How Your Body Fights Stress

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MODULE 4

HOW YOUR BODY FIGHTS STRESS

The Stress Response & Stages

Everyone experiences stress differently, and not everyone feels all the stages of stress or has the same response to stressors. People with PTSD (without coping skills) have unnatural, exaggerated, and sometimes ‘out of this world’ reactions to perceived or real stress provoking situations, people, and objects.

When a non-PTSD person is stressed, their body generally has a physiological response that allows for a normal and natural adaptation to stress. But a PTSD diagnosis and the cocktail of symptoms and side effects it brings makes it almost impossible to properly, calmly, and collectively respond or adapt to stressful situations.

For someone with PTSD, not having coping mechanisms and learned skills in place makes their responses to stress disorganized, magnified, and draining. The need for skills for PTSD sufferers is directly related to quality of life.

The Stress Response

Hans Selye, a famous Austrian-Canadian endocrinologist, conducted research on human stress response and was the first to demonstrate the existence of biological stress: the body’s response to stress.

He called it the General Adaptation Syndrome (GAS), and for PTSD sufferers, it’s the first gas they need to keep in. GAS plays a crucial role in every person’s daily functioning and ability to adapt to stress. For people with PTSD, adapting to stress has a whole new meaning and connotation because without the ability to adapt and properly respond to stress, every person, object, or situation has the potential to produce anxiety.

According to Selye, an event that threatens a person’s well-being (a stressor) leads to a three-stage response from the body to deal with the stressful situation, person, or object. The stress response has three main stages:

Stage 1: Alarm

The Alarm Reaction Stage is the initial warning your body experiences. This is the stage where you encounter the event that threatens your life, when you feel that you are in danger, and where your body activates your fight or flight response and your sympathetic nervous system is also activated. This is the stage where your body starts preparing for the perceived imminent danger in front of you.

In the face of danger, your nervous system sends an emergency signal to your brain, and all your body parts activate their functions to back you up and protect you from the danger.

Your heart rate accelerates.
Your blood pressure increases preparing to supply your muscles and brain with more oxygen.
You are more energized, and your muscles feel strong and your limbs fast: You are ready to take it head on or get the heck out of there.
Your facial expressions show your feelings: tense? afraid?
Blood flow to your stomach, kidneys, skin and liver decrease.
Sexual and immune functions are suppressed.
Your body’s natural painkillers are released in your bloodstream.
Your attention is fully focused on the alarming situation in front of you and your senses are on high alert.

ALL THIS HAPPENS IN ABOUT A SECOND.

Whether it is primary stress (such as a car accident), or a secondary stress (such as stress due to a deadline), for people with PTSD the response will be very similar, as almost any stressor can be perceived as a life or death situation.

The alarm stage and subsequent reaction is an expensive process for our bodies because it requires a great deal of energy to produce and maintain. As someone with PTSD, it is paramount that you learn to recognize your own warning signs of stress and danger so that you can learn to control them. As someone who has suffered from PTSD for more than two decades, I can tell you this: always strive to stay at the Alarm stage. Always.

The Alarm stage is where all your learned skills should kick in and do their job at helping you control yourself and relax.

You should be able to recognize the signs…

Fast breathing
Sweating (could be your face, hands, or feet)
Your heart rate accelerates
Your blood pressure increases
In my case, my stomach gets upset

Stage 2: Resistance

As a PTSD sufferer, if you have not arrived at a point where you have mastered your skills and know when to implement your coping mechanisms, you won’t get relief from the first stage, and will enter the stage of resistance.

At this stage, your body tries to adjust to the demands of the ongoing threat by putting your system in full red alert, and full red alert for a person with PTSD means they believe they are in imminent danger.

In stage 2, you’ll gradually start feeling a reduction in your energy levels, but you would want to keep fighting the danger and adapt to the new situation. Your body will react by releasing stored fats and sugars into your system, and your physical and mental patterns change.

