What Does PTSD Look Like?

January 31, 2007

This is part 2 in my PTSD Series. I hope that everyone finds it informative and will be able to use the information to help themselves if suffering from this disorder, or can use the information to help a loved one or accquaintance.

The first thing that people need to understand about Post Traumatic Stress Disorder, is that it’s NOT a mental illness. Instead, PTSD is the normal human reaction to an extreme stressor or series of stressors that occurs in a person’s life. It’s vital both for the person suffering from PTSD, as well as the people in their lives to understand and recognize the signs of PTSD. If family members, friends and employers can recognize these signs and be able to give them the support, understanding, acceptance and the help that they need, then this person is much more likely to overcome the effects of PTSD and be able to return to a normal and functional life.

So, what exactly does PTSD look like? What can the person suffering from this sometimes debilitating disorder and those closest to them watch for? Many of these signs and symptoms will of course be very familiar, others not so familiar. We’ll address some of few specific ways that PTSD can have negative implications on a person’s life.

Symptoms of PTSD

Cynicism or distrust of authority figures
Anger, sudden outbursts of rage
Isolation and Avoidance
Insomnia or sleep disturbances
Inability to concentrate
Psychological or emotional numbing
Memory impairment
Emotional constriction
Hypersensitivity to perceived injustices
Loss of interest in work and other activities
Problems with intimate relationships
Hyper-alertness and hyper-arousal
Avoidance of activities that might remind them of the traumatic event
Emotional distancing from loved ones
Suicidal feelings and thoughts
Flashbacks to the traumatic event or intrusive thoughts about the incident
Self-deceiving and self-punishing behaviors
Unrealistic fantasies of retaliation or destruction
Suddenly taking part in high risk behaviors, employment and activities

(Taken from the book “Down Range: To Iraq and Back” by Bridget C. Cantrell, PhD & Chuck Dean)

Flashbacks for instance, are the re-living of the traumatic event, as if that event were happening again. A flashback can seem very real to the person.

The person may experience the sights, sounds, smells or the touch that they experienced during the incident. Things that might trigger a flashback to a soldier suffering from PTSD might be, sudden sounds like a car backfiring, the sound of fireworks, the sound of helicopters, the sound of motorized heavy equipment. Smells such as the smell of human waste, blood, diesel or jet fuel. Experience such as driving down a dirt or sand road, along a freeway guardrail and an overpass or passing through narrow city streets. The triggers may be different for each person and the triggers may be subtle.

Isolation and avoidance is the withdrawing or isolating oneself from social relationships emotionally as well as geographically. Avoidance of social activities, places and people. This can cause problems in family relationships, as well as in employment.

Emotional numbing is distancing oneself emotionally from a topic of conversation, from a situation or other people. Doing this may make the person suffering from PTSD appear aloof, cold, uncaring and detached from those around them. Some people, out of a fear of how they will react to situations will “close” themselves off in order not to feel or respond. Some may resort to using mind-altering substances such as alcohol or illicit drugs to numb their feelings.

Depression is a very common symptom of PTSD. This may be seen as the act of withdrawing and isolating from others. It can be a result of situations in the environment that cause the person to feel overwhelmed with sadness or the sense that things will never get better. Certain classic signs of depression are good to know. When depressed, a person may feel helpless, hopeless, insecure or even unworthy of being loved. They may sleep excessively, as a way of avoiding the emotional pain they’re experiencing. They may experience a lack of interest in activities that previously gave them great pleasure. They may experience a lack of interest in intimate relationships.

Anger is an emotion that often manifests itself in persons suffering from PTSD. Anger is a secondary emotion that reflects a variety of feelings such as a sense of betrayal, lack of trust, frustration, sadness and guilt. Many times in persons suffering from PTSD, displays of anger may be abrupt and without warning, extreme and may leave the person and those around them stunned at the severity of their reaction. Lack of impulse control as manifested in road rage is one example of how a person who has experienced a traumatic event might react. Non-verbal reactions, such as threatening stance, body posture and eye contact, may make the person appear that they are out of control and ready to explode. Anger will many times manifest itself in abuse of others, such as physically assaulting a person who cut in front of them in line at the store or as domestic violence against a spouse, significant other or their children. The use of mind altering substances, while not the cause of violent outbursts, only serves to weaken the persons ability to tolerate a situation and allow them to more easily act in an unacceptable manner that could lead to cause serious injury to someone they love and possibly end with incarceration. While anger is a normal human emotion, it must be managed and acted upon appropriately, or it may become dangerous to the person and those around them.

The use of mind altering chemicals, such as alcohol or drugs on a regular basis in an attempt to “forget or to numb or suppresses feelings or memories is a form of self-medication that can have extreme consequences. Many think that they can forget the problems or the memory by drinking or using drugs, when in reality, it’s just a temporary solution and does not make the situation go away, but instead has the potential of making it worse.

Guilt is a feeling that many who return from combat report dealing with. They may constantly wonder why they survived an incident, when their friend did not and blame themselves because of that. They may feel that they didn’t do enough to ensure the safety of one of their teammates. They may feel that they don’t deserve to live when their buddies were killed or wounded in combat. This is many times referred to as “survivor guilt.” The blame themselves for something happening that was totally out of their control.

