What happens to someone with PTSD?

First of all, this is not about diagnosis. This is about how the condition affects people on a practical level in everyday life. The following is taken from the first-hand experience of someone with the condition.

Although it is from one person, many others with the condition have the same or similar experiences to varying degrees.

The frustrating thing with PTSD is the mixture of symptoms and feelings that occur.

The feelings of the person are generally contradictory to their ‘normal’ or logical thought process. An example would be a feeling of sadness in a happy situation with no quantifiable reason for the feeling. Or, a feeling of irritability when one can not understand the reason for feeling irritable. These ‘conflicts’ can affect every aspect of the life of a person with PTSD.

In addition to these feelings, there are the feelings that go with conditions which are usually present with PTSD. These can be various forms of quite serious depression, forms of anxiety, and other mental distress. Anyone who has experience clinical depression or anxiety knows how debilitating they can be by themselves, let alone with the added problems PTSD brings with it.

From here on, some of the basic feelings and conflict will be addressed in no particular order.

1:         Life in general.

Many people with PTSD become very disillusioned with the life they are leading, and everything associated with it. PTSD (or the cause of the condition) can literally change the way someone thinks and feels about their life. It is not uncommon for people to (or want to) change career, change where they live, and every other aspect of their daily life.

This is not necessarily because they hate the life they have. Many people find the experience they have, and the realisation that they have PTSD, as an opportunity to seriously re-evaluate life and what they find important. Often, they will no longer be interested in material possessions or financial wealth, preferring to concentrate on what they need to live, rather than what ‘society’ or peer pressure dictates they should have.

This is a good thing in a way. Most people tend to ‘drift along’ in life and never REALLY have time to evaluate what really makes them happy (or unhappy), and take things as they come. Most with PTSD have an intense need to look into themselves and re-build their life in a totally different and meaningful way.

If the person is in a position to change their life, then they will inevitably begin to look at the changes they need to make. This can come as a surprise and sometimes a shock to those who have known the person as they were before the condition became involved. It is important for those involved with the person to understand that things are going to change. It is totally negative to try and make the person how ‘they used to be’. The persons views on and concepts of life may have changed, their wants and needs will have changed.

The author has undergone such a change. Before the condition came to a head, they were in a highly paid and powerful job, had a family, and tried to live the life they thought they should be. All of the usual commitments most people have in life, and aspirations for wealth and success.

Once the condition took hold, a serious re-evaluation had to take place. This resulted in giving up a 25 year career and the prospects the career held, the selling-up of everything, and moving away from the place they lived.

After taking stock of everything, the person decided to follow a totally different career, and has ended up doing something they are fulfilled in. Financial wealth is no longer of interest, and the emphasis is certainly on relationships with close friends, and happiness in work. A total change of direction and attitude. And the person is now happy in life, which has been reduced to basic needs and wants with none of the ‘rubbish’ that can accumulate.

So, if someone wants to change their life, they should be supported and not ridiculed.

2:         Personal relationships.

This is an area that is most difficult for someone with PTSD to cope with.

Family and friends can be a great source of support, but to someone with PTSD they can be a source of frustration and conflict of feelings. One thing to remember is that whatever the reaction of someone with PTSD towards those close to them, generally it is not ‘personal’. Internal feelings can range from intense love to intense hatred, and these can change at the drop of a hat.

Ironically, the person with PTSD generally exhibits blunted emotions towards those who are close. They may seem unloving, distant, uninterested. But this is generally in conflict with their internal feelings. In fact, close personal relationships are very important to someone with the condition. They need the consistency and support of those who are close.

Consistency is important in dealing with people in other areas of the person’s life. For example, seeing the same doctor at the GP’s practice, seeing the same person at a clinic, and every other place where contact with an organisation is needed.

There are a few other things that those close to someone with PTSD need to understand.

NEVER tell them you understand their condition – you don’t unless you have been through it. One of the most frustrating things for someone with the condition is to try and express their feelings or what they are going through on a daily basis.
There is an intense mix of emotions and feelings, some of which can be in direct conflict with each other. The person WANTS to express these things, but it is often difficult to find the appropriate words.

If someone were to say they understand, and the person with PTSD knows the person has never experienced the condition, then this is extremely frustrating, because it is impossible to understand the condition unless one has experienced it. So the reaction of the person with PTSD maybe irritably, verbal outbursts, increased distancing from those close to them, or maybe (in extreme circumstances) physical outbursts against themselves or others.

Although someone with PTSD may seem as though they want to be left alone, this is not always the case. Just being around one or two close people (even without reference to the condition) can be a valuable source of security for the person. In a way, this can provide some form of normality to a very confusing situation. The person will usually say or make it clear that they want to be left alone, and they should be. Many people can only be around others for short periods of time before they start to experience distress.

