How To Cope With Post-Traumatic Stress Disorder In College

Support & Coping Techniques for a Positive Education Experience

According to the National Center for PTSD, 60 percent of men and 50 percent of women have suffered at least one traumatic event in their lifetime; of those individuals, 8 percent of men and 20 percent of women will develop post-traumatic stress disorder, or PTSD. Given how prevalent the problem is, it isn't unusual to find someone in the college classroom who suffers from PTSD. A study through the Eastern Colorado Healthcare System found that up to 17 percent of college students suffer from PTSD; that's much higher than the incidence of PTSD found in the general population. Learn more about coping with PTSD as a college student.

Those who are in crisis can get in touch with immediate help, around the clock, by calling the National Suicide Prevention Hotline at 1-800-273-8255.

What is PTSD?

Post-Traumatic Stress Disorder, also known as PTSD, can affect those who have either witnessed or experienced a traumatic event, such as a natural disaster, combat situation, sexual assault or life-threatening event, such as a serious car accident or physical attack.

Those who experience or witness a life-threatening event might suffer from a wide range of problems in the immediate aftermath. They might have nightmares, trouble sleeping, flashbacks of the event when they least expect it, fear of seeing or experiencing it again, or memories that make it tough to go about their day-to-day lives. These reactions are all natural, normal and expected.

After a traumatic event, some people will soon begin to feel better. Those terrible memories will begin to fade, and the flashbacks will come much less often. The nightmares will stop. They might even be able to face their fears and go back into a similar situation; for instance, a person who has been in a terrible car accident might get back behind the wheel, or a person who has seen combat might choose to sign up for another tour of duty.

But there are some who don't fully recover from what has happened to them or what they have witnessed. Those individuals are said to have PTSD. What triggers the post-traumatic stress response is different for every person. However, there are two main categories most who suffer from PTSD will fall into: Veterans of the armed services and people who are survivors of trauma and extreme violence.

Learning from a Student with PTSD

Tyler Browne served as a Machine Gunner in the United States Marine Corps from 2003 to 2007. He was deployed to Fallujah, Iraq and the Korengal Valley in Afghanistan. He graduated from the University of California, Berkeley with a degree in Political Economy in 2012 and is the founder of To the Cloud Vapor Store.

How does PTSD affect your day-to-day life?

It really depends on the day. It becomes agitated with seasonality (anniversaries of bad things happening). As I get older it is crazy to think of friends from the Marines who will forever be 19- & 20-year-old kids.

After waking up from nightmares – if I ever wake up from a really bad nightmare I have to do something to get my mind off it. I get upset at myself for having such vivid thoughts.

Staying busy is the number one way to keep my mind clear – work, work, work. Jumping at loud noises or cracks is something that I will always do, but it doesn't bother me.

As a college student, were there certain "triggers" that you didn't anticipate?

In college some of the non-combat veterans (known as POGS in the Marines) who deployed overseas really liked to play up their experiences in the military to get attention from class mates. Their lies and fabrications angered me in a weird way and in turn caused flare up of symptoms and thinking about combat.

As college got harder or certain tests (which determined grades or if I would get into a good major) would make me freak out and go blank and shake. Like it was life or death. This was the same thing that would happen after a firefight or when we took incoming mortar rounds.

I would have to talk myself back to normalcy, but knowing that I was freaking out over nothing and the natural reaction of doing it were two different things. Kind of like being my own shrink and saying “Hey this is what you are thinking, but this is the reality.”

Did you turn to any particular resources or assistance to help you through PTSD while in college?

I was stubborn and in retrospect this was not a good way to be. While there were excellent resources at my disposal, I felt they were for the weak minded.

I finally went to the VA psychologist my last year in college and began using the services they offered. The one on one counseling was more up my alley and what helped me the most. Helping me understand what was going on really would minimize the symptoms. There were groups to help veterans on campus, but I really didn't like hanging out with other veterans.

During my freshmen and sophomore years the best therapy was making friends with normal college kids and hitting the reset button like the previous four years in the Marine Corps never happened.

What advice would you offer to an aspiring college student who suffers from PTSD?

Find what makes you tick, make as many friends as possible and live it up, engage in physical activities and join extra-curricular activities which you enjoy and try new things.

Anything else you want to add?

If you are having a hard time, seek professional help and don't be stubborn. There are so many resources to help. At the same time don't play the pity party or expect 18-year-old kids and professors who have no clue what you experienced to accommodate exclusively to you.

The world is a large place full of lots of experiences, ideas and opinions. Learn, travel and explore during college. It sounds trite and cliché, but it will really help with PTSD.

