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On PTSD (And the shit those of us who have it wish everyone else knew)

September 11, 2012

The first time I had the term PTSD assigned to me, I was 12. My parent’s divorce was in the beginning stages of the decade plus of hell it would become and I was positively miserable and depressed. I didn’t understand until many years later exactly what PTSD meant or the fantastic “quirks” it would leave me with.

From the lessons I’ve learned the hard way, I hope that someone out there can use this information to the benefit of a better relationship with the people in their life who are affected by PTSD. Please note that these are based off my personal experiences with PTSD and should not be considered the end-all, be-all guide.

First of all, having PTSD does NOT mean I’m going to freak out, grab a gun and start shooting people while I cackle maniacally. Seriously, stop it. If I could carry around a neon sign that says the above, I would. Post-Traumatic Stress Disorder is about being unable to control the fear reaction from a trauma. I’m not angry, I’m not trying to kill everyone. I’m trying to fix whatever occurred in the traumatic experience to un-do the trauma, to stop it from happening.

This leads me to my second point, when PTSD strikes, it isn’t a panic attack. Many people, including myself, with PTSD will refer to our episodes as “PTSD-related panic attacks” because the term “panic attack” is socially acceptable and generally understood. However, calling a PTSD attack a panic attack is like comparing a flash flood to turning on the kitchen sink. The similarities between the two are that there is anxiety, fear and physical reactions to them both. The difference is that PTSD rips out out of this world and throws you back into hell. You’re disoriented, you’re partially or completely disconnected from reality and even if you do recognize the people standing in front of you, they are going to be overlaid with the motives, intentions and actions of the people who were in the original traumatic event.

Third, I can go from zero to “oh fuck, I’m going to die” in about point two seconds. All it takes is the right trigger and I will quite literally lose my shit. Trust me, it isn’t any more fun for me than it is for you. The affects of a full-blown attack can last for days and during the actual episode, I may not be able to effectively communicate what is going on.

Fourth, this is something I’m going to have for the rest of my life. It isn’t ever going away. It can be managed, to a point, but it’s a process that requires awareness and management.

PTSD affects more people than you might realize. Recent studies have shown that there are children being born post-9/11 who have PTSD, even though they have never experienced a trauma in their lives outside the womb. Basically, that means these kids are growing up never knowing that their fear isn’t normal. The worst part is they’re growing up in a society that doesn’t really understand or respond well to PTSD.

So, you just found out someone in your life has PTSD and you have no idea what to do about it. Now what?

1. Don’t treat me like I’m a fragile psycho who could snap at any minute. I may punch you on principle.

2. Talk to me about it, learn what my triggers are and ask questions if you don’t understand. 

3. What’s a trigger? A trigger is something that reminds me of the traumatic event or increases my anxiety level. They vary from person to person, but there are a few consistent ones that I will list below. Remember that a trigger does not have to be rational or make sense to you. You just need to be aware of what it is and have respect for it.

4. Understand that sudden, unexpected loud noises, like something heavy being dropped or a balloon popping, will put me (and anyone else with PTSD) instantly on high alert. This won’t usually push me over the edge, but will make me more prone to having a full-blown attack if I’m exposed to additional triggers.

5. Please, for the love of god, do not make someone with PTSD sit with their back to a door or open room if at all possible. The possibility of having someone sneak up behind us (even unintentionally) will cause extreme anxiety and can cause an attack if we are startled too many times or if the anxiety is sustained for too long. Depending on the group I am in, I can comfortably sit near a door or with my back to a crowded room, because I know I can trust the people in my group to look out for me. However, on a high-stress day, you will find me with my back to a wall, if at all possible.

6. Don’t sneak up on me. Don’t tell me you have a surprise for me. Don’t startle me. You might get reflex smacked.

7. People with PTSD have a limited tolerance for large crowds, loud environments, rowdy parties and aggressive people. That tolerance depends on how much sleep we’ve had, how stressed we are, if we’ve had alcohol, if we’re on medication, how aggressive the crowd is, how much our personal bubble is respected…yeah, it varies and what may be fine one day may not be fine the next.

