“The strongest people are not those who show strength in front of the world but those who fight and win battles that others do not know anything about.” J. Harnisch

PTSD (Post-Traumatic Stress Disorder) is a debilitating mental health condition that can riddle a person with a plethora of unpleasant symptoms. Most people who are not directly or indirectly touched by the disorder have little understanding of it, or what the coexisting symptoms feel like. But those directly affected by PTSD live with the cocktail of symptoms on a daily basis.

PTSD symptoms vary in type, intensity, and duration, and affect each person differently. Three of the most impacting categories of symptoms of PTSD are intrusive thoughts, hyperarousal, and emotional numbing. These cluster of symptoms can affect all aspects of the PTSD sufferer’s life, and those around. Understanding what these symptoms are, what they feel like, and what you can do to help can reduce stress and anxiety for all involved.

Family, friends, coworkers, and even strangers tend to have negative interpretations and reactions to the PTSD sufferer’s behaviors, rarely understanding that these derive from these symptoms. For those with PTSD, not being understood by others can have detrimental effects on their desire and ability to be social, leading them to isolate themselves to avoid stigmatization.

Whether you are personally touched by the disorder or you know someone who is battling with PTSD’s symptoms, it’s important to have some understanding of the underlying foundation of these three major categories.

Intrusive Thoughts

One of the most difficult problems to battle with a PTSD diagnosis are the unexpected, uninvited, unannounced, and unwelcome thoughts. Intrusive thoughts, such as flashbacks, are those annoying and repetitive thoughts, images, and mental impulses that are unacceptable and unwanted because they are reminders of the experienced trauma and have the potential of disrupting the person’s flow of thinking.

Intrusive thoughts creep up into the PTSD sufferer’s brain, rapidly taking over, affecting their actions, reactions, and ability to stay calm, utterly disturbing their day. For a person with PTSD, their mood is regularly affected by how they gauge themselves and others. If they are scared and anxious, then their evaluation of their surrounding world will be consistent with those thoughts. For non-PTSD sufferers, loneliness, pessimism, fear, or even distrust are not active components or form part of their daily feelings. For them, the perception of the world around them is not fed by negative thoughts and feelings, hence their actions and reactions are usually positive and appropriate.

But for those with PTSD, intrusive thoughts can greatly interfere with their ability to be in the present moment and interact with those they care about. Aside from affecting their ability to pay attention, intrusive thoughts can also make daily tasks seem more daunting than they really are. Nightmares can also rob the PTSD person from valuable sleep, affecting their energy, social interactions, and ability to complete tasks.

How to Help with Intrusive Thoughts?

Check on a PTSD sufferer if they seem distracted or spaced out while you’re trying to interact with them. This simple action can help them come back to the present moment, giving them a chance to clarify what this behavior is all about. Having someone to assist them in snapping out of it will help them pay attention and be mindful of their thought process and how it influences their mood. It will also will help them address the likelihood of any imminent negative thoughts than can change their mood and manifest behaviorally.


Living with hyperarousal symptoms is physically and emotionally exhausting.  Hyperarousal makes PTSD sufferers feel on guard and overly cautious about their safety, often appearing jumpy. The hyper-reactivity to the world makes them easily frightened because they feel as if the world is out to get them, even when there is no imminent danger. Hyperarousal makes PTSD sufferers startle easily, have outbursts of anger, and can affect sleep patterns and concentration. This can be quite exhausting, further worsening symptoms of irritability. To a person with PTSD, everything requires action and attention, the results of which are generally exaggerated reactions that can impact the person’s ability to socialize normally.

Hyperarousal may lead a person with PTSD to turn down social invitations because they are extremely tired. To preserve physical and mental energy, a PTSD sufferer will often avoid or limit social interactions, as these can be quite exhausting and/or frustrating. In addition to taking a toll on their energy levels, hyperarousal can also affect a person’s ability to snap out of a bad or negative mood, and their tolerance levels will be lower than normal.

How to Help with Hyperarousal?

If you want to help a trauma survivor with PTSD, start by understanding that their energy levels and patience are not what they used to be. Before you invite them to a social situation, notice or ask about their energy levels to see where they are, and be ready to be flexible with social plans. If bowling with 10 other people does not work for them, then perhaps going to a movie is a more relaxing environment as there is not as much engagement with other people. Regardless of what their energy level or desire for social interaction is, don’t blame a failed social outing event on a person with PTSD, as their mental well-being matters more.


Emotional Numbing

People with PTSD often numb themselves physically and emotionally to avoid feelings that may hurt them or remind them of trauma. While at the time of the traumatic experience numbing could have kicked in as a defense mechanism, long-term use of this faulty coping strategy will make a person feel and look emotionless, and can take a serious toll on their personal and professional relationships. A person with PTSD numbs when activities they once enjoyed are no longer of interest, which can make them feel and look quite apathetic and indifferent about their life and relationship. This affects their view of the future, as they feel as if there’s not point in making plans because everything they do and everywhere they go reminds them of the trauma.

Emotional numbing, known as constriction, is often misrepresented as a PTSD sufferer’s lack of interest or care for others. A wife might worry that her husband with PTSD doesn’t want to be with her because he’s not engaging in conversations about the future. However, it’s important to understand that for many PTSD sufferers the issue is not about the future, but the present. Understanding that certain people, places, situations, or objects can be reminders of the trauma and can serve as triggers of undesired and unwelcome symptoms is a better approach to it.

How to Help with Emotional Numbing?

Try to give the trauma survivor a chance to understand and explain their behavior before making assumptions. Asking a person with PTSD what their numbing behavior is about can be of incredible help. Their inability to think about or plan for the future is a temporary halt in their thought process, and not something personal against you. With help and guidance, the PTSD sufferer can learn to self-reflect, seeing and understanding that their behavior means and where it originates. Don’t be afraid to throw some ideas out for them, as a PTSD brain is usually affected by coexisting symptoms that can also impact creativity and idea processing.

The PTSD brain cycle is very different from non-PTSD sufferers. Feelings of hyperarousal, intrusive thoughts, and emotional numbing are impacted by the person’s symptoms, their coping mechanisms and strategies, and the responses of their surrounding environment. Family, friends, coworkers, and even strangers will respond to trauma related behaviors in their own way. Having some understanding of how a PTSD brain works, and giving the person room to explain will avoid misrepresentation on both sides. The way the world responds to a person with PTSD, and the way the PTSD sufferer responds to their surrounding environment will positively affect or negatively impact this cluster of symptoms and everyone involved.

Be part of the solution

instead of perpetuating the problem.

Diana Giorgetti
Diana Giorgetti

Diana Giorgetti is a multiple trauma survivor, author, idea brewer, problem solver, professional freelancer, and web-designer. A graduate of the University of Miami and Nova Southeastern University with degrees in Psychology and Education Law, she is passionate about helping others, scuba diving, and writing (though not necessarily in that order). She lives in Miami, Florida with her two children and three dogs. She is the author of "The Fundamentals of PTSD: A Guide to Disemboweling the Disorder and Reclaiming Your Life," "PTSD & Relationships: A Survival Guide to Love and Be Loved," and "The PTSD Warrior Healing Mindset: Changes in Habits and Routines to Help Retrain the Brain After Trauma," and she's working on her fourth self-help book. You can find Diana's books on Amazon: amazon.com/author/dianahelps