Don’t pressure the person. One of the worst things for someone with the condition is to receive any pressure to do anything or say anything. Just let the person talk about things, and make suggestions, rather than saying the person should or should not do something. Pressure on the person can lead to intense irritability and further withdrawal.

Communicating with someone with PTSD can be a long process if it is about something that has the potential to cause them further stress or to feel pressured.

Don’t be afraid to hug them! Although they may seem distant (and even horrible), close physical contact with someone close can be a valuable source of comfort, and (again) a feeling of contact with something that is consistent and ‘normal’. It can do more good than words. BUT, don’t overdo it!! Smothering is also something that can cause intense irritation to a person with the condition.

Personal relationships with someone with PTSD can be difficult and frustrating. But a little understanding that they are experiencing VERY REAL DISTRESS can help a lot.

3:         Irritability

This can happen at any time with or without reason. The simplest of things can make the person with PTSD irritable to varying degrees.

The irritability is usually quite intense and is difficult for the person to control. Sometimes the person may appear to be irritable and snappy, but not realise they are being so.

There is not much those close to the person can do. Usually it will pass, and it is important for those close to the person not to take too much notice of the irritable episodes.

4:         Withdrawal / anti-social behaviour

This is a big problem for those with PTSD, and is an extremely frustrating conflict of feelings and emotions.

Often, someone with the condition WANTS to go out in social situations, WANTS to visit friends and family, and WANTS to take part in activities, but there can be some inexplicable inner ‘thing’ that stops them doing so.

Social withdrawal is a big problem for someone with PTSD for two main reasons. Firstly, it creates incredible conflict between the person’s feelings and what they want to do. Secondly, withdrawal from social situations can inhibit the development of coping with the condition.

Exposure to different social situations can stimulate the person with PTSD, and help them to regain some ‘normality’ and meaning in their life. However, caution needs to be used in exposing someone with PTSD to social situations that they may find overbearing, and which may induce heightened anxiety and stress.

In general, a person with PTSD will soon show signs of being uncomfortable in a social situation. This mostly depends on the person, but may include agitation, irritability, or just going very quiet.

At these times, it is essential that the person with PTSD is allowed to freely decide (without any pressure from anyone else) whether to stay or go. In many situations a short break from the social situation, a few moments alone, is enough.

On the other hand, there may be a tendency for the person express their concerns about going into a social situation, or may protest at ‘having to go’. In these cases it is very important that those close make it clear that there is no pressure. The person can go along with the support of those close, and can leave whenever they want – no pressure. Most times the person will go and be relieved that they did!

If the person with the condition feels they are safe, and there are people who understand that the person may have to leave, then this can help build confidence in social situations. In reality, the person does NOT want to be aloe all of the time, and NEEDS some form of social normality that is not intense.

It is very easy for someone with PTSD to become very isolated from everyone and everything. The nature of the condition may mean that they seek safety within themselves, only venturing out of their perceived safe world when they have to. Going to the shop can become impossible, making or answering telephone calls can become impossible, opening letters can become impossible.

The person with PTSD is being dragged into themselves, and it is difficult for them to fight their way out of the ‘thing’ that is consuming them without help from others.

A good analogy is that having PTSD is like being stuck in quicksand. It will suck one down in to it’s depths if you let it and can drain all of one’s energy, but it is difficult (if not impossible) to get out of it without a helping hand.

5:         General memory and concentration

Most people have ‘lapses’ of memory from time to time. We may forget where we put the car keys, or if we switched an appliance off before leaving the house.

For someone with PTSD who has memory and concentration problems (possibly because of the depression that often accompanies PTSD), this can affect basic functioning in every day life to a much greater degree.

Many of those with the condition find that short-term memory is most affected, and may mean that forgetting what one was about to do can bring on further irritability and frustration, or exacerbate these feelings if already present.

Longer term memory can also be severely disrupted. Appointments, people’s names, and deadlines can all become one confusing mess if the person has not developed other skills or systems to remember these things. Ironically, it is not uncommon for people with PTSD to remember things in detail some weeks (or months later).

Concentration is generally severely affected. Some people find it difficult to concentrate on anything for more than a few minutes, while others can not concentrate on things they feel are unimportant to them. Still others have developed different systems for dealing with these problems out of necessity, although still a very frustrating experience for someone with the condition.

6:         Enhanced startle response.

One of the criteria for diagnosis is an enhanced startle response. In practical terms, this means the person with PTSD may be more ‘jumpy’ than they used to be. This can be anything from literally jumping out of a chair when there is a sudden noise 9such as the telephone) to becoming internally stressed at unusual or loud noises.