Red flags at this level will be indicated by:

Weariness
Forgetfulness
Anxiousness
Exhaustion

Stage 3: Exhaustion

I refer to this stage as the ‘broken down stage.’ If you have PTSD and you allow your stress to get to the exhaustion stage, then you will not be able function at all. Your entire system and physical existence stops functioning properly. Inability to bounce back from this stage can seriously exacerbate your PTSD symptoms and leave you susceptible to depression, isolation, disease and death.

When you don’t have the necessary coping skills to return to a normal level (Stage 1), resistance and stress continues beyond the second stage, and the final stage of stress settles in. Exhaustion means you are totally tired and out of energy. You are physically and emotionally beat. You are no longer interested in work or life. Everything is just too heavy and too hard.

In this stage, your body’s endocrine activity is heightened. High cortisol levels begin to have negative effects on your immune, circulatory, digestive, and other systems. This will weaken your body’s defense system and make you an easy target for colds and flu symptoms. The symptoms here are strikingly like those present in the Alarm stage, but with greater intensity and duration.

Prolonged, recurrent, or intense stress reactions can cause a variety of stress-related health disorders such as ulcers, high blood pressure, arteriosclerosis, arthritis, kidney disease, and allergic reactions. If untreated, these problems can become permanent.

Battling the effects of PTSD can be a challenging and exhausting mind and body endeavor. The mind of a PTSD sufferer can produce 50% more stress that the body can handle. The overproduction of stress makes the body feel overly taxed and exhaustion sets in.

Fighting Stress

Stress is a biological and psychological response that occurs when we encounter a threat. For those with PTSD, the response experienced is more noticeable, as the PTSD brain doesn’t feel capable of dealing with negative stimulus of the stressor. But you can learn skills and mechanisms that will ameliorate these responses.

When you confront a situation that you perceive as a threat (e.g., death of a loved one, moving to a new house, loss of a job, divorce, or even an exam), your body goes through a series of physiological changes because it senses that you are under stress. This response comes with an increase in heart rate and breathing - the lungs dilate, the digestive activity decreases, and the liver releases glucose for energy. These changes are brought on by your body’s defense system kicking in to protect you from the detrimental effects of stress.

People feel and act differently during stressful situations, so does each body adjust to cope with the changes. Non-PTSD sufferers can return to a normal state with ease. In the case of PTSD sufferers, returning to a calm state after a stressful situation requires proper coping mechanisms because the PTSD brain chemistry is different and perceives the environment as more dangerous than it is.

Your body judges the situation and decides whether it is to be deemed stressful. The decision is made based on the sensory input received - how you see and hear the situation, and your stored memories - what happened the last time you were in that situation.

Most people can assess and see stressful situations for what they are: non-emergencies. But for people with PTSD, the fear and stress reactions don’t have to be provoked by a genuine threat or challenge but a perceived one. Because of traumatic memories/experience, PTSD sufferers enter an excessive and inappropriate state of arousal characterized by a variety of feelings of apprehension, uncertainty, and fear. The anxiety response does not have to be triggered by a real threat, but it can still paralyze the person with inaction, withdrawal, or worse, an aggressive reaction.

Once your stress level begins to rise, the hypothalamus gland orders the pituitary gland to release ACTH hormone. Adrenaline and noradrenaline are released. Since the situation was judged as being stressful, the hypothalamus, in charge of the stress response, activates. Once the stress response is triggered it signals the pituitary gland and adrenal medulla. Short term responses to stress are produced by the fight or flight response via the Sympathomedullary Pathway (SAM). Long term stress responses are regulated by the Hypothalamic Pituitary-Adrenal (HPA) system.

It’s crucial to understand the chemical changes that happen in your body during a reaction to a stressor.

The Hypothalamic Pituitary-Adrenal (HPA) System

The HPA regulates long-term stress. First, the stressor activates the HPA, the hypothalamus stimulates your pituitary gland, the pituitary gland secretes ACTH.

ACTH stimulates the adrenal glands to produce the hormone corticosteroid (cortisol). Then, cortisol enables your body to maintain steady supplies of blood sugar. These sugar supplies have several functions including releasing stored glucose from the liver, which will give you energy, and controlling swelling after injury. While all this is taking place in your body, the immune system is suppressed. Adequate and steady blood sugar levels will help you cope with prolonged stressors and help your body return to a normal non-emergency state.

