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PTSD and Anesthesia (Surgical Procedures)

PTSD and Anesthesia (Surgical Procedures)

This is a topic that I find is rarely discussed, and it really is one that everyone needs to understand more about when life includes PTSD‬… Anesthesia. Craig even told me last night while we were talking, he was processing what he went through yesterday, that he wanted me to write about this today.

I have to add my note in here, I am not a doctor or in any medical field, so not speaking from a medical point of view, but as a spouse/caregiver of one with PTSD. The following is from our personal experiences.

Anesthesia is so commonly used these days, especially for many types of surgery, but what about when the one having surgery or procedure also has PTSD? Have you thought about that?

Let me explain…

One with PTSD stays on guard, so to speak, pretty much all of the time. They most likely use more coping skills than you realize in day to day life living with PTSD. They are able to manage symptoms, in a way they have some level or sort of grip on those symptoms.

When one has to have anesthesia, their guard is going to be down when they are coming out of it. Some may handle this well, but others may not. You do not know what recovery after a procedure will be like until you are there. Each time may be different, it could depend on how symptoms have been recently, it could depend on how anxiety was right before the procedure, it could depend on how the staff manages things as you are coming to, there are many factors involved.

(Craig gave permission to use him as an example and asked that I talk about this because it is serious and people need to understand what can take place.)

Before his surgery, we made sure the entire staff knew that Craig has PTSD. One of Craig’s traumas was violent and we know he has physical nightmares etc. from that trauma, so there could be the chance when coming out of anesthesia and disoriented that his PTSD could affect him, especially with guard being down. I was told “he did not have any issues noted from his last surgery so we don’t expect any this time”, which was true, he did not have any issues last time. I was quick to explain that it is PTSD, and it can change from how he responded last time when coming to, that we honestly don’t know how he will be each time. That he has had increased symptoms for several months now and that needs to be taken into consideration. Which they did, they listened to me. I also told them that if they needed me to come get me, I do know how to manage his symptoms.

Craig said that when they took him back he told them again not to get close to him when he starts coming to, and we had already explained to everyone not to touch him when he’s coming to, to stand back and talk to him for a moment so he knows who is there and they can get him focused on them (how to ground him), to tell him what they are going to do or where they have to touch him before they do so it does not catch him off guard, so they can continue with what they need to do for him without triggering PTSD.

If you do not know how the steps of surgery work, once through surgery they take you to post-op, then from there they take you to recovery this is when they will allow another person to come in with the patient. At post-op I received a call. “Rebecca we need you back here, we are sending someone to get you right now. Craig has stated four times he needs his wife, asking where is my wife? We need to bring you back.” I said, “No problem come get me”. I knew right then something was not okay because they never take me back at that stage.

When I went back I remained calm and focused. I saw Craig as I crossed the room, he was sitting up contious, but what I saw, well let’s say I am thankful they took me back. Craig was obviously having flashbacks. He was disoriented, “lost” was what he worded it as, he had no clue where he was, why he was there, or that he had just come out of surgery or even needed surgery, and he kept repeating the same things and questions over and over.

His eyes were widened and he was scanning the room, which was a sign of a flashback starting. I knew exactly what was at hand and started talking to him as I approached him. He needed to be grounded. I got him to focus on me, eye contact, and started feeding him information of where he was, why he was there, telling him he just came to from anesthesia, etc etc. It was only a few minutes later and he started scanning the room again, flashback, and I went straight into grounding him again. He kept going in and out of flashbacks.

Every time he would get grounded he was concerned he had hit someone, was convinced he had hit someone even though he did not which was sending him into more confusion and worry. The nurse was quick to tell me that she would step back from him and followed what I had told them to do, but that Craig never tried to touch anyone, but they knew they needed me back there with the confusion he was having. The flashbacks went on for nearly an hour as we pushed fluids, the staff brought him out of the anesthesia, and I kept grounding him from flashbacks. Everything worked out okay and no major episodes that could not be managed, and no he never swung on anyone but to him due to the flashbacks he was convinced he had and it worried him.

Craig experienced so many flashbacks yesterday after surgery that once home last night he did not recall that hour or many details of the long day. He remembered some details from before surgery, then remembered me coming into the room carrying coffee for him, he said he remembered he felt relief when he saw me. Last night he mentioned how much he truly trusts me and that he felt that yesterday and was so thankful I was there. I can not even state how many times last night he thanked me for being here and for being there for him yesterday. PTSD really had a grip on him yesterday, but the steps we took and plan we put in place helped tremendously. And the entire medical team was just awesome.

So here is what we want you to know and the serious reason for talking about this…

* Anesthesia can cause a person’s guard to be down and they may not be able to cope as well as they normally can with PTSD symptoms. You cannot know ahead of time how PTSD will be affected or triggered. Never assume each time will be the same as last time.

* It is urgent that you let medical staff know one has PTSD ahead of time, for the well being and safety of the one with PTSD and everyone involved. Give them any information that could be useful ahead of time as well as right before a procedure so it’s fresh in their minds. Such as how anxiety levels have been over the past 24 hours, how to approach one, what things can be said such as you are at [place], you just had [procedure] done, etc.

* Make sure the staff knows how to ground one! And make sure someone that is used to grounding that person, that the one with PTSD responds to, is present in case they are needed by staff. Let the staff know if that person is needed they are there and the staff can get them if need be. Make sure they have your name and phone number, which they should get anyway. Not everyone with PTSD grounds the same way, so make sure the medical team and staff are educated on the individual and what works for them.

* Never assume that just because they are medical staff that they understand or know how to manage symptoms for each individual. Many have worked with many PTSD patients and are great with them and with helping them through symptoms, however every patient is still different.

~Bec
A Spouse’s Story PTSD : Facebook Page

PTSD: Memories and Triggers

PTSD: Memories and Triggers

Let me tell you a short story…

The other day Craig and I were sitting in the room, it was quiet just the two of us, then out of nowhere he said, “Are you going to make some of those bead things like you used to work on all of the time?”

I looked at him in dead silence for a moment, then asked “What exactly are you talking about?” He replied with, “You know, those bead anklets that you used to make tons of each year when the weather started warming up. You know, you used to sit in the front of the RV with your feet on the dash and make them while I would be driving. Everyday you would wear a different one, whatever matched your clothes or swimsuit.”

I sat there speechless again for a moment. The thoughts ran quickly through my head. Where did that come from? He remembered that? That was around 11 years ago! His memories are so fragmented and some completely gone, that this caught me completely off guard.

