7 Reasons You Still Have PTSD Symptoms
Learn why PTSD symptoms persist, and how to break free.
Posted January 26, 2019
Are you struggling with symptoms like anxiety, hypervigilance, painful memories, nightmares, depression, avoidance and shameful thoughts and feelings? These are a set of symptoms that can make life miserable and may be caused by post-traumatic stress disorder (PTSD). Anyone can develop this complication following a traumatic event.
If you need a refresher or aren’t familiar with this disorder, this article by the National Institute of Mental Health reviews the basics.
There are many reasons that PTSD symptoms might persist over time. Here are some possible reasons you or someone you care about may still be suffering.
1. You’ve tried therapy, and it didn’t work.
Many well-meaning therapists are able to help somewhat with PTSD symptoms, but may not be trained in or using the most effective methods. However, in recent decades, the mental health field has nearly perfected a few types of therapy that are shown to work. While they might not solve all of life’s problems, repeated research shows they alleviate the worst of PTSD symptoms for most people, typically within 2 to 4 months. For adults, these include cognitive processing therapy (CPT), prolonged exposure (PE) and Eye Movement Desensitization and Reprocessing (EMDR). This article from the U.S. Department of Veteran’s Affairs (VA) describes these approaches further. For kids and teens, the gold-star treatment is trauma-focused cognitive behavioral therapy, or TF-CBT. You can learn more here from the developers of TF-CBT here.
2. You tried one or more of the therapies from #1 and it still didn’t work.
While these therapies, if properly provided, work for most people, there are always exceptions in any treatment. You might be an outlier (which just means different approaches would work better for you). This is where alternative therapies become key, because everyone’s brain is a bit different. You might try alternative methods like expressive therapies, movement, or mindfulness practices, which we’ll begin exploring in this blog in coming weeks and months.
Even if you’ve struggled with PTSD for many months or years, it doesn’t mean you have to accept these symptoms forever.
3. You don’t have access to the therapy you need.
Sometimes it can be hard to find a therapist who is trained in these specialized methods in your area. If you’re struggling to find a qualified therapist, look for those confident in providing the therapies listed above (you can even search for specific therapies at Psychology Today), or contact the national referral line administered by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Meanwhile, while you’re searching you can start learning more about PTSD symptoms through books and other resources, like this handy app called PTSD Coach by the VA.
4. Your trauma is recent.
It’s common to experience PTSD-like symptoms during or in the first several weeks following a trauma. The majority of people do not develop complications beyond this point. That’s why I don’t automatically start the therapies above with clients if they’ve just come out of a traumatic experience. Instead, we build on natural coping skills and strategies to help them get through this difficult time, and avoid negative coping that’s shown to make things worse (Thompson, Fiorillo & Rothbaum, 2017). If you have just experienced a trauma, focus on resiliency strategies such as keeping in touch with your typical support system.
PTSD is set of symptoms in reaction to a trauma — it’s not something you were born with and you don't have to live with it forever.
5. Avoidance is getting in your way.
Did you know avoidance is one of the main categories of PTSD and often what fuels it? While avoiding thoughts, memories and feelings relating to bad things that happened seems to make sense and may even be necessary to get through a dangerous time, in the long-run it actually makes things worse. That’s because you don’t get to process and work through the thoughts and feelings that relate to what happened, and these thoughts and feelings, even if they’re deep down, build up in a myriad of ways and complicate PTSD.
Sometimes we also avoid situations that remind us of the trauma, or that otherwise feel out of control. Many also avoid therapy or drop out of treatment because it becomes overwhelming. Again all of this makes sense in context, yet can also be reinforcing symptoms. We’ll also discuss more about avoiding in future blog posts.
PE specifically targets avoidance, but other therapies also help you gain the confidence to face difficult (but physically safe) situations, thoughts and feelings.
6. The PTSD is making you be very hard on yourself.
Sometimes people with PTSD blame themselves inaccurately for what happened, take on too much blame or shame relating to the situation, or believe they are forever damaged by the trauma. This can further be complicated in a culture that tends to blame victims for things like sexual assault (there's much more to explore here). While self-blaming thoughts are typical and common, they keep us from moving forward. One of the therapies I mentioned earlier, CPT, specifically targets these thoughts that perpetuate PTSD. For many clients, this laser approach works quickly, and if they stick with it for several weeks, they find relief.
7. You need a diagnosis update.
If you’ve been diagnosed with PTSD in the past, you may incorrectly believe you still have it when there may be something else happening (such as general anxiety or a physical condition). Occasionally people may also get an inaccurate diagnosis in the first place. An experienced therapist or psychiatrist can help you sort through what’s going on now.
Even if you’ve struggled with PTSD for many months or years, it doesn’t mean you have to accept these symptoms forever. Just like with a physical issue, sometimes you need to keep looking for a clinician, treatment or alternative approach that’s right for you. PTSD is set of symptoms in reaction to a trauma—it’s not something you were born with and you don't have to live with it forever.
Thompson, N. J., Fiorillo, D., Rothbaum, B. O., Ressler, K. J., & Michopoulos, V. (2017). Coping strategies as mediators in relation to resilience and posttraumatic stress disorder. Journal of affective disorders, 225, 153-159.