The Sympathomedullary Pathway (SAM)

The SAM is another example of the how the body responds to stress. It is the system designed to help us cope with acute stressful situations by producing short-term stress responses that allow us to react with speed in case of a perceived threat. The SAM is the life-saving psychological and biological response experienced when we encounter a threat we don’t feel we have the necessary resources to manage.

At the same time the SAM is activated, the hypothalamus activates the adrenal medulla. These activations are all part of your Autonomic Nervous System (ANS). The ANS regulates certain body processes such as breathing rate and blood pressure. It is the part of your peripheral nervous system in charge of acting as a control system to help maintain stability in your body. The adrenal medulla secretes adrenaline, getting your body ready for a fight or flight response.

The adrenaline creates changes in your body: it decreases digestion and increases sweating, pulse, and blood pressure. Your bloodstream is overcrowded with red blood cells full of energy, almost as if they were joining hands with the newly released hormones to give you a power boost to deal with the perceived threat.

This is what makes your heart beat faster and your fingertips pulsate.
This is what increases your body temperature making you feel as if you are burning from the inside.
This is what makes your hands sweaty.

How SAM Feels with PTSD

For non-PTSD sufferers, once the perceived threat is over, the parasympathetic nervous system takes control of the body and brings it back to a balanced state. For PTSD sufferers, the perceived threat doesn’t easily dissipate, especially if the person doesn’t have healthy coping mechanisms to deal with the perceived stressor. If this cycle persists, the stress response is heightened and can lead to physical and psychological distress far beyond what is experienced by others who have normal responses to stress.

For PTSD sufferers, perceived stressful situations produce a stronger SAM reaction and various involuntary changes in the body: increased sweat, eyes open wider than normal, concentration levels soar, mouth is dry and saliva production decreases, digestion changes, urination and defecation completely stop, uncontrollable diarrhea, and the hands and feet may get cold as blood is pulled together to fight the perceived danger.

When confronted with negative stimulus, your PTSD mind body perceives it as a threat and the stress response kicks in. But PTSD affects your stress response making your reaction to stimulus stronger, making it challenging to return to a balanced state. Your attention is fixed on the stress point. It has your full concentration. You are only aware of one single thing – STRESS – produced by the perceived threat in front of you. Your mental alertness is so activated that you are swarming with excitement and fear. The power of your idle senses is at its highest, and so is your hypersensitivity: emotional and cognitive responses are magnified.

People with PTSD keep many of the psychological symptoms of stress regularly, even when there is no stressor around. They always appear anxious and hyper-attentive, even in non-threatening situations because the mind is chronically stressed.

The stress period is a vulnerable one for people with PTSD, as the immune system suffers a sort of ‘breakdown.’ The body finds itself defenseless against foreign bodies, making you easy prey for infections and serious illnesses. During the stress period, people with PTSD are more prone to fall sick and less likely to be able to fight away illness.

For people with PTSD, the best course of action to reduce stress is learning skills and techniques that will serve as the coping mechanisms to fight against the over-exaggerated responses to stimulus and which can affect your health.

The PTSD Body & Stress

The body’s stress system (HPA-axis & SAM) is crucial to our physiological response to stress. Non-PTSD sufferers lack exaggerated physical and behavioral responses that activate in the presence of stress. They have milder responses because they can adapt better to and in stressful situations. Their brain chemicals are not affected, at least not by PTSD.

But those with PTSD have an excessive and prolonged activation of the stress system. The wheels of a car screeching as it takes off might make a PTSD sufferer jump from their seat, while others may just turn their heads to notice where the sound is coming from. Remember, chronic stressful situations without adaptation can have a significant impact on your overall short and long-term health. Therefore, it’s important to learn skills and get your life under control.

A person with PTSD is constantly under stress and their response to stress is different from non-PTSD sufferers, other people with anxiety-based disorders, and unique to each sufferer’s set of PTSD symptoms. Your reactions and responses to stimulus are exclusive to you, and no one else.