I told him, “You know, I think I should make some of those, I did love making them and wearing them. He said, “You should, you always seemed happy when you were working on them.”

I was still puzzled by this conversation that “seemed” to come out of nowhere. But I went along with it, and he was right. Then I realized he had the phone in his hand. I asked him what he was looking at? You know what? He was looking at the weather and how it is suppose to be warming up again!

It is amazing to me how at times something so simple can trigger a memory, especially when it was one that was thought to be simple or even forgotten. I just smiled at the fact of the conversation, it meant the world to me that he was able to recall something so simple but yet had such a huge meaning behind it.

This was a good memory for Craig. But you know what? Just like him looking at the weather brought that memory of me making anklets to thought/mind, that is the same way things happen to those with PTSD‬. It only takes one simple or seemingly simple to others thing related to one’s trauma, for PTSD to be triggered or a person’s trauma to be brought back to their mind. Those memories are not something that a person can just get over or brush under a rug, they can come when you least expect them. Please do not dismiss what those with PTSD actually experience.

~Bec
A Spouse’s Story PTSD : Facebook page

PTSD and Dissociation (Dissociative Symptoms)

PTSD and Dissociation (Dissociative Symptoms)

It was brought to my attention yesterday after my dissociation or sleepwalking and PTSD question that many do not know what dissociation or dissociative symptoms are. These are important terms to understand when it comes to PTSD, because it “may” explain some of the unexplained for many.

I will be right up front on this one, if your loved one with PTSD does experience these symptoms, this is going to be the hardest part of PTSD to wrap your head around! You NEED to learn about this.

The DSM-5 has included “dissociative symptoms” to PTSD.

I want to start by saying right up front, dissociation/symptoms does not mean a person experiences the symptoms of it ALL of the time. It does NOT mean they are a bad person. It means there is indeed a “why” to things which may be happening.

Many times with PTSD people act in ways that “are not themselves” AT TIMES. Things that don’t add up from the basic symptoms of PTSD. This is one of the hardest things to get your head around, so to speak. Especially when you knew that person before PTSD and what they were like, how they acted or didn’t act, their morals, etc. in comparison to now. AGAIN, this is not something that is experienced 24/7, this can happen to the most loving, caring, respected people there are, and can happen from a trigger or when they are overwhelmed, rhyme and reasons to when this may happen do not always fit with this so to speak.. it seems to normally happen during high stress situations but not limited to those times.

In all my years being around PTSD, I have heard the term “dissociated” used once in awhile and even seen it in medical reports, “dissociative symptoms”, however it’s never been explained to us and never pointed out as something to really think about or look into, it’s been one of those “just another term” used.

So I started doing more research into it. I’m by no means an expert on the topic, and sure not a doctor wink emoticon , but found it may bring a lot of understanding to others by having/knowing this information. If it was not explained to us, I’m sure there are many others that might be in the same boat.

Now, mind you, there is a lot to this and many different levels, also not everyone with PTSD may experience this as well. But it might be a huge light bulb to many. Dissociation is a very difficult condition to understand or wrap your head around! It does take research, talking to your doctors, and learning how to accept that it may be a part of what one with PTSD experiences. The good news is, in many cases dissociation can be treated with psychotherapy and at times medications, and symptoms can decrease or change as different coping skills are learned.

The most commonly known types of PTSD which dissociative disorders are seen, are “chronic PTSD” (which is actually what Craig has) and “complex PTSD”. The highest numbers to develop dissociative disorders are those of child abuse, long-term sexual and/or emotional abuse. However, anyone with PTSD or one who has experienced a trauma may experience dissociation…war, natural disaster, assault, car accident, etc and can be an adult or child when developing the symptoms. There are also other mental health conditions which dissociation can also co-occur.

Again, I’m not a doctor or in any medical field… I’m just another spouse of one with PTSD. So I do advise you to do your research and talk with your doctor on this subject if you or a loved one feels this might be something you may be experiencing.

Let’s start with what “dissociation” is.

“Your sense of reality and who you are depend on your feelings, thoughts, sensations, perceptions and memories. If these become ‘disconnected’ from each other, or don’t register in your conscious mind, your sense of identity, your memories, and the way you see things around you will change. This is what happens during dissociation.”mind.org.uk

Everyone can experience a “normal” range of dissociation to one extreme or another. It could be something as simple as getting “lost” within a movie where you feel you are there experiencing it yourself for example, daydreaming, while driving a common route not realizing how far you have gone or what was along the way to where you are now. So this is common with everyone to some extent.

However there are more serious cases which involve one who has suffered a trauma rather it’s child abuse, a natural disaster, combat, assault, etc. All the traumas linked to PTSD.

Dissociation is a psychological term used when one suffers a mental absence from reality. Even though dissociation is not considered a mental disorder in every case, ones with PTSD as well as acute stress disorder, and conversion disorder (what Craig was originally diagnosed with) can have the symptoms of dissociation.

The human brain stores traumatic events/memories in a different way then normal memories in some cases. With dissociation, the memories are what they refer to as “split off” and can surface from time to time or triggered into consciousness without warning. Over time there are two sets of memories, normal and trauma, which parallel each other without coming together, and the person does not have control over them or when they surface. In extreme dissociation cases it can lead to multiple personalities (DID: Dissociative Identity Disorder), however again, there are different levels of dissociation and not all are to that extreme even though this seems to be very commonly related to traumatic events. And, just to note, dissociation does not mean you are crazy! It means your brain is handling things in a different way. In a way that it is “protecting” you.

Now I will say, a lot of research has been based off of childhood development (some type of trauma that happened normally before the age of 9 years old) however, there have been newer studies (2012) showing that dissociation can very well form as an adult not related to the development stage of one’s youth, due to a trauma as an adult such as combat.

So, What are Dissociative Disorders?

To accurately explain, I am using excerpts from the Mayo Clinic website and PsychCentral website… the professionals.

“Someone with a dissociative disorder escapes reality in ways that are involuntary and unhealthy. The person with a dissociative disorder experiences a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity.

The symptoms of dissociative disorders — ranging from amnesia to alternate identities — depend in part on the type you have. Symptoms usually develop as a reaction to trauma and help keep difficult memories at bay. Times of stress can temporarily worsen symptoms, making them more obvious. Dissociative disorders cause problems with functioning in everyday life.