8. If you’re with someone you know has PTSD and you notice them becoming very quiet and withdrawn, trying to become one with the wall at their back or curling up into the smallest ball they can manage, they’re very likely experiencing an anxiety spike and/or are becoming overstimulated. When I’m with a significant other, I have a tendency to press my back against his/her chest and torso, then wrap their arms around me. 

If you see any of the signs above, notice the person is acting erratically or that there has been exposure to a known trigger, ASK QUESTIONS.

1. Do you want to get out of here? – I will tell you as someone with PTSD, having an option to escape a triggering situation is the biggest relief I could ask for. If you can’t necessarily leave, offer to try to move to a quieter, less crowded area.

2. What’s wrong? – Ask questions to get the specifics about the trigger if you aren’t sure what the issue is.

3. Is there anything I can do to help you feel safer? – Again, PTSD is about fear.

The most important thing to remember is to BE PATIENT. Triggers won’t always cause the same reaction, some days will be better than others. Be flexible and understand that if we need to leave the party early, it’s not because we’re trying to ruin your evening.

Sometimes, even if you do everything correctly, a major PTSD event may occur. The actual event may be anything from a flashback to kicking into full blown “fight-or-flight” mode. If this should happen, the situation needs to be de-escalated as quickly as possible.

1. REMAIN CALM. If you start freaking out that I’m freaking out, it will only make me freak out harder.

2. DO NOT yell at the person. It will make you appear to have harmful intentions and can get you classified as a threat.

3. DO NOT physically manhandle the person. This means: do not grab, try to pull around, pick up, carry, attempt to restrain, block the exit, etc. Really, if I need to explain why, you may want to roll a check on your empathy. 

4. DO NOT try to prevent the person from leaving the triggering situation. You can offer alternatives by asking if there is a place the person will feel safer, but refusing to let them leave will make them feel trapped and will escalate the situation.

5. DO NOT try to take away keys, wallets, purses, personal items, etc. It will only escalate the feeling of being trapped and the person will likely become more frantic and/or violent.

6. Although some people may object to the comparison, act around the person having the attack as you would around a wounded wild animal like a wolf or cougar. Keep your voice calm, move slowly, keep your hands where I can see them, respect my comfort levels, don’t let people crowd around me.

Major PTSD attacks are scary, ESPECIALLY for the person having it. In my case, when I hit fight-or-flight, I am literally not thinking about anything other than figuring out how to get out of the situation I’m in, otherwise someone is going to kill me. Every thought I have during the attack will be geared toward getting away and to a safe place. Anyone who isn’t helping me is helping the person I’ve determined is a threat. Don’t bother trying to reason with me about anything else, I only have one mission.

Okay, so you’ve survived watching the person you care about go through a PTSD attack. The next part may be the hardest to do, because an attack shakes everyone.

After the crazy part of the attack is over, there will be a complete meltdown. Crying, shaking, the works. Mentally, physically and emotionally, I will be completely fried. This may last for hours or days after the attack, depending on how severe the attack was. During this time, I usually want to curl up in bed and be held. This may not be true for everyone, but when my PTSD flares up, I feel like a failure, like I should be able to control it, like any harm I’ve caused to anyone else – even if it is just freaking them out – should make everyone hate me. 

During the crash period, I become hyper-sensitive to noise and triggers. I will spend a lot of time shaking. I won’t be able to tolerate music with too heavy a drum beat. I will have little to no energy. I will have extreme self-hate going on in my head. I will need a lot of gentle compassion and reassurance.

THIS is the point where people with PTSD are the most fragile. We need to know that you still love us and are going to support us, even though we can be crazy monsters sometimes. THIS is where you need to be the most patient and gentle. This is the part where we are most vulnerable and need the most care. Please don’t abandon us, it only makes everything worse.

Until Next Time,

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One Comment
  1. Gina permalink

    I wanted to let you know that I have read a bunch of your posts and think they contain a lot of good information. Thank you for writing them and putting them out into the world.

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