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PTSD episode is a stressful event that affects people suffering from Post-Traumatic Stress Disorder (PTSD) as they recall their traumatic experiences with emotional and physical manifestations. 

PTSD is a mental health disorder estimated to occur in 6% of the U.S. population at some point in their lifetime. It is triggered by exposure to stressful and traumatic events such as physical assault, rape, war, or disaster. In an episode, a person may be overwhelmed by the memories of the trauma, get images, intense emotions, and bodily sensations such as racing heart and sweating. 

It is important to know what causes these episodes and how to deal with them to help people who suffer from them and live their lives.

PTSD is a multifaceted disorder that impacts the lives of individuals in various ways. It can occur following natural disasters, severe injuries, acts of terror, battle, or other acts of violence. The condition is associated with prolonged emotional discomfort, which can significantly affect one’s functioning. PTSD is characterized by symptoms, which include intrusive recollections, avoidance behaviors, negative alterations in cognition and mood, and sensitization.

PTSD is an illness where the individual experiences a mental and emotional reliving of the traumatic event. In an episode, the person relives a part of the traumatic event in a way that is as if it is occurring in the present. These episodes are not just memories; they have the feelings and bodily sensations associated with the trauma at the time it occurred. This re-experiencing can be so intense that it disrupts the present reality of the affected person.

What Does A PTSD Episode Look Like

A PTSD episode is characterized by high levels of stress and extreme discomfort that can interfere with a person’s functioning significantly. In an episode, the person may have sudden and intense recollections of the trauma, which seems like is occurring. These flashbacks can be provoked by anything that resembles the incident, for instance, sounds smells, or visual images [1]. 

People may also develop significant levels of anxiety, panic attacks, and increased activity such as increased heart rate, perspiration, and being on high alert. 

Depersonalization and derealization are typical, as well as the inability to feel emotions and experience the world as if through a veil. Behavioral changes may include staying away from places or situations that remind the person of the trauma, aggression, and temper tantrums. Such episodes may be distressing and the individual gets a feeling of being powerless and out of control [1].

What Happens After a PTSD Episode

People who suffer from PTSD go through several aftereffects that may persist for hours, days, or even months after the episode. They may feel exhausted, as the stress response is a highly charged one and takes a lot of the body’s energy. After that, there might be some period of increased tension and watchfulness, that is, the person stays alert for another episode. 

Cognitive responses can be seen as negative thoughts, angry thoughts, and thoughts about regret and failure, especially if the person feels they cannot regulate their emotions [2]. Other symptoms that are also known to persist include sleep disorders, which may include nightmares or insomnia. Other effects include social and occupational dysfunction, as the person may avoid activities and people which may precipitate the condition. 

During this time, the person needs to have someone to turn to – a family member or a mental health worker, who will help the patient come to terms with the episode and its consequences.

How Long Does a PTSD Episode Last?

It is important to understand that the length of time for a PTSD episode can be quite diverse depending on many factors. 

It can take from several minutes to several hours depending on the duration of the episode. Sometimes the episode may be severe only in the sense that it includes intense flashbacks or panic attacks, while the aftereffects of the episode can last much longer. It is unique to the person and may involve coping strategies, stress levels, and available support in determining the duration and intensity of the episode. 

In some cases, the episode will last for a long time, and the person will be distressed and impaired, while in other cases, the episode might be short-lived. Cognitive-behavioral therapy and other forms of medical treatment can assist people in lowering the incidence and severity of episodes throughout their lives.

It is characterized by events that remind the person of the trauma in a PTSD episode. These can be in the form of stimuli that are through the person’s sense organs, through emotions, or through events and situations that make the person relive the trauma in a very dramatic way. Knowledge of such factors is critical in the prevention and treatment of PTSD.

Sensory Triggers

Sensory stimuli may also be considered potent stimuli that may lead to the onset of PTSD episodes. These can include:

Sights: Flashbacks where the same events are repeated over and over again, or being reminded of the trauma by seeing a similar place or person.

Sounds: Stressors that have a similar sound to the specific traumatic event, for instance, loud sounds for a combat-related trauma or sounds of car horns for a car accident trauma [1].