Treatment for dissociative disorders may include talk therapy (psychotherapy) and medication. Although treating dissociative disorders can be difficult, many people learn new ways of coping and lead healthy, productive lives.” (Excerpt from Mayo Clinic staff, mayoclinic.org)

What are the different types of Dissociative Disorders?

“There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association:

Dissociative amnesia. 

The main symptom of this disorder is memory loss that’s more severe than normal forgetfulness and that can’t be explained by a medical condition. You can’t recall information about yourself or events and people in your life, especially from a traumatic time. Dissociative amnesia can be specific to events in a certain time, such as intense combat, or more rarely, can involve complete loss of memory about yourself. It may sometimes involve travel or confused wandering away from your life (dissociative fugue). An episode of amnesia may last minutes, hours, or, rarely, months or years.

Dissociative identity disorder. (DID)

This disorder, formerly known as multiple personality disorder, is characterized by “switching” to alternate identities. You may feel the presence of one or more other people talking or living inside your head, and you may feel as though you’re possessed by other identities. Each of these identities may have a unique name, personal history and characteristics, including obvious differences in voice, gender, mannerisms and even such physical qualities as the need for eyeglasses. There also are differences in how familiar each identity is with the others. People with dissociative identity disorder typically also have dissociative amnesia and often have dissociative fugue.

Depersonalization-derealization disorder. 

This disorder involves an ongoing or episodic sense of detachment or being outside yourself — observing your actions, feelings, thoughts and self from a distance as though watching a movie (depersonalization). Other people and things around you may feel detached and foggy or dreamlike, and the world may seem unreal (derealization). You may experience depersonalization, derealization or both. Symptoms, which can be profoundly distressing, may last only a few moments or come and go over many years.” (Excerpt frommayoclinic.org)

The other two are…

“Dissociative Fugue

Like dissociative amnesia, dissociative, fugue also is characterized by sudden onset resulting from a single severe traumatic event. Unlike dissociative amnesia, however, dissociative fugue may involve the creation of a new, either partial or complete, identity to replace the personal details that are lost in response to the trauma. A person with this disorder will remain alert and oriented, yet be unconnected to the former identity. Dissociative fugue may also be characterized by sudden, unplanned wandering from home or work. Typically, the condition consists of a single episode without recurrence, and recovery is often spontaneous and rapid.

Dissociative Disorder Not Otherwise Specified

Dissociative Disorder Not Otherwise Specified (DDNOS) is an inclusive category for classifying dissociative syndromes that do not meet the full criteria of any of the other dissociative disorders. A person diagnosed with Dissociative Disorder Not Otherwise Specified (DDNOS) typically displays characteristics very similar to some of the previously discussed dissociative disorders, but not severe enough to receive their diagnoses. DDNOS includes variants of Dissociative Identity Disorder in which personality “states” may take over consciousness and behavior but are not sufficiently distinct, and variants of Dissociative identity disorder in which there is no amnesia for personal information. Other forms of DDNOS include possession and trance states, Ganser’s syndrome, derealization unaccompanied by depersonalization, dissociated states in people who have undergone intense coercive persuasion (e.g., brainwashing, kidnapping), and loss of consciousness not attributed to a medical condition.” (Excerpt from: psychcentral.com, In-Depth: Understanding Dissociative Disorders By MARLENE STEINBERG, M.D.)

Now that we know a little more based on professional information, dissociative disorders and/or symptoms are very real, and when they accompany PTSD, well, it will throw you for a loop and then some whether you are the one with PTSD or the spouse/partner… until you learn about them, understand them the best possible, and learn better alternatives of coping.

Craig and I know these symptoms, if you think back to some of the personal stories I have written, then compare them to the symptoms and definitions, you will see the connections. Yes, he did things and acted in ways that were completely out of his character. Yes, he would wander and later have no knowledge of it or not know where he had been. Yes, he has “lost” memory or gaps. There are a lot of things that fit that he has experienced, without going into all of them.

Those “out of control PTSD” days, as I call them… yes dissociation had it’s hand in them in ways that in reality should have torn us apart! But you know what? We did not allow that to happen. When Craig started receiving treatment for PTSD, and they started him on medications and put him through (ongoing) therapy, I’ve noticed a huge change in dissociative symptoms, they have decreased as he has learned healthy coping skills.

Let’s jump to some of the largest subjects I see and to examples of dissociation. You know when you say “he/she isn’t acting like themselves” or “why did they do that, they would have never done that”…

One thing I hear from others a lot… “He/She’s a pathological liar”

Oh there’s one of the largest misconceptions with PTSD! Which could in a lot of cases, not every case due to other symptoms or personality traits, but many may be linked to dissociation. I commonly refer to it as “filling in the blanks” when one with PTSD does not recall the truth or what really happened. So, many times will “fill in the blanks” with what they believe is real or facts. Again, this does NOT happen all of the time, it only occurs when dissociation occurs which can be random or triggered by something.

Here is what actually happens.

The difference between one that lies, because we all know there are ones that do just lie out there, and one that dissociates, is ones that dissociate believe what they are saying as the truth, the “lies” are emotionally accurate to them based on what they are feeling rather there are accurate facts involved or not.

The one that dissociates sometimes believe feelings over the actual facts, what they feel at that very moment becomes facts to them. Then when their mood changes they might very well rearrange facts to be more consistent with the way they feel. Thus leading to others viewing them as “the liar who’s story changed.”

One that truly lies, knows they lied, they know and understand what actually happened or why they lied. See the difference now?

Then comes the confrontation! When one that dissociates is faced with hard evidence of what actually took place. This relates to my saying “they will fight to their death they didn’t lie.” In truth, because to them, they didn’t! Their “truth” is based on their feelings of what they feel is real, and not always to the hard facts.

However, there is hope in these situations. If the hard evidence is enough, one can adjust their opinions and views to see the facts before them. I hate to say, with PTSD this can very well bring on the fight or flight, so watch how this is handled and handle it as calmly as possible IF it’s something that needs to be addressed, remember to them, their reality is it never happened.

An example of the “twisted truth” could be money they spent and swear they didn’t spend it. But in fact there are bank or credit cards records to prove the hard facts, but in their true belief they did not spend a dime. In this example the hard evidence might or might not appear as facts to them. If not, save it for later, if one is experiencing a dissociative state you need to wait to address important things. A dissociative episode will pass once their brain has handled whatever stress was at hand.

