Ask A Therapist: Can PTSD and Social Anxiety Randomly Return?

Q: Can PTSD and social anxiety relapse randomly for no particular reason? I had therapy for months last year, and I was normal for months after. Now I can barely function and do basic things at work like speak up in meetings. I’m seriously considering handing in my notice, as I feel like I’m failing at my job so they’ll fire me anyway.

Dear Ayah,

To answer your question, YES — PTSD and anxiety symptoms can pop back up months,  even years later. It’s typical for them to resurface without any clear reason, which can feel really frustrating and confusing. But here’s the thing, 2020 is far from a typical year, and there has been a LOT to be anxious over these days. Even if you are not directly impacted by the physical effects of COVID-19, social and racial unrest, or the ongoing election stress, you cannot avoid all of the news and social media coverage which can have a devastating impact.

Being constantly exposed to so much news of trauma can create something called vicarious trauma and can be incredibly harmful to our mental health.  Research is finding that the bombardment of traumatic materials in the media can lead observers to  anxiety, difficulties in coping, feelings of fear and helplessness, and in rare cases PTSD. Because of your history you’re more vulnerable to the effects of news and media in your environment.

What you’re experiencing is a relapse of your symptoms. I highly recommend jumping back into therapy with your therapist! In all of the years that I have been providing trauma therapy, my clients often come back months or even  years later for a few “maintenance” sessions. This is completely normal, and in some trauma protocols like Cognitive Processing Therapy it’s strongly recommended as a standard part of the process. Therapists plan for these recurrences of symptoms.

Of course this must feel extremely distressing. Does it make sense though, that despite the overwhelm and frustration, that this isn’t the best time to quit your job? Avoidance is a really common symptom of PTSD (and anxiety), but avoidance of the things that scare us does little to calm our fears. This is a decision that can create a lot more stress as opposed to relieving it. We lose perspective when our mental health is compromised. You’re in pain, Ayah. You’re not working up to your capacity because your mental health needs care, not because you’re incapable.

Reach out to your manager and communicate what’s going on.  My guess is that this isn’t going to come as a surprise. Most employers will follow a planned protocol. If they didn’t have one before 2020, they probably do now.

I applaud the courage it took to engage in therapy last year. Therapy is vulnerable and requires  dedication — especially when dealing with trauma. It’s not a singular event though, and your ongoing dedication to your mental wellbeing will require tune-ups throughout your life. You have the advantage this time around. You already have some tools and a blueprint for what your mental health feels like. You have control over how you manage this and an already established lifeline to grab onto. Reach for it. I can’t say it enough — this is a normal part of the process. You will feel better again. And when you do, reach out and let us know. You’re not alone Ayah.

-Ashley

 

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