We’ve already discussed that anxiety levels are a good indicator of overall symptoms related to PTSD. We’ve also discussed that PTSD symptom management is literally a constant and ongoing process. Some days, your survivor might feel symptom-free, or they might come across as symptom-free. Other days, your survivor might struggle to get out of bed, have exaggerated startle responses, or be hyper vigilant to the degree of nerve-wracking for both of you. However, keep in mind that there are symptoms that your survivor is dealing with all the time. If your survivor is on a medication regimen that works for them, receiving regular therapy, and is in a safe environment, the symptoms of your survivor are probably well-managed. Even then, however, anxiety levels can flare if your partner is exposed to potentially triggering stimuli.

What I’m going to talk about is when symptom regularity can get hijacked by increased triggers, sensitivity and anxiety. These can create a potentially highly volatile episode of emotional irregularity and increased emotional dysregulation.

Dysregulation, medically speaking, is a regular component of PTSD, since PTSD involves being on constant high alert. Emotional dysregulation feeds the symptom clusters of PTSD by prolonging their duration, intensifying their effects, and draining the survivor. Emotional dysregulation hijacks symptom management a survivor normally works with and plays havoc by increasing the vulnerability (and severity) of a survivor to their everyday symptoms. Not only are the everyday symptoms more likely to be experienced, the severity also increases with emotional dysregulation.

It may be obvious at this point, but emotional dysregulation is fundamentally dangerous to symptom management. I’ll talk about how the brain functions in detail down the road, but in short, the amygdala (the little almond-shaped part of the brain that triggers the fear response) hijacks the brain, shutting down the cognitive part of the brain and putting the brain on high alert. In threatening circumstances, this can literally mean the difference between life and death. However, in your survivor’s brain, the smallest of stimuli—however unthreatening—can trigger this response. Because the cognitive part of the brain shuts down, it means that the survivor can’t reason their way out of it.

So what can be done? When the cognitive part of the brain goes offline, it’s important for the survivor’s support to provide that buffer. Remind your survivor of grounding techniques, point to techniques s/he learned in therapy, but be careful not to exacerbate the survivor’s symptoms. Maintain safety at all costs, since that is primarily what your survivor needs during emotional dysregulation.

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