Managing meltdowns in trauma disorders

In the context of trauma disorders, a “meltdown” typically points to an experience of intense overwhelm. For people living with post-traumatic stress disorder (PTSD) or complex post-traumatic stress disorder (C-PTSD), meltdowns can be triggered by an emotional flashback. Suddenly, whether due to an internal or external trigger, the person re-experiences the upsetting emotions they had when the trauma occurred. In response, they may have trouble regulating their thoughts, feelings, and behavior. 

While meltdowns can occur with many other conditions (like autism spectrum disorder), irritability and outbursts are two official symptoms of PTSD. This suggests that meltdowns are a common occurrence among people with trauma disorders.

Fortunately, whether you’re experiencing PTSD meltdowns or C-PTSD meltdowns, you can learn to prevent them with the right support. With help from a trauma-informed therapist, you can gain insight into your triggers, spot an oncoming meltdown before it takes hold, and manage these intense feelings in healthy ways.

What a meltdown feels like with PTSD

Having a meltdown doesn’t automatically mean a person has a mental health condition. Much like a toddler might have a tantrum when they become overwhelmed, most of us have moments when stress, irritability, or anger cause us to lose control or “snap.” But when it comes to PTSD and C-PTSD, meltdowns can take on a different meaning. 

While the term isn’t a clinical symptom or diagnosis, meltdowns for people with trauma disorders can be more severe. This is because, for them, meltdowns are tied to symptoms of trauma that can be difficult to manage. Here are a few examples of what that might look like in real life:

• During a Fourth of July fireworks display, a veteran begins to panic. The loud noises and explosions take her back to the terror she witnessed during her last deployment, and her fear overwhelms her. Desperate to escape the noise, she starts racing toward the nearest exit. As she darts into her parked car, she begins feeling ashamed and embarrassed about her behavior. The terrifying flashback, combined with feelings of shame, causes her to spiral further. Shaking and crying, she asks herself, “What is wrong with me?” and, “Why am I like this?”
• After enduring years of psychological abuse from his mother, a man finds himself struggling to maintain relationships. He’s easily annoyed by his partners and quick to anger at minor inconveniences. Whenever he’s criticized, the man feels, internally, like he’s a 13-year-old boy again, being scolded by his domineering mother. His reactions are harsh and volatile, and he often feels guilty after an outburst. The man knows his anger is getting in the way of his happiness, but he doesn’t know how to break the cycle.
• A woman who survived a home break-in has had trouble feeling safe in the world ever since. Her memories of that night are spotty, but she distinctly remembers that the perpetrator was wearing a strong cologne. During a recent trip to the grocery store, someone passed her in the aisle, and instantly, she recognized the smell. The woman freezes in fear, abandons her cart, and heads straight home. In her mind, she knows that the person who committed the break-in is behind bars. But her body reacted to the familiar smell as if she were in danger of being harmed again.

As you reflect on these examples, keep in mind that while PTSD and C-PTSD can both cause meltdowns, they’re not the same condition. Experts aren’t in full agreement about whether C-PTSD should exist as a separate diagnosis from PTSD. However, C-PTSD is recognized by many providers as a distinct response to repeated trauma (like ongoing abuse or neglect). 

If you’re experiencing frequent or debilitating meltdowns, you don’t need to know whether they’re due to PTSD or C-PTSD to ask for help. A trauma-informed therapist can provide an accurate diagnosis to ensure that you get the right help for your needs.

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Things that can trigger a meltdown after trauma

For people with PTSD or C-PTSD, meltdowns can occur when they’re unable to manage the emotional distress brought on by a trigger. It would be impossible to list all of the potential meltdown triggers for people with trauma disorders. But a few of the most common include:

• Nightmares of the traumatic event(s)
• Perceived threats or safety concerns
• Sensory reminders of the trauma(s)
• Shouting or loud noises
• Returning to a setting similar to where the trauma(s) occurred
• Forecasts for major weather events or natural disasters
• Overwhelming stress due to major life changes
• Feeling rejected or criticized
• Anniversaries or other significant dates related to the traumatic event(s)

Overcoming meltdowns in C-PTSD and PTSD

If you have experienced trauma and are struggling with meltdowns, know that you’re not alone and help is available. Trauma therapies  — like exposure therapy, emotional freedom technique (EFT), and eye movement desensitization and reprocessing (EMDR) — can help you identify and respond to triggers in healthy ways. While processing trauma can bring up some uncomfortable emotions (like anger), eventually, it can help you learn to better manage your thoughts, feelings, and behaviors. 

In the meantime, here are some tips to help you manage meltdowns:

• When you feel it coming on: Just like a yellow traffic light gives you the alert to slow down when you’re driving, it’s important to watch for signals in your mind and body that a meltdown is coming. These can vary from person to person. But if you start to shake, sweat, or feel nauseated, it could be a sign that you need to change your environment, practice a stress-reducing technique like breathwork, or ask for help from someone you trust. 
• During a meltdown: If a meltdown has already begun and you’re in a safe environment, try to focus on your five senses. Concentrating on what you can see, smell, taste, touch, and hear can help you stay grounded. You can also use positive self-talk and say something to yourself like, “I’m here in [location], and I’m having a meltdown. It won’t last forever, and I’ll be OK.” 
• After a meltdown: Meltdowns can be physically and emotionally exhausting. So, afterwards, you may need some extra time for self-care. This could be journaling, exercising, calling a friend, or taking a long nap. Just do whatever feels soothing and nurturing to you. 
• To prevent future meltdowns: After the meltdown has passed and you’ve had some time to process it, see if you can identify the trigger. Also, take note of anything that helped you work through it. These insights can help you prevent and manage future meltdowns.

Find care with Rula

From the outside, meltdowns can look like an outsized response to the situation at hand. But for people with trauma disorders like PTSD or C-PTSD, meltdowns are an intense emotional reaction to a trigger they don’t have the capacity to manage. Left untreated, meltdowns can negatively impact a person’s mental health, relationships, and quality of life. But fortunately, with help from a therapist, people with trauma disorders can process their experiences, identify their triggers, and stay grounded in times of stress.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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