Coping with PTSD is possible through everyday strategies and those that help soothe your autonomic nervous system.

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. Its symptoms include intrusive, involuntary forms of reexperiencing, avoidance practices, and changes to your thinking and behavior.

Approximately 5% of adults living in the United States have PTSD each year. For some, PTSD naturally improves with time. For others, PTSD requires professional treatment.

If you’re living with PTSD, coping strategies can help you manage symptoms in real time.

Coping strategies are personal processes that help you in times of adversity. They’re mental or physical techniques that allow you to adapt to the moment and regain control.

PTSD coping strategies involve methods of ongoing PTSD management and in-the-moment self-regulation to de-escalate PTSD symptoms that flare up.

Active coping strategies for PTSD include:

Calming your autonomic nervous system

Lea Trageser, a licensed marriage and family therapist and owner of Helix Marriage and Family Therapy in New York City, explains coping with PTSD involves finding ways to calm your autonomic nervous system.

“One of the most important parts of coping with PTSD is learning to soothe and regulate your nervous system,” she told Healthline. “Strategies you can practice daily in order to regulate your nervous system include deep breathing, guided meditations, and movement.”

Your autonomic nervous system includes your sympathetic and parasympathetic systems. It’s responsible for many of the fight, flight, or freeze responses that can occur when the body perceives a threat.

Because PTSD puts you in moments of reexperiencing trauma, it stimulates the autonomic nervous system, creating anxiety, fear, apprehension, and physical changes, like a rapid heart rate.

One of the simplest ways to calm your nervous system is through movement.

Leah Riddell, a licensed clinical mental health counselor and trauma specialist from Greenville, North Carolina, recommends light activity every day when living with PTSD.

“One everyday coping skill when working on healing PTSD would be light exercise, like going for a walk, stretching, riding a bike, playing tennis, or swimming,” she said. “By utilizing our bodies and movement, we can help relax our muscles and remind our body that we are safe now.”

PTSD episodes are periods when PTSD reexperiences are intense and produce physical and emotional reactions. Some of these episodes, like flashbacks, can feel vivid and so real to the point where they overtake everything else around you.

When you experience a PTSD episode, the main goals are to:

  • control your breathing
  • remind yourself the actual traumatic event is over
  • return your attention to the present
  • seek comfort, like hugging a loved one

“Breathing exercises are a solid go-to, when someone finds themselves with quick breath, rapid heartbeat, fearful or anxious,” Riddell said. “Breathing exercises are a way that we can send signals back to our brain to CHILL and let our brain know we are not in danger and are actually just sitting on the couch or trying to go grocery shopping.”

Other examples of breathing-based exercises are boxed breathing and progressive muscle relaxation.

If breathing exercises aren’t part of your PTSD tool kit yet, Trageser recommends another technique known as grounding.

“Grounding brings you out of your panic and into the present moment,” she said. “You can do
this by utilizing your five senses. Name five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.”

Trageser said temperature is another helpful tool in grounding that can be used by placing ice on the back of your neck or behind your elbows or knees.

What to do during a PTSD flashback

PTSD flashbacks can be challenging to manage. They can feel as though you have been teleported back into the traumatic moment or that the trauma is happening again.

Riddell and Trageser agree coming back to the present is key during a flashback.

In addition to your standard in-the-moment PTSD coping strategies, Riddell recommends two grounding techniques for flashbacks.

“I love a good fidget toy to use as a way to ground yourself,” she said. “Something like a rock, fidget ring, bracelet, or anything that feels good to hold in your hand. The item can help remind you of the present; that you are here, you are safe, it’s just a memory.”

You can also splash your face with cold water to activate the mammalian dive reflex and bring your awareness back to the present, Riddell said.

Learning to recognize a PTSD episode can help you initiate PTSD coping strategies as soon as possible. According to Riddell and Trageser, signs to watch for include:

  • increased irritability
  • feeling anxious or on edge
  • not sleeping well
  • tunnel vision
  • a racing heart
  • feeling numb
  • sweating
  • increased avoidance practices
  • suicidal ideation

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

PTSD is treatable. Psychotherapy interventions and medications are both evidence-based treatment options for this condition.

Cognitive behavioral therapy (CBT) is a framework of psychotherapy widely used for PTSD. It’s a form of therapy that involves many approaches, such as:

All of these methods are designed to help you face trauma in a safe, controlled atmosphere where you can restructure unhelpful PTSD thoughts and behaviors.

Because everyone experiences trauma differently, your exact treatment program will be tailored to your needs. It may include other therapy frameworks, like interpersonal therapy or psychodynamic therapy.

To help take the edge off symptoms, your doctor may prescribe medications, like:

PTSD is a mental health condition featuring distressing reexperiencing episodes, avoidance, thinking difficulty, and mood and behavioral changes. It can significantly impair everyday life.

PTSD is treatable, though, and you can learn to ease your symptoms with coping techniques. PTSD coping skills involve active, ongoing strategies like trigger identification as well as in-the-moment management techniques like deep breathing.