Smells: Sounds or smells that were present during the occurrence of the traumatic event like the smell of burning, alcohol, or a specific perfume.

Tastes: Sensations that were experienced during the trauma and which trigger feelings and emotions.

Touch: Sensory perceptions that are similar to the feelings that were experienced during the actual occurrence of the distressing event, for instance, touch sensations of a specific material or pressure on the body.

Emotional Triggers

Emotions or feelings can also be the cue for PTSD episodes to occur This is because PTSD is a result of a traumatic event. These can include:

Stress: Coping with high stress or anxiety can trigger the memory of the traumatic event.

Fear: Stressful situations that can bring about feelings of fear or danger can also cause one to have an episode.

Sadness: When the individual feels sad to the deepest level like feeling sad due to a loss, then the memory of the trauma is triggered.

Anger: This may be because intense anger or frustration may trigger fear which is similar to what the person felt during the traumatic event [1].

Situational Triggers

Some specific circumstances or settings may cause PTSD symptoms to surface. These can include:

Anniversaries: The anniversary of the traumatic event, which is commemorated through different dates.

Locations: The reminders include: Going to or being in places where the traumatic event took place.

Media: Watching movies or television programs, or reading news stories that narrate similar events.

Social Interactions: Contact with individuals who participated in the traumatic event or others that the person concerned comes across [2].

Conversations: Narrating the trauma or listening to others narrate a similar incident.

Interrupting PTSD requires both crisis intervention to address the episode and self-interventions to prevent the episodes from happening in the first place. Familiarizing and implementing these strategies can assist a person to gain back control during an episode and enhance his or her quality of life.

Immediate Strategies

In the case of the PTSD episode, some techniques can help reduce the level of the person’s distress and bring them back to reality. 

Here are some effective immediate strategies:

1. Grounding Techniques 

Grounding techniques assist in re-orienting the individual back to the present time. These can include:

5-4-3-2-1 Technique: Five things that you can look at, four things that you can feel, three things that you can listen to, two things that you can smell, and one thing that you can taste.

Physical Sensations: Pinch something with your fingers, wash your hands with cold water, or step on the floor with your feet.

Deep Breathing: Breathe in slowly and deeply and then breathe out slowly in the same manner, paying attention to how your lungs feel.

2. Distraction Methods

Distraction can take the subject’s mind off the distressing memories that they might be experiencing. Some methods include:

Engage in a Task: Just count backward, solve a puzzle, or arrange something even if it is a very simple task.

Use Your Senses: Take a favorite song, have a strong-flavored food, or look at a picture of something that makes you smile.

Movement: Walking, stretching or any other light exercise can help regain attention during the class.

3. Self-Soothing Techniques

These techniques can be useful for stress reduction and relaxation. Examples include:

Comfort Objects: Cuddle an object that is near and dear to you, like a soft blanket or a stuffed toy.

Positive Affirmations: Parrot reassuring phrases such as “I am safe now” or “This feeling will pass. ”

Visualization: Imagine a safe environment that is free from any form of violence and conflict in your mind’s eye.

Long-Term Strategies

However, it is crucial to point out that not only urgent actions are required to address PTSD and prevent episodes from happening, but also long-term measures.

1. Therapy

One of the best ways to treat PTSD is through professional therapy. Types of therapy include:

Cognitive Behavioral Therapy (CBT): Assists in modifying the negative cognition process associated with the trauma.

Eye Movement Desensitization and Reprocessing (EMDR): In this technique, the patient is guided through eye movements to help in the processing of traumatic events [3].

Exposure Therapy: Slowly helps the person confront trauma-related stimuli to help decrease anxiety levels.

2. Medication

Various medications can be administered to assist in controlling symptoms of PTSD. These might include:

Antidepressants: May help lessen the severity of symptoms associated with anxiety and depression.

Anti-Anxiety Medications: Support in the treatment of anxiety and panic disorders [3].

Prazosin: It is usually given to patients to minimize nightmares and enhance the quality of their sleep.

3. Lifestyle Changes

PTSD management can also be facilitated through other healthy lifestyle changes. These include:

Regular Exercise: Exercise helps to alleviate stress and also helps in enhancing mood.

