When looking at the various ways people attempt to cope with exposure to one or a series of traumatic events, it’s important to recognize the ways that they may manifest, says Gary Brown, PhD, a licensed psychotherapist in Los Angeles who has worked with organizations like NASA and the Department of Defense in addition to seeing patients in his everyday practice. “You probably have a sense that something is wrong, you don’t quite feel like you normally do, and might alternate between feeling extremely upset or possibly nothing at all,” he says.
Inability to trust
This can be related to a lack of trust in other people and the greater world around you, but is often more likely rooted in a lack of trust in yourself. “After a traumatic experience, it’s common to be generally distrusting of others, the world, and one’s self. You might feel like you can’t take anything at face value, or you may be subconsciously ‘testing’ your relationship with people or constantly questioning the other person’s commitment or loyalty to you,” Grimste says. She continued to explain that you might start looking through another person’s phone or emails someone’s without their permission, calling or texting often to “check-in,” or even showing up to someone’s place unexpectedly. “On the other hand, you might have the opposite reaction and have an avoidant reaction, which means you won’t engage in any real relationship with anyone because that kind of vulnerability feels very risky,” she says. “You might find yourself starting to lie, pretend to like or enjoy something you don’t, or becoming paranoid about someone’s motivation, or even their lack of response during a certain period of time.”
Living with trauma can make work, social gatherings, even commuting a terrifying and exhausting experience. Over time, we learn and adapt our behaviors based on our past experiences and how we’ve processed them. Grimste notes that if you’ve experienced a traumatic event, you feel that if it happened once, it can happen again. In a way, this hypervigilance provides a sense of security—if someone is always “expecting the unexpected” they can be better prepared and hopefully enact a different outcome than when the trauma happened. It is, in a way, an attempt to protect yourself. “You are always on the lookout for when the next ‘bad thing’ is going to happen and actively try to prevent it by anticipating the threat and protecting yourself against it before it’s too late,” she says. “Unfortunately, the surge of adrenaline that makes us feel on edge, anxious, and panicked, like we have to do something or run, often create even more chaos, problems, and even physical health conditions.”
It makes sense that to avoid all of the racing thoughts, anxiety, paranoia and other uncomfortable behaviors associated with the above symptoms that you might try to avoid being around people as much as possible or develop social anxiety. “Many people try to cope by withdrawing from typical sources of support, like family, friends, and colleagues,” says Dr. Brown. “The problem with social withdrawal is that we wind up leaving ourselves isolated and alone at precisely the time when we really need to be reaching out to others for help, comfort, and support. By withdrawing, we actually wind up prolonging our suffering.” Instead of withdrawing, he suggests, do the exact opposite. “Reach out to at least one or two people that you normally trust, and let them know what is happening to you,” he says. “This is one of the very best ways to begin your journey of recovering from the trauma.”
Drinking or using drugs
There is a strong connection between PTSD and increased drinking or drug use, a behavior often referred to as self-medication. “People suffering from PTSD are often desperate to find a way to soothe these unpleasant feelings, and that’s where substance abuse enters the equation,” says Dr. Mogali. “They might think that self-medicating will help them feel better, and when they first start using, it does. Increased drinking in general, both alone and in social settings, is a common way that people cope, since it enables you to feel more relaxed when you’re otherwise unable to relax.” However, things usually don’t stay that way for long. Substance use—which commonly includes, in addition to alcohol, the use of marijuana, opiates, and benzodiazepines (Xanax, Klonopin or Valium)—increases your “feel good” sensations. The way your body is interpreting alcohol or drugs is “I feel happy and good.” However, she says, these feelings are always temporary, and often keep people from being able to recover from PTSD. In some cases, it can lead to addiction or dependence that only makes things worse. “You may not feel as depressed or anxious when using drugs, but when they’re not using, the anxiety and depression will rear itself in a really intense way. And the more you self-medicate, the harder time you will have in being able to feel in control of your own emotions and able to deal with them in a healthy way on your own,” says Dr. Mogali.
Avoiding normal activities
In addition to avoiding people you once held dear, you may also start steering clear of other daily routines that once represented life inside of a comfort zone that no longer exists after it’s been so severely disrupted, Dr. Brown observes. “A good night’s sleep has been out of reach for hours, days, weeks, and possible months, so you may have also stopped engaging in activities that normally brought you pleasure,” he says. “Maybe it was going to the gym four days a week, yoga classes, movies on Saturday nights, cooking dinner, a weekly book club, or nightly walk with your partner. Now, you find yourself sitting at home, no longer feeling any pleasure in anything.” Ideally, pushing yourself to show up for these activities or pick the routine back up would be an important way to “fake it until you make it” but if you feel unable to function at all, it’s important to contact a trauma specialist, like a therapist, or psychologist, immediately.
Change in s*xual behavior or romantic relationships
Whether you’re single, married, in a relationship, or something else altogether, people suffering from PTSD often find that their s*xual relationships become dysfunctional or may engage in promiscuous behavior, says Dr. Mogali. “The reason for this is complicated, but can involve the trauma leaving behind feelings of worthlessness and beliefs of being unlovable,” says Dr. Mogali. It can also be a direct result of inhibition being let down by the aforementioned substance abuse or increased drinking, and a tendency to the also previously aforementioned tendency towards risky behavior. You may notice that the dynamic in your committed s*xual relationship has changed, you seem somehow unable to have normal intimate romantic relationships and are shying away from physical encounters with your significant other. Perhaps you’re making decisions to have s*xual intercourse with people on a whim, or while intoxicated and without thinking it through, or you’re cheating on your partner. You may find that you have feelings of low self-esteem when you used to be confident and bold, or that you’re suddenly using s*x in your relationship as a way to assert control. “Also, those experiencing PTSD may cope by attempting to assert control in their s*xual relationships. Performing s*xual acts or having intercourse becomes a way of experiencing validation and can lead to an unhealthy way of coping,” says Dr. Mogali. “This behavior actually often results in an even lower feeling of self-worth and encourages a feeling of despair.
There are many effective courses of treatment for PTSD ranging from cognitive behavioral therapy and dialectical behavioral therapy to EMDR (Eye Movement Desensitization and Reprocessing), and art therapy. These are often coupled with medications to treat the anxiety, depression, and insomnia that come along with the PTSD. Additionally, if you have turned to self-medicating to cope and find that you’re facing alcohol or drug addiction, checking out a 12-step recovery program may also be helpful, and of course, a holistic approach to finding inner peace, like yoga, exercise, and medication, are also excellent ways to round out the above courses of professional medical treatment. “The sooner you ask for help, the sooner you will begin to feel better. Left untreated, PTSD can have a devastating effect on a survivor and her or his loved ones,” says Dr. Brown. “I know, I’ve been there. The biggest mistake I made when I left the military was not immediately getting the help I needed.” And if getting help for yourself is not a good enough reason, he says, then ask yourself this: Am I the only one impacted by this? How are my loved ones impacted by what is happening with me?Those who reach out to family, friends, colleagues, and professionals trained in the treatment of psychological trauma, have significantly better outcomes than those who don’t