How to recognise PTSD in others and what to do
Thank goodness for Betty Mama
I’m so grateful to Elizabeth for returning to help us further understand Post Traumatic Stress Disorder.
PTSD is becoming a more occurring disorder that presents more often as violence and exposure to violence and trauma escalates. It is a sad reality but An estimated 8% of Americans − 24.4 million people − have PTSD at any given time. That is equal to the total population of Texas*.
The Manchester attack had not occurred when I scheduled this post. But it’s happened and it is tragic. There are hundreds of families dealing with the consequences. My thoughts and prayers are with them.
Thank you Elizabeth, we really appreciate you sharing your experiences and understanding of PTSD. It is brave to face this and still look inside it to help us understand it better. Thank you.
How to recognise PTSD in others and what to do
Hello again! It’s Elizabeth “Betty Mama” Brico, site author of Betty’s Battleground: a blog about living and parenting with PTSD. You may remember me from my previous guest post “PTSD: A Personal Story.” Lovely Michal has invited me back today to talk to you a little more about PTSD; this time about how you can recognize it in others and how you can help.
PTSD often comes from traumas people don’t want to discuss
PTSD can be tricky to identify. It arises after someone has experienced a life-threatening or sexual trauma.
People don’t usually hesitate to disclose traumas related to accidents or natural disasters, but due to the stigma surrounding assault, especially sexual assault, many people choose to hide their trauma when it stems from human action. This fact alone makes it difficult to know whether someone is at risk for PTSD.
When people are unable to disclose their trauma, they are often misdiagnosed. Depression, panic disorder, and borderline personality disorder are common misdiagnoses for people with unrecognized PTSD. Because PTSD is a disorder which results not only from exposure to trauma, but also due to a lack of support or access to supportive resources, it is imperative that people who have undergone a serious trauma are recognized as such.
This article is not meant to replace the opinion of a psychiatric professional.
If you believe that you or someone you know may have PTSD, the best thing to do is acquire a proper diagnosis from a licensed professional.
The information in this article is knowledge compiled by a complex abuse survivor who has lived with severe PTSD for nine years. It is meant to assist in recognizing the symptoms of possible post-traumatic behavior, and to be used in concert with professional help. PTSD is not curable, but it is treatable-with professional help.
How to recognise PTSD in others:
Signs That Someone You Know May Have PTSD
1. S/he has suddenly begun to rock raccoon eyes.
There are a lot of reasons why people may be overtired that have nothing to do with trauma. A new baby, for example. Long work hours. A loved one with an illness.
But if your friend is showing signs of deep fatigue without explanation, she may have PTSD. Besides dark circles and tired behavior, she may show symptoms like not wanting to get out of bed for days, or staying up really late. Like you wake up and see she’s posted a bunch of random stuff on Facebook or Twitter or whatever at 4am.
Insomnia can occur for many reasons; PTSD is one of them.
2. S/he starts avoiding stuff
Sorry about the vague language, but PTSD avoidance behaviors really can cover many different things.
Your friend could stop going to a favorite bar or club if that’s where an assault occurred. If he was in an accident, he could change his route-sometimes drastically-to avoid driving on the same street. Or, he could start avoiding people.
Maybe you have nothing to do with what happened at all but for some reason you remind him of the event. Perhaps you resemble his assailant. Maybe you know the person. It could also mean just not talking about certain people or places. If he clams up when you bring up a subject that was normally not an issue, there may be reason for concern.
The avoidance behaviors can even extend to really strange and specific things, like certain foods or smells. Anything that reminds a traumatized person of the event can be a trigger. Triggers suck, so people tend to avoid whatever stuff will trigger them.
3. S/he is hypervigilant
Once while I was waiting for the light to change at a crosswalk something clanged loudly at a nearby construction site. Nothing bad had happened; just a normal loud construction sound, but an elderly man waiting next to me ducked very suddenly in response and raised his hands to protect his head. When I glanced at him to see if he was okay, he explained that he was a Vietnam vet.
Likewise, if I run into someone unexpectedly when turning a sharp corner or after an elevator door opens, for example, I visibly startle. I experience symptoms of hypervigilance, like a racing pulse and breathlessness, for several minutes.
If you notice your friend starting very easily or reacting in an exaggerated manner to slight disturbances, she may have PTSD.