Spotting the Symptoms of PTSD

When someone has gone through a traumatic event, they often have certain reactions that hit hard at first but slowly ease with time. Those who develop PTSD, however, feel as though they are caught in a never-ending loop of those reactions. Even during times when a person feels “fine,” something that reminds them of the event might trigger a response that puts them right back to the very beginning emotionally.

The most common symptoms of PTSD cover a wide range. They include:

• Agitation and irritability
• Hyper-vigilance
• Social isolation
• Insomnia
• Self-destructive behavior
• Nightmares
• Feeling emotionally detached from others
• Intrusive negative thoughts and emotions
• Flashbacks
• Guilt
• Loneliness
• Severe anxiety or fear
• Loss of interest in activities you used to enjoy
• An avoidance of anything that might trigger a memory related to the event
• Distrust and wariness, even in “safe” situations
• Sudden reactions that don't fit a given situation
• Hostility toward others for no apparent reason
• Depression

Not all survivors will show all these symptoms. There might be only one or two that persist, but that can be enough for a diagnosis of PTSD. It's important for anyone who has witnessed or survived a traumatic situation and is now dealing with the above issues to visit a mental health professional for a screening for PTSD.

Making the Transition to College with PTSD

It isn't unusual for the symptoms of PTSD to fluctuate during the first year of college, when students are learning about a new place, moving into new routines and possibly coming upon triggers for PTSD symptoms that they didn't expect.

A 2016 study at the University of Buffalo revealed how the symptoms of PTSD fluctuate during the first year of college – a crucial time when many things are changing in a student's life. The researchers separated 649 study participants into three categories: People with no symptoms, moderate symptoms and severe symptoms. Participants were assessed again five times throughout the first year of college – three times the first semester and twice during the second semester.

RESULTS

The largest fluctuations came during the first part of the first semester, when life changes were happening and the symptoms changed as well. As students settled into the rhythm of school, they became more fixed in their categories. By catching the symptoms of PTSD early and getting students needed help from the start, students can get a boost in getting better.

For students with PTSD, making the transition to college should not be handled alone. A strong support group, including family and friends, can help ease the changes. A strong mental health team can also be an enormous benefit, as a counselor, psychologist or support group offers a safe haven for someone with PTSD to talk about the changes in their life and how those changes affect their symptoms.

By being aware of the fluctuations that might happen in PTSD symptoms during that first year – and especially during those first few critical weeks and months – students can be better prepared to move into college and reach out to their support system when necessary.

What Are Colleges Doing to Support Students with PTSD?

There are many things colleges can do to help support students who suffer from PTSD, and some schools are doing all the right things. That charge is often led by faculty and staff who have taken the time to understand PTSD and look for ways to help their students succeed.

One of those people doing right by their students is graduate professor Korie Leigh, who has taught students with PTSD and gained a unique perspective along the way.

Dr. Leigh points out that it's important to learn to teach from a trauma-informed stance.

“In my class, this takes the shape of teaching from a trauma-informed philosophy which understands that trauma takes the shape and form of many experiences,” Leigh said. “I am not the one to decide ‘what is traumatic material' and what is not – any and all content could potentially be ‘triggering' for a student. Therefore, I provide ample notice of lectures, videos and music shared in class, and group content. I upload my power-points and videos to a shared folder for students to view beforehand. Additionally, anytime there will be a guest speaker inform the class and let them know what the topic will be.”

It's also important to put away any ideas of what PTSD is “supposed” to look like, according to Dr. Leigh.

“PTSD does not look like one thing and is experienced in a unique way for each student,” Leigh said. “What works well for one, may be triggering for another. Therefore, its best to never assume and take an inquiry stance regarding the situations.”

While some classroom protocols are important to the learning process, this shouldn't preclude students with PTSD from receiving the support they need during instruction, said Dr. Leigh.

“If a student needs to leave the room, sit in a certain place, or not engage in a specific activity, allow them to advocate for their needs. As an educator, you must find a way to be flexible and meet them where they are at,” Leigh pointed out. “Never force a student to engage in an activity where there is physical contact such as team building activities. Always provide an alternative that does not single out any student and provides the opportunity to ‘opt in' or ‘opt out'.”

Military-friendly colleges such as Arizona State University (home of the Pat Tillman Veterans Center) and the College of Staten Island, which makes special accommodations for veterans with disabilities, are doing a great job serving students with PTSD. Given how robust veteran services are in several schools across the nation, it stands to reason that there is also a strong mental health team on or near the campus as well – they stand ready to help those who suffer from PTSD, whether they are veterans or not.

