Recognizing Early Warning Signs of PTSD
PTSD COPING The severity of post-traumatic stress disorder (PTSD) symptoms can change over time, and therefore, it is important to recognize PTSD early warning signs that may indicate your symptoms are being triggered or worsening. How to Identify Early Warning Signs Managing the symptoms of PTSD takes a lot of effort and the regular use of healthy coping skills. Sometimes stressful experiences or changes in mood may make it difficult to keep up these healthy coping skills. For instance, a person with PTSD may notice herself slipping into the use of avoidance behaviors (for example, isolating herself from loved ones) or unhealthy coping strategies, such as substance use, deliberate self-harm, or binge eating.1 This could lead to PTSD symptoms returning or becoming worse, or, in other words, a relapse. Given this, it is very important to learn how to catch a relapse early on. While the term “relapse prevention” is commonly used with regards to substance abuse—that is, a person with a substance use problem is considered to have “relapsed” if they go back to regularly drinking or using drugs after a period of abstinence—the term can also be used with other conditions, such as PTSD. PTSD: Coping, Support, and Living Well Relapse Prevention in PTSD Relapse prevention is a set of skills designed to reduce the likelihood that symptoms (such as those of PTSD) will worsen or that a person will return to unhealthy behavior, such as substance use.2 Skills include: Identifying early warning signs that symptoms may be worsening Recognizing high-risk situations for relapse Understanding how everyday, seemingly mundane decisions may put you on the road to relapse (for example, skipping lunch one day may make you more vulnerable to being in a bad mood) You can think about relapse prevention in the same way you think about fire prevention. We can take a number of steps to prevent fires, such as having fire extinguishers handy, using smoke detectors in our homes, or making sure we keep flammable things away from open flames or sources of heat. However, despite taking all of these steps, fires still happen. However, all of these preventive efforts do a lot to reduce the frequency and severity of fires. Similarly, there are a number of things you can do to prevent the return or increase of PTSD symptoms. That being said, it would be unreasonable to think that PTSD symptoms may never be triggered. Some things are out of our control. For example, you may inadvertently see a reminder of your traumatic event or get pulled into a conversation about something that reminds you of it. Anniversaries of a traumatic event are also unavoidable and are often associated with a resurgence in PTSD symptoms. Through the use of relapse prevention skills, you can identify the early warning signs of returning or worsening PTSD symptoms, which allows you to take quick action. PTSD Warning Signs Symptoms do not usually just pop up out of the blue. They are usually preceded by some warning signs. These can be many (sometimes minor) things, such as the experience of certain emotions, changes in thoughts, or changes in behavior. Below are common warning signs.3 See if any of these are consistent with your experience, but remember that everyone's PTSD symptoms and signs are unique. Changes in How You Think “I don’t care about going to therapy anymore.” “Nothing is working out for me. I am never going to get better.” “No one cares about me or what I do. What’s the point of going on?” “I’m feeling a little down. This must mean that I am going to fall into a deep depression again.” Changes in Your Mood “Everyone is getting on my nerves lately.” “I just don’t feel happy, even when I am around people that I know I love.” “I am beginning to feel really jumpy and on edge.” “My mood keeps changing rapidly. In minutes, I can go from feeling really happy to really down or terrified.” Changes in Your Behavior “I just don’t have the energy to take care of myself in the morning. I haven’t showered for days.” “I don’t want to be around people anymore. I’ve been isolating myself.” “I’ve been drinking more, but just to take the edge off of my feelings a little.” “I’ve noticed that I am less talkative than I used to be.” What Are Your Warning Signs? Awareness of your own personal warning signs may make a return of PTSD symptoms feel more predictable and less unexpected.4 Recognition of your own warning signs also provides you with the opportunity to cope with these changes before they become unmanageable. Once you have identified your warning signs, come up with a plan of action. You can turn to a mental health professional to help with this. PTSD Discussion Guide Your therapist or psychiatrist may also engage you in a form of psychotherapy or "talk therapy" called stress inoculation therapy, where you learn to manage stressful and anxiety-ridden situations. In the end, under the guidance of your therapist, you need to figure out how you can best cope. In addition, it is also a good idea to share your warning signs with a loved one so that he can also be on the lookout and help you cope should one arise.