PTSD: National Center for PTSD

Coping with Traumatic Stress Reactions

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Active Coping

• Active coping means accepting the impact of trauma on your life and taking direct action to improve things.
• Active coping occurs even when there is no crisis. Active coping is a way of responding to everyday life. It is a skill that you can learn and develop.

Know That Recovery Is a Process

Following a traumatic event most people experience stress reactions. Understand that recovering from the trauma is a process and takes time. Knowing this will help you feel more in control. A few tips:

• Having an ongoing response to the trauma is normal.
• Recovery is an ongoing, daily process. It happens little by little. It is not a matter of being cured all of a sudden.
• Healing doesn't mean forgetting traumatic events. It doesn't mean you will have no pain or bad feelings when thinking about them.
• Healing may mean fewer symptoms and symptoms that bother you less.
• Healing means more confidence that you will be able to cope with your memories and symptoms. You will be better able to manage your feelings.

Positive Coping Actions

Certain actions can help to reduce your distressing symptoms and make things better. Plus, these actions can result in changes that last into the future. Here are some positive coping methods:

Learn about trauma and PTSD

It is useful for those who have been through trauma to learn more about common reactions to those events and about PTSD. Find out what is common. Find out what the signs are that you may need assistance from others. When you learn that the symptoms of PTSD often happen after traumatic events, you realize that you are not alone, weak, or crazy. It helps to know your problems are shared by hundreds of thousands of others. When you seek treatment and begin to understand your response to trauma, you will be better able to cope with the symptoms of PTSD.

Talk to others for support

When survivors talk about their problems with others, something helpful often results. It is important not to isolate yourself. Instead make efforts to be with others. Of course, you must choose your support people with care. Don't be afraid to ask them clearly for what you need. With support from others, you may feel less alone and more understood. You may also get concrete help with a problem you have.

Practice relaxation methods

Try some different ways to relax, including:

• Muscle relaxation exercises
• Breathing exercises
• Meditation
• Swimming, stretching, yoga
• Prayer
• Listening to quiet music
• Spending time in nature

While relaxation techniques can be helpful, in a few people they can sometimes increase distress at first. This can happen when you focus attention on disturbing physical sensations and you reduce contact with the outside world. Most often, continuing with relaxation in small amounts that you can handle will help reduce negative reactions. You may want to try mixing relaxation in with music, walking, or other activities.

Distract yourself with positive activities

Pleasant recreational or work activities help distract a person from their memories and reactions. For example, art has been a way for many trauma survivors to express their feelings in a positive, creative way. Pleasant activities can improve your mood, limit the harm caused by PTSD, and help you rebuild your life.

Talking to your doctor or a counselor about trauma and PTSD

Part of taking care of yourself means using the helping resources around you. If efforts at coping don't seem to work, you may become fearful or depressed. If your PTSD symptoms don't begin to go away or get worse over time, it is important to reach out and call a counselor who can help turn things around. Your family doctor can also refer you to a specialist who can treat PTSD. Talk to your doctor about your trauma and your PTSD symptoms. That way they can take care of your health better.

Many with PTSD have found treatment with medicines to be helpful for some symptoms. By taking medicines, some survivors of trauma are able to improve their sleep, anxiety, irritability, and anger. Some medicines can also reduce urges to drink or use drugs.

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Coping with the Symptoms of PTSD

Here are some direct ways to cope with these specific PTSD symptoms:

Unwanted distressing memories, images, or thoughts

• Remind yourself that they are just that, memories.
• Remind yourself that it's natural to have some memories of the trauma(s).
• Talk about them to someone you trust.
• Remember that, although reminders of trauma can feel overwhelming, they often lessen with time.

Sudden feelings of anxiety or panic

Traumatic stress reactions often include feeling your heart pounding and feeling lightheaded or spacey. This is usually caused by rapid breathing. If this happens, remember that:

• These reactions are not dangerous. If you had them while exercising, they most likely would not worry you.
• These feelings often come with scary thoughts that are not true. For example, you may think, "I'm going to die," "I'm having a heart attack," or "I will lose control." It is the scary thoughts that make these reactions so upsetting.
• Slowing down your breathing may help.
• The sensations will pass soon and then you can go on with what you were doing.

Each time you respond in these positive ways to your anxiety or panic, you will be working toward making it happen less often. Practice will make it easier to cope.

Feeling like the trauma is happening again (flashbacks)

• Keep your eyes open. Look around you and notice where you are.
• Talk to yourself. Remind yourself where you are, what year you're in, and that you are safe. The trauma happened in the past, and you are in the present.
• Get up and move around. Have a drink of water and wash your hands.
• Call someone you trust and tell them what is happening.
• Remind yourself that this is a common response after trauma.
• Tell your counselor or doctor about the flashback(s).

Dreams and nightmares related to the trauma

• If you wake up from a nightmare in a panic, remind yourself that you are reacting to a dream. Having the dream is why you are in a panic, not because there is real danger now.
• You may want to get up out of bed, regroup, and orient yourself to the here and now.
• Engage in a pleasant, calming activity. For example, listen to some soothing music.
• Talk to someone if possible.
• Talk to your doctor about your nightmares. Certain medicines can be helpful.

Difficulty falling or staying asleep

• Keep to a regular bedtime schedule.
• Avoid heavy exercise for the few hours just before going to bed.
• Avoid using your sleeping area for anything other than sleeping or sex.
• Avoid alcohol, tobacco, and caffeine. These harm your ability to sleep.
• Do not lie in bed thinking or worrying. Get up and enjoy something soothing or pleasant. Read a calming book, drink a glass of warm milk or herbal tea, or do a quiet hobby.

Irritability, anger, and rage

• Take a time out to cool off or think things over. Walk away from the situation.
• Try to exercise daily. Exercise reduces body tension and relieves stress.
• Remember that staying angry doesn't work. It actually increases your stress and can cause health problems.
• Talk to your counselor or doctor about your anger. Take classes in how to manage anger.
• If you blow up at family members or friends, find time as soon as you can to talk to them about it. Let them know how you feel and what you are doing to cope with your reactions.

Difficulty concentrating or staying focused

• Slow down. Give yourself time to focus on what it is you need to learn or do.
• Write things down. Making "to-do" lists may be helpful.
• Break tasks down into small do-able chunks.
• Plan a realistic number of events or tasks for each day.
• You may be depressed. Many people who are depressed have trouble concentrating. Again, this is something you can discuss with your counselor, doctor, or someone close to you.

Trouble feeling or expressing positive emotions

• Remember that this is a common reaction to trauma. You are not doing this on purpose. You should not feel guilty for something you do not want to happen and cannot control.
• Make sure to keep taking part in activities that you enjoy or used to enjoy. Even if you don't think you will enjoy something, once you get into it, you may well start having feelings of pleasure.
• Take steps to let your loved ones know that you care. You can express your caring in little ways: write a card, leave a small gift, or phone someone and say hello.

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A Final Word

Try using all these ways of coping to find which ones are helpful to you. Then practice them. Like other skills, they work better with practice. Be aware that there are also behaviors that DON'T help. Learn more about these negative coping methods that you should avoid in our Self-Help and Coping section. You will also find information there about lifestyle changes that can help you cope with PTSD.

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