Seeing a loved one go through a PTSD episode can be confusing and even distressing if you’re unsure what’s happening. Episodes can look different for each person, with symptoms that might seem alarming or hard to understand, like flashbacks, heightened alertness, or sudden withdrawal. Knowing what these episodes look like and how to respond can make a big difference in offering comfort and support.
In this post, we’ll explore common signs of PTSD episodes, what they might look like to an observer, and practical steps you can take to help. With this knowledge, you’ll feel more prepared to provide reassurance, apply grounding techniques, and make the person feel safe and supported during challenging moments.
How Do PTSD Triggers Work?
PTSD triggers are cues like sounds, sights, or situations that remind someone of a traumatic event, causing intense reactions. These triggers activate the brain’s “fight or flight” response, a long-term effect of trauma that can lead to flashbacks, emotional distress, or hyperarousal. Over time, PTSD treatment can help individuals identify triggers and develop coping strategies to manage their responses.
What Does a PTSD Episode Look Like?
Experiencing a PTSD episode can be intense, and each symptom affects a person in specific ways. Here’s a more detailed look at what each symptom might feel like for someone with PTSD and how it could appear to others:
Flashbacks
During a flashback, a person with PTSD might feel as though they’re transported back in time to the traumatic event, like watching a movie playing in their mind. They might feel physical sensations, such as the same heartbeat, smells, or sounds from the event. Flashbacks can be triggered by sights, sounds, smells, or even emotions that remind them of the trauma.
How to Spot It
A flashback may look like the person is staring off into space, freezing up, or acting fearful or tense. They may become unresponsive to others, as if they don’t see or hear what’s happening around them. Some might even talk to themselves or act as if they’re defending against something invisible, and they may need gentle reminders that they’re safe and in the present moment.
Nightmares
Nightmares related to PTSD can be vivid and frightening, replaying aspects of the traumatic event or symbolizing its emotional impact. These dreams are so intense that a person might wake up feeling as if they just experienced the trauma again. They might wake up feeling sweaty, anxious, or panicked and struggle to get back to sleep. Nightmares can disrupt sleep, causing exhaustion and making it hard to function during the day.
How to Spot It
This can look like someone frequently waking up in the night, talking, crying out, or even physically moving in their sleep. They may seem restless or disturbed when they wake, and it can be challenging to calm them down afterward. If someone notices these signs, gentle reassurance and support can help, though the person may need time to feel safe again.
Hyperarousal
Hyperarousal is when a person’s nervous system is always on high alert, making them feel like they have to be ready for danger at any moment. This can lead to being jumpy, overly cautious, or easily startled by loud noises or sudden movements. It might also make them feel irritable or quick to anger, as their body and mind are constantly in a state of tension.
How to Spot It
To others, hyperarousal may appear as if the person is unusually tense, restless, or easily distracted. They might flinch at noises that others barely notice, seem anxious about what’s going on around them, or react strongly to small disturbances. This constant state of alertness can be tiring, so someone with PTSD may seem worn out or nervous and may avoid crowded or unpredictable places.
Avoidance
Avoidance is when a person with PTSD intentionally steers clear of people, places, conversations, or situations that remind them of the trauma. This could include skipping social events, not wanting to talk about certain topics, or avoiding people who were present during the trauma. For them, these triggers can bring back painful memories, so avoiding them can feel like a way to keep themselves safe.
How to Spot It
This can look like the person is withdrawing from friends, family, or activities they once enjoyed. They may come across as distant, uninterested, or isolated. They may even seem to have sudden “reasons” for missing events, refusing to join in on activities, or making up excuses to avoid situations that make them uncomfortable. This behavior can sometimes make others feel shut out or confused, especially if the person doesn’t explain why they’re avoiding certain things.
Emotional Distress
People with PTSD often experience intense waves of emotion, such as sadness, anger, guilt, or shame. This emotional distress can come on suddenly and may feel overwhelming, often without an obvious trigger. For them, it’s as if they’re carrying a heavy emotional burden they can’t control. They may feel that their reactions are “too much,” leading to feelings of helplessness.
How to Spot It
Emotional distress can look like sudden mood swings, irritability, or bursts of sadness. The person may go from calm to upset quickly or seem overly sensitive to things others might consider small. This can be confusing to others, who may not understand why the person is reacting so strongly. Supportive listening and patience can make a big difference for someone in emotional distress.
