Students with PTSD
On a post-traumatic stress disorder (PTSD) forum, a college student cries out for help: “Hey, everyone, I’m having a really hard time with course work right now.” He elaborates, “I’m dissociating a lot right now, and it’s making me pretty dysfunctional some days. For those of you who are, or have been, in college, do you have any suggestions that might help me deal with dissociation and concentration problems?”
My heart went out to this student, so I wanted to take the opportunity to help college students with PTSD and to educate instructors in assisting those students. I am glad that this person knew that he had PTSD, which is something that not everyone with this disorder would be aware of. Obviously, whether this student was diagnosed by a therapist or self-educated, he was able to identify symptoms that are typical in PTSD, such as lack of concentration and dissociation (a feeling of being out of the body).
What is PTSD? “Currently, for a diagnosis of PTSD, the student must experience a traumatic event in which he/she perceives a threat to either self or others, and must experience distress (horror, fear, helplessness)” (Kataoka et al. 2012). Traumatic events can range from childhood trauma, an assault, a medical trauma, natural disasters, school bullying, a mugging or robbery, an attack by an animal, a major car accident, and more. “The three symptom clusters for PTSD include reexperiencing (for children, this can be repetitive play or reenacting the trauma in play), numbing and avoidance (such as avoiding traumatic reminders and talking about [the] trauma, not participating in activities previously enjoyed), and hyperarousal (such as irritability, anger, difficulty sleeping)” (Kataoka et al. 2012). Other symptoms of PTSD that people experience are lack of concentration, flashbacks, hypervigilance (sensitivity to sounds, light, and energy), emotional extremes, and dissociation.
Recognizing, being aware of, and understanding how PTSD is affecting you are the first steps you can take. As the student described, there were days when he felt dysfunctional, and had difficulty doing his homework or being in the right space to concentrate on exams. Once you are aware that you have PTSD, you often can register with your school’s disability services to buy yourself more time to complete your homework when you have “off days” or to reschedule exams for another day. However, disability services might ask you for a diagnosis from a school psychiatrist or therapist in order to accept your application. You might think, Oh, but disabilities only describe people with physical limitations, such as being in a wheelchair or on crutches. But the term disabilities shouldn’t be limited to this interpretation; instead try to think of it as part of your support system. But receiving support isn’t always easy for people with PTSD, and signing up with disability services can spark feelings of shame. What’s important is to remember that you want a degree and in the end, nobody will look at how you received it, not even your future employer.
Once you sign up with disability services, many colleges want you to inform your instructors about your request. Be prepared for the reality that not every instructor will be sympathetic, although most will be. My client Lisa (name altered), who suffers from PTSD, told me that registering with disability services had allowed her to achieve a 4.0 grade-point average, and she proudly announced her acceptance to a prestigious university in the fall. Generally, during her college experience, she had encountered very understanding teachers whenever she had missed classes or been unable to meet homework deadlines due to her PTSD symptoms. However, Mrs. Abraham (name altered), one of her instructors, had completely dismissed her at first. With her eyebrows lifted as a sign of disapproval and distrust, Mrs. Abraham had pointed out that she, too, had experienced trauma and that it was probably worse than Lisa’s. Mrs. Abraham didn’t see the problem, couldn’t understand why Lisa missed classes, and didn’t accept her situation. First, Lisa was shocked and then experienced all kinds of sadness, anger, and frustration. She decided to write a letter to Mrs. Abraham explaining why she was traumatized. Lisa, a young, beautiful, smart, and articulate woman who seemed to have it “together,” described in her letter how she had been forced into prostitution and tortured for many years. Even though this traumatic history had left her with PTSD that was difficult to manage sometimes, she was eager to give her best as a student. Fortunately, Mrs. Abraham read her letter, called her to apologize, and, with tears in her eyes, started to understand Lisa’s needs.
Although Lisa’s trauma turned out to be one of the worst experiences that one could imagine, we really cannot compare ourselves to other trauma survivors. We often assume that if we didn’t experience anything as seemingly horrific as others have experienced, our trauma doesn’t count. But it does. On the contrary, we cannot dismiss someone’s symptoms just because our trauma seems more serious. Many factors play into whether or not we develop symptoms, and they usually depend on our internal and external resources at the time of the trauma. Internal resources might be your coping skills, strength, resilience, age (developmental stages are important; an adult can make more sense of a situation than a three-year-old, for example), and genetics, whereas external resources are anything that is outside of you that provides you with support, strength, and relaxation. External resources might be your network of friends, your family, your instructors, and your community. Your exercise, eating, and sleeping habits, and your environment, such as your home and the sounds you are surrounded with, are all important.