4. S/he is emotionally hyper-reactive
Some people are naturally more sensitive than others. When someone has PTSD, however, sensitivity skyrockets well beyond what would ever be considered “normal.”
She could get offended by the tone of your voice, when you were only feeling tired. Or you may begin to notice she is holding back tears in her eyes at random moments. People with PTSD have a shortened emotional spectrum, but those emotions we do experience are strong. Unfortunately, they tend to be the more unpleasant emotions, like anger or sadness.
When not displaying something like rage or deep sadness, your friend may present with “flat affect,” which is the appearance of having no emotions. PTSD doesn’t cause people to stop having feelings, but it may feel dangerous to display emotions, so she doesn’t. Flat affect can also be mistaken for anger, aggression, or “resting b*tch face,” so if your previously joyful friend starts looking dull or angry, all the time, it may be the result of PTSD.
5. He lessens or totally stops socializing
This is not exactly an avoidance behavior in the sense I mentioned earlier. While avoidance behaviors aim to lessen the chances of encountering a trigger, a decrease or total stop in socializing happens for a different reason, though both may be connected to PTSD.
Often times people with PTSD will feel as though they are totally alien from the rest of humanity. This is especially prevalent among survivors of sexual or physical violence, though it is a category symptom for all PTSD. The best way I can describe it, in my experience, is feeling like I have a layer of filth embedded just under my skin. Maybe you can’t fully see it, but you can smell it or sense it or something and it makes me repellent. Other survivors have described it as feeling like everybody knows what happened to them and are judging them for it.
If you felt like you stank, or everyone you met instantly knew your most painful secret, would you want to hang out
6. Despite displaying many concerning symptoms, s/he doesn’t go to therapy
One of the most frustrating and misunderstood PTSD symptoms is that survivors often don’t seek help. This isn’t a sign of stubbornness; it’s a symptom of PTSD. When a person experiences trauma severe enough to cause the brain changes that manifest as Post Traumatic Stress Disorder, she becomes implanted with the idea that she cannot be cured. This unfortunately, is actually true. What becomes difficult to believe is that these horrible symptoms can be treated.
Once have you looked into the dark, indifferent face of the universe and have seen it at its very worst, directed right at you, how are you supposed to believe you can ever un-learn such terrible insight?
Even for those less prone to existential angst, how do you un-experience trauma? You don’t. It is an actual, listed symptom of PTSD that people who have it believe they cannot be helped. People with depression, or anxiety, or many other similar disorders will often seek treatment but people with PTSD will put it off, or see a therapist for a short time and then leave. Therapy seems pointless.
Trauma work is long and laborious, and often people have to face things that make them feel much worse before they will even begin to feel better. You’re going to be hard-pressed to find someone jumping at the opportunity to feel worse, in any population.
What to do once you recognise PTSD in others
What to do if someone you care about has PTSD
Now that you have checked off all these symptoms, and you believe that someone you love may have PTSD, what do you do about it?
PTSD is a very difficult disorder.
It is a mental illness that arises in response to external events. People are not born with it. It isn’t fear or sadness without cause.
1. Don’t assume medication is the answer
While medication can help, PTSD cannot be medicated away.
I was talking to my doctor recently about the possibility of taking meds, and he reminded me that while some people with Major Depression may be able to take these same medications and feel better without anything else, this would not be the case with me. I would still need therapy, because although my body underwent physical changes that can be helped with medication, those changes are a symptom of my disorder, not the cause of it.
2. Stick Around
PTSD is a heavy, disheartening disorder to carry around. But there are ways you can help. The biggest thing I recommend is to stick around. Just stay her friend. Show her you care. Tell her you care. Don’t leave. And please remember that PTSD cannot be cured.
It sounds simple, but believe me when I say: you will be tried.
When I was first diagnosed, there were countless sympathetic, supportive people. A few years later, not so many. Now, a decade later, only a couple remain. People get annoyed by repeatedly hearing about a person’s trauma, or seeing a person react to something that happened so long ago. People don’t like to be sympathetic forever.
I can’t say it enough: PTSD cannot be cured.
