Sadness in PTSD - What You Can Do About It

April 10, 2014 Tom Cloyd, MS, MA

Posttraumatic-stress disorder (PTSD) involves a lot of sadness: about your having been victimized, about having developed a persistent mental disorder (and that's exactly what it is), about how few people understand what happened to you, about how few people understand how your life has been changed as a result, and about how difficult it is to get it all resolved - fixed - taken care of. And that's hardly a complete list. What do these all have in common? Loss. Sadness is a reaction we have automatically and outside any direct control when we realize we've lost something that matters.

What can you do about it? Two things, basically. You can shift your attention or you can deal with the problem directly. The first option is almost always the easiest, but you should know that it's temporary at best.

Shifting your Attention Away from PTSD Sadness

Sadness is part of PTSD. You can try to distract from it or deal with the PTSD sadness directly. Only one of these things will work in the long run.

In one of my recent posts, is pointed out that anger is never a choice, but that it is an involuntary response to fear. Sadness is exactly the same, as it is an involuntary response to loss. (It's actually part of a continuum of responses we have to loss, beginning with mild annoyance and rising all the way to anguish.)

If this is true, then one way to deal with sadness is simply to "change the channel" - to pay attention to something that does not make you sad. This can be quite easy.

The simplest way to do this may be to eat or drink something you like, and indeed many people do this when dealing with the sadness they encounter in depression (also a frequent part of having PTSD). Regrettably, this response can easily have undesirable side effects. It's surely better to learn to shift to something that quite literally grabs your attention or interest.

Here are some alternatives, one of which is a bit absurd, but all would probably deal with the problem well:

  1. Throw yourself overboard, while floating down a white-water river! Presto - no more sadness. Panic instead! Obviously, this may not be an ideal choice, but it certainly would deal with the problem, for the simple reason that your attention would be strongly shifted to something that doesn't make you sad.
  2. Take a brisk walk - as if you're late to get somewhere. This is non-fattening, costs nothing, can be done with a kid or dog, and will get you to breath some fresh air. The sun (we hope) in your face is a definite bonus. When you return home, you can feel good for having done something healthy.
  3. Tackle some housecleaning you've been putting off. For most of us, this is not especially mentally challenging, does require physical activity, and the result will usually please you. Those good feelings are a perfect outcome.
  4. Dive into some seriously absorbing subject you've been setting aside for a rainy day. This has to be something you know you have a deep interest in and is not passive. Read - or watch a training video - about something you truly want or need to learn. Take notes, make plans. The more mentally active you are, the better. "Interest" is a powerful, positive emotion.
  5. Find someone who truly needs your help, and help them. (This suggestion is found in a parable from India, about a meditation student who was feeling discouraged with their own efforts.)

For some people - women especially - what may be the most effective way to shift your attention is to find someone you can talk with. Seek out someone you can trust, and who is accepting of whatever you feeling, be it good or bad. If you haven't cultivated such a person, make a note to prioritize this when you get your energy back. It's important!

When that Doesn't Work, Address the Sadness by Addressing the PTSD

As I promised, this is the more difficult option, simply because some real and permanent changes will be required.

Let's take an example. Let's say you've had a canine companion for many years, and you were both in a car accident. Your dog passed away from his injuries, and you now have flashbacks when you ride or try to drive a car. You have a lot of losses to deal with, and consequently a lot of sadness.

Some of the time, when sadness strikes you, it may be possible to shift your attention and temporarily bring your sadness to an end. If so, then it's a quickly applied response, and you should use it. However, all it deals with are your feelings of the moment.

What do you do if your attempts to shift your attention just don't help the sadness in PTSD? First, be sure you're making a full-scale attempt to sift your attention. Half measures often won't do with the feelings of sadness that PTSD provokes. If it seems clear that your brain wants to pay attention to your pain, then that's what you have to do.

In reality, if you have PTSD, you should make a very major effort to get qualified professional help, because we now know how to deal quite effectively with most PTSD, and that will also take care of the sadness. If you haven't yet realized that this is what's needed, your persistent, won't-be-deflected sadness is telling your something. Can you hear it?

Addressing permanently the problem of PTSD-related sadness really does requires that you resolve your PTSD. Doing this won't negate your losses, certainly, but it appears to bring about a change both in one's emotional dynamics and in how we think about our situation. That result has an extremely good chance of resolving your sadness and a number of other PTSD-related feelings you really don't want in your life. Sound good? It is. Don't you deserve this?

Connect with Tom Cloyd also at Google+, LinkedIn, Facebook, Twitter, his Sleight of Mind blog, his Trauma Psych blog, or his professional website.

