crisis

Mental Health Monday #MHM – PTSD Help

Back in March I wrote an article about PTSD and recognizing the symptoms and a very brief paragraph about how to reach out for help. The other morning we had a call, and I regretted that I had not put more focus on how to provide aid and support for a family member who has PTSD rather than just the symptoms. If you have a family member with PTSD, I need to start by saying I am sorry that I did not give you as much help as I might have.

I do need to provide a link to the original article because recognition of the symptoms are the first step. It can be found here: https://nrhpdmedia.com/tag/ptsd/

Also, I have mentioned a couple of things that I need to bring up again quickly.

First, I have talked about cortisol and how that hormone, a result of stress, has enormous physical and mental consequences when it is not released; This bit of info ties into the next thing I need to refresh us all on.

Second, the amygdala is, along with the thalamus, the part of the brain that deals with fear, stress, and emotion. If the amygdala receives a threatening message from the thalamus, it sends out an emotional response.

Issues arise when cortisol is being continually dumped into the system. The brain begins adding additional connections in these parts which then trigger more depression, anxiety, stress, and hyper-reactivity while simultaneously reducing the ability of the brain to access the prefrontal cortex which is where we do our real thinking. More reactivity, less processing… see where this is heading?

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Whew, it sure took me a long time to get to what I said was going to be the focus, didn’t it? Sorry, but I feel like if we understand the “how” and “why ” we can wrap our heads around the “what” to do.

So what do family and friends do when they see someone they care about going through the symptoms we have discussed before?

Well, here is a pretty good list cobbled together from a few different sources:

  • Learn as much as you can about PTSD. Knowing how PTSD affects people may help you understand what your family member is going through. The more you know, the better you and your family can handle PTSD.
  • Offer to go to doctor visits with your family member. You can help keep track of medicine and therapy, and you can be there for support.
  • Tell your loved one you want to listen and that you also understand if he or she does not feel like talking.
  • Plan family activities together, like having dinner or going to a movie.
  • Take a walk, go for a bike ride, or do some other physical activity together. Exercise is important for health and helps clear your mind and also helps the body process cortisol.
  • Encourage contact with family and close friends. A support system will help your family member get through difficult changes and stressful times. People who have PTSD may isolate themselves which will significantly compound the problem.
  • Practice “mindfulness” or “Loving-Kindness” meditation techniques. It is ok to allow yourself to feel your feelings. Trying to suppress them means they will take control. Sure, maybe this seems pretty “sappy” or “granola, ” but it works. There are many videos on YouTube to guide you through this.

Your family member may not want your help. If this happens, keep in mind that withdrawal can be a symptom of PTSD. A person who withdraws may not feel like talking, taking part in group activities, or being around other people. Give your loved one space, but tell him or her that you will always be ready to help.

What if they get angry or have an outburst? Well, we all know it is nearly pointless to attempt a discussion when someone is overly upset. Here are some pointers:

  • If anger leads to violent behavior or abuse, it is dangerous. Go to a safe place and call for help right away. Make sure children are in a safe place as well.
  • It is hard to talk to someone who is angry. One thing you can do is set up a time-out system. This helps you find a way to talk even while angry. Here’s one way to do this.
  • Agree that either of you can call a time-out at any time.
  • Agree that when someone calls a time-out, the discussion must stop right then.
  • Decide on a signal you will use to call a time-out. The signal can be a word that you say or a hand signal.
  • Agree to tell each other where you will be and what you will be doing during the time-out. Tell each other what time you will come back.
  • While you are taking a time-out, don’t focus on how angry you feel. Instead, think calmly about how you will talk things over and solve the problem.

After you come back:

  • Take turns talking about solutions to the problem. Listen without interrupting.
  • Use statements starting with “I,” such as “I think” or “I feel.” Using “you” statements can sound accusing.
  • Be open to each other’s ideas. Don’t criticize each other.
  • Focus on things you both think will work. It is likely you will both have good ideas.
  • Together, agree which solutions you will use.

Finally, how can you communicate better?  We have discussed some of this in the past, but I found this great YouTube video that has the key ways to talk to someone in crisis: The Secrets of Hostage Negotiators.

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I hope this helps.  Again, it is something I wish I had included the first time around.

 

Please, don’t ignore a problem. If you have someone who needs help, call someone for help. Me, the VA, a rape crisis center, whomever. Just help that person find help or an outlet.

Take care,

Chris

 

Where to get help:

https://www.ptsd.va.gov/public/where-to-get-help.asp

https://www.ptsd.va.gov/public/family/resources_family_friends.asp

 

Other info:

https://www.ptsd.va.gov/public/family/helping-family-member.asp

https://www.helpguide.org/articles/ptsd-trauma/helping-someone-with-ptsd.htm

 

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Let’s talk about…talking #MHM

Talking through a crisis – LISTEN

Hi all,
For Mental Health Monday, I’d like to talk about talking. Actually, let’s talk about communicating… not at all the same thing. To communicate effectively, it’s more important to be listening which is key to being able to help someone in crisis.
Many of us are guilty of being in a conversation where we aren’t listening. Our brains are engaged not in processing what we are being told but rather churning away on what we want to say on our next chance to talk.

  1. When someone is in crisis, first we need to LISTEN to them and help them burn off that emotional load. Doing this in a controlled way helps keeps them from fueling their own fire. We do that by asking questions and giving replies that bring out and identify what has caused the crisis. For example, “What has happened to make you feel this way today?” When they are telling you, nod your head and reply with “mm hmmm” and “okay” which doesn’t interrupt them but lets them know you are listening. When they pause, you might ask, “It sounds like this made you very sad/hurt/etc.” which helps you both label the emotions they are feeling and, again, lets them know you are listening. Even if you are wrong, it gives them a chance to correct you. Either way, now you know how they feel.
  2. Next, we EMPATHIZE with the person. This doesn’t mean we must agree with what they think or say but we can express something like, “I can understand how that could have hurt you.” This, again, shows the person they are being heard. Let’s say, for example, they are suffering from audible hallucinations like tormenting voices. While we can’t know what it’s like to experience that, we can honestly say, “That must be very frustrating for you.”

By LISTENING and EMPATHIZING, we can help calm a person’s mind and help them become more rational which then let’s us all move toward finding a positive outcome for a situation.
If you’re interested in reading more about verbal de-escalation, you might check out “Verbal Judo” by Dr George Thompson or “In the Eye of the Hurricane: Skills to Calm and De-escalate Aggressive and Mentally Ill Family Members” which can be found at www.edgeworkbooks.com. The book I mentioned last week, “I’m Not Sick, I Don’t Need Help” also talks about this process.

-Officer Morgan, MHO 817.427.7092

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