Most people have positive or tolerable responses to stress if the negative experience doesn’t last. It also helps if you have a good and solid support system. But, if the exposure to the event is too impacting, too repetitive, or too prolonged, the person won’t have a chance to regain control of their fight-or-flight response and get back to a safe place where the body’s stress system is not on high alert. If the mind can’t rest, the body won’t be able to either.

Living with PTSD is a continuous and painful challenge that people didn’t ask to live with or signed up for. Yet, it’s a disorder that anyone can take control of. The overabundance of side effects associated with the condition play a significant role in why the lives of people with PTSD are often so stressful, in disarray, and full of anxiety.

Many of the symptoms directly affect the person’s ability to function in a world where much of the population doesn’t suffer from PTSD, and few seem to care about those who are touched by it.

Aside from affecting your life in inconceivable ways, unmanaged stress can also have serious negative impact on your friends, loved ones, children, coworkers, and everyone else you encounter daily. PTSD affects your relationships at a deep level, and managing stress is the best way to take control of the symptoms. Remember that PTSD is not just difficult for you, but it also takes a toll on your loved ones.

The stigma of living with PTSD keeps many sufferers ‘bottled up,’ unable or unwilling to express themselves. Internalizing and not talking about PTSD and its symptoms prevents people from finding and accessing appropriate resources that could help them heal and move forward. In addition, many of the evidence-based resources are only available to military veterans, or to private citizens at inflated costs.

There is no shame in admitting that you have PTSD, and absolutely no shame in acknowledging that it stresses the heck out of you. Different people handle stress in diverse ways. What works for one person may not necessarily work for another. Understanding your stress and what triggers you, your mind, and your body are the best approaches towards living a more controlled and less stressful PTSD life and to achieve your fullest potential.

I’ve always been amazed at how some people can simply shrug off chaos around them, while others can have one simple occurrence or change in routine throw them out of balance. I’ve been there, many times. Throughout the guide you will hear constant repetition of coping mechanisms, retraining your brain, management skills, and the like. You will also hear me refer to people with PTSD as sufferers as well as warriors because the reality is that they are both.

I repeat information about acquiring coping mechanisms and skills because without these [proper] strategies in place, people with PTSD can only carry a certain amount of stress on their shoulders before it becomes too much to handle, making their symptoms worse and negatively affecting everything and everyone around them.

Without the skills I’ve learned throughout the years, and the time I have taken to disembowel this disorder, I would’ve most likely drowned in both salt and freshwater. Sometimes stress accumulates to such degree, that those with PTSD can ‘lose it’ about simple things such as a plate not washed after dinner. This reaction is almost always the result of unmanaged stress, and our inability to identify the source, address it, and find a way to release it before it blows up in our faces with undesirable and sometimes long-term consequences.

Your friends and loved ones don’t have to take the brunt of the disorder. With proper coping techniques in place, you’ll be able to slow your brain down, and realize that the insurmountable amount of stress you are feeling about the dirty plate is just unfounded and quite frankly, stupid, and you will be able to address it properly, like perhaps just washing it yourself.

Stress is not a life or death situation for most people. But for those with PTSD, facing a worry or feeling uncomfortable with something around can turn into a deep feeling of anger, fear, frustration, or other negatives. These feelings, if unmanaged, can feed more negative feelings to the mind and body, resulting in a short-tempered reaction to the issue that can quickly and easily ruin your day, and affect others. This is the essence of the disorder. Being worried can turn into physical aches and pains, or manifest behaviorally through explosive and exaggerated reactions to stimuli. Therefore, learning to manage the stress associated with PTSD is paramount because it will reduce your anxiety levels and give you a chance to control your reactions.

PTSD Symptoms

Every single symptom associated with PTSD has the potential of disrupting your daily routine and, if unmanaged, continue to affect your life.

Whether your PTSD symptoms began right after the traumatic experience or started years after, managing the PTSD’s psychological, behavioral, and physical symptoms without knowledge of the disorder and a solid plan of action can be an intimidating task.

PTSD is an anxiety-based disorder, and the only anxiety disorder that has a known cause. Tackling the stress in your life will hurt PTSD, as stress is the #1 cause of anxiety for people with PTSD.