3. Stay Patient and Compassionate
Even if your friend is diligent with therapy and learns coping skills, he or she is going to, every once in a while, have a bad day, or month, or year. I urge you to remain patient and compassionate. This is a person who has endured traumatic pain far beyond the normal scope of human experience. It isn’t something that anyone can “just get over,” and it isn’t their fault. Remember that.
4. Encourage Therapy
Keep encouraging your loved one to seek therapy. Therapy helps. But as I mentioned, one of the symptoms of PTSD is not believing therapy will help or to avoid therapy because it hurts so much for so long before it helps. Don’t get mad at her if she starts and then leaves. Finding a therapist you trust enough to share your trauma experience is hard. Keep encouraging her, but don’t shame her for not doing it.
5. Find support from fellow survivors
Direct her over to my blog bettysbattleground.com. This isn’t a shameless marketing ploy. It really helps to read the stories of other people who are going through the same disorder.
If he doesn’t relate to my blog, I have a links and resources section with other suggestions. The other alternative is to do an internet search for “PTSD blog,” “PTSD website,” “PTSD resources,” etc.
There are more of these out there than you would expect, and it often feels safer to reach out over the internet than in person.
6. Expect the outburst
Finally, people with PTSD often have a short fuse, but they are also often kind, highly empathetic people who don’t want to hurt anyone. That whole violent trauma patient the media loves to show us is not very common.
Your loved one is more likely to have an outburst of unkind words than to gun you down, but either way; telling her she’s behaving in an abusive manner is okay, but try to consider how you word it.
7. Be mindful of the way you speak
The word “abusive” itself may be trigger for the person suffering from PTSD. It’s going to feel really bad to be compared to the person who caused her to have PTSD If she has it from an abusive relationship for example. If her outbursts are hurting you or others, try to tell her in a non-accusatory and inclusive way.
Something like, “I care about you. Some of the things you say hurt my feelings and feel unfair. I’m being careful toward your feelings; could you do the same for me?”
Most likely, she doesn’t want to hurt you in the first place. It can be hard to react that way when someone has hurt or embarrassed you, so I urge you to just step back from the situation until you emotions have calmed. If you begin accusing her, she will get defensive, but if you tell her in a gentle manner that makes her aware she is doing it, she will probably stop.
If you guys end up getting in a blow-out fight that ends the friendship, I guarantee that she will probably never step forward to mend it, even if she misses you. Her line of thinking will be that you are better off without her. Remember that she feels awful about herself. Try to avoid a fight like that, because if you’re supportive enough to care, she can’t afford to lose you.
8. Don’t silence the person
Often, when a person experiences a serious trauma, we want to avoid him. It can be difficult to hear that someone we love has experienced something shocking and horrific.
We sometimes can’t handle that someone we care about has suffered rape or near-death event.
It is easier to look the other way and pretend it never happened, but this is a form of silencing.
As a trauma survivor, I can tell you that being silenced and ignored by the people I needed to care, was almost as bad as being traumatized in the first place. The discomfort you feel facing someone else’s trauma is nothing compared to the pain he will feel facing it alone.
There are things he can do to help himself, but, ultimately, compassionate, sustained support will be key to his recovery.
Diagnosis Takes Time
Finally, someone can only receive a PTSD diagnosis one month or longer after traumatic exposure. This is because, while trauma can cause these types of symptoms, it is only when they become chronic that they become considered evidence of a disorder.
Just because a person experiences trauma does not mean she has to be traumatized. In order to help someone avoid developing PTSD, it is imperative the sufferer begins therapy immediately after the traumatic event, and that she receive diligent, compassionate care and assistance from her loved ones.
That means more than a sympathetic Facebook message.
That means going to her house and keeping her company, helping her get through the day, telling her you care and that she matters,and not stopping.
More from Betty Mama
Elizabeth Brico is a speculative fiction writer, award winning poet and playwright, feminist blogger, DV survivor, vegan, and mama x three from the Pacific Northwest.
She blogs about living and parenting with PTSD at bettysbattleground.com. If you would like to help her end mental illness stigma, join her Facebook community or answer her call for submissions . You can also see more from her by following her on Twitter: @bettymama206 , Instagram: @bettymama206 or Pinterest: @elizabethbrico .
* Statistics relating to PTSD
For the source of this fact and other facts pertaining to PTSD follow the link to PTSD United.