Dissociation
Dissociation is a sense of being disconnected from one’s surroundings or even from one’s body. It can feel like being in a dream, as if they’re watching things from a distance or through a fog. For some, dissociation is a way to mentally escape from overwhelming memories or feelings associated with their trauma. They may feel numb or “zoned out,” unaware of time passing or what’s going on around them.
How to Spot It
If the person is staring into space, unresponsive, or “checked out” of a conversation, they may be disassociated. They might not react when spoken to, or they may seem to struggle to “snap back” into reality. In extreme cases, they might not remember what happened while they were dissociating. Offering calm, reassuring words and giving them space to ground themselves can help.
What to Do When PTSD is Triggered
If someone you’re with has a PTSD trigger or episode, being a safe, supportive presence can make a big difference. Here’s a step-by-step guide on how to cope with PTSD triggers:
1. Stay Calm and Grounded
When someone experiences a PTSD episode, they may feel scared, overwhelmed, or disconnected from reality. Keeping yourself calm can help them feel safer and remind them that they’re in the present. Speak in a soft, steady voice, avoid sudden movements, and try to remain relaxed.
2. Give Them Space but Stay Nearby
Some people may feel better with a bit of physical distance, so give them space if they seem tense or are physically withdrawing. Let them know you’re there for them, but avoid touching them unless you know they’re comfortable with it. Just being close can be a reassuring presence without overwhelming them.
3. Use Grounding Techniques
Grounding can help bring someone back to the present moment. You can gently suggest simple grounding techniques, such as:
- Breathing exercises: Encourage slow, deep breaths to help reduce panic.
- Name five things you can see: Ask them to look around and name items nearby to reconnect with the present space.
- Use sensory items: If possible, provide something with texture, like a soft object or a cold drink, to focus on.
4. Offer Reassurance
Sometimes, saying comforting, simple phrases can help. Remind them they’re safe, that the episode will pass, and that you’re there to help. For example, you might say, “You’re safe now,” “I’m here with you,” or “You’re not alone.” Avoid asking a lot of questions, as it might overwhelm them.
6. Avoid Talking About the Trauma
Avoid bringing up details of the trauma or asking them to explain what’s happening. This can intensify the episode. Instead, keep the focus on the here and now. Simple, grounding phrases, like “I’m right here” or “We’re at [location],” can help them reconnect with the present.
7. Respect Their Needs
Each person with PTSD may have specific ways of coping that help them. If they ask for space, give it. If they prefer to talk or need certain items to calm down, try to support them in those ways.
8. Be Patient and Listen
When the episode starts to pass, some people may want to talk, while others might feel embarrassed or drained. Be patient and supportive without pressing them to talk about it. Just listening if they do choose to open up can be incredibly helpful.
Who to Call When PTSD is TriggeredÂ
Often, PTSD episodes can be managed with calm, grounding techniques, and by simply being a supportive presence. If the person is not a danger to themselves or others and seems able to start calming down, calling someone may not be needed. Reassuring them that you’re there and supporting them in grounding techniques may be all that’s required.
It’s generally best to follow the individual’s wishes if you know them, as each person with PTSD may have different preferences. Respecting these preferences while prioritizing their safety is key.
That said, in some cases (like if you feel scared or overwhelmed) it can be helpful to call someone, but it depends on the severity of the PTSD episode and what the person prefers. Here’s some guidance on when and who to call:
Trusted Love One if Known and Agreed Upon
If the person experiencing the PTSD episode has a trusted friend or family member they would want involved, you could contact them if the episode feels severe or if the person asks for them. Knowing they have support from people they trust can be comforting. However, only do this if they’ve previously given permission, as calling someone unexpectedly might make them feel more vulnerable.
A Mental Health Professional if They Have One
If you know the person has a therapist or mental health provider and they’ve agreed to let you reach out in emergencies, contacting their provider can be helpful, especially if the episode is intense or prolonged. Mental health professionals can offer specific guidance tailored to their patient’s needs.
Emergency Services if There’s a Safety Concern
In rare cases where the episode includes behaviors that may put the person or others at risk—such as extreme panic, disorientation, self-harm, or threats of harm—calling emergency services may be necessary. However, try to be transparent if you need to call for help, as unexpected involvement from authorities can sometimes escalate the situation. Let them know calmly that help is on the way to avoid further distress.
Find Professional Support for PTSD Triggers
If you or someone you love is experiencing PTSD episodes, professional treatment can be a powerful step toward healing. Our PTSD treatment program provides specialized support, helping individuals learn effective coping techniques and find relief from the intense symptoms of trauma.Â
Contact us today to learn more about our program and how we can support you or your loved one on the path to recovery.