In my opinion, therapy or medicine management alone do not fully address the complexity of daily living with PTSD symptoms. Those affected must live in a world where the rest of the population is not on therapy or medicine, and most don’t care to understand what it’s like to live with PTSD.

Each PTSD sufferer has their own set of symptoms, and PTSD symptoms affect each person different. While some people might struggle with hypervigilance issues, others might suffer from insomnia, anger, or excessive amounts of guilt and shame. While flashbacks may be one person’s biggest problem, feelings of depression might be someone else’s worst enemy.

Regardless of which PTSD symptom is your nemesis, all of them can turn your life upside down if you don’t learn to manage your stress and reduce your anxiety.

As if the impact of PTSD symptoms in your life was not enough, unmanaged stress can exacerbate each symptom. Understanding your PTSD symptoms and how stress affects them is crucial to your healing.

Psychological Symptoms

Avoidance & Emotional Numbing

Avoidance is another central symptom of PTSD. It occurs as a result of trying to reduce or eliminate exposure and reaction to triggers that produce anxiety, fear, and traumatic memories and thoughts. While staying away from physical or mental stimuli that reminds you of traumatic events can be good in certain circumstances, you will not be able to avoid all situations, people, or places. Also, triggers can present themselves unexpectedly, and can sometimes be unrelated to thoughts, feelings, or conversations associated with the trauma. In reality, avoidance works for just a short period of time, but in the long run it can become severe, worsen your PTSD symptoms, and truly interfere with your quality of life.

Breaking down avoidant behaviors is not easy. On a daily basis, you avoid activities, places, or people that arouse recollections of the trauma. You actively avoid everything that could remind you of your trauma, even if what you consider a trigger makes no sense to others. But there are steps you can take to reduce this behavior.

When suffering pain becomes too much to handle, those with PTSD resort to numbing their feelings as a coping mechanism. Emotional numbing can lead to withdrawal and isolation, and many other problem that can trickle down after a personal chooses to avoid the world. Personally, I found that emotional numbing became much worse when I was taking a cocktail of medicines to help manage my PTSD symptoms. Not everyone has the same reaction and side effects to medicines prescribed for mental health issues, but for me, it made me walk around like a zombie, unable to enjoy life.

There are a plethora of reasons why a person with PTSD decides to numb themselves from the world. It’s a defense mechanism, an action made to hinder or stop a bad, unpleasant, or painful emotion from happening again. It could be fear, shame, or sadness, but we always find a way to push emotions and traumatic experiences away. It’s almost like choosing to withhold your emotions. But avoiding emotions may worsen other PTSD symptoms, which is why community is so important. Emotional avoidance is a destructive coping strategy that will only provide you temporary comfort. Those emotions are not going away, so finding a way to deal with them will help keep them weak, while avoiding them will only strengthen them. You want to address the emotions before they come back to fight you.

Depression

Depression is a common problem among those with PTSD. People tend to get depressed after experiencing trauma. Depression affects your mood, it makes you feel sad or low all the time. It doesn’t go away and come back, it’s always there like a permanent bruise to remind you what you lived through. Depression can also affect your ability to perform daily activities, as well as your concentration. Not being able to function normally is difficult, and many people lose passion for life. It can also affect your sleeping and eating habits, which will affect your stomach. Your gut health is related to your mental health. Depression hammers your confidence and self-esteem to a level difficult to rebuild, but not impossible.

Regardless of how you view it, depression is a pain to deal with. It puts you in a place where you are unable to look forward to events in the future, robs you of your ability to enjoy the present, and keeps you dwelling on a past you have no control over. It greatly diminishes your interest or participation in significant activities. Depression will affect your ability to enjoy or be excited about positive things currently happening in your life. You won’t find joy in anything, and if you do, it will be in very small amounts, almost as if you were watching it from a distance. This can take a huge toll on your mental balance, and will also affect your family and loved ones.

Dissociation

If you suffer from C-PTSD, then there is a very good chance you have experienced dissociative episodes. Dissociation happens when your brain feels that you have to protect yourself from whatever disturbance is present at the time. In essence, you feels as if you must detach from the current reality to avoid feeling something you perceive as painful, hurtful, harmful, or otherwise dangerous to your mental and physical well-being. Since the event happening in front of you is perceived as overwhelming to your system, your brain can’t process it, and you disconnect to protect yourself.

