Understanding how stress from positive change adds to our stress load improves our self-care and helps us stay on the path to posttraumatic stress disorder (PTSD) recovery. While the word "stress" applies to life-altering situations like traumatic or stressful events as often as it pertains to a long to-do list, it is not typically associated with times when things are good. However, positive change and stress do exist together and it helps people with PTSD to recognize them when they occur.

We can't get away from having toxic people in our life sometimes. In a perfect world, we would never encounter someone unhealthy for us. The people with whom we hold company would all be healthy influences. Unfortunately, as those of us with posttraumatic stress disorder (PTSD) likely already know, we do not live in a perfect world. Although we can choose our friends, and we can migrate toward or away from certain co-workers, acquaintances, and even family members, we cannot always prevent having some toxic people in our life.

Sleep deprivation is a common complaint among people who experience posttraumatic stress disorder (PTSD). Research shows that at least 50% of individuals with PTSD have experienced recurring nightmares, and the majority of people with PTSD report either difficulty falling asleep (sleep onset insomnia), or trouble staying asleep long enough to feel rested (maintenance insomnia). Even though sleep difficulties often accompany PTSD, their importance might be underrepresented. Knowing how to recognize the symptoms of sleep deprivation and how to manage them are useful tools in treating the symptoms of PTSD.

There are several approaches to healing from posttraumatic stress disorder (PTSD), and they may include finding comfort and support from faith communities. Yet, some doctrines do not foster self-care and recovery. If you have a faith community or consider yourself a member of an organized religion, you may develop beliefs that can stand in the way of your healing from PTSD. Here are some observations on faith systems and their impact on PTSD recovery.

Seasonal holidays involve many inherent rituals, but have you considered creating your own personal rituals to protect you from holiday stress and anxiety? I had the opportunity to discuss rituals--both helpful and harmful ones--with psychologist Stanton Peele while researching an article about addiction for Vice.1 He describes the ways in which some rituals actually protect people from developing addictions--such as Jewish customs of drinking wine only during certain occasions. He finds that Jews who associate wine in that religious context often find it odd to think of alcohol as a "party drug." This conversation made me think of the routine rituals we encounter during the holidays. Can trauma survivors intentionally create personal rituals as a means of coping with some of the extra stress associated with holidays?

Setting goals for posttraumatic stress disorder (PTSD) recovery can be difficult, in part because PTSD impacts every aspect of daily living, every day. When seeking help for recovery, it is understandable to want to feel better as quickly as possible in order to put the worst behind you and move on. Sometimes it can be difficult to notice what progress is being made when you are still experiencing the symptoms of PTSD daily. This is where understanding your PTSD diagnosis as well as any coexisting conditions and setting goals for PTSD recovery can help you feel successful.

To avoid the stigma around posttraumatic stress disorder (PTSD), many people keep their PTSD symptoms secret. How others perceive people with PTSD creates the stigma. Yet, there is another form of derision at play here --that of self-stigma. Identifying, understanding and correcting self-stigma can significantly impact us and the stigma around PTSD as well.

In the course of my recovery, there came a time when I wanted my abusers to suffer. Most people who have been, or are being abused, don't seek help. Statistics on abuse show that as many as 60 percent of perpetrators are never prosecuted. In my case, my abusers were never called to account for their actions. When I began to talk about my abuse and work through all that had occurred, I came to a point where I was angry and resentful. My nightmares of abuse shifted to ugly visions of ways in which I could cause as much suffering to them as possible without killing them. I had to work to reconcile these intense emotions where I wanted to make my abusers suffer to continue healing.

Do you appreciate your successes, or does pausing to appreciate success scare you? Even though success is a very normal aspiration, feeling happy about a success (or feeling happy for any reason) can be scary for trauma survivors. The definition of success varies greatly between individuals and can even change during different stages of the same person's life. However, for those of us living with posttraumatic stress disorder (PTSD), the experience of success is sometimes a little extra complicated, even scary. I'm slowly learning to appreciate success in my life with PTSD.

Finding the right level of self-care for posttraumatic stress disorder (PTSD) shouldn't be that hard considering that self-care is a concept I read or hear about daily. The Internet is replete with self-care checklists and ideas for busy parents, overloaded students, and almost every mental health condition ever diagnosed. However, balancing my level of self-care with PTSD becomes lopsided because self-care frequently presents as an activity or item that is considered to be a treat. Manicures, chocolates, long baths, and time to read are common self-care suggestions. Personally, I find self-care to be more complicated, as it is not always about taking it easy on myself. Here is why I balance my indulgence level of self-care with PTSD against challenges.