Posttraumatic stress disorder, commonly known as PTSD, is a complex condition that can develop after exposure to a traumatic event. It is normal to experience some distress after trauma, but those with PTSD continue to experience significant impairment for months or even years. The disorder manifests in a cluster of symptoms, including flashbacks, hypervigilance, avoidance, and emotional numbing.

A key characteristic of PTSD is the intense episodic nature of symptoms. PTSD episodes refer to periods where symptoms flare up and become much worse than usual. These distressing episodes can arise suddenly and feel completely debilitating at the time. Understanding what causes episodes and the range of possible symptoms can help those struggling with PTSD identify and manage them.

Triggers for PTSD Episodes

PTSD episodes are usually triggered by some reminder of the original trauma. These reminders, known as triggers, can take many forms. Some common triggers include specific dates, locations, smells, sounds, images, weather conditions, or interpersonal interactions. Even everyday experiences can serve as trauma reminders and send someone into an episode.

Anniversaries of the trauma often trigger episodes. It’s known that anniversary dates can trigger memories of traumatic events and potentially lead to an increase in trauma-related symptoms such as nightmares Locations similar to the trauma site can also commonly evoke episodes. For sexual assault survivors, interactions with perpetrator types can serve as triggers. Basically, any sensory cues or situation resembling the trauma can instantly transport PTSD sufferers back into that painful headspace and time period.

Flashbacks and reliving the trauma

Flashbacks are one of the most vivid and frightening symptoms of PTSD episodes. These are incredibly lifelike replays of the trauma that temporarily distorts an individual’s awareness of their current environment. It feels as if the trauma is genuinely happening again in the present moment.

Flashbacks can be visual, auditory, olfactory, or somatic. A sexual abuse survivor may vividly see the perpetrator’s face, hear their voice, and feel the touch of their hands. Combat veterans often describe smells of explosives or gunfire and sounds of fellow soldiers yelling during flashbacks. These real-life experiences illustrate how profoundly episodes can disrupt PTSD sufferers’ sense of time and reality.

Hyperarousal and reactivity

In tandem with flashbacks, PTSD episodes are characterised by intense hyperarousal. This refers to the body and brain being continuously on high alert for threats. Hyperarousal causes PTSD sufferers to be overly reactive to any perceived danger during episodes.

The amygdala, the brain’s emotional processing centre, becomes overactivated, while prefrontal cortex functions like logic and reasoning are impaired. As a result, episodes often involve a hair-trigger temper, easier startle responses, and concentration difficulties. Hypercautiousness and hypervigilance also emerge due to the constant feeling of being unsafe.

This chronic reactivity stems from trauma conditioning in the nervous system. The original trauma taught the brain that danger is everywhere, so it remains perpetually on guard even when no legitimate threat exists in the present situation. Episode triggers fool the brain into thinking the trauma could recur at any moment.

Avoidance and emotional numbing

To cope with reliving trauma and hyperarousal, those with PTSD often instinctively withdraw and isolate themselves during episodes. They may actively avoid any people or environments even remotely associated with the trauma as a form of self-protection. Emotional numbing also emerges as a survival mechanism to block out agonising PTSD symptoms.

A traumatised individual’s social interactions, emotional expressions, and overall personality can appear significantly dulled. They retreat inwardly, feeling disconnected from loved ones and activities previously enjoyed. This avoidance and numbing may temporarily alleviate the inner anguish of episodes, but negatively impact relationships and quality of life. It also prevents the trauma from being fully processed.

Managing episodes

Effective PTSD treatment focuses on minimising episode frequency, intensity, and duration. Sufferers can learn to recognise personal triggers and early warning signs of an impending episode. Relaxation techniques, social support, and cognitive coping skills are key to mitigating episodes. Medications may help reduce episode severity for some as well.

With proper treatment, PTSD episodes can be substantially controlled. But episodes can still occasionally break through and will likely never disappear entirely. Having emergency coping strategies prepared can help PTSD sufferers get through periodic turbulent episodes while staying anchored in the present.

Though intensely painful, episodes are ultimately opportunities for healing by learning to navigate reactions to trauma reminders. Each successfully weathered episode is proof of one’s resilience and adaptability. Over time, episodes typically become less easily triggered as traumatic memories are processed and integrated. For those living with PTSD, each small triumph over an episode brings hope that recovery is possible, one day at a time.

Kaizen Mori is a qualified mind-body healing practitioner who has helped PTSD sufferers regain inner peace and balance for the past 10 years.