Dissociation can be difficult to understand, even among those PTSD sufferers who deal with it. Many simply cannot wrap their heads around the concept that a human being can disconnect their emotions, thoughts, behaviors, memories, and with it, their identity. But it is important to understand that it is a natural process that occurs to protect us when being present might not be the best choice for us at the moment.

Dissociation comes with its own little army of negative experiences:

Derealization is the feeling of being detached from people and things. Derealization makes things that previously seemed normal look strange, unreal, or unfamiliar.
Depersonalization is the awful feeling of separating yourself from your body. It almost feels as if You are observing your own body from an outside perspective, as if in a dream situation. *Depersonalization and derealization often occur simultaneously.
Amnesia can happen for those who experience dissociative episodes. You may have sections of time you cannot remember or account for even though You are awake. You may not remember where you were, or what you were doing.
Identity Confusion is the internal struggle about who you really are and what your identity is.
Identity Alteration happens when you act like another, a different person. Identity alteration can have an effect on a person’s mood and behavior if the person is not under control.

To control dissociative episodes, a person with PTSD or C-PTSD must learn to stabilize their current emotional state to reprocess the old traumatic memories that make them feel unsafe. In brief, you must learn to stay in the present, in your body and mind, and to do so, you have to get creative and have coping mechanisms and strategies in place.

Flashbacks

Flashbacks mind/memory instances where you believe, feel, or act as though the traumatic event is happening all over again. In some cases, flashbacks are temporary and a connection to the present time is maintained. But in other cases, flashbacks can lead a person with PTSD, but more common for someone with C-PTSD to disconnect and lose awareness of their present and now of what is happening around them, and the person is transported back to the moment when the traumatic event happened. A flashback is one of the ways the brain tries to process a traumatic experience, reminding you that it is a past memory that can be stored of filed away because it’s no longer a threat. This can enable healing. However, for a number of PTSD sufferers, flashbacks can precipitate dissociative episodes. Having a solid set of grounding techniques and skills can make all the difference.

In my personal case, and due to the extent of my trauma, flashbacks have comprised a great part of my living with PTSD, and they really suck. Once flashbacks arrive in your mind, it is difficult to control or get rid of them. Learning to prevent is what works best. To prevent flashbacks from happening and taking over, a PTSD sufferer must learn what triggers them, and if possible, eliminate or reduce exposure to those triggers.

Intrusive Thoughts

One of the most difficult problems to battle with a PTSD diagnosis are the unexpected, unannounced, and unwelcome thoughts. Intrusive thoughts are those annoying repetitive thoughts, images, and mental impulses that are unacceptable and unwanted because they have the potential of disrupting your flow of thinking. Intrusive thoughts creep up into your head and rapidly take over affecting your actions and reactions, your calmness, and screwing your day up. Our mood can be affected by how we gauge ourselves and others. If we are scared and anxious, then our evaluation of the world around us will be consistent with those thoughts. For non-PTSD sufferers loneliness, pessimism, fear, or even distrust are not necessarily part of their daily feelings. For them, their perception of the world around them is not fed by these negative thoughts and feelings. But for us, intrusive thoughts can greatly affect our behavior. For this reason, paying attention (being mindful) of your thought process and how it influences your mood will help you address any likelihood of incoming negative thoughts than can change your mood and manifest behaviorally.

Guilt & Shame

Guilt and shame play a key role in your ability (or inability) to become the warrior of our own healing. Guilt and shame are common symptoms for PTSD sufferers. They are often thought of as interchangeable concepts, but there is a difference between them. Guilt and shame each influence your PTSD behavior in different ways, with shame being associated with higher levels of PTSD. The feeling of guilt comes when you judge your behaviors or actions as negative. Shame is an emotion that happens when you evaluate yourself in a negative manner. Guilt is about one’s actions, while shame relates to one’s self-worth and ethics.