I hate to say, dissociation can be very destructive to those who suffer from it as well as those close to them. Dissociation goes beyond the common errors, self-indulgent denial, or fantasy. It can be very pervasive without a logical explanation or conclusion and can harm your quality of life in many ways. Dissociation can make one appear very irrational, illogical, and cause them to shrug off important things as if they don’t exist as well as have a false reality to things that don’t exist. False memories can form, be altered, or even rearranged at any given time, dissociation also comes with memory lapses or gaps in the memory forming a sense of memory issues to appear and they can also have amnesia where nothing is remembered at all.

Some examples include:

* Telling a story multiple times, but the facts in the story changes.

* They might mirror someone’s else’s story or experience as if that story were their own.

* Opposite, they might view their own story or experience as if it were someone else’s.

* When confronted with facts they may ignore them or swear they are not true or real. (Such as spending money)

* They might commit an immoral or unethical act and refuse to believe they did it. (Such as cheating) When in fact it is not something in their character to do.

* They might not remember an important event which happened or other times recall/speak of something that didn’t really take place.

This all can be very frustrating or frightening to someone who lives with a person who dissociates… can you imagine how the one who does experience it feels??? I can imagine the word “lost” comes to mind.

When one is dissociating, it is hard for a loved one to have a logical debate or argument, persuasion and reasoning will very rarely come into play. And it’s not something that they are going to just “snap out of”, just like with PTSD itself. If you refer to your loved one with the “Dr. Jekyll and Mr. Hyde” theory, you might just have a little more then PTSD at hand. So it’s something to really think about and look into, because it is very real. In other words, they are not making this up!

Dissociation can also be a part of why people walk away from you or your loved one. It goes back to one believing you are telling lies. Stories can change and people can start not trusting what you say. They normally won’t confront you on things, they just simply stop coming around. One of the hardest things in life when in reality you both need a support system. If dissociation does come along with your PTSD, it might be best to explain it to others so your support system stays in place. It is something very difficult to understand, but very much a need to know situation.

One important thing to keep in mind. Remember that the person who experiences dissociation does not realize what they are doing when these episodes happen. As a loved one, don’t try to get back at them for what they did or said, when they are in this state don’t argue with them… agree to disagree and talk about it another time. It goes back to what we are taught… will that effect me 5 years from now, 10 years from now, is there really an urgency to discuss it right now this moment when they are not going to be able to be rational about the conversation? Sometimes you are going to be better off to address a topic later when they are not dissociative, or if it’s not urgent, just let it go!

You may also struggle with memory lapses or fragmented memory. This can play a huge toll on everyday life, work, school, and relationships. You might forget something you studied, a learned skill, appointments, etc. and also leads and adds to feelings of being disconnected form others. It can bring that feeling of floating outside of yourself wondering who that person is you are looking at, the “this is not reality” feeling. It can cause you to be confused, and can even cause you to become unsure about boundaries between yourself and others.

Like I said there is a lot more that goes with this then I could possibly write here, but this will give you a bases to start learning from and let you know that this might be a possibility in your situation. There are many different levels of dissociation from minor, even normal, to severe, and many more details.

Now, there is something different here then with PTSD itself, there have been reports showing that dissociation is or can be “curable” in many cases. So if this is something that you feel has become or MAY be a part of your life, PLEASE contact your doctor and see what they feel/think or what they feel will help.

The whole key to me writing this boils down to “Don’t jump to conclusions”! If your loved one is not acting like themselves, the person you know, other than the “normal” symptoms of PTSD itself, then find out why! PTSD is caused by a trauma and affects one in many ways, but with that trauma might come other things as well. Dissociation is a form of “guarding” one’s self, survival so to speak, which is not controlled by them, and may very well come with PTSD.

Dissociation or symptoms of are NOT excuses, they are or can be ones brain’s self-preservation reality from extreme stress or trauma related triggers.

~Bec
A Spouse’s Story PTSD : Facebook page

PTSD: Sleepwalking or Dissociative like episodes with Night Terrors

PTSD: Sleepwalking or Dissociative like episodes with Night Terrors 

This is a topic we actually got on in another posting regarding binge eating at night, unknowingly, when awakened from nightmares/night terrors.

This is something that I am actually very familiar with and “seems” to be what Craig has been experiencing since his PTSD anniversary time back in October, when PTSD and Depression symptoms were higher than everyday normal.

We could not figure why Craig was experiencing weight gain, especially when I am the one that monitors his eating, and makes sure he eats. His cognitive dysfunction does not allow his brain to relate feeling/being hungry to the need to eat. For awhile we thought it was medication related and lack of exercise, which reality is part may be related, however not to this extent.

Then it happened. He was found in the kitchen at night after being awoken we will say, from a nightmare/terror. He was eating all sorts of things, and had no recollection of even getting out of bed, and sure did not know he was up eating. It was not like normal sleepwalking. He was fully alert… and sure could make a peanut butter and jelly sandwich… one right after the other.

So we kept a close eye on him throughout the nights to follow after discovering this. This is part of the reasoning behind us taking shifts sleeping, when I sleep he stays near me and does not leave so I can get sleep, when he sleeps I’m awake. Physical nightmares are the other reason behind this “for now” sleep shifts pattern, which we are working on changing and getting back to a better normal.

Sure enough, I noticed he would be having a physical nightmare, terror I believe would be the correct term for it, very stressed, then he would come up out of the bed and head to the kitchen.

For awhile I could not understand why when I woke in the mornings, there would be food out on the counters, bread left open, and there were those pb&j containers sitting there, along with other things. I honestly thought one of the kids were getting up at night, until we discovered it was actually Craig. But, he had absolutely no memory of it, to him he never got out of bed and had slept the entire night.

So we spoke to the doctors regarding it. It still has not been defined as dissociative episodes or sleepwalking and night terrors. However, since PTSD symptoms have decreased some, and we are past the PTSD anniversary time frame, this binge eating unknowingly at night has eased off as well.

After hearing that someone else has witnessed something similar from their PTSD loved one, I thought this was a good topic to touch on. You know how it is, if one person experiences it, there are probably more that do as well… and may think they are alone in what they are experiencing.

I located a study this morning that I wanted to pass along to those interested in reading it. I found it quite interesting and relates to this topic. The examples are civilian, but I have a feeling it really does not make a difference of trauma type a person experienced. Now, I do know that Craig’s has nothing to do with any childhood trauma, his traumas were all military related (respectfully, without going into details of his traumas, because there are traumas he has not told publicly.)

