs that you are bad, or that you deserved the trauma
- Feelings of shame or blame
- Loss of interest in your favorite activities
- Feeling lost or detached from others
- No feelings of satisfaction or happiness
- Isolating yourself from others like family and friends
- Staying away from certain places that remind you of your trauma
- Trying to pretend the trauma never happened
- Feeling worthless
- Missing work or school
Intrusive thoughts and feelings include:
- Having flashbacks
- Frequent nightmares or night terrors
- Experiencing frightening thoughts
- Anxiety attacks including fast heartrate, fainting, shaking, dizziness, headaches, chest pain, and feelings of impending doom
What Are PTSD Flashbacks?
Flashbacks, also known as a PTSD episode or PTSD attack, are different for everyone. However, they usually include hallucinations, losing awareness with the world around you, and feeling as if you are not there.
A flashback is an intrusive and frequent memory that has to do with the traumatic incident you experienced. It can make you feel like you are back in that moment, living the same trauma over again. You may even hallucinate and you may dissociate from your surroundings.
Dissociation is feeling disconnected from yourself as well as everything around you. You may feel like you are dreaming but you have visions of the traumatic event that caused your PTSD. It will feel like you are watching yourself from somewhere else as you see yourself becoming frantic from visions of your trauma.
Unlike regular healthy memories, something or someone that reminds you of the traumatic experience triggers flashbacks. It may be a certain sound or smell like hearing someone yell may remind you of the abuse you experienced or smelling smoke can bring back memories of fire.
What is a PTSD Trigger?
A PTSD trigger can be anything and anywhere, which is why many who have the disorder avoid going anywhere. Knowing what your triggers are can be difficult because you never know until it happens, and then it is too late. That is one reason why keeping a journal is a good idea - to record your triggers.
Knowing what your triggers are can help you avoid them, but it can also help you face them. After all, you cannot avoid going outside forever in fear of hearing a dog bark or brakes squeal that can send you into a panic attack.
How A PTSD Flashback Affects Your Brain
There have been numerous studies done with imagery called topography where scientists examine the activity in the brain during a flashback. Increased activity was found in the amygdala in 17 out of 22 participants during a flashback in one study. The amygdala controls memory, decision-making, and emotion. Other areas of the brain that were affected include the:
- Thalamus: Controls the motor signals, sensory signals, and regulates alertness, sleep, and consciousness.
- Occipital lobe: Controls memory and vision.
- Anterior cortex: Controls heart rate, blood pressure, nervous system, emotion, motivation, and attention.
- Striatum: Controls dopamine levels and voluntary movement.
How Do PTSD Flashbacks Affect Your Life?
Avoiding your triggers may work for a while but it is not a practical solution if you want to live a normal and productive life. Even if you spend every day writing down your triggers and learning to avoid them, eventually you will have to face them to help you be the fullest version of yourself.
In addition, you will need to get back to work and move on with your relationships and social life. Facing your triggers will let you take control of how those fears affect you and your life. Using relaxation techniques or other forms of therapy can help you get over the fear of having a flashback.
For example, living in fear all the time can just cause you more anxiety, bringing on more hypervigilance like being overly cautious or on edge all the time. It is important for you to learn how to ground yourself when a flashback happens. This is a way of coping with any kind of trigger that may pop up unexpectedly.
Grounding Techniques You Can Try
You can learn to ground yourself when you start to feel a PTSD panic attack or flashback about to happen. It is a coping method that therapists teach to help you bring yourself back from a flashback or attack.
- Touch: Hold something in your hand that can remind you of where you are. Take your grounding item with you wherever you go and if you sense a PTSD hallucination coming on, grip your grounding item to bring you back to the present.
- Taste: Take a bite of a strong-tasting candy or food like peppermint or lemon. The strong sensation you get can get you grounded back into the present.
- Sound: Put on some headphones and blast some music. Any kind of music. As long as it is loud. Having loud music in your ears is hard to ignore so you will be busy paying attention to the music rather than focusing on your flashback.
- Smell: Take a whiff of strong perfume or a strong essential oil. Having something like that in your nose will bring you back to the present. This stops you from paying attention to the flashback.
- Vision: Look around you and focus on everything you see, naming each item as you go along. Concentrate on the colors of the items or the number of pieces of furniture in the room. Anything to break your attention from your impending flashback.
Also known as prolonged exposure therapy, this therapy gradually exposes you to the trauma while you are in a safe environment with your therapist or counselor. You will typically talk about the traumatic experience in detail repeatedly. This will help to desensitize you to the trauma, eventually letting you think of the traumatic event without any feelings of anxiety at all.
Cognitive Processing and Restructuring
A therapist can teach you skills that will help change your negative beliefs and thoughts into less stressful feelings. You will develop more positive ways to see what is going on within you. The therapist will also introduce you to certain cognitive distortions that you may be showing like catastrophizing, delusions, labeling, blaming, and personalizing.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is another way of changing your thoughts to change your actions. The therapist will teach you how to see those negative thoughts and turn them into more positive ones to change how you deal with any PTSD issues that arise.
You may also be asked to keep a journal detailing your daily thoughts, feelings, and actions to study. Each week you will bring your journal to the therapy appointment so you and your therapist can examine how you are dealing with your triggers and flashbacks. This helps the therapist determine what kind of actions you can take to improve your situation.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a way to reprocess how your brain codes the trauma and your memories of the event. The therapist will have you talk about your traumatic event while you focus on a flashing light that moves back and forth. This is similar to the eye movement that you experience in REM sleep.
This works by showing the brain that it can heal itself. Similar to having something that constantly causes you physical pain such as a splinter, once you remove it, your body can heal. Once the emotional wound in your brain is unblocked, it will begin to heal.
Talk to a Professional about PTSD
Although it may seem impossible right now, it is very possible to take control of your flashbacks so you can stop living in fear and start enjoying your life again. Talking to a mental health professional is one of the most effective treatments. If you are not ready to be outright yet, you can try online therapy from your home. In fact, you do not even need an appointment.
NOTES: I would recommend removing that you could find out you have PTSD based on a quiz, as only a mental health professional is trained to assess and diagnose PTSD. This is a disorder that is often self-diagnosed and that should not be reported as so. You can also utilize the quiz as a guide for bringing it up to a mental health professional. Please just clarify this section; otherwise, the article is great! Thank you.
Does not go against what is clinically accepted.
Does not encourage mindsets or practices that may be harmful to the reader.
Is factual and up-to-date.