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Post-Traumatic Stress Disorder
How to Get Help for PTSD if You’re an Immigrant or Refugee
Adjusting to a new country and struggling with trauma symptoms?
Posted December 19, 2022 Reviewed by Lybi Ma
Key points
- Immigrating to a new country can be traumatic and even increase the risk for PTSD.
- PTSD comes with recognizable symptoms, including flashbacks, a tendency to avoid reminders of the trauma, hyper-arousal, and memory issues.
- Treatment might involve re-imagining the traumatic event; this may help you master the trauma.
Co-authored by Adrelys Mateo Santana, Emily Satinsky, Yael Waizman, and Darby Saxbe.
Over 47 million immigrants currently reside in the U.S. In fact, in 2021 alone, U.S. border patrol encountered 1.6 million migrants along the U.S.–Mexico border. Escaping poverty and violence in their home countries, these migrants traveled by land from Mexico and Central America to the U.S. Along the way, many experienced trauma, like family separation, bureaucratic nightmares, accidents and injuries, and sexual violence.
Traumatic events from before and during the journey to the U.S. may be exacerbated by new stressors, including experiences of racism and discrimination (see this blog post for more information about racial trauma). This means that millions of people currently living in the U.S. are at high risk for post-traumatic stress disorder (PTSD), a mental health disorder triggered by experiencing or witnessing traumatic events (those that are life-threatening or which involve death, severe injury, sexual assault, or abuse). Not everyone who experiences trauma will go on to have PTSD, but it has some characteristic symptoms.
What are the symptoms of PTSD?
People with PTSD may find themselves frequently reliving the traumatic event, as though the trauma is happening to them again and again. This can translate into intense, vivid flashbacks or nightmares, often accompanied by elevated heart rate, sweating, rapid breathing, stomachaches, and headaches. They may also feel agitated, depressed, or as though they have no control over their thoughts, feelings, and actions.
Given how distressing it is to relive the trauma, people with PTSD tend to avoid reminders of the event. This can lead some people to feel numb or detached. Maybe they no longer enjoy activities they used to or develop negative thoughts about themselves, others, the future, or life in general. (“No one can be trusted,” “The world is dangerous.") These feelings and thoughts can become so intense that some people may even blame themselves or others for the traumatic event.
Additionally, people with PTSD tend to live in a constant state of fight or flight. This is the body's adaptive response to traumatic events to facilitate survival. However, in the case of PTSD, it shows up even in safe situations. A constant fight-or-flight mode makes it hard for people to sleep at night, leading to exhaustion, violence, or recklessness, and persistently scanning the environment for potential threats.
Finally, people with PTSD may forget or block key details of the traumatic event from their memories. Doctors call this dissociative amnesia, memory loss caused by the traumatic event and not by other causes.
How do you know if you have PTSD?
If any of these symptoms sound familiar, you may want to delve further into screening for PTSD. Maybe you’re having unpleasant flashbacks of your immigration journey, or maybe you’re avoiding people or situations that remind you of the experience.
Licensed mental health professionals (including psychologists or psychiatrists) are qualified to diagnose someone with PTSD, following criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). If you are worried you might be experiencing PTSD, it may be beneficial to seek help from a professional who is well-equipped to treat PTSD and, ideally, well-versed in the unique stressors experienced by immigrants and refugees.
How can you find professional support that is suited to your needs?
Finding a mental health provider can feel quite abstract, but here are some tips:
- Ask your primary care doctor for a referral.
- Reach out to your local immigrant and refugee services office for assistance in connecting you with a mental health provider. The International Rescue Committee and Mental Health for Migrant and Refugee Communities may be good places to start.
- If money is an obstacle, contact the National Alliance on Mental Illness for assistance finding an affordable option, or try Seneca’s Todo Por Mi Familia free mental health program.
- Many universities have in-house training clinics where psychology graduate students provide therapy. These services are often low-cost or use sliding scale fees based on your income.
- If immigration status is a concern, contact local community organizations that can assist you. Some places to start: Immigrants Rising’s Mental Health Connector Program and UndocuHealth’s National Mental Health Directory.
- If language is a barrier, you may ask for help finding a provider who speaks your native language or who is open to using an interpreter.
- Talk with your community or religious leaders about helping you find a provider.
- Navigate through Psychology Today’s provider search engine
What is PTSD treatment like?
As you search for a mental health provider, you may wonder“What will therapy look like?” The course of your treatment will depend on your therapist’s expertise, the type of trauma exposure you experienced, and any other factors your therapist deems relevant, but multiple treatments have been shown to work well for trauma.
One example is narrative exposure therapy (NET). Researchers at the University of Konstanz have found NET to be effective for treating PTSD in immigrant and refugee populations. In NET, the therapist provides information about PTSD symptoms and why it is important to face your trauma. Then, the therapist asks you to describe, in detail, the traumatic event and the emotions, thoughts, and sensory and physiological reactions you experienced.
This technique is known as imaginal exposure. By the end of treatment, the therapist provides you with a written summary of the experiences you described. The intention is to give you the freedom to reflect on your life, regain your self-identity and self-respect, and acknowledge your role in protecting your human rights. Learn more about NET here.
Note that while NET can be helpful for immigrants and refugees with PTSD, this is only one type of treatment. There are many other treatments that researchers have found to be helpful. For example, cognitive processing therapy has been used successfully with combat veterans and other groups. It is also helpful to know that most therapists in the community may integrate a mix of therapies and skills to best meet their clients' needs. Your treatment may look different than the descriptions found online or in pamphlets.
The key is to ask questions and not get discouraged.
What can I do while I’m trying to access care?
Sometimes it can be hard to even pick up the phone and call a provider, or you may encounter other barriers like cost, time constraints, language differences, and stigma or discrimination. If you are navigating challenges to find a provider, consider exploring the following strategies:
- Learn about PTSD. Knowledge is power – if you understand the causes, symptoms, and treatments for PTSD, you’ll find it easier to tackle your symptoms head-on. However, there is a lot of misinformation out there. Make sure to look for trusted sources.
- Find support. You may feel isolated and alone. Reach out to loved ones for support, look into joining community organizations with other immigrants or refugees, attend religious services, or search for online support groups to build your network.
- Practice mindfulness. Mindfulness is frequently used in PTSD treatment to help clients focus on the present moment, break patterns of avoidance, and increase purposeful behavior. Guided mindfulness meditation videos are available on YouTube.
- Develop emotion regulation strategies. PTSD symptoms can make it difficult to control feelings and may lead to emotionally charged responses (angry outbursts or extreme sadness). Emotion regulation strategies can be used to help you manage these emotions. This blog post contains a number of strategies that you can try.
Navigating PTSD is difficult, but with the right resources and support, you can begin to gain control over your symptoms and focus on adjusting to your new country with better mental health.
References
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