“Is there a dissociative process in sleepwalking and night terrors?”
D Hartman, A H Crisp, P Sedgwick, S Borrow
Postgraduate Medical Journal

It will be interesting to see if others with PTSD experience night terrors and sleepwalking. Also, are dissociative episodes common during the day as well or not, if you experience this.

(To see comments by others please visit my facebook page for this posting)

~Bec
A Spouse’s Story PTSD : Facebook page

More about Dissociative Disorders/Symptoms and PTSD

The other day some very real comments appeared under one of our topics, which did lead me to posting a question asking “How many with PTSD suffer from #dissociative symptoms?”

You knew I was going somewhere with that question. 

Many, especially spouses/partners do not understand that there ARE many with PTSD that also suffer some level of dissociation, rather a disorder or symptoms. After reading some of the comments I realized this was a topic that we really needed to learn more about so there is an understanding that one with PTSD MAY NOT always have or be in control of their actions, that is if they are experiencing a dissociative state/episode.

Now, I will say this up front…

Dissociation is a very difficult condition to understand or wrap your head around! It does take research, talking to your doctors, and learning how to accept that it may be a part of what one with PTSD experiences. The good news is, in many cases dissociation can be treated with psychotherapy and at times medications, and symptoms can decrease or change as different coping skills are learned.

The most commonly known types of PTSD which dissociative disorders are seen, are “chronic PTSD” (which is actually what Craig has) and “complex PTSD”. The highest numbers to develop dissociative disorders are those of child abuse, long-term sexual and/or emotional abuse. However, anyone with PTSD or has experienced a trauma may experience dissociation…war, natural disaster, assault, car accident, etc and can be an adult or child when developing the symptoms. There are also other mental health conditions which dissociation can also co-occur.

Another thing I want to be clear about, just because a person may experience symptoms of or have a dissociative disorder of any level, does NOT make that person bad!!! Even if their actions to you may be. It simply means their brain uses a different way of coping, protecting them, from their trauma and the after effects of it.

I also want to state that dissociation is not something one has noticeable symptoms of 100% of the time. This state/form of coping normally occurs when one is under high stress or is triggered by something linked to or is a reminder of their trauma. However, it can be a very damaging form of coping and does need medical attention.

So, What are Dissociative Disorders?

To accurately explain, I am using excerpts from the Mayo Clinic website and PsychCentral website… the professionals. 

“Someone with a dissociative disorder escapes reality in ways that are involuntary and unhealthy. The person with a dissociative disorder experiences a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity.

The symptoms of dissociative disorders — ranging from amnesia to alternate identities — depend in part on the type you have. Symptoms usually develop as a reaction to trauma and help keep difficult memories at bay. Times of stress can temporarily worsen symptoms, making them more obvious. Dissociative disorders cause problems with functioning in everyday life.

Treatment for dissociative disorders may include talk therapy (psychotherapy) and medication. Although treating dissociative disorders can be difficult, many people learn new ways of coping and lead healthy, productive lives.” (Excerpt from Mayo Clinic staff, mayoclinic.org)

What are the different types of Dissociative Disorders?

“There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association:

Dissociative amnesia. 

The main symptom of this disorder is memory loss that’s more severe than normal forgetfulness and that can’t be explained by a medical condition. You can’t recall information about yourself or events and people in your life, especially from a traumatic time. Dissociative amnesia can be specific to events in a certain time, such as intense combat, or more rarely, can involve complete loss of memory about yourself. It may sometimes involve travel or confused wandering away from your life (dissociative fugue). An episode of amnesia may last minutes, hours, or, rarely, months or years.

Dissociative identity disorder. (DID)

This disorder, formerly known as multiple personality disorder, is characterized by “switching” to alternate identities. You may feel the presence of one or more other people talking or living inside your head, and you may feel as though you’re possessed by other identities. Each of these identities may have a unique name, personal history and characteristics, including obvious differences in voice, gender, mannerisms and even such physical qualities as the need for eyeglasses. There also are differences in how familiar each identity is with the others. People with dissociative identity disorder typically also have dissociative amnesia and often have dissociative fugue.

Depersonalization-derealization disorder. 

This disorder involves an ongoing or episodic sense of detachment or being outside yourself — observing your actions, feelings, thoughts and self from a distance as though watching a movie (depersonalization). Other people and things around you may feel detached and foggy or dreamlike, and the world may seem unreal (derealization). You may experience depersonalization, derealization or both. Symptoms, which can be profoundly distressing, may last only a few moments or come and go over many years.” (Excerpt from mayoclinic.org)

The other two are…

Dissociative Fugue

Like dissociative amnesia, dissociative, fugue also is characterized by sudden onset resulting from a single severe traumatic event. Unlike dissociative amnesia, however, dissociative fugue may involve the creation of a new, either partial or complete, identity to replace the personal details that are lost in response to the trauma. A person with this disorder will remain alert and oriented, yet be unconnected to the former identity. Dissociative fugue may also be characterized by sudden, unplanned wandering from home or work. Typically, the condition consists of a single episode without recurrence, and recovery is often spontaneous and rapid.

Dissociative Disorder Not Otherwise Specified

Dissociative Disorder Not Otherwise Specified (DDNOS) is an inclusive category for classifying dissociative syndromes that do not meet the full criteria of any of the other dissociative disorders. A person diagnosed with Dissociative Disorder Not Otherwise Specified (DDNOS) typically displays characteristics very similar to some of the previously discussed dissociative disorders, but not severe enough to receive their diagnoses. DDNOS includes variants of Dissociative Identity Disorder in which personality “states” may take over consciousness and behavior but are not sufficiently distinct, and variants of Dissociative identity disorder in which there is no amnesia for personal information. Other forms of DDNOS include possession and trance states, Ganser’s syndrome, derealization unaccompanied by depersonalization, dissociated states in people who have undergone intense coercive persuasion (e.g., brainwashing, kidnapping), and loss of consciousness not attributed to a medical condition.” (Excerpt from: psychcentral.com, In-Depth: Understanding Dissociative Disorders By MARLENE STEINBERG, M.D.)

Now that we know a little more based on professional information, dissociative disorders and/or symptoms are very real, and when they accompany PTSD, well, it will throw you for a loop and then some rather you are the one with PTSD or the spouse/partner… until you learn about them, understand them the best possible, and learn better alternatives of coping.