Guilt is an emotional and cognitive experience that could be helpful when it comes to correcting behaviors, making amends or apologizing. Gilt makes you understand that you are responsible for committing an offense. It is comprised of negative emotions related to failures or inappropriate actions or reactions. Shame is a painful emotion that comes from being conscious of having done something improper, disgraceful, embarrassing, dishonorable, ridiculous, etc. Shame is attributed to feeling guilty about something (e.g., improper, disgraceful, etc.), that’s how they intertwine. But for a PTSD sufferer, shame can lead you to engage in self-punishing behaviors. It could be isolation or deliberate self-harm, but performing these actions will do very little to alleviate your shame. In my experience, isolation just served to intensify my shame.

As a PTSD sufferer, it is imperative you understand the role that guilt and shame play in your life. They are important emotional responses present in many of the symptoms and side effects associated with PTSD. Guilt and shame are common among PTSD trauma survivors, they can affect overall symptom severity, and if unmanaged, both guilt and shame can greatly interfere with your PTSD recovery.

When you cannot get past your negative experiences, it will be difficult to move forward. Constantly reliving the event thinking you could’ve done something to prevent it will only drive you crazy. Do not blame yourself for the tragic events. For those whose trauma happened while serving, you might experience ‘survivor’s guilt,’ because you survived while your teammates didn’t. Don’t do that to yourself. You must understand that none of it is your fault.

Managing Guilt

Managing Shame

Failure, helplessness, hurt, and the like are feelings that create anger and increase your chances of feeling shame. Shame is a tricky little sucker because it can have roots stemming all the way back to childhood, where the abuser made the victim believe that they needed to feel ashamed all the time. Whenever shame is present, there are usually other accompanying emotions. Guilt is, without a doubt, always present when there’s shame.

Trying to handle shame on your own can be difficult because of the self-infliction component. PTSD sufferers tend to increase their own negative self-talk when it comes to shame. Shifting feelings of shame require that you deal with other emotions present, such as disgust, helplessness, guilt, hurt, failure, and the like. If you learn to deal with and manage these accompanying emotions, your feelings of shame will lessen, even disappear.

One truly important component of handling shame is not mixing past with present feelings. You have the capacity to heal your present and understand your past. But if you keep remembering old feelings of shame, perhaps from childhood, then you have a feeling of shame based on past memories causing you more pain in the present. There is very little you can do today as a adult to rid yourself of memories of feeling ashamed earlier in life. Think of them as present and past tense, and focus on the present, even if you still feel ashamed of the past.

Repression

Repression is yet another defense mechanism, it’s an intentional blockage of painful memories in an attempt to distract yourself. You must keep in mind that these memories want to express themselves. If you already have an explosive personality, repression can lead to serious behavioral outbursts when you least expect it. Repression will also have an impact on your mood and health.

The mind is not designed to be static or solid, but rather active and dynamic. It is constantly in movement, trying to maneuver emotions in a favorable way throughout each person’s life. But PTSD affects your mind and changes our degree of awareness, rendering us unable to resolve tensions and instead choosing to repress them. The stressful emotion is not gone, just ignored as a coping mechanism to deal with disturbing information. But the stressful emotion or memory does not cease to exist and may reappear unbidden by another trigger.

Withdrawal

For me, withdrawal came from believing no one understood what I had endured or what I was going through with PTSD and the symptoms it brings. Sadly, this was the case for a long time. I had a bad support system and actively avoided people and activities I routinely enjoyed. If you have a family and children, withdrawal can have a heavy negative effect on your relationship and connection to them. For some people, withdrawal can lead to social isolation, and even to the point of avoiding contact with their own family and friends, despite their closeness.

People with PTSD withdraw because sharing time with others can be exhausting, upsetting, and takes too much work. Withdrawal can turn into a vicious cycle that could instigate issues such as depression, if it develops into a real problem, and it can. The more time you spend alone, the less likely you are to find people who understand you. If you don’t find people who understand you, then you would want to be alone all the time. Human interaction is important and necessary.

