Coping Strategies for College Students with PTSD

College is a pivotal time in our lives where we learn skills and develop talents that will impact the rest of our lives. It is also well known that college is hard, and for many, it is a test of our fortitude to push through in difficult times. Attending college with a disability or mental illness can be hard, but with the right support, accommodations, and adjustments, it can be done.

                Mental health is an important topic to discuss on college campuses because of the rising prevalence and impact of mental health disorders. Some mental illnesses, such as schizophrenia and bipolar disorder, typically begin in late teens and early 20’s and are usually triggered by stress and we know that college is stressful, and most college students are in their early twenties, making these concerns very real for many college students(Burke, pg. 176, pg. 188, pg. 146 – 162). As stated in this article, a study on college students during the 2020 – 2021 school year determined that 60% of college students met the criteria for a mental disorder.

                A cross-sectional study of 332 higher learning facilities published May 30, 2024, on Jamanetwork.com found that between 2017 and 2022, the prevalence of students with PTSD increased 4.1%, leaving a total of 7.5% of students suffering from PTSD. As the number of students with PTSD is growing, it is important to have an understanding of the symptoms, support, and ways to cope with the disorder while still fulfilling obligations. In this article, I will explore ways of coping with PTSD in college.

            It is well known that PTSD happens because of trauma, but that is an oversimplification. Most people who suffer from a traumatic event will not develop a stress-related disorder, like PTSD or ASD, but become stronger from it (Burke, pg. 327). All types of traumatic events can lead to a stress disorder, including a global pandemic, a turbulent political climate, and the ever-looming threat of school shootings.

                The COVID pandemic had a lot of factors that could make it more likely to develop a disorder, but two of the main ones are that there was the ever-present threat of death to you and your loved ones, and the very nature of the pandemic forced us to self-isolate. Social support is both an insulator against developing mental illness and an important factor in the effective treatment of many mental illnesses (Burke, pg. 334).

Much research has been done attempting to figure out why some people will develop PTSD while others don’t, and researchers have found that a mixture of environmental factors, genetics, and many other factors may aid in determining who will develop PTSD after being exposed to a traumatic event (Burke, pg. 337-338). Whether or not someone has efficient and healthy coping skills is another major factor in determining the development of the disorder because coping skills allow us to process and let go of stress rather than holding onto layers and layers of stress that will eventually need to be dealt with at the most inconvenient times. A main coping skill for many people is social support (Burke, pg. 324).

The rate of those with PTSD who are attending higher learning institutions of some kind is increasing in the U.S., and there is still much that is not understood about it. PTSD, as well as many other mental disorders, does not have obvious disabilities. The symptoms of guilt and shame that are a part PTSD can become worse as people close to the patient doubt the physical, mental, and emotional difficulties they experience (Molina, 2023).

SYMPTOMS OF PTSD

                According to the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition text (DSM-5), which is used by health professionals to diagnose and treat mental disorders, to be diagnosed with PTSD, a person must have experienced, or been in close proximity to someone who experienced, a traumatic, usually life threatening, event. They may also have been repeatedly exposed to traumatic events, such as frequently witnessing violent crimes  (Burke, pg. 335).

How is PTSD Diagnosed?

1. An individual must have experienced or been in close proximity to someone who experienced a violent, or traumatic event that is usually life threatening in nature.

2. The symptoms must last longer than 1 month.

3. They must have the specified number of symtpoms from each of the four symtom categories of PTSD.

4. The symptoms create dysfunction or impairment in a persons life.

The four categories of PTSD Syptoms

1. Re-experiencing the traumatic event through flashbacks, unwanted memories or intrusive thoughts, nightmares.

2. Avoidance of stimuli related to the traumatic event which can be avoiding people, places and things that remind a person of the traumatic event.

3. Changes in cognition and mood. This category includes sudden depression, brain fog, distorted sense of self, and memory trouble.

4. Changes in arousal and reactivity including iritability, reckless behavior, difficulty concentrating, heightened startle response.

How PTSD Symptoms Affect College Performance

The symptoms of PTSD can be very disruptive to a person’s life, especially anxiety and avoidance. Many sufferers have difficulty focusing and “brain fog” that causes difficulties recalling and retaining memories. The brain structure of the hippocampus, which is in charge of forming memories and evaluating danger or no danger, is sometimes hyper (over) and sometimes hypo (under) active (Burke, pg. 338).

                Difficulty focusing can be due to flashbacks, anxiety, and depression. In response to triggers, the stress hormones cortisol, adrenaline, and norepinephrine are released. These hormones cause increased heart rate, sweating, slower digestion, decreased urination, increased blood pressure, and other symptoms. In a person without PTSD, the body would quickly return to normal, and these physical responses would be short-lived and not damaging. However, for individuals with PTSD who frequently experience anxiety attacks, flashbacks, and hypervigilance, the physiological response can cause damage over time (Lovering, 2022). Because of the long term strain on the body, it is not uncommon for those with PTSD to also suffer from high cholesterol, heart disease, or cardiovascular disease, as was found in this study from 2011. I went into more detail about the relationship between PTSD and disease in this article. Other conditions common with PTSD over the course of someone’s life are substance abuse, gastrointestinal disorders (like GERD), unexplained aches and pains, sleep disorders, and more (Tanasugarn, 2020).