Craig and I know these symptoms, if you think back to some of the personal stories I have shared, then compare them to the symptoms and definitions, you will see the connections. Yes, he did things and acted in ways that were completely out of his character. Yes, he would wander and later have no knowledge of it or not know where he had been. Yes, he has “lost” memory or gaps. There are a lot of things that fit that he has experienced, without going into all of them.

Those “out of control PTSD” days, as I call them… yes dissociation had it’s hand in them in ways that in reality should have torn us apart! But you know what? We did not allow that to happen. When Craig started receiving treatment for PTSD, and they started him on medications and put him through (ongoing) therapy, I’ve noticed a huge change in dissociative symptoms, they have decreased as he has learned healthy coping skills.

I have always said, if your PTSD partner is acting in ways that just don’t “fit” PTSD symptoms, doing things out of their character, it’s best to look deeper into dissociative disorders/symptoms and talk to your doctor about what is going on. There are many things a person my do or that may happen that are indeed out of one’s control. Those things can damage the person, their partner, as well as their family structure, those things will tamper with morals, beliefs, and everyday life itself. But they don’t have to! Get help if you or your partner fit into the definitions or symptoms.

#PTSD as we know is no easy ride, but things can change and things can improve. Dissociative disorders/symptoms are no different, you learn how to manage them and life can get better then it may be right now. 

~Bec
A Spouse’s Story PTSD

Traumas in life… PTSD or Not

I want to talk about something from a different angle… 

Many people have experienced a trauma in their lifetime, rather they have developed PTSD or not. Craig and I had a very odd thing happen a couple of nights ago and it really made me start thinking. There are some topics that we have never discussed on here and this mishap that happened made me realize that this is something that everyone really needs to think about… and talk about. 

Craig was actually picking on me in what he thought was a funny way of waking me up, and he was using humor to help with anxiety. He honestly meant no harm in it, and had no idea what was going to happen by what he did. We had been watching a show late that night, and I fell asleep. Well, sometimes those with PTSD just want someone awake with them. Rather it’s comfort just knowing someone is awake with them, they need to talk, or they just don’t want to feel alone at that moment… and I’m sure many other reasons. So he woke me up.

Something he picked up during his career, and I guess it was a way of waking people in a joking manner (no harm intended) when they would not wake up, was by pinching their nose shut for a few seconds. Yep, it works, brings one right out of sleep quickly and it did just that to me… and I DON’T recommend doing it! 

See, Craig’s focus was on whatever he was feeling and therefore wanting me awake. But in focusing on what he was feeling, he was not focusing on the big picture… and probably could not in all honesty. To state this up front, I’m not upset with him at all and we did have a talk about this after the fact, so everything is okay.

But… what about that big picture?

In his focus, what was Craig not picturing? Why was this such a huge deal to me? It never crossed Craig’s mind in his focus that I had a trauma in my past. (I’m not upset with him by the way, but felt this example could help others) Many of you know my story somewhat, ***trigger warning to those that have been assaulted, you might want to skip to the next paragraph now*** I had a stalker for several months that tormented me daily, this person left evidence that this person had been there, even became friends with my dog I had at that time (and the main reason my dogs are never outside by themselves or left alone) but I never saw this person until I was attacked by that person inside my home, and I was left unconscious, and they left out the front door in the middle of the day like no big deal. (Yes, this person was caught eventually)

I was stalked and attacked. Now picture me in a deep sleep and someone pinching my nose closed, even though it was meant to be harmless. NOT a good combination and it took me right back to that attack and me fighting the person off, for a very brief moment.

I have handled what I went through extremely well. I do have anxiety during certain episodes/situations, am a little more cautious then the normal person, but I have coped with what happened well. But that one small harmless act with my nose, did effect me, for a brief moment I panicked.

My point in sharing this is… So many that live with a person who has PTSD focus on the PTSD and the other person’s symptoms. At times they do not talk about their own traumas… their own triggers or what could be possible triggers. On the other hand, the ones with PTSD have to focus so much on themselves, that sometimes what another person went through is in a way blocked from their thoughts, during their own coping and/or what they are experiencing at that moment.

I had no clue that waking me in such a manner would cause me to react the way I did. It was not something Craig would have thought about, he’s never had an issue waking me before. No real fault from either of us, but something we learned. Craig and I were dating at the time of what I went through, we have talked about it a lot, but I have never talked about what could possibly be my own triggers besides the obvious. Craig knows I’ve coped with the trauma well, I do not have PTSD from it, but I do have some triggers. It was just a mishap the other night that neither of us would have ever thought about.

Communication and thinking before acting. Take time to talk to each other. Even if a person does not have PTSD, if they have experienced a trauma don’t dismiss the facts… neither of you or yourself. Listen and talk to each other so you have an idea of things that could be or become triggers… for either person.

Rather you have PTSD or not, if you have experienced a trauma, talk about it so mishaps like we experienced the other night can be avoided.

It really is a two way street when any trauma has been experienced, by either person. Don’t dismiss that fact. Talk and make sure you are hearing each other, and talk about possible triggers and/or what you know effects you… so you are on the same page.

~Bec
A Spouse’s Story PTSD

More about PTSD and Triggers

More about PTSD and Triggers

Triggers can be almost anything that remind you of an event that caused PTSD or is related to it. Triggers are a huge part of PTSD. Learning about yourself and what triggers you is extremely important.

Like with Craig, I know many of his triggers. With knowing what they are I can majority of the time help ground him to what I see coming… or hear. Examples of his are helicopters… not the sight of them, but the sound and the vibrations that come from them. Another we have found, even though we haven’t pin-pointed it, is the fluids in a car (we know it’s not car oil, but a different fluid)… changing the fluids, something with one of them sets of his sense of smell, a smell related to a ship/carrier.

As much as we say triggers come out of nowhere, which it seems and not literally speaking they do because you never know when they will happen… the fact is triggers can be known. If you pay close attention to the here and now when triggered by something you can figure out what your triggers are. What is happening when your heart starts racing? What smell was there? What were you looking at or watching? What sound did you hear? What were you eating or food you were around? Think about it, focus on is happening and you can link your reactions to something.

By doing this and recognizing your triggers, you can get a better grip on coping with them when they happen. Like with Craig, once he hears or feels a helicopter coming he will say out loud “I know you are there” or “I hear you coming”. Over time it’s become a normal saying around here “Eye in the sky”, that’s our cue to him that we hear or feel a helicopter. With knowing, he can start right then on coping with the fact it’s coming and work towards keeping himself grounded. Now I will say he normally knows it before the rest of us or about the same time, he has extremely sensitive hearing and can feel the vibrations, but it allows him the coping time to handle it passing and staying grounded.