Image credit: Rodolfo Amoedo, via Wikimedia Commons - public domain

APA Reference
Cloyd, T. (2014, April 10). Sadness in PTSD - What You Can Do About It, HealthyPlace. Retrieved on 2024, July 25 from

Author: Tom Cloyd, MS, MA

August, 9 2017 at 5:46 pm

Me too. I'm 28 and I have ptsd clinical depression anxiety and now to back and forth with psychotic episodes. I've came a long way but I'm on alot of medication. I had suicide attempts. But I changed my whole life after my last one failed. But I see myself slipping back into the same thing again. My drinking. I hate to be sober. I can not handle my mind sober. Or everyday things. Things with my family. Out of the house. I was so bad I could not leave the house but now I'm better and force myself but it's getting bad again. I don't have much support and my marriage is not the best often abusive. I'm working on getting myself back up and self sufficient. I think because I've came so far now he is realizing he can not do me that way or i will leave but it's putting me in a bad spot in my mind. Idk how to feel any more. Mostly because I was never allowed to feel or have any emotions. It caused more drama And I was blamed. I had some thearapy but wasnt able to finish it due to my husband and lack of support. Idk what to do. Idk who to tell. My dr. Just told me he's switching me to someone else and moving away. I don't want to have to talk to someone new all over again. I feel really sad and depressed and so tierd all the time but I push myself so hard with 3 kids and no help. But I feel as a but at the same time nothing at all any more. I need help. Idk what to do. Someone help me.

In reply to by Anonymous (not verified)

August, 16 2017 at 3:36 pm

Bethany, I know it is difficult and painful. For your health and for your kids find another counselor or provider to speak with. You might find it easier to tell your story a second time. You might consider someone who can help with your mental health and drinking at the same time. My best to you on your healing journey.

April, 22 2014 at 8:05 am

I have been told as a young adult, I suffered from PTSD. I have also been told I suffer from depression and anxiety. When I have used anti depressants, it has frequently turned very nasty with large bouts of drinking and suicide attempts or a complete numb zombie like state. I really don't remember ever not feeling this way... I know Im not 'normal'. I really have no idea what to do. I am 38 and still can't quite get on with life.

April, 16 2014 at 11:24 am

But HOW should a therapist help deal with PTSD? I've already got BP II and Anxiety Disorder. How can they address PTSD alone and help work on that alone? How do you "fix" it? What kind of therapy?

In reply to by Anonymous (not verified)

April, 18 2014 at 8:52 am

Frankie - PTSD is caused by memories of bad things that have happened to you which have failed to be fully processed by your brain. The result is that they still can produce serious negative feelings when triggered. Research and years of clinical experience have shown that deliberately triggering the memory in a safe and supportive context will result, almost always, in the permanent quieting of the memory. At that point it cannot be triggered again.
There are two well-researched and fully validated treatment models for PTSD which use this trustworthy method: EMDR (Eye Movement Desensitization and Reprocessing) and PE (Prolonged Exposure). You can read an article I wrote which details just how highly they are valued by reputable authorities.
Bipolar disorder is considered to be an organic brain disorder, and is treated with medication and psychotherapy to teach you adaptive skills. For PTSD, however, there is no medication other than antidepressants to help you with secondary symptoms. The "fix" is to deal with the primary cause: trauma memories which have not been fully processed, as normally happens when something bad happens to us.
So, I suggest you find a therapist who can treat you using either of those two models. If you do, your prospects for recovery are actually good.
I wish you all the best in your healing journey!

Jennifer Todd
April, 16 2014 at 10:53 am

i don't seem to be able to recover. i've been in therapy for 30 years on and off. i've been retraumized i think, (not by therapy) but by unfortunate incidences. i'm on medication too. i'm chronically anxious and sad. i have dissociative identity disorder too. thanks for listening.

In reply to by Anonymous (not verified)

April, 18 2014 at 9:01 am

You are dealing with some very real challenges. Dissociative Identity Disorder is one of my two specialties. I can tell you that while fairly good success can be achieved in treating it, it takes quite a while (a rough estimate is five years or more) and a skilled, experienced therapist. An ordinary therapist will not do. They must be trained and/or well experienced in treating dissociative disorders. This is important.
Medication can be helpful, and what I'm referring to is antidepressants for management of depression. We don't really have good long term medication for anxiety, and what we do have tends to interfere with therapy anyway, so it should only be used from time to time when you really need it.
Beyond that, it is important to work, as we all must, at both good self-care (the basics: sleep, decent food, exercise, and good social experiences), and at constructing a life that engages us and offers us real interest and productivity.
I know you are struggling, and I feel real concern for you. Stay focused on what you know is good for you, minimize or eliminate what is not, and know that over time things DO tend to get better.
I wish you all the best in your efforts!

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