                In the short term, the physiological responses leave a person tired and unable to focus, or in a heightened state, unable to calm down.  As these are not things we can plan for, they often interfere with school obligations, such as a major test, projects, and even going to class. The depression and agitation associated with the disorder also lead to issues with interpersonal relationships, and feelings of guilt and shame native to the disorder, leading to self-isolation, increasing the individual’s tendency to isolate (which is an avoidant symptom), which means not going to class (Campbell, 2019). Difficulty sleeping and nightmares can also interfere greatly with maintaining daily obligations.

How to cope with PTSD in college

There is no magic pill for any disorder that can make symptoms completely disappear, and we find that the world we live in is often not made to suit those who operate differently than the majority of people, however there are a lot of ways to manage PTSD symptoms and do well in college. Most of the techniques I’m going to present for managing PTSD in college may also work well for managing symptoms overall. Everything below is a suggestion, even if there is a lot of evidence showing the efficacy of some techniques, because different things work for everyone.

Mindfulness Meditation

                A prime example of something that works for some people, but not all, is mindfulness meditation. In my travels on social media, I have seen many people with PTSD who say that mindfulness meditation doesn’t work for their symptoms, and being required to be still allows intrusive thoughts, ruminating, and flashbacks to have free rein in their heads. I have not found any relief from meditation on its own either, but trauma-informed mindfulness might help some (Lawrenz, 2022).

Organization

                The first thing that will help with conquering college and PTSD is to get organized and start using a planner, digital or old-fashioned (I like the old-fashioned pen and paper). Anxiety is a major symptom of PTSD, and writing things down so that you don’t have due dates and project ideas floating around in your head to be ruminated on is effective. Planning out your assignments can also help you to make sure that you don’t plan to do too many things in one day, and then freak out when you realize you have no concept of how long things take (I’m speaking from experience). I use a productivity planner that incorporates mindfulness, inspiring quotes, and has a lot of good planning features (and came with stickers) because I like the extra push that it gives me to keep moving forward.

                On the subject of planning things out, I have begun to use a program called Goblin Tools, which was brought to my attention by my college’s Disability Department. A great resource to work with when you have a disability of any kind is the disability department of your school. You can also work with your mental health provider and the Disability Department regarding any accommodation you might need (within reason, of course) to succeed.

Take care of your body

                We have to put ourselves first and use the coping skills that we know work for managing all types of mental illness. Go to the doctors for a regular check-up to make sure that you don’t have a deficiency or a condition that may be driving symptoms. We know that regular exercise of some kind lessens anxiety and depression, and this is good for everyone, but we need to be especially mindful of our bodies on our road to recovery. I said earlier that meditation itself does not help me; I like to do yoga, which incorporates meditation, but only while focusing on the breath and movements, so my mind does not wander to dark places. I do cardio as well, but not as frequently as yoga. Joining a gym can also give a person a reason to leave the house and interact with people, and that exposure and social interaction helps our mental health too.

The benefits of an anti-inflammatory diet for PTSD

                Follow a healthy, anti-inflammatory diet, which does not have to be entirely clean, but keep in mind at least how many cookies you’ve eaten and how much junk food you’re consuming in a week. In an attempt to cope with the symptoms of PTSD, it is common to turn to food or other addictions, but consuming these things can actually make the symptoms worse and increase the risk factors of suffering from diseases associated with PTSD, such as heart disease (Bernstein, 2023). It might be wise to stay away from alcohol, and quitting smoking will improve depression and anxiety in the long run because some of that depression and anxiety are the effects of nicotine withdrawal due to nicotine dependence (Washington, 2022).

Medication is not a cure for PTSD

                Though there are FDA-approved medications for PTSD, only two SSRIs (Sertraline, paroxetine), it is not uncommon for people with PTSD to not respond well to any psychoactive medications. Medications are only tools used to help manage symptoms, while other treatments are utilized, so this is not necessarily some great loss. If an individual wants to try medication, it is up to them to talk to their doctor, do their research, and decide if they want to give it a go (Burke, pg. 343).

Be kind to yourself

                My last piece of advice on managing symptoms of PTSD in college is to be kind to yourself, and not to berate yourself when you can’t focus on getting a project done, or you are just having a bad week. Having PTSD is sometimes like starting the day off at half abattery life, and sometimes things have to be pushed off to the next day or penciled in somewhere else in your schedule. What matters is not how many small breaks you take, or even if you miss a few small assignments, but overall, it matters that you get the work done well. Communicating with your professors when you’re having trouble can also help, and you never know until you try.

In conclusion

PTSD is a complicated mental disorder that has a lot of symptoms that work against people trying to live a productive life. With proper coping skills, organization, and social support, those who suffer from it can finish college or other higher learning and go on to reach their dreams. It also means not being able to go to late-night parties, drink, or possibly completing assignments as fast as your peers, but it can also mean fewer hangovers and better grades than your peers. Coping with PTSD is not a super-secret lifestyle management technique, but it employs a lot of healthy living habits that are good for everyone.  

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The Diary Of A Flopping Fish and any posts or articles published on Diaryofafloppingfish.com are not reviewed by a therapist or medical or mental health professional. Resources are cited, and opinion is opinion. No advice or opinions in any articles replace professional advice from a doctor, therapist, or any other kind of health professional. The author is not a licensed professional of any kind.