Those who develop posttraumatic stress disorder as a result of experiencing trauma often suffer from nightmares, flashbacks, anxiety, hypervigilance, and/or depressed mood. They may also go through periods of heightened irritability, hostility, and self-destructive behavior. But the question is when? Jessica Tappana, a licensed clinical social worker who specializes in treating PTSD, says it can vary as the illness often takes an unpredictable course.

An Unpredictable Course

Tappana says the greatest honor of her career is helping her clients work toward healing from PTSD. “Memories of and hope for new clients whose fear and PTSD was so significant that they could barely function in their day-to-day life who find healing, meaning, and freedom from their PTSD symptoms is exactly what brings me to work each and every day,” Tappana explains. This passion as well as her experience allows her to delve into the course and development of PTSD below:

“When someone experiences something traumatic, it’s expected that they will show signs of PTSD initially. You may feel like you’re looking over your shoulder, worry about going out at night, or double check the locks on the door for a few weeks. PTSD is what develops when a person gets stuck and those symptoms develop or continue down the road. We usually say PTSD is present when the symptoms are interfering with a person’s life for more than three months after the stressful event.

PTSD can get either better or worse over time. What I see with clients in my own practice is that for a while, they are able to ignore thoughts, feelings, and reminders of the trauma so they say they’re coping really well. The trauma doesn’t impact their life on a day to day basis and life moves on. However, at some point it becomes nearly impossible to keep stuffing down the feelings associated with the experience. Maybe something happens in your personal life that reminds you of what you went through or you are just feeling really stressed. Whatever the reason, your PTSD symptoms start to get worse. On the other hand, some people notice that their PTSD symptoms gradually start to go away over time without any significant intervention. You slowly start to rejoin areas of your life, focus on self-care, and notice that your anxiety and fear about the situation start to dissipate.

For many people, some sort of PTSD specific treatment is needed for PTSD to go away. The good news is that PTSD treatments work! We have a variety of evidence-based PTSD treatments that we know help people get better. These treatments include EMDR, Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and Trauma-Focused Cognitive Behavior Therapy (TF-CBT). It’s common to tell yourself that your symptoms will get better later or that you aren’t ready to face the trauma you experienced. Unfortunately, however, the only way over the fear you’re experiencing is to face it and a skilled trauma therapist can help you do so.”

Learning to Cope With PTSD: 5 Techniques

1) Deep-breathing. To prevent anxiety from continuing or progressing, take some deep breaths. Start by breathing in through your nose and then letting out a big sigh through the mouth. Do it again, but this time count to three before you let that breath back out. You can repeat again and again, increasing the length of time with each repetition, until a calmness comes over.

2) Progressive Muscle Relaxation. This is another great strategy for combatting unwanted stress and anxiety, and its technique is simple: you tense and relax different muscles in the body to bring greater attention to a feeling of relaxation. You can start by finding a quiet place and squeezing the muscles in your right hand. Squeeze, release, squeeze, release. Exhale as you release the tension and focus on the relief you feel.

3) Mindful meditation. Reduce negative feelings and tune into the present moment—which is often difficult for those with PTSD—by practicing mindful meditation. All this technique requires is that you shift your focus to right now: Where are you? Who are you with? What are you doing? How are you feeling? If your mind wanders to the past or future, gently guide it back to the present.

4) Hobbies. This one’s simple: get back to doing what you love to do. If you like to cook, make a new dish. If you like to work out, go to the gym or outside for a run. If you like to paint, get busy on your next masterpiece. Making time for engaging in our favorite hobbies can do us more good than most of us realize!

5) Socializing. And finally, spend time with your loved ones. Dedicating at least a little bit of time each day to catch up with an old friend, chat with your parents, or even just hang out with a few people from work can go a long way, as socializing has proven to boost feelings of wellbeing and decrease feelings of depression—two benefits that’ll certainly help one battle the harmful effects of PTSD.