Therefore, create as many resources as you can at all times. Expand your external resources by trying to get your instructors on your side for support. Some instructors are not sympathetic, and you will have to remind them of school rules and possibly talk to the dean. Even though that’s extremely hard, you are doing it for you and your future.
Going to a psychologist, psychiatrist, or therapist who specializes in trauma will ensure that you find understanding and sympathy, as well as help in lessening or relieving your symptoms. Many psychology programs offer very low-fee therapy sessions conducted by professionally supervised interns who need to practice their skills. Recognizing your PTSD symptoms and getting support, such as by registering with disability services, seeking scholarships, signing up for free or low-fee psychotherapy, can be helpful.
In addition, reduce triggers from your study environment. Some people with PTSD get too distracted by background sounds or the people around them, while others thrive in that environment. Do you study better at the café or library, in study groups or alone, or at home or a friend’s house? Check what lighting is best for you, natural light or a dark room? Find out how long you can concentrate, and then take a break. Ideally do some exercise on a regular basis and practice some kind of relaxation technique, such as yoga. When you feel anxious or triggered, try to move your body even in the slightest way, such as by stretching your hands or tapping your feet. Eat a stress-free diet: limiting coffee, sugar, fatty foods, and sodas while drinking adequate amounts of water, and eating vegetables and protein. In addition, students on a PTSD forum gave some additional study tips, including that it helps them to take notes while reading. See which suggestions work for you and which do not.
To expand your internal resources, make a list of what makes you feel good, balanced, grounded, and relaxed, and do those activities more often. Perhaps listening to guided imagery CDs, such as Belleruth Naparstek’s Healing Trauma CDs, might help you, as well as using a self-help method called Emotional Freedom Techniques (EFT). EFT are tapping techniques you use on your body that have shown to be very successful at reducing distress and triggers. The website www.EFTUniverse offers free YouTube video instructions and research articles. Go to the site and use the techniques when you are triggered in order to determine whether EFT might reduce your anxiety or reactions.
Find a Somatic Experiencing (SE) therapist at www.traumahealing.com to work on your trauma. SE works with your nervous system, which often gets stuck in stress or trauma, keeping you in a hyperalert, survival mode. Read books on trauma, such as In an Unspoken Voice by Peter Levine, and Healing from Trauma by Jasmin Lee Cory and Robert Scaer. But most important, don’t give up!
Those are some of the tools for staying on the road to getting your degree and landing in your dream profession. Your trauma matters, and you should get support!
It’s also important for instructors to understand that students with PTSD who seem to fail their classes might, in fact, be very smart people and that their grades are not a reflection of their intelligence or potential, but only the interference of PTSD. Mike Denney (2012), who wrote the memoir Nobody’s Boy: An Old Doctor and a New Science, reveals his various traumas, from childhood incidents to the aftermath of World War II, and how he seemed to fail school at first, even though he had received very high scores on intelligence tests. Eventually he not only graduated from high school, but also became a doctor and, later, a psychologist.
“It is estimated that approximately 4 to 6 percent of youth in the general population nationwide will meet criteria for a diagnosis of PTSD following a traumatic event, including symptoms such as poor concentration and intrusive thoughts, which can also severely interfere with school functioning” (Kataoka et al. 2012). Instructors should also learn about PTSD, and when their students seem anxious, hypervigilant, zoned out, or lacking in concentration, instructors should have a conversation with them in private, ask if they are okay, give them a handout on PTSD, and refer them to a counselor.
When students and instructors have the same goals—to create the best learning environment possible and to understand and combat PTSD—we will have a more thriving community.
Denney, Mike. 2012. Nobody’s Boy: An Old Doctor and a New Science. North Charleston, SC: CreateSpace.
Kataoka, Sheryl, Audra Langley, Marleen Wong, Shilpa Baweja, and Bradley Stein.2012. “Responding to Students with PTSD in Schools.”Child and Adolescent Psychiatric Clinics of North America 21 (1):119–33. doi:10.1016/j.chc.2011.08.009. www.ncbi.nlm.nih.gov/pmc/articles/PMC3287974.
PTSD Forum: https://www.ptsdforum.org/c/threads/suggestions-for-student-with-ptsd.23260
First published on Psychology Today.