Does Anxiety Cause PTSD or Does PTSD Cause Anxiety?
“PTSD is a whole-body tragedy, an integral human event of enormous proportions with massive repercussions.” ― Susan Pease Banitt
This question came up in conversation when I was speaking with someone who has experienced severe panic attacks to the point of calling them “debilitating”, requiring inpatient care. As they were sharing about the ordeal, they told me that when they contemplate the time spent seeking treatment and the aftermath, it ramped up both the anxiety and PTSD symptoms. Even as a career therapist with decades of experience treating people with stand-alone anxiety, with no overt PTSD symptoms, I had not considered that remembering the anxiety was re-traumatizing. I have heard clients share that anticipating panic attacks was in and of itself anxiety provoking. For this person and so many others, it is hard to determine the line between the two.
As is the case for many who struggle with this condition, they experienced body memory, flashbacks and tremors, as if the events of the past were recurring. Reminding themselves, “I am here and now, not there and then,” alleviated some of the more intense indicators.
This person is also intent on taking on challenges and resilience is one of their superpowers. Overcoming life changing physical conditions were part of the symbolic exercise equipment that helped them to become stronger and more flexible. They were aware that life events happen, unbidden at times and all they can do is ride the waves, sometimes treading water, until things settle back into place. Having solid support from family, friends and professionals keeps them afloat.
Although it might be hard to acknowledge an upside to anxiety or trauma, this person and others I have encountered in both personal and professional realms have been grateful for accompanying lessons. Keep in mind, that no one is sugar-coating it, nor are they denying the pain. They are making a conscious decision to face what comes their way. Paradoxically, the one certainty of life is uncertainty. A catch-22, since anxiety thrives on unpredictability.
The field of Positive Psychology, which offers a strengths-focused perspective to recovery from traumatic experiences, was pioneered by psychologist Martin Seligman, who directs the Positive Psychology Center at the University of Pennsylvania. One concept in this approach is post-traumatic growth, which reflects counterintuitive responses to horrific circumstances. Research from Lawrence G. Calhoun and Richard G. Tedeschi of the University of North Carolina Charlotte found that survivors of trauma often experienced profound healing, a stronger spiritual faith and philosophical grounding. One powerful reframing is referring to the outcome as Post Traumatic Growth.
The 21-item Post-Traumatic Growth Inventory examines responses to painful event in five areas:
- Relating to others
- New possibilities
- Personal strength
- Spiritual change
- Appreciation for life
When survivors view themselves in that light and additionally as thrivers who give back or pay it forward, rather than as victims who have no choice but to feel as they do, healing is possible. One such thriver is Michele Rosenthal, a keynote speaker, award-winning blogger, award-nominated author, workshop/seminar leader and certified professional coach. Michele is also a trauma survivor who struggled with posttraumatic stress disorder (PTSD) for over twenty-five years. She calls herself Chief Hope Officer (CHO) of Your Life After Trauma, LLC.
Her trauma came in the form of a condition called, Toxic Epidermal Necrolysis Syndrome (TENS), which she describes as “a freak allergy to a medication that turned me into a full-body burn victim almost overnight.” This horror was followed by a series of physiological and psychological conditions that would flatten even the strongest of people. It took years of determination to recover that led her to be symptom free and now she guides others to overcome their own trauma-trials.
What helped her see her way clear to the other side of suffering is what she refers to as a “healing rampage.”
Rosenthal says, “It is an approach to recovery that is, 1) committed — we keep going no matter what; 2) consistent — we work at it every day; 3) creative — we look for new options and healing opportunities; and, 4) complex — we do the deep work rather than skim the surface as we seek relief.
These are important resiliency building skills regardless of diagnosis or symptomology, whether it falls under the umbrella of anxiety or PTSD.
- Learn relaxation and breathing techniques to center yourself in the here and now.
- Do grounding exercises such as walking barefoot on the grass or sand or tapping the bottoms of your feet.
- If possible, avoid people, places or things that may overtly trigger reaction. Some PTSD survivors may steer clear of fireworks or large numbers of people if loud noises or crowds are related to the initial events.
- Contemplate an exit strategy if you get inadvertently triggered.
- Breathe in relaxing aromas, such as lavender, chamomile, vanilla or bergamot.
- Listen to music that is soul soothing.
- Seek support from family and friends who may understand your situation and if not, offer a listening presence.
- Engage in therapy with a licensed professional.
- If medications are indicated, work with a Psychiatrist or CRNP (Certified Registered Nurse Practitioner) who can prescribe.
- Attend a self-help group.
- Utilize the therapeutic modality of EMDR (Eye Movement Desensitization and Reprocessing).
- Exercise, whether it is in a gym, or a dance floor or basketball court assists in moving the energy. I think of emotion as ‘e-motion’ or ‘energy in motion’.
- Spend time in nature which is restorative.
- Dig in the dirt, and plant seeds for new beginnings.
- Avoid self-medicating with drugs, alcohol, gambling, work, shopping or food.
- Indulge in healthy hobbies, such as reading, crafts, music, playing board games, putting together puzzles or models.
- Volunteer your time in your community.
- If you have a spiritual practice, use it as an additional therapeutic modality.
- Determine your passion and live it as fully as you can.
- Spend time with children and learn how to be silly from them.
- Lighten up by experiencing Laughter Yoga.
- Enjoy a pampering therapeutic massage.
Weinstein, E. (2019). Does Anxiety Cause PTSD or Does PTSD Cause Anxiety?. Psych Central. Retrieved on June 2, 2020, from https://psychcentral.com/blog/does-anxiety-cause-ptsd-or-does-ptsd-cause-anxiety/