By Dan Pitzer
PTSD is a syndrome, a collection of symptoms that can vary from person to person, yet have many characteristics in common. Folks with PTSD experience to varying degrees, anxiety, panic attacks, depression, insomnia, hypervigilance, fear of crowds, and too much stimulation. In normal life, our frontal cortex, the center of our brain that processes logic, cause and effect, and rational thought, is in charge. The amygdala controls our survival instincts or “fight or flight response” and takes over when we feel that our life is in danger. People exposed to traumatic events and situations when they fear for their life for prolonged periods of time experience almost a “rewiring,” where the limbic system takes over for survival. The problem that many have when they leave that life-threatening environment is that the wiring stays that way, and they continue to fear for their life on a daily basis. This is where the conflicts lie.
Family members continue to go about their lives focusing on what they need to get done for that day: worries about bills, work, etc. The person with PTSD is worried constantly about threats, possible attackers, and is assessing for danger at every turn. Their senses are heightened, and they hear, see, smell, everything going on around them and their loved ones and feel vulnerable to attack. Often they felt safer in combat situations because there were like-minded peers with weapons and the same vigilance, who they knew “had their back.” In the “civilian” world, they feel no one has their back, no one understands. And they are right. They feel solely responsible for the safety of themselves and their family, and that is an exhausting job.
- I Don’t Want to Go
Pick your battles. “I don’t want to go!!” If you hear that, appreciate what they are saying. Crowds are terrifying for them. The overstimulation of sights, sounds, smells from all different directions is too much to handle, and are in danger of triggering traumatic memories or “flashbacks” that are re-experienced at the moment. If the event is not that important, let them stay home where they feel safe. If it is important they attend, then consider travel with two cars if possible. If they can control when they leave they are much more likely to have a chance at enjoying themselves. Let them choose where to sit even if it is an inconvenience. Consider shortening the time at the event. Tolerate their needing to take breaks to walk outside, get some fresh air.
- I Just Want to be Alone
Let them be alone, it’s where they feel safe. Then encourage them to connect with support who gets them and understand not to let the isolation go on too long.
- I Want to Drive
When it comes to keeping individuals calm, especially in circumstances like driving a car, it’s important to know if the individual is comfortable driving, or being a passenger. Once you get that answer, you can make the right decision. If they want to drive, let them drive. The more control they feel in a situation, the calmer they will be.
- I Don’t Want to Talk About It
Do not push them. They never talk to people about it who were not there with them and can’t relate. The conflicting, complex myriad of emotions that go along with that is unbearable and they have no idea how to deal with it.
- I’ll Be Fine
No, they won’t; encourage them to get help. Encourage and support them to reach out to a “battle buddy” and/or a program that specifically treats PTSD. Most medical providers don’t understand PTSD, and when the person is ready to ask for help, it is critical that it is a positive experience.
- Don’t Surprise Me
No surprise parties. No sneaking up behind them. No startling them awake. Remember, their instincts for survival will take over and you may be hurt unintentionally. If you need to sleep in a separate bed, then go ahead. The combination of insomnia and nightmares makes trying to sleep sometimes unbearable for everyone. You deserve your rest too.
- Take Care of Yourself; It’s Not Your Fault
You will not be able to relate or understand, and that’s okay. Professionals that work with PTSD encourage patients to tell family members things like, “I’m upset, and I don’t know why” or “I’m dealing with things from the military or from the past that are overwhelming” and leave it at that. Then they can follow up with their treatment team. Just being able to reveal that much is a big step forward, but it doesn’t need to go further than that.