Thanks Thanks:  5
Likes Likes:  1
Results 1 to 3 of 3
  1. #1
    Join Date
    Mar 2004
    Location
    Ottawa, Canada
    Posts
    35,397
    Mentioned
    20 Post(s)
    Tagged
    0 Thread(s)

    Anticipating When PTSD Symptoms Might Flare Up

    The Seasons of Trauma: Recognizing When Symptoms Might Flare Up
    By Anastasia Pollock, LCMHC, GoodTherapy.org
    January 21, 2014

    A woman who has experienced a traumatic event seeks counseling when she finds that symptoms related to the trauma affect her ability to enjoy life and function normally. She meets with her therapist once per week for nine months, and she makes tremendous progress in therapy. As she works hard and stays committed to the process of resolving her trauma, she feels very proud of herself and receives validating feedback from her therapist, who acknowledges her hard work and progress. She then notices that with the change of seasons, some of the symptoms she tried so hard to minimize or eliminate altogether come creeping back. She notices, as the time of year associated with her trauma approaches, her symptoms worsen still. She becomes very frustrated. She fears she will experience the same degree of trauma she did immediately after the traumatic event. She wants to just give up. ?What?s the point?? she asks herself and her therapist. ?I have worked so hard and here I am, going right back to the trauma!?

    This case example illustrates a very common occurrence in trauma work. Trauma symptoms may resurface or worsen at certain times of year?it is almost as if the change in seasons is a catalyst that causes a person to feel as if they are regressing. It is easy at these times to dismiss the progress that has been made in therapy and focus, instead, on the reemerging symptoms. Rather than consider this a regression in therapy, I prefer to think of it as an expected occurrence in trauma work that should be normalized and discussed.

    Several factors can be at play here. First, as the time of year when the traumatic event occurred comes around again, a very powerful reminder of the trauma often occurs. The brain is triggered and begins remembering. The body also remembers and symptoms reemerge.

    Another consideration is that holidays can also trigger trauma memories and symptoms, especially if loss has occurred. The loss of a loved one is one of the most common and difficult traumatic events humans can experience. Even if the loss did not occur around the holidays, holiday times often serve as reminders of loved ones who are deeply missed.

    Furthermore, according to the American Psychiatric Association, 80% of people who meet criteria for a diagnosis of posttraumatic stress disorder (PTSD) also meet criteria for other mental health diagnoses. In my experience, one does not have to have an actual diagnosis of PTSD to become more susceptible to other troubling mental health symptoms after a traumatic event. Just experiencing a traumatic event can make someone more likely to experience symptoms related to anxiety, depression, and other challenges.

    Certain times of the year can make symptoms worse. For example, with colder weather and less daylight during the winter months, a trauma survivor who also experiences symptoms associated with seasonal affective disorder (SAD) may encounter a worsening of both SAD and trauma symptoms. Similarly, someone prone to anxiety may find symptoms flare up during the holidays, when more cars are out on the road, malls and stores are more crowded, and financial and social pressures are mounting.

    Unfortunately, many people are ashamed to talk about reoccurring or worsening symptoms, and this can cause symptoms to escalate even more, impacting well-being and functioning. Beliefs may surface that all the time and hard work one has given in moving forward from a traumatic experience has been wasted. Feelings of frustration and an urge to give up on therapy are very common during these times, as illustrated in the case example.

    In addition, a fear of disappointing one?s therapist may come up, preventing some people from openly discussing new or reoccurring symptoms. Making progress in therapy is validating and rewarding, as the case example demonstrated. Returning to therapy when symptoms reoccur can bring up feelings of shame or guilt, causing one to feel as though they will somehow disappoint the therapist or that the reoccurring symptoms will suggest to the therapist that he or she is not working hard enough.

    I find this point in trauma work is sometimes the most critical, when clients have a wonderful opportunity to make the most progress toward resolving their trauma for good. This is the time to talk to your therapist to let him or her know exactly what you are experiencing and how it is making you feel. A good trauma therapist will validate and normalize what you are going through and help you to confront the fear of reoccurring symptoms so that when other triggers come up, it is not so daunting to confront them. This is an opportunity to practice skills with your therapist that will reinforce that you are strong and capable of handling whatever may come up.

    Going back to our case example: The therapist validated and normalized what the woman was feeling and experiencing. She reassured the woman that what she felt was very common in trauma work and presented it as an opportunity. The woman stuck with therapy, continuing to talk about her urges to give up on therapy and her feelings of disappointment as they came up. She continued working hard and trusting the therapeutic process. Eventually she was able to overcome her reemerging symptoms. The time of year that served as a trigger passed, and she found that when she thought of that time of year rolling around again, she was not as distressed as she expected. She felt better and more confident as she moved forward. Eventually, she did not need to see her therapist anymore, although she always knew she could return if she felt the need. And when the next trigger appeared, she handled it beautifully, which just reinforced her strength and the belief that she could continue to move forward.

    Reference
    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

  2. #2
    Join Date
    Jun 2011
    Posts
    3,415
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Re: Anticipating When PTSD Symptoms Might Flare Up

    Pretty much my entire life a specific day of the week has been hard for me.It has also always been hard for my sister too and we both have always said there must be something about that day,something that happened that maybe we don't remember.

    I recently realized what it was about that day.It wasn't something we had forgotten,it was just that we didn't realize what day it happened on.I was almost ecstatic when I realized it,I thought just by being aware of that fact it would change the way I felt on that day.I was actually excited for that day to roll around again the next week.

    To my surprise,when it did roll around again I felt worse than I ever have on that day.It was horrible and I was so upset and disappointed about it.I felt like everything I have learned,all the work I have done in therapy was a waste of time.

    To me,the trauma I experienced on that day didn't even seem major or that traumatic.It seemed so insignificant that I had mentioned it in the beginning of therapy but hadn't talked about it since then.I scheduled a session with my therapist and when I started talking about it I was really surprised at the amount of details and tears that came out over something that seemed so insignificant to me.I realize it was just denial,,it really was major after all,it was extremely traumatic.

    Now I know this is something I need to continue working on and working through.I don't know if that day of the week will ever get easier,I hope it does,but I am not going to get so upset about it anymore if I do struggle.At least now I am aware of it and why it happens and can work on ways to help myself through it.

  3. #3
    Join Date
    Jun 2011
    Posts
    3,415
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Re: Anticipating When PTSD Symptoms Might Flare Up

    Today is that day that has always been hard.I don't know why I said a ' specific' day instead of just saying Fridays are hard.

    Fridays are hard.There,I said it.

    ---------- Post Merged at 05:05 PM ---------- Previous Post was at 10:09 AM ----------

    When I was pretty young I witnessed my dad commit an extremely violent crime,in case anyone cares or was wondering.I tried so hard to save the person even though I was so little.

    And then afterwards my mom forced me to lie about what happened,told me what I had to say when I was questioned by the police.I knew what the truth was but I knew I couldn't tell it so I didn't talk at all when I was questioned.My sister had to testify since she was the oldest,she said exactly what mom told us to say but he still went to prison.

    I didn't think it really bothered me much,but obviously it did for Fridays to still be this hard,this many years later.

    I am tired of holding stuff in and hiding the truth.

Bookmarks

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Disclaimer: PsychLinks is not responsible for the content of posts or comments by forum members.

Additional Forum Web Design by PsychLinks
© All rights reserved.