Behavioral Symptoms

Alcohol & Drug Use & Abuse

Excessive liquor, OTC medications, or illegal substances are forms of self-medicating. Many people with PTSD resort to all or some of these to mask their symptoms and cover up any issues they don’t want to face. While having a drink might help you relax and unwind from a stressful day, PTSD sufferers must pay special attention to not getting ‘hooked’ on drugs or alcohol as it will have further negative effects on their ability to manage their symptoms and behavior.

Extreme Rage

Extreme rage is when you experience huge amounts of anger over a minor event that would have normally not bothered you. Extreme rage happens when little things suddenly become huge triggers for screaming contests over non-issues.

Hopelessness

When everyday is a battle, when nothing positive seems to lie in front of you, a deep feeling of hopelessness about the future sets in. You feel as if there no good in the world, no clear path ahead, and no good things to come. It’s like being lost on an immense sea of nothing.

Hyperarousal

When your anxiety is heightened and your stress unmanaged, it will affect your arousal response and create problems. Hyperarousal makes you look on edge and feel jumpy all the time because You are easily frightened. To you, everything requires an action or exaggerated reaction. Hyperarousal can affect your sleep patterns and concentration, as well as make you more irritable. This can be quite exhausting.

Hypervigilance

When your perception of the world is that of a constant threat, you find yourself scanning crowds, traffic, and any other areas, that could be problematic. When your perception of the world around you is one of fear, everything can prove to be problematic: a diaper bag in the middle of a restaurant is seen as a potential bomb or everyone seems suspicious at the coffee shop.

Insomnia

Because your brain won’t shut off, you have difficulty falling asleep. Despite your being utterly exhausted, you lie awake for hours. You’ll get up a lot, perhaps to check the door to make sure it’s locked, your family is all tucked in and safe, or other peculiar nighttime security concerns.

Irritability

When you live in a state of constant fear and anxiety, staying in a good mood can be challenging. Every single little thing can irritate you. Irritability is a hyperarousal symptom of PTSD, and many instances, situations, or people can trigger it.

Low Self-Esteem

Through social withdrawal or avoidance, self-esteem and confidence take a toll for those with PTSD. Social interactions, dealings, and knowledge of particular things tend to increase self-esteem. PTSD robs you of your confidence, it makes you retreat into an unknown self. Surrounding yourself with a support system that helps boost your self-esteem is one of the best steps you’ll ever take for your PTSD life.

Nightmares

Extremely disturbing and vivid bad dreams. They are not necessarily associated to trauma. The nightmares can come with other symptoms, such as sleep walking and physical aggression while asleep. I’ve had them both, they are not fun.

Overeating

Eating more than your body requires is another form of self-medicating. People look for food to drown the pain associated with PTSD trauma by endlessly eating.

Short Fuse

Short tempered or easily sparked up, however you want to name it, PTSD makes you have a short fuse and go from being relaxed or just mildly irritated to extreme rage in a matter of seconds. Many people describe this as blowing up, because the ordeal resembles lighting up a tank of gasoline and watching it explode.

Physical Symptoms

Headaches

People with PTSD have a higher tendency to suffer from headaches. Stress, especially unmanaged stress is linked to the presence of headaches. Very high levels of stress and emotional strain may feel like someone is crushing your head between two pieces of wood. The type of traumatic event you experienced is also directly related to the type, strength, and duration of your headaches, especially if you suffered head injury.

Muscle Pain

By all means not the only, but pain is a serious and common physical problem for people with PTSD. Regardless of the source and intensity of your traumatic event, PTSD and pain coexist. Living in a state of hyperarousal can cause chronic muscle pain.

Nausea, Vomiting, Diarrhea

Whether You are taking medications to help control your PTSD symptoms or not, nausea, vomiting, and diarrhea is a cluster of symptoms that seem to be present for many PTSD sufferers. For us, many of the symptoms associated with PTSD manifest in a psychosomatic way in the form or nausea, vomit, or even diarrhea. For years, I felt as if I had morning sickness even though I was not pregnant.

Rapid Heart Rate

For years I lived with my heart beating so fast and strong that it felt as if it was going to jump out of my chest, or perhaps explode. Medicines made this worse. When anxiety kicks in, your heartbeat accelerates. It doesn’t even have to be trauma related. Your heart rate increases, you break out in a sweat, and start hyperventilating.