To those that do not understand the term “grounded”, grounded is when one focuses on the exact present time, place, surroundings, and people to help prevent themselves from going into a flashback where they believe they are back to the time the trauma took place. Others can help one stay grounded to the present as well.

Many when they hear the word “trigger” automatically think of sights and sounds to which one with PTSD responds to.

Fact is, triggers don’t stop there! Triggers can be set off by any of the body’s sensory system. Sight, sound, smell, taste, touch. Anything that is from the physical world transferred to the mind.

So when you are focusing on what triggers someone or yourself, never stop with sight and sounds. Triggers can come from anything which was experienced at the time of “what happened” that caused PTSD.

Examples:

* Weather conditions.

This could be storms, heat, cold, humidity…

* The taste of a food.

This is something I have found common with the Vietnam era. Certain taste of foods can be linked to triggers.

* Vibrations.

These can be related to accidents… cars, trains, planes, military such as helicopters and flight decks of ships and ships themselves, storms…

* Smell.

The smell of fuels, fireworks can be linked to combat smells, smell of certain foods or places that were present at the time of the trauma…

*Sound.

Sounds can have an endless list also… clicking, radio noises such as from headsets, car backfire, crackling from a fireplace, fireworks, the sound of the wind…

* Touch.

The feel of a fabric, or certain fluids, a physical touch from another person, a breeze on your face or sun…

* Sight.

Again, anything related to the trauma they experienced. A uniform or other clothing, a hat (this one is common with our Vietnam Veterans), a certain color or style of car, someone that looks kind of like someone else…

So when trying to pin down what triggers a person in order for them to learn techniques to cope the best they can with their triggers, you have to think about all of the senses involved with the mind. You might just notice things you never realized before. A trigger is caused by “something”, they don’t just come out of the blue with no meaning behind them, even though they can come at any point in time. When you find the meanings or what triggers are, you can find ways of getting through them better then before.

Learn your triggers, learn your partner’s triggers. This knowledge is of great help to trying to stay grounded from full flashbacks or the anxiety that comes.

Each person with PTSD has triggers and they are not always the same as another person’s. It all depends on you and your trauma to what triggers have developed. I can’t say it enough, learn what yours are. Then learn what techniques help you or your loved one through them.

~Bec
A Spouse’s Story PTSD

Learning about Triggers…

Learning about Triggers.

Many when they hear the word “trigger” automatically think of sights and sounds to which one with PTSD responds to.

Fact is, triggers don’t stop there! Triggers can be set off by any of the body’s sensory system. Sight, sound, smell, taste, touch. Anything that is from the physical world transferred to the mind.

So when you are focusing on what triggers someone, never stop with sight and sounds. Triggers can come from anything which was experienced at the time of “what happened” that caused PTSD.

Examples:

* Weather conditions.

This could be storms, heat, cold, humidity…

* The taste of a food. 

This is something I have found common with the Vietnam era. Certain taste of foods can be linked to triggers.

* Vibrations.

These can be related to accidents… cars, trains, planes, military such as helicopters and flight decks of ships and ships themselves, storms…

* Smell.

The smell of fuels, fireworks can be linked to combat smells, smell of certain foods or places that were present at the time of the trauma…

*Sound.

Sounds can have an endless list also… clicking, radio noises such as from headsets, car backfire, crackling from a fireplace…

* Touch.

The feel of a fabric, or certain fluids, a physical touch from another person, a breeze on your face or sun…

So when trying to pin down what triggers a person in order for them to learn techniques to cope the best they can with their triggers, you have to think about all of the senses involved with the mind. You might just notice things you never realized before. A trigger is caused by “something”, they don’t just come out of the blue with no meaning behind them. When you find the meanings or what triggers are, you can find ways of getting through them better then before. 

~Bec
A Spouse’s Story…PTSD

PTSD does not always come with choices…

I had the following comment/question posted to my posting on Saturday “Living with a person who has a Mental Illness/Disorder” and I felt that it was something that needed to be addressed separately since it is a view that more then one person does have.

From the poster-
“I’m sorry but, I just don’t understand. We teach Autistic/ mentally impaired children what is appropriate and inappropriate behavior and everything is all about choices. With that being said, in my case, things that have happened in our marriage were choices he made. If somebody is capable of, say…. Not putting their fist through a wall out of anger in the workplace or outside the home but unable to control their anger around the ones they love, how is being supportive and understanding not enabling such behavior? A choice is made not to do it at work. The same choice should be made at home. In my opinion, this is completely unacceptable.”

Now to say the least you know upfront my answer is not going to be short to this one. But this is something where education is needed, so bare with me here. The poster of the above comment was very honest when saying “I just don’t understand.” And I am by no means disrespecting this, and will give the benefit of the doubt is probably new to PTSD. But I do say it like it is. Also, again, I am not a doctor of any sort and my opinions and postings are based around our personal experiences, self education, and what I have learned from thousands of others… doctors, individuals who suffer from PTSD, and ones who live beside PTSD.

To start with, PTSD is NOT all about choices. And viewing it from that point of view will set one with PTSD off in a heartbeat. If you tell one with PTSD it is about choices, that may be one of your first issues at hand.

PTSD is a totally different ballgame from other mental illnesses. I myself have personally worked with children and young adults who suffer from autism, adhd, ocd, bipolar disorder, down syndrome, and other metal impairments as well as ones with physical disabilities. So I can and do see the difference between PTSD and other disabilities. No matter what the illness or disability is, a solid support system is still urgent.

PTSD comes with nightmares/terrors, flashbacks, dissociation, and many things that are medically proven are not a choice. However those things are very real and do exist. Those things do not in any way, shape, or form leave a person with PTSD a choice.

The first step to understanding comes with education. You have to learn about what PTSD is, what comes with it, and why one may react to things the way they do. Until you have an understanding of the illness itself, it is going to be difficult to be a solid support system for that person or even grasp and accept PTSD is at hand. For those of you that do not know already, I do have a blog aka “My Journal” page on my website with many postings which are in categories you can use as a resource for when issues arise.