Suicidal thoughts and feelings are common. Guilt and suicidal thoughts many times go hand in hand. Both can cause a person to act out inappropriately. Many will commit what is called “relational suicide” which is the intentional sabotaging of relationships with those they love, in reaction to feelings of self-worth and guilt.

Anxiety and nervousness can be manifested by an exaggerated startle response that can be set off by numerous factors such as fireworks, cars backfiring and other loud noises. Anxiety and nervousness may also be displayed by hyper arousal and an uncomfortable feeling or feeling of unease when someone walks close behind them, or they’re in a confined place. They may feel uncomfortable in crowds and feel the need to always be near a door.

Emotional constriction can best be described as putting your emotions in a pressure cooker. Eventually, the pressure becomes so great that it can no longer be contained and the person explodes. If not controlled and the pressure is not released in a constructive manner instead of extreme outbursts, considerable problems could arise.

Everyone reacts to stress in their lives differently. In the majority of cases, there are usually warning signs that indicate that a person is having difficulties managing their stress. These are things that a person experiencing a traumatic event, as well as their family members, friends and co-workers can be aware of and be alert for. If the warning signs are recognized for what they are, then steps can be taken to get the necessary help in dealing with the PTSD and help the person learn to manage their PTSD. These warning signs include but are by no means limited to:

Persistent fatigue
Inability to concentrate
Flashes of anger. Lashing out at family, friends or co-workers for no apparent reason.
Changes in eating and sleeping habits
Increased use of drugs, alcohol and tobacco
Prolonged tension headaches, lower back aches, stomach problems or other physical ailments
Prolonged feelings of depression, guilt, anxiety and helplessness

PTSD does not have to be debilitating. PTSD can be and is being successfully treated. The first thing that we have to do, is to educate ourselves about what exactly PTSD is. By becoming knowledgeable of the signs and symptoms and being willing to seek help for ourselves or our loved ones when suffering from them, things can and do get better.

The effects can be managed and the person suffering from PTSD can recover and go on to lead a very normal and happy life. If PTSD is ignored, the effects can become chronic and affect the life of not only the person suffering from PTSD, but everyone around them.

My next article in this series, will discuss treatments that are successfully being used to treat persons suffering from PTSD.


9 Responses to “What Does PTSD Look Like?”

  1. Anthony on January 31st, 2007 7:08 pm

    Another excellent post Terri. Very informative and detailed. Had to take a smoke break in the middle! Thanks for the information, something I really don’t have much knowledge on.

  2. Terri on January 31st, 2007 7:11 pm

    LOL! Smmoke break huh? I had to do the same today when I was writing it. Hopefully by the time I’m finished with this series, our troops that are suffering from PTSD and their families will know that there IS help available for them both on their military installations as well as many other places and they’ll seek that help.

  3. PJ on January 31st, 2007 7:29 pm

    For a person who suffers most of these symptoms without any specific event triggering it, can that also be called PTSD? I think you know what I’m talking about. Do you have any suggested reading for folks like that?

  4. Terri on January 31st, 2007 7:31 pm

    One thing I would suggest reading, the book that I referenced here in this article. “Down Range, To Iraq And Back.” Even though it’s written about PTSD in the military, their suggestions and their information is relevant to anyone suffering from PTSD, for whatever reason. Another one that you might find helpful “I Can’t Get Over It: A Handbook for Trauma Survivors” by Aphrodite Matsakis. There’s also a world of information online.

  5. Terri on January 31st, 2007 7:32 pm

    That’s the thing about PTSD PJ, anyone can experience it when exposed to traumatic events or repeated traumatic events in their life. For instance, a rape victim who suffers from PTSD suffers the same symptoms.

  6. PJ on January 31st, 2007 8:27 pm

    Thanks Terri, I’ll check those out, and look forward to your continuing posts. As you know, I’m not in the military, but in a job where that sort of trauma is constant. Any other suggestions would be appreciated.

  7. Terri on February 1st, 2007 4:55 am

    My biggest suggestion PJ is to not hold your feelings inside. Get them out whether it be talking about it with someone you work with, talking about it with someone you trust or even journaling. Don’t isolate yourself. If necessary, seek out counseling with someone who has experience with PTSD survivors. I worked in the field you’re in for about 10-12 years total, before we even knew about PTSD and it’s effects. We all would get together after a particularly traumatic event and debrief ourselves. I think we did this more out of instinct than anything, but it helped tremendously.

  8. Mike Schoneman on August 5th, 2008 4:42 pm

    The VA is saying I have PTSD but that it is not service connected. Then they say I don’t have PTSD. When I tried to change my status I confronted a bureaucratic nightmare. I go from one professional to another and then wind up going in circles. Literally. It is a wonder that some of these people even get a pay check. I was recently advised to write my Senator. Hopefully I will have success there. So sad. Thanks for being there and helping me understand what PTSD is all about. Mike

  9. Terri on August 5th, 2008 5:02 pm

    Mike, I’m glad that our articles we’ve written here have been helpful. I’m hoping that the VA can get things figured out and that you’ll be able to get the treatment that you need. Please keep us posted. Thank you also for your service and sacrifice. We appreciate you.

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