Healthy Diet: Consuming good foods enhances health.

Adequate Sleep: To enhance the quality of sleep, one should ensure that he or she follows proper sleep hygiene.

4. Support System

It is important to note that developing a network of support is essential for PTSD. This involves:

Family and Friends: Maintain communication with friends and family, who can help in providing encouragement and empathy.

Support Groups: Participate in forums where you can discuss the issues with other people who have PTSD, and get useful tips.

Professional Support: Have consistent follow-ups with the therapists or counselors.

5. Mindfulness and Relaxation

Stress management is also important in dealing with the effects that triggers have, and this is done through practicing mindfulness and relaxation. Techniques include:

Mindfulness Meditation: Learn to be present in the moment without passing any judgment [3].

Progressive Muscle Relaxation: Consciously tighten and release muscles all over the body to alleviate physical stiffness.

Yoga: It involves the use of physical movements, breathing techniques, and meditation to help in calming the body.

It can be disturbing and difficult to observe a person who has PTSD having an episode. It is empowering to know how to respond and that can help the person regain their control. 

Here are some steps to take when someone is having a PTSD episode [3]:

Stay Calm and Grounded

Your presence is also important and should be calm at all times.

Remain Calm: Do not raise your voice or become harsh with the patient.

Avoid Panic: This is because your anxiety can easily trigger your anxiety.

Ensure Safety

It is important to ensure that the environment is safe for the person.

Assess the Situation: Scan for any threats in the environment that may pose an imminent threat to his life.

Provide Space: If possible, get rid of possible threats and keep the person at a distance.

Communicate Effectively

Successful communication may assist in drawing the individual back to reality.

Use Simple Language: Avoid using long sentences and instead opt for simple and concise sentences.

Be Reassuring: Use such phrases as; “You are safe now” and “I am with you. ”

Avoid Confrontation: Lastly, do not argue with them or attempt to bring them back to reality.

Use Grounding Techniques

Bring the person back to reality.

5-4-3-2-1 Technique: Help them name five things they observe, four things they feel, three things they listen to, two things they smell, and one thing they can taste.

Physical Sensations: Remind them to grasp something with cold hands, or to put their feet on the floor.

Deep Breathing: Guide them to breathe slowly and deeply to calm themselves down.

Provide Physical Comfort

This will help comfort the person physically and may also assist in calming him down.

Offer a Comfort Object: Give them a comfort object such as a blanket or a toy.

Touch with Caution: If the situation is warm and comfortable, then it is encouraged to place a hand on the person’s shoulder or upper arm lightly.

Privacy and Personal Space

This entails recognizing that the person has a right to be left alone and that he or she has a right to privacy.

Ask for Permission: In case it is a person, it is good to ask whether or not it is alright to touch or come closer.

Give Space: Move back a little or do not touch them if they do not want to be touched.

Be Patient and Supportive

It is very important not to get frustrated when dealing with an individual experiencing PTSD as it is a process that may take time.

Allow Time: It’s important to remember that the episode may take some time to pass and that it is crucial to give it time to do so.

Stay With Them: Stay with the person until they are more comfortable and feel that they can manage the situation.

Listen: If they wish to discuss the episode, emotions that led to the episode, or any issue they are facing, then be a good listener and do not judge them.

Follow Up

Finally, follow up to help them more if needed after the episode.

Check-In: You may want to ask how they are doing and if they require any assistance.

Encourage Professional Help: Encourage them to seek a therapist or a counselor if they haven’t yet.

Plan Together: Examine what has been done for future episodes and how you can be of help.

1. Better Help. Is It A PTSD Attack? Living With Post-traumatic Stress Disorder. https://www.betterhelp.com/advice/ptsd/is-it-a-ptsd-attack-knowing-the-signs-and-symptoms/

2. GoodRx Health. What PTSD Flashbacks Feel Like, and How You Can Cope With an Episode. https://www.goodrx.com/conditions/ptsd/ptsd-flashback

3. Mayo Clinic. Post-traumatic stress disorder (PTSD). https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

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