When something does happen with one with PTSD, have you asked yourself “why”? It is VERY rare that something comes “out of the blue” with PTSD. Of the 10 years Craig and I have been together, I can not think of even one time something happened that did not have a reason to it, with that said, I do not believe things just come out of the blue without a reason attached rather I noticed it at that time or not. There is normally a reason rather it is a trigger they encountered, anxiety from a rough day, flashbacks, etc etc etc. Whatever it is, there is a reason to it. You have to take the time and patience to find the reasons so you can work on correcting the issues that stem from them. In many cases, the one with PTSD might not see or know the reasons, they at times may not even realize how the are coming across to another person… this goes back to one part of why a solid support system is urgent. When you find what causes things then you can work TOGETHER to coping with those things.

With the example at hand of making it through a work day without punching a wall or getting angry, but then at home does act out in that way…

This is what Craig and I refer to as “putting on a smiley face”. When one with PTSD has to work or be out in public in general, they want others to view them as normal. At work, they probably are in a position where they NEED that job to support their family or themselves. They have no choice in order to keep that job but to put on that smiley face and HIDE their PTSD. This in return leaves PTSD and all of it’s symptoms bottled up for that amount of time to the point sooner or later they could or will explode if they do not know how to cope with the symptoms. They are being forced through an environment which in reality they may not be able to actually handle.

Then they come home. Home is their safety zone, where they are comfortable around people they trust and trust won’t judge them because of what they suffer from, it’s where they can let down, vent, talk, show emotions, express what they are struggling through, etc. Now is hitting a wall necessary or acceptable? No, absolutely not. However if one is hitting a wall… why? Normally it’s because they are not or do not know how to cope with their symptoms. Maybe their medications are off balance or they are not on any and trying to learn how to cope without the use of them.

It can also be because they become frustrated/angry because the one person they have to count on and lean on is not “getting it” or taking time to understand it. In many of these cases, the one that is seeing this is probably telling them what to do, such as the example of “make choices” or it’s your choice or constantly complaining about what they say or how they act instead of actually helping them through it to cope. It goes back to not understanding PTSD or/and what they are experiencing with it. I told you, I only lay facts on the table. Now that part goes back to my posting “Living with a person who has a Mental Illness/Disorder”. The bottom line is, you are going to stay on the route and cycle you are on or you are going to make the choice to step up to the plate and do something to help make a change and help them cope through what PTSD does bring.

Being supportive and understanding is not enabling the action, whatever it might be. It’s providing a support system to say “Hey let’s find a way to cope with this so you don’t feel that way or the feeling is manageable.” You as the one without PTSD have to view things from a different perspective. You can’t beat them up for what they might do because of PTSD, you have to find ways to help them cope so next time it can be prevented, as well as yourself cope. When coping is used, the outburst of symptoms and actions can reduce. But know upfront, PTSD is PTSD and it’s not just going away. You HAVE to accept your life now has PTSD in it. However, it CAN be managed!

PTSD brings something referred to as “fight or flight”, and it’s VERY real. Now, as the spouse, those two things can be very damaging to your relationship, your family, and the one who suffers. When there is not a support system in place or understanding, you can almost bet you will be facing the “fight or flight” of PTSD. And it is exactly the way it sounds. They are either going to fight or they are going to leave, and I hate to say the truth is, the leave part might not be walking out the front door, it may very well be leaving by taking their own life. Suicide is a high cause of death among those with PTSD, it’s very real and signs of it are not to be taken lightly or brushed off.

There has to be a support system, balance, and there has to be ways to cope used. You have to educate yourself and not expect someone else to give a quick fix to PTSD, there’s not one. That is pretty much the bottom line to making sure things at home go as smoothly as possible, as well as away from home. Without coping and correct treatment, you can pretty much guarantee sooner or later the symptoms will show up away from home as well. Take time to understand the best to your ability… and that does not mean you will understand what happened to them, there is no way for you to know true understanding of that part, it means you learn to understand what they experience now from what happened. And learn as well as help with coping.

~Bec
“A Spouse’s Story…PTSD”

PTSD and Fireworks…

Has anyone noticed that many with PTSD are having additional symptoms or increased symptoms right now? Now, do you know why?

For those of you in the United States… What’s coming? Ah… the 4th of July! (There are certain anniversaries or such going on in other countries as well) Which means…

Fireworks…Crowds…Celebrations…Expectations! Oh fireworks!

Fireworks. 

Many ask why fireworks. Because they might resemble what someone, especially military/war related OR a natural disaster, went through.

Many that do understand believe it’s because of the sound they produced, which is very true however not the full truth to them. What about the vibration they give off, vibrations from them can also effect one. Then you have the light produced from them, it can be another PTSD trigger as well.

So the one with PTSD might be able to manage through the lights, vibrations, sound but you can’t figure out why fireworks are still a trigger to their PTSD. But are you still missing something? What about the smell? Ah… you might not have thought about that one, the smell. Many that have experienced military trauma relate the smell of fireworks to combat.

In a situation where natural disaster was at hand, it may be more of the sound, lights, and vibration over the smell sense that trigger a person.

You have to keep in mind ALL of the body’s senses when it comes to PTSD. PTSD can react to anything that can be sensed that reminds them of what happened to them.

At times, ones that are triggered by fireworks can find ways to cope through them, others may have a more difficult time doing so. It all depends on the person and their level of coping at that time.

So what can you do?

* Some will face what is going on. Actually sit, watch, and focus on fireworks to try to help keep themselves grounded to present time and place.

* Some will stay inside to avoid the smells fireworks produce. Or to avoid the light they produce, also by keeping the curtains shut to block the light.

* The vibrations are a slight bit more tricky. There’s no avoiding those. If vibrations are a trigger you have to focus to keep yourself grounded. Prepare yourself to what you know is actually taking place or going to take place. Helicopters are another thing that is a huge trigger to many due to vibrations.

* If the sound is a trigger, sometimes playing music or something you like such as watching a movie can help drown them out. Ear buds or headphones/headsets are wonderful in these cases.

* Using coping techniques/skills can help.

* Talk to someone through these times. Having someone to talk to and focus on can help, as well as help keep you grounded.

Whatever works for you, or try different things until you find what’s best for you in each situation, just make sure you do something. Flashbacks and triggers are no joke and sure not a fun experience so do or try things that can help get you through these times.

PTSD does start showing more symptoms when one is getting closer to days like the 4th of July. Recognize what there is a cause for additional symptoms and they are not something that are just coming out of the blue. With PTSD, there is always a “something” to cause the flashbacks or triggers. When you learn to recognize the causes or reasons, it makes it a little easier to handle and learn to cope best as possible when those things come. 

~Bec
A Spouse’s Story…PTSD