Stress and PTSD

Stress

Experiencing stress is natural and normal. It enables us to mobilise all required energy in an important situation and is, thus, basically a positive mechanism and crucial for our survival. However, stress can also cause severe damages on a chronic scale. When being exposed to long-term stress, people get exhausted, hopeless sometimes even aggressive. All types of mental illnesses are more likely to be triggered when a high amount of stress is experienced. Obviously, the stressed reaction is depending on the number of stressful situations one is exposed to. However, it is also highly influenced by the individually available resources to cope with stressful situations. Inter alia, such resources can be helpful social interactions with family members or close friends, knowledge on coping strategies or a higher self-esteem.

What to do

  • Pay attention to the stress feeling. Where does it come from? Is it triggered by something specific or is it more of an underlying subtle feeling? What causes the stress to decrease, a casual discussion with your neighbour, spending some time talking your native language with a family member…? Why not trying to intentionally integrate such instances in your everyday life?

For more ideas on what you could do, see also the page  What can you generally do.

PTSD (Post-Traumatic Stress Disorder)

“The mind replays what the heart can’t delete.” ― Yasmin Mogahed

PTSD is cuased by a high level of long-term stress. Even after some time has passed since then, PTSD patients experience a past traumatic event over and over again, where a traumatic event could be the loss of a close relative, sexual abuse, experienced violence or any stressful incident that would cause a reaction of deep despair, helplessness and shock for almost everyone.

In addition to personal coping resources, the risk likelihood to actually develop a PTSD depends first on the duration and second on the type of the traumatic event. While one-time accidental traumatic events, such as a road accident, lead to a light risk, the risk increases when the event persists over a long period and is intentionally caused by others, such as long-term abuse in childhood.

As mentioned at the beginning, PTSD patients are so shocked and horrified by their traumatic experience that they are not able to effectively process it, resulting in a loop of reactivation of that experience. This may manifest in one of the following:

  • Recurring involuntary and stressful memories
  • Traumatic nightmares
  • Dissociative reactions (Flashbacks: Re-experiencing the traumatic event)
  • Intense and long-lasting stress after being reminded of the traumatic experience
  • Strong physiological reaction (e.g. heart racing and fast breathing) after being exposed to a stimulus somehow referring to the traumatic event.

Because any type of re-experiencing is so painful, PTSD patients avoid thoughts, feelings or external stimuli associated with the traumatic experience, such as certain persons, areas, actions or situations.

Furthermore, mood, thoughts, responsiveness and behaviour are negatively affected in such a way that PTSD patients can have

  • Difficulties to remember important aspects of the traumatic event
  • Persistent and often distorted negative assumptions about themselves and the world in general
  • Persistent distorted accusations against themselves or others to be guilty of the traumatic experience or its negative consequences
  • Persistent negative trauma-associated emotions, such as fear, shame, guilt or anger
  • Significantly reduced interest in important (non-trauma associated) activities
  • The feeling of being a stranger to others
  • The persistent inability to feel positive emotions
  • Irritated and aggressive behaviour
  • Self-harming or reckless behaviour
  • Increased vigilance (readiness to react)
  • Excessive startle response
  • Concentration difficulties
  • Sleep disturbances.

Important note: All those symptoms are the natural consequence and completely normal reactions to abnormally horrible experiences. This way to react is completely understandable and exactly what one would expect after such an experience. However, they are counterproductive, and the patient has to work on it for PTSD to be healed. Doing this, the chances for recovery are quite high.

The following list gives a few examples of typical thoughts a PTSD patient would have:

  • “You cannot trust others.”
  • “The world is bad and unfair.”
  • “I’m inferior to other people.”
  • “It’s my fault.”
  • “I might go crazy.”
  • “My life is ruined.”
  • “I will never be able to recover.”
  • “I won’t live long.”

What to do

  • Relaxation as the necessary basis: Imagine a place where you feel safe and comfortable, a place that makes you relax and maybe even smile. It could be a place of your past, such as your parents place or one of your present life. Whichever it is, it will act as your safe harbour and you can come back to it whenever you feel bad feelings or thoughts emerging. Once you visit that place, literally or just in your mind, focus on the positive memories you associate with it. Feel the positive feelings and how this leads you to slowly relax.
  • Once you feel safe and relaxed, slowly confront the traumatic event: Even though, it might seem insane to actively confront the cause of extreme fear, it is crucial in the process to overcome the PTSD symptoms. The reason is as follows: By slowly and willingly confronting the traumatic event (either by imagining it very lively or by visiting the fear triggering objects, persons, locations associated with the respective event) you will experience that just the thought of it is not dangerous anymore. Note that the distinction is important: The goal is NOT to make yourself believe that whatever you experienced is not horrible, it rather consists of the insight and the feeling that it has happened in the past and that it doesn’t have to threaten you anymore in the presence. It is further important to stick with the confrontation once you started. The whole exercise is about the decrease of fear. Even if the fear might seem invincible in the first instance it will always decrease over time. Why? Because this is simply the way our brain works, after a certain amount of time exposed to a certain trigger any physical reaction will decrease. But for this to really happen you need to stick with it, to really expose yourself to those feelings and thoughts caused by the event you are so afraid of. Pay attention to the decrease of the fear. Feel how relaxation replaces it slowly.
  • This task can be very difficult, and you might want to have someone helping you with it. Professional psychological therapists are trained to assist you with it and to develop other helpful coping strategies. The links below will help you finding professional psychologists.

For more ideas on what you could do, see also the page  What can you generally do.

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