One of the co-morbid conditions of PTSD and Complex PTSD is often crippling anxiety. Symptoms of anxiety include feelings of panic, fear and uneasiness, difficulty sleeping, muscle tension, cold or sweaty hands/feet, shortness of breath, heart palpitations, restlessness, dry mouth, nausea, dizziness, excessive or unrealistic worry, and avoidance of triggering situations. Temperament and prior experiences with stressors are key determinants of whether a person develops problematic anxiety in response to life events. Though their genetics and past experiences cannot be changed, people can better prepare for the inevitable ups and downs of life by understanding their emotional responses and by nurturing healthy daily practices.
Fear and anxiety are natural and adaptive responses to stressors. Fear is a reaction to a present danger in the environment, while anxiety refers to the anticipation of some potential threat in the future.
When the mind perceives a threat, the nervous system activates the fight-or-flight response. A complex physiological event, the fight-or-flight response mobilizes a person for action in the face of a life-threatening danger. Because the human nervous system does not distinguish between real and imagined threats, this response system can work against a person, resulting in panic and anxiety.
The good news is that our understanding of the biological underpinnings of the fight-or-flight response has led to well-researched, effective treatments and coping methods. Below are some healthy strategies that you can begin to practice right now, regardless of whether this is a time of stress:
- Practice deep breathing, meditation, or relaxation: Breathing and meditation can help you focus on the present moment and reduce ruminative worry and anticipatory anxiety. Regular relaxation exercises lower overall physiological arousal.
- Look back to other stressful times: Reflect on past stressors and remind yourself that stressful periods are temporary and will pass.
- Identify effective coping from the past: You’ve been through tough times in the past. Review what helped you during those times.
- Accept negative feelings: Don’t deny anger, guilt, sadness, or negative feelings. Try to accept and acknowledge your feelings. Journaling can provide a safe space to express and process feelings.
- Engage in active problem solving: Identify aspects of the situation that you have control over and appropriate responses.
- Maintain and utilize supportive relationships: Build loving and warm relationships with trusted others you can lean on during difficult times.
- Get plenty of sleep: Aim to get seven to eight hours of sleep each night. Establish a regular bedtime and wake-up time.
- Exercise: Daily exercise is one of the most effective ways to reduce stress and anxiety. If cleared by your physician to do so, try to exercise vigorously four or more days a week.
- Eat well: Eat a balanced diet, and don’t skip meals and snacks.
- Schedule rest breaks: Set an alarm on your phone to remind you to take a few minutes several times a day to meditate, breathe, or otherwise relax.
- Engage in pleasurable activities: Be sure to carve out time to engage in things you enjoy on a daily basis.
- Avoid caffeine and alcohol.
As a result of my Complex PTSD, I experience severe bouts of anxiety both General Anxiety Disorder and Social. It is very debilitating and at times has prevented me from leading a normal life. However, with dogged persistence and implementation of the above strategies and EMDR therapy I now have that anxiety and other symptoms of my CPTSD under control most of the time. It’s not to say when I am triggered I do not get plunged back into flashbacks and trauma again – I do but I am coping better. Managing anxiety is a matter of practice. You can never give up and you can never assume you have it completely beaten. It’s a slippery beast !!!!!