9 Healthy Coping Skills for PTSD

Strategies for managing anxiety and other PTSD symptoms

Most people experience anxiety sometimes, but for people with post-traumatic stress disorder (PTSD), these anxiety symptoms are much more frequent and intense. Because their anxiety can be so strong, they sometimes rely on unhealthy coping methods, such as drug or alcohol use.

It's not just anxiety that makes it tough to cope with PTSD. Other common symptoms of the condition include intrusive thoughts, flashbacks, nightmares, avoidance of reminders, negative thoughts, and a heightened startle response. These symptoms tend to make anxiety even worse. No wonder it can be so hard to function in different aspects of everyday life.

At a Glance

Trauma leaves lasting emotional wounds, including increased feelings of anxiety. Fortunately, many healthy coping skills for PTSD can help ease anxiety and other symptoms. Strategies that may help include deep breathing, progressive muscle relaxation, mindfulness, and self-monitoring. Social support, self-soothing, and expressive writing can also be helpful. These strategies may help reduce the intensity of anxiety, lessen its frequency, and/or make it more tolerable.

Deep Breathing

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Breathing plays an important role in the stress response. Unfortunately, many people do not breathe properly.

Natural breathing involves your diaphragm, a large muscle in your abdomen. When you breathe in, your belly should expand. When you breathe out, your belly should fall.

Over time, people forget how to breathe this way and instead use their chest and shoulders. This causes short and shallow breaths, which can increase stress and anxiety.

Fortunately, it is possible to re-learn how to breathe deeply from your diaphragm and help protect yourself from stress. Practice simple deep breathing exercises to improve your breathing and combat anxiety.

Progressive Muscle Relaxation

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Using relaxation exercises can also be effective coping skills for PTSD, providing a way to reduce stress and anxiety. Progressive muscle relaxation alternates between tensing and relaxing different muscle groups throughout the body. This relaxation method is similar to a pendulum.

To completely relax your muscles, you first start by doing the exact opposite. In other words, tense your muscles before relaxing them.

In addition, by tensing your muscles (a common symptom of anxiety) and immediately relaxing them, the symptom of muscle tension may become a signal to relax over time.

Mindfulness

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Mindfulness techniques are useful coping skills for PTSD. Mindfulness has been around for thousands of years, and mental health professionals are beginning to recognize that mindfulness can benefit people dealing with anxiety, depression, and other mental health conditions.

Mindfulness is about being in touch with and aware of the present moment. So often, we get stuck in our heads, caught up in the anxiety and worries of daily life. Mindfulness can help us get out of our heads and into touch with the present moment.

It is important to note that this type of self-reflection can sometimes bring difficult emotions or thoughts to light, particularly if you have a history of trauma. Some research has also reported that some people may experience significant distress when practicing mindfulness, including increased anxiety symptoms, dissociation, and emotional numbing. 

You may find it helpful to practice mindfulness under the guidance of a trauma-informed therapist

Self-Monitoring

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Self-monitoring can be a helpful way of getting a handle on your anxiety symptoms.

Self-monitoring is a technique that involves carefully observing and recording specific thoughts, behaviors, sensations, or emotions.

People are creatures of habit. This means they often go about the day without thinking about what they are doing, feeling, or experiencing.

Lack of awareness may make people feel their thoughts and emotions are unpredictable and unmanageable. Unfortunately, this means that people cannot address uncomfortable anxiety symptoms without first being aware of what situations bring up these feelings.

The goal of self-monitoring is to help people gain more insight into their symptoms and coping skills. It can be a useful coping skill for PTSD and a simple way of increasing awareness.

Social Support

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Anxiety is easier to deal with when you have people to stand by and support you. Research has found that finding support from others can be a major factor in helping people overcome the negative effects of a traumatic event and PTSD.

When you are dealing with a stressful situation, it helps to have a trusted person to turn to. Supportive people can also be a great source of emotional validation.

However, simply having someone available to talk to may not be enough. A supportive relationship has several important pieces that may be particularly beneficial in helping someone manage their anxiety.

A support group led by a professional may be helpful, particularly if you would benefit from learning and practicing new coping skills for PTSD.

These supportive connections, whether they come in the form of an in-person support group led by a mental health professional or an online group, can help people with PTSD connect with other people who share their struggles. This can be a source of valuable connection, encouragement, advice, and strength as people cope with the troubling symptoms of PTSD.

Self-Soothing

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When you are experiencing anxiety, it is important to have ways of coping with those feelings. For example, seeking out social support can be an excellent way of improving your mood. However, the anxiety associated with symptoms of PTSD can sometimes occur unexpectedly, and social support may not be readily available.

In order to handle those situations where anxiety seems to strike out of nowhere, it is important to learn coping strategies that you can do on your own. These coping strategies focus on improving your mood and reducing anxiety and are sometimes described as self-soothing or self-care coping strategies.

Self-Soothing Strategies That Can Help

Self-soothing tactics that can help calm your body include:

  • Incorporating the senses to ground you in the present moment
  • Self-touch, such as self-holding or self-massage
  • Lying down with a weighted blanket
  • Listening to relaxing music
  • Aromatherapy

Expressive Writing

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Journaling can also be a useful coping skill for PTSD. It can help people express and process their thoughts and feelings (also called expressive writing), which can be a good way of coping with anxiety.

Expressive writing has been found to improve physical and psychological health.

In PTSD, in particular, expressive writing has been found to have several benefits, including improved coping, post-traumatic growth (the ability to find meaning in and have positive life changes following a traumatic event), and reduced PTSD symptoms, tension, and anger.

Distraction

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Purposeful use of distraction techniques can be of benefit in coping with emotions that are strong and feel uncomfortable, such as anxiety and fear. Distraction is anything you do to temporarily take your attention off of strong emotion.

Focusing on a strong emotion can make it feel stronger and more out of control. Temporarily distracting yourself can give the emotion time to decrease in intensity, which makes it easier to manage.

Some helpful distraction techniques for coping with PTSD include:

  • Talking to a friend or family member
  • Doing housework
  • Exercising
  • Engaging in a creative task
  • Watching a tv show or movie
  • Reading a book
  • Playing a game
  • Counting backward
  • Reciting a mantra or affirmation
  • Visualizing an enjoyable scene
  • Coloring in an adult coloring book
  • Playing a video game
  • Taking a nap
  • Doing yoga
  • Meditating

Behavioral Activation

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Anxiety and avoidance go hand-in-hand. While the avoidance of anxiety-provoking situations may help reduce anxiety at the moment, in the long term it may prevent you from living a meaningful and rewarding life (especially as this avoidance grows bigger and bigger).

Behavioral activation is a way of increasing your activity level, as well as how much you engage in positive and rewarding activities. Through behavioral activation, you can reduce symptoms of depression and anxiety.

To try this approach, list activities that you find rewarding. Examples might include:

  • Spending time with friends
  • Engaging in exercise
  • Going out for coffee
  • Visiting the library
  • Volunteering
  • Rearranging furniture
  • Hiking
  • Taking photos
  • Painting
  • Cooking a meal
  • Listening to a podcast 

Next, set a goal for how many activities you want to complete each week and then track your progress as you engage in these different tasks.

Takeaways

Trauma and anxiety often go hand in hand, but there are a number of coping skills for PTSD that can help bring relief. Strategies such as distraction, deep breathing, mindfulness, and behavior activation are just a few techniques that you can try.

If you find these approaches are not doing enough to help with your symptoms, talk to a doctor or mental health professional. Treatments for PTSD can help you process your experiences and develop new coping skills.

If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.