Each person is different, and reacts differently, but they will experience stress in some way if there is a loud noise or something takes them by surprise.

Usually if someone is aware of this within themselves I does not cause any worsening of the condition or their feelings, and they can generally accept that it is just part and parcel of everything else.

I remember and instance with an ex-military friend of mine who had returned from the Falklands war. We were in a club and they played the Phil Collins track ‘In The Air Tonight’. The start consists of several heavy drum beats. When my friend heard these he hit the floor in an instant. No one else detected any seemingly logical reason for his actions. But it was a major source of instant and incontrollable stress for him.

7:         Noisy environments.

The level of noise someone with PTSD can stand depends on their own make-up and experiences with the condition.

For many, persistent noise is very difficult to deal with. For example, people speaking in high-pitched voices, children playing, noise at parties and nightclubs, factory noise.

Most can stand this noise for a short period of time. Then the noise starts to feel as though it is invading their skull, becoming an incomprehensible mess. Then it starts to almost become painful and the person experiencing it has to find peace and quiet.

It is almost as though the noise has moved from the outside world and is slowly making its way inside the person. The higher the pitch, the worse (and in some cases more painful) it becomes.

The only way to cope with these feelings and the immense stress they bring is to find peace and quiet.

Some people find listening to one or two people for prolonged periods of time difficult. People close to the person may find it difficult to maintain a conversation for more than a few minutes before the person with PTSD seems to shut-off, or even shut-down.

8:         Deadened emotions

Some people who have encountered others with PTSD find them to be distant and unemotional, perhaps almost callous and uncaring about things in life.

This may seem ironic when one considers the emotional and mental distress someone with PTSD suffers.

However, many with PTSD find it difficult (if not impossible) to express either negative or positive emotions. Many partners find PTSD has a significant impact on their emotional lives. Children may find a parent with PTSD difficult to understand because of the reduction in emotional activity.

People may find those with PTSD to appear totally detached when discussing disasters or other traumatic events that appear in the news.

Although the person may outwardly seem to have deadened emotions, this is often not the case within them. In a way, the appearance of deadened emotions is a mask – a way of not breaking down to the outside world.

The ‘I really don’t care’ or ‘what the hell’ attitudes are NOT REAL! They are something the person with PTSD does for perceived protection, and it is very difficult for them to overcome.

9:         Sleeplessness, restlessness and oversleeping.

Many of these are the result of the person’s mind being unable to settle. It may be because of nightmares/flashbacks, or for no immediately apparent reason.

People with PTSD can spend periods where sleeping is very difficult, and others where they seem to be continuously sleeping. Part of the reason may be physical exhaustion that comes with PTSD. Lethargy and restlessness, sleeplessness and oversleeping, they all go hand in hand.

10:       Flashbacks and disorientation.

Flashbacks can come in many and varied forms, and vary in intensity. Some people have extremely intrusive flashbacks with sights, sounds, smells and emotions. Others can have milder forms of any of these.

Sometimes there is a trigger such as a certain smell or picture, other times they just come without warning/

Many of those with PTSD have learned to limit the impact of these on their daily life. However, they still have an effect on the person to some degree. This can be from a couple of seconds to many hours.

It is unlikely that the person experiencing the flashback will show any significant sign to others that they have just had the experience, other than perhaps seeming more distant for a few seconds or minutes.

Flashbacks are difficult to shift from one’s mind. Even if they last a couple of seconds, the person generally has the experience in the back of their mind while tying to ignore them and get on with whatever they are doing.

Some people with the condition find that flashbacks are very debilitating for a while.

Whatever the experience of the flashback, one common aspect of this is that the person becomes disorientated in actions and/or thoughts for a period of time.

Conclusion.

PTSD is a very difficult condition to live with. On one hand, the person experiences normal day-to-day things almost the same as anyone else. Their intelligence is not affected, and they are still capable of functioning within society at a basic level.

However, this ‘normal’ functioning brings problems. The person with the condition tends to be continually frustrated that the condition has such an impact on their life, and they find it difficult to control the condition (and the emotional and mental distress that goes with it) through actions that are logical to them.

Many feel as though they should be able to overcome the condition, and feel as though they should know that the turmoil is illogical. But there seems nothing they can do about it – it is something deep inside they have no control over.
The lucky ones get help. For others, they try to cope with it for years (many cases of PTSD are discovered many years after a trigger event has occurred), and for others the condition develops into a very serious disorder, and may result in suicide or very aggressive behaviour, both as a result of extreme frustration.