When seeking out a college that provides ample help for someone with PTSD, look for veterans' services and a sterling reputation for mental health awareness. Often a simple phone call to the school will provide a wealth of information on whether a particular institution will be a good fit for someone with PTSD.

PTSD Management & Treatment

Over the last several decades, PTSD treatment and management has evolved into a careful science – and it's still evolving, with new options introduced every year to help those with PTSD cope with the trauma they have suffered. Here are a few of the most promising treatments and management techniques.

Trauma-Focused Cognitive-Behavioral Therapy

This therapy involves talking to a counselor about the situation; specifically, talking about the event, the emotions that have come to light since it happened, and how the individual is processing those emotions. Therapy focuses on minimizing the stress caused by thoughts and feelings about the incident, as well as helping create new coping strategies for those who are dealing with difficult symptoms.

Prolonged Exposure Therapy

This works by asking an individual to talk through the event over and over, explaining it as clearly as possible to “relive” it often. It might also involve a person going to places that remind them of the event and deliberately “triggering” themselves to evoke a reaction. Over time, a person can become desensitized to what happened to them, and no longer suffer the PTSD symptoms.

Family Therapy

Especially helpful for those who have suffered from childhood abuse and neglect, this therapy can help individuals come to terms with what has happened to them and can help stop cycles of abuse and neglect in their extended family. Family therapy is also good for spouses who want to understand more about what their loved one went through.

Medication

For some, a proper medication regimen can help them cope with the symptoms of PTSD. Some antidepressant medications, specifically Selective Serotonin Reuptake Inhibitors, can reduce anxiety and depression while improving an individual's ability to concentrate, sleep, and otherwise cope with the lessened symptoms of PTSD.

College Stressors & Coping Techniques

The college environment can bring surprising challenges to those who have PTSD, even those who believed they had their symptoms well under control. That's because college life comes along with a variety of very specific stressors. Here's what students might encounter that could cause issues for them:

Crowded Classrooms
For some with PTSD, being in a room with many people can lead to feelings of being trapped, and that doesn't bode well for getting through that lecture. Students might be able to sit at the back of the room, near an exit, to help control some of the more uncomfortable moments.

Noises
Loud laughter, a door slamming, a person screeching with surprise – all of these are common in the college setting, and they can easily set off triggers for someone with PTSD. Though some can be avoided through the judicious use of headphones when possible, it's impossible to avoid them all.

Lack of Sleep
Not getting enough sleep can leave almost anyone irritable and cranky, but for someone with PTSD, that feeling of exhaustion can mean they aren't as able to handle triggers or upsetting moments that might come their way.

Changes in Routine
For many individuals, routine is comforting. Starting college is clearly going to upset well-established routines; and once the new routine is established, it changes again with the new semester. These changes can leave anyone feeling a little discombobulated, but it can be especially tough for students with PTSD.

Some Assignments
Some classes might require assignments that can include triggering material. For instance, a movie that students are asked to view in film class might have content that brings back a traumatic incident, or a chapter in a history book on world wars might bring back memories for a veteran.

Prevalence of Alcohol
For most, alcohol is a mood-altering substance. But when someone has PTSD, that altered mood might go in a frightening or even dangerous direction. It's very important to ease into drinking carefully – if at all – and never imbibe enough to lose your bearings.

Feeling “Different” Than Others
Those who have suffered severe trauma and suffer from the long-term effects of PTSD might feel as though they don't fit in with the typical happy-go-lucky college crowd. Being unable to find someone who understands the struggles might lead to feelings of isolation, depression and the like.

Fortunately, there are many coping techniques that a person can use to help them get through the college experience. Here are a few that can be a great help:

Support from the College Community

One of the best things a professor, staff member, administration, or anyone else at college can do is simply be ready to listen and act when a student asks for assistance. When a student chooses to reach out and share what would make them feel safe, secure and successful, pay attention to their request and provide them with as much of an accommodation as possible. For instance, a student who has trouble with loud noises might be much more comfortable sitting in the back of the classroom, where the sound from the speaker system isn't so overwhelming for them.

Professor Leigh offers a few additional tips for those who want to help students with PTSD but don't really know where to begin:

In my experience, students that could have agency over obtaining an academic accommodation were better able to articulate what they needed from their professors,” Leigh said. “Accommodations as simple as sitting in a certain seat in class, having extensions on certain assignments, or flexibility with creating new assignments can empower the students.
Dr. Korie Leigh

• Educate yourself on how to be an ally to someone coping with PTSD.
• Never assume you know what the person is experiencing – instead, ask them.
• Never ask the person to disclose the specifics of their experience, unless they want to share it willingly.
• Always ask before you engage in physical contact. Even a simple hug or pat on the shoulder can be a very challenging experience for someone with PTSD.
• Ask them what they need. Oftentimes people struggling with PTSD have a sense of what they need to help them feel safe and secure.
• Create a coping plan. Know what items or techniques work to help ground the student, bring them to present, and help them maintain a sense of safety and security.
• Help to lessen the stigma of mental illness by talking about engaging, and educating the student body in discussions about trauma.

