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Coping with Post Traumatic Stress Disorder

Specific Coping Strategies for Traumatic Stress and PTSD Symptoms

Positive Coping Actions are those which help to reduce anxiety, lessen other distressing reactions, and improve the situation in a way that does not harm the survivor further and which improves things not only today, but tomorrow and later. Positive coping methods can include:

Using natural supports and talking with those one is comfortable with - friends, family, co-workers - at your own pace, is strongly recommended. Following one's own natural inclination with regard to how much and to whom you talk is usually best for the majority of people.

Learning about trauma and PTSD. It is useful for trauma survivors to learn more about trauma and PTSD and how it may affect them. For those with PTSD, by learning just how common PTSD is, and finding that their problems are shared by hundreds of thousands of survivors of trauma, they can better recognize that they’re not alone, not weak, and not "crazy."

Talking to other trauma survivors for support. When survivors are able to talk about their problems with others, something helpful often results. Seeking out support from other trauma survivors, the survivor of trauma may feel less alone, feel supported or understood, or receive concrete help with a problem situation. One of the best places to find support is in a specially-designed "support group." Being in a group with other survivors of trauma with PTSD may help a trauma survivor reduce sense of isolation, rebuild trust in others, and provide an important opportunity to contribute to the recovery of other survivors of trauma.

Talking to a doctor about trauma and PTSD. Part of taking care of oneself means mobilizing the helping resources around one. A doctor can take care of physical health better if he or she knows about PTSD symptoms, and doctors can often refer trauma survivors for 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 reducing contact with the external environment. Be aware that while physical sensations may become more apparent when a person is relaxed, continuing with relaxation in a way that is tolerable (i.e., interspersed with music, walking, or other activities) is, in the long run, helpful in reducing negative reactions to internal thoughts, feelings, or 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 inner feelings in a positive, creative way. This can be helpful as a means of improving mood, limiting the harm caused by PTSD, and rebuilding a 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 too well. The survivor of trauma may feel fearful or depressed. At these times, it is important to reach out and telephone a counselor, who can help the survivor of trauma turn things around.

Taking prescribed medications to tackle PTSD. One tool that many survivors of trauma with PTSD have found helpful is medication treatment in partnership with their doctor. By taking medications, some survivors of trauma are able to improve their sleep, anxiety, irritability and anger, or urges to drink or use.

Starting an exercise program. It’s important to see a doctor before starting to exercise, but after getting the OK, exercise in moderation has a number of possible benefits for those with PTSD. Walking, jogging, swimming, weight lifting, and other forms of exercise may reduce physical tension. They may help distract the person from painful memories or worries, and thus give them a break from difficult emotions. Perhaps most important, they can improve self-esteem and create feelings of personal control.

Starting to volunteer in the community. It’s important to feel like you’ve got something to offer to others, that you’re making a contribution. When you’re not working, it can be hard to get this feeling. One way that many survivors of trauma have reconnected with their communities and regained a feeling of contribution is to volunteer to help with youth programs, medical services, literacy programs, community sporting activities, and so on.

Negative Coping Actions help to perpetuate problems. They may reduce distress immediately, but short-circuit more permanent change. Actions that may be immediately effective but cause later problems can be addictive, 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, eating, and different types of self-destructive behavior (e.g., attempting suicide). Before learning more effective and healthy coping, most people with PTSD may try to cope with their distress and other reactions in ways that lead to more problems.

Practicing Lifestyle Balance

(Excerpted from: Saakvitne, K. W., & Pearlman, L. A. (ed.). (1996). Transforming the pain: a workbook on vicarious traumatization. New York: Norton).

There are many ways to restore lifestyle balance, and keeping track of and making progress with as many of the following changes is a good way to regain balance after having been exposed to or witnessed cumalative traumatic experiences:

Physical Self-Care

Eat regularly (e.g. breakfast, lunch, dinner)
Eat healthily
Get regular medical care for prevention
Get regular medical care when needed
Take time off when sick
Get massages
Dance, swim, walk, run, play sports, sing, or do some other physical activity that is fun
Take time to be sexual--with yourself, with a partner
Get enough sleep
Wear clothes you like
Take vacations
Take day trips or mini-vacations
Make time away from telephones

Psychological Self-Care

Make time for self-reflection
Have your own personal psychotherapy
Write in a journal
Read literature that is unrelated to work
Do something at which you are not expert or in charge
Decrease stress in your life
Notice your inner experiences -- listen to your thoughts, judgements, beliefs, attitudes, and feelings
Let others know different aspects of you
Engage your intelligence in a new area, e.g., go to an art museum, history exhibit,sports event, auction, theater performance
Practice receiving from others
Be curious
Say no to extra responsibilities sometimes

Emotional Self-Care

Spend time with others whose company you enjoy
Stay in contact with important people in your life
Give yourself affirmations, praise yourself
Find ways to increase your sense of self-esteem
Reread favorite books, re-view favorite movies
Identify comforting activities, objects, people, relationships, places, and seek them out
Allow yourself to cry
Find things to make you laugh
Express your outrage in social action, letters, donations, marches, protests
Play with children

Spiritual Self-Care

Make time for reflection
Spend time with nature
Find a spiritual connection or community
Be open to inspiration
Cherish your optimism and hope
Be aware of nonmaterial aspects of life
Try at times not to be in charge or the expert
Be open to not knowing
Identify what is meaningful to you and notice its place in your life
Spend time with children
Have experiences of awe
Contribute to causes in which you believe
Read inspirational literature (talks, music, etc.)

Brain and Mental Health

References and Sources: Medline, Pubmed, National Institutes of Health

last update: February 2009

This information is not intended to be a substitute for professional medical advice. You should not use this material to diagnose or treat a health condition or disease without consulting with your healthcare provider.
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