How to Anticipate and Manage PTSD Intrusive Thoughts

Symptoms of posttraumatic stress disorder (PTSD) often arise unexpectedly. If you have PTSD, you've probably identified a number of behaviors, situations, and occurrences that tend to trigger your symptoms. You watch out for them and keep your distance from them if you can. But there's always the risk that you'll find yourself in a new or changed PTSD trigger situation that puts you at risk for symptoms.

How can you know when you're at risk for the onset of PTSD symptoms? You don't have a crystal ball, but you can look ahead in constructive ways to anticipate PTSD triggers and symptoms. The idea is to get out in front of them and take appropriate action to avoid them or lessen their impact.

As always, knowledge is power. The information presented below will help prepare you to anticipate PTSD trigger situations and reduce your risk that symptoms could get in your way.

Managing Intrusive and Unpleasant Thoughts

Woman looking into the distance

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Unwelcome and distressing thoughts and memories, a common occurrence for people with PTSD, can arise suddenly. They're especially upsetting if they're connected to a traumatic event.

PTSD intrusive thoughts can trigger other PTSD symptoms, such as intense arousal, that may make the situation even worse.

Discover ways to manage the flow of PTSD intrusive thoughts, such as by using self-monitoring techniques and correcting errors in thinking, in this informative article.

Identifying PTSD Symptom Triggers

"Then it happened! Out of the blue!" People with PTSD often feel as though their symptoms occur spontaneously. But that's not necessarily the case. You may think your PTSD symptoms happen this way because you aren't completely aware of all the triggers around you.

It's important that you learn to increase your awareness of PTSD triggers and "manage" them – and your symptoms – ahead of time?

Dealing With the Onset of Flashbacks

Flashbacks are major PTSD intrusive thoughts and a common PTSD symptom. They're considered one of the re-experiencing symptoms of PTSD.

If you've ever had a flashback, you know it can feel as though your traumatic event is happening all over again. Thinking that you were facing the original threat, you may have reacted suddenly and aggressively, trying to escape or protect yourself. You may even have injured yourself or others before the flashback ended. Like others with PTSD, you may be looking for ways to reduce your risk of flashbacks. Learning more about your flashback triggers may help you prevent some of them.

If you or a loved one are struggling with PTSD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Coping With a Sense of Foreshortened Future

Have you heard the expression, "a feeling of impending doom"? That's what a sense of foreshortened future is for people with PTSD: feeling, for no identifiable reason, that your life will somehow be cut short or you won't ever reach important life milestones, such as marriage or a career goal.

If you've been having a sense of foreshortened future, you may have begun to feel hopeless and helpless, which can increase your risk of depression.

Feeling this way is currently considered an avoidance symptom of PTSD. Fortunately, there are strategies you can use to help minimize these avoidance behaviors.

Reducing Avoidance Behavior

If you have PTSD, you may often avoid certain situations or activities because of fear that they'll trigger unpleasant or uncomfortable PTSD symptoms. Unfortunately, avoiding trigger situations can increase your isolation and put you at risk for depression. It can even increase your avoidance behavior. How? By further reinforcing the idea that you need to avoid those PTSD symptoms.

To help reduce avoidance behavior and increase your contact with positive events and activities, consider trying a technique called behavioral activation.

Getting Help for Sleep Problems

Sleep problems are common among people with PTSD. They're considered a PTSD hyperarousal symptom--meaning that they stem from a high level of anxiety.

If you have PTSD and problems sleeping, it's important to find ways to improve your sleep. Sleep problems can make your other PTSD symptoms worse. In addition, poor sleep can negatively impact your effectiveness at work or school.

Managing Memory Problems

People with PTSD experience intense anxiety and arousal that can interfere with memory and concentration. This can lead to problems at work and at school. Fortunately, there are skills you can use to improve your memory and concentration.

Controlling PTSD Symptoms at Work

Work can be particularly stressful for people with PTSD. If you have PTSD and spend your days at a job, you may have found that your work environment has the potential to trigger your PTSD symptoms.

Discover coping strategies you can use to keep your PTSD symptoms under control while you're at work.

4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Post-traumatic stress disorder.

  2. Bisson JI, Cosgrove S, Lewis C, Robert NP. Post-traumatic stress disorderBMJ. 2015;351:h6161. Published 2015 Nov 26. doi:10.1136/bmj.h6161

  3. Etherton JL, Farley R. Behavioral activation for PTSD: A meta-analysis. Psychol Trauma. 2020; doi:10.1037/tra0000566

  4. Pace-Schott EF, Germain A, Milad MR. Sleep and REM sleep disturbance in the pathophysiology of PTSD: the role of extinction memoryBiol Mood Anxiety Disord. 2015;5:3. doi:10.1186/s13587-015-0018-9

By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.