How to write PTSD

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PTSD is a post-traumatic stress disorder.

Trauma: any event that overwhelms our ability to cope. Anything is considered traumatic depending on the individual.

The memories aren't recorded in a movie like fashion. It's recorded in bits with multiple skips and blanks. What a victim takes in during any trauma may differ depending on how much they remember after. It may differ again a week or a month later. This aspect of the memory is where you, as the author, can strategically choose which details your characters focus on, are haunted by, and prioritize.

Think of the brain as a detective's file drawers, most memories (even the traumatic ones) are filled in for later reference. This relates to how we handle this and react to certain details. Context is key!

PTSD memories are left in the "to-be-filled-" box because the brain doesn't know where to put them. The brain can't exactly figure out how to react to and interpret things. This leads to the lack of control over the memory which remains a constant threat.

Studies done after WW1 showed soldiers just returning from the battlefield answering questions of the incident while it was still fresh in their memories. Forty years later, the same soldiers were interviewed again with the same questions. Those with PTSD recalled the same sounds, smells, sights, and sensory details almost word for word.

How can you use this information when writing trauma or PTSD memories for your character?

Emotions have three jobs.
    1    To warn us
    2    To protect us
    3    To tell us

This is extremely helpful when thinking about how to show the effect of trauma on one's memories. This also includes why they're triggered. Any situation that recreates that feeling can trigger the traumatic memory: Someone standing next to them while they're seated, physical contact, having to speak to someone in authority (police officer), etc.

For those with PTSD, this triggered emotion will activate survival instincts the character will immediately need to obey. Usually, whatever helped them survive will be the default action. They may be aware that their action is not rational to the situation, but it happened to make perfect sense in the trauma situation.

Get curious about the consequences of your character being triggered, their actions will either way result in consequences.

How do they handle the aftermath?

Do they feel guilty?

What might happen when the impulse reaction is anger or violence?

Survivors will often focus on what's out of place, on what's wrong, what shouldn't be. When writing memories for your character, instead of seeking to capture the complete horror of an event, try narrowly focusing on what would be most upsetting to them.

To show the overwhelming/overstimulating feeling, use the things they remember and the things they forget. Add multiple sensory details; smell, sound, etc.

Self-awareness is crucial for management. Your mind starts the whole ball rolling and sets your body off: I'm not safe, I'm not safe. It's very hard to catch this mental initiation. More often, your body tips you off that your mind is racing. The self-awareness has one purpose, to enable you to manage what's coming/what you see coming.

Does your character have a physical symptom they are aware of? Have they trained themselves for it? If your character isn't self-aware, build up on their personality throughout the novel. They most likely want to hide what's going on, it makes others uncomfortable.

A disproportionate environment can cause the following symptoms:
    •    Blushing
    •    Sweating
    •    Shortness of breath
    •    Nausea
    •    Light-headed
    •    Trembling hands or legs

To soothe the symptoms:
    •    Hands in cold water
    •    Play games on your phone
    •    Saying what senses you feel
    •    Deep breaths
    •    Jumping up and down
    •    Meditation

Carefully avoid the temptation to use one aspect of PTSD while ignoring all the intrusive and debilitating aspects of this disorder. (It's more of a brain-injury). Flashbacks are basically traumatic memories which will affect your character emotionally, visually, physically, and/or sometimes as an auditory memory.

Some people experience the pain they endured during the traumatic event, not just the psychological effects.

It's more like a nightmare rather than a memory to be honest, because it can block out all sense of time and place. These memories are exhausting in every single way possible.

PTSD is not a joke. It's not something you can write about for the plot of your story. It comes with many horrible side effects that can destroy someone mentally. Your character has to show all sides of the disorder, not just being a quiet person with a dark past.

It can also be:
    •    Intrusive thoughts
    •    Dissociation
    •    Insomnia
    •    Negative beliefs
    •    Cognitive distortions
    •    Detachment
    •    Arousal
    •    Hypervigilance
    •    Depression

When writing trauma memories, keep in mind how many years or months have gone by. Some unconsciously altered their memories as a result of internal consequences; guilt and shame.

A representation of PTSD is shown after The Hunger Games when Katniss Everdeen returns to district 12.

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