Secondary Traumatization

Those who have experienced a traumatic event aren't the only ones who can suffer from PTSD. First responders, such as firefighters and police officers, can also develop PTSD in response to witnessing one traumatic event or several events over time. This is especially true if they witness something of such a scope that it's difficult to comprehend the loss. A good example of this is the lingering symptoms and common triggers found among those who were first on the scene of the 9/11 attacks, or those who work the front lines of humanitarian efforts in war-torn countries.

However, the legacy of PTSD doesn't stop there. Second-line responders, such as mental health professionals, social workers, humanitarian workers, and even journalists and attorneys, can develop the signs of PTSD after working with victims of assault, tragedy and violence. By helping others to the best of their ability, they can't help but empathize with the stories that they hear or see; as a result, they eventually begin to experience some of the same symptoms their clients or patients do. That's why sometimes secondary traumatization is known as “compassion fatigue.”

Those who are suffering from secondary traumatization might develop a variety of symptoms, including:

• Hopelessness
• Hypervigilance
• Sleeplessness
• Chronic exhaustion
• Guilt
• Avoidance (of triggers or clients)
• Anger or cynicism
• Unexplained illness and physical ailments
• Loss of creativity
• Inability to establish boundaries
• Insensitivity to violence
• Inability to work through complex situations
• Diminished self-care practices
• Withdrawing from family and friends
• A feeling of disconnect

Sometimes secondary traumatization takes other forms. For instance, burnout is a common problem among those who work with individuals who have suffered trauma. Emotional exhaustion, a diminished feeling of satisfaction and depersonalization are all hallmarks of burnout. Burnout usually appears as a symptom of general stress with the person's occupation; it doesn't stem from one particular incident, but from dealing with several of them over a period of time.

Vicarious trauma is another problem faced by those who work with individuals with PTSD. It is a special danger for those who are more empathetic with their clients, as they might find their own inner experiences change as they work with clients. There can also be subtle cognitive changes that accompany constant exposure to traumatic stories.

It is vitally important that those who suffer from secondary trauma do not ignore the symptoms and hope they go away; instead, they must reach out for help for themselves. This is not only to remain effective in their jobs and continue helping others, but to ensure that they stay in good mental health throughout the rest of their lives.

Scholarships

Students who have been through a difficult time will be happy to see a little easing of their financial burden. These scholarships are specifically for those who suffer from PTSD, including veterans, victims of abuse and more.

PTSD Resources

The following resources focus on PTSD information, treatments, college transition and more.

• Everyday Health: PTSD Resources
  This list of resources provides help for everything from finances to alternate therapies and clinical trials, all focused on PTSD.
• Help Guide: Post-Traumatic Stress Disorder
  This comprehensive page provides everything from definitions to symptoms to treatment and self-help techniques for those with PTSD.
• National Center for PTSD
  A service of the Department of Veterans Affairs, this site provides information for both military and non-military on PTSD symptoms, treatments and more.
• National Suicide Prevention Hotline
  Those who are in crisis can get in touch with immediate help, around the clock, by calling 1-800-273-8255.
• Post-Traumatic Stress Awareness
  This list of resources from the American Psychological Association provides in-depth information on PTSD, services and more.
• Psychology Today: Students with PTSD
  This article is an informative guide to various resources and accommodations that might help those with PTSD.
• National Center for Victims of Crime
  Those who suffer PTSD as a result of a crime can fine resources, information and further help here.
• Very Well Mind
  This site provides information on a variety of disorders, including the latest information on PTSD.
• PTSD Alliance
  A site supportive of those with PTSD, especially those who suffer from PTSD that has led to addiction.
• Veterans Families United
  This site offers in-depth information on PTSD for service members and their loved ones.
• RAINN: National Sexual Assault Hotline
  Many who suffer from PTSD as the result of sexual assault. This site and hotline offer comprehensive help.
• Veterans Crisis Line
  Those who need immediate help can go to this website for online chat, text or call options.
• NIMH: Post-Traumatic Stress Disorder
  The National Institute of Mental Health provides pertinent information for those suffering from PTSD, including treatments, therapies and possible research study opportunities.