Think about how many people you walk past every day who appear to be happy and healthy. Out of these people, how many do you think are suffering beneath the surface? When you see someone with an oxygen tank, for example, you immediately think that this person is ill. But the woman who smiled at you at Starbuck’s this morning may not be smiling inwardly. She may be suffering from an invisible illness called PTSD, post traumatic stress disorder.

There are many serious illnesses that often go undetected and unnoticed but are very real nonetheless. In honor of Invisible Illness Awareness Week, I hope you join me in bringing awareness to invisible illnesses—PTSD, bipolar disorder, anxiety, panic attacks, chronic fatigue syndrome, and fibromyalgia.

To learn more about mental illness and healing from trauma I turned to dear friend, coach, founder of HealMyPTSD.com, and regular contributor, Michele Rosenthal. Having struggled with undiagnosed PTSD for over 25 years, Michele knows firsthand what it’s like to suffer from an invisible illness.

Explain why illnesses such as PTSD, bipolar disorder and anxiety are referred to as invisible illnesses?

When you see a cancer patient with a bald head or a stroke victim using a cane or a heart attack survivor carrying an oxygen tank your mind immediately registers illness. These kinds of visual examples of impairment are easily understood and recognized as suggesting both physical and even emotional limitations and alterations from normal daily functioning.

With mental and physical illnesses like PTSD, bipolar disorder, anxiety, fibromyalgia and chronic fatigue syndrome, for example, the limitations and altered functioning are not so readily apparent. On the outside these patients can seem “fine” in any random moment depending on the circumstances. Spend a full day with someone with any of these illnesses, however, and you’ll immediately start to see dysfunction that is more visible. In fact, many of these conditions cause and/or originate in altered brain function, a situation that is extremely physical even though we need hi-tech machinery to see it.

We call these “invisible illnesses” because they don’t necessarily manifest in easily recognizable physical symptoms. Our mistake is to believe that just because an illness can’t be seen, per se, that it doesn’t exist or isn’t critical. Invisible illnesses can be just as disabling as any commonly recognizable disease. Our biggest challenge as a society is to give invisible illnesses the respect they deserve so that the diagnostic and recovery processes find the support and resources they need and deserve.

What inspired you to write Heal Your PTSD?

There are many things that make PTSD healing difficult, so I wrote Heal Your PTSD to make it easier. During my own PTSD recovery I felt overwhelmed, incompetent and uncertain. I didn’t know what to do, how to do it, or where to turn for results that would lead me out of the PTSD darkness and into the light of a healthy life. I banged around through a lot of trial and error and meltdowns until I reached complete success…. which left me thinking: We need a process for healing that chunks things down to size so that it’s manageable.

It’s that thought that inspired me to write Heal Your PTSD. Written from both my personal and professional perspectives, the book is designed to help readers create a personalized healing program that can be comfortably approached on a daily basis to make life easier to live during symptoms and recovery easier to manage in reducing them.

What are the two or three greatest challenges people face in PTSD recovery?

Healing PTSD creates many challenges as the process meanders along around curves and bends you can’t predict. The top three challenges are:

1. Fear: PTSD recovery feels terrifying for many reasons, including the fact that healing requires a) giving up the coping mechanisms that have made you feel safe; b) giving in to the fact that there is no preset process or destination; and c) acknowledging and even accepting disturbing feelings, memories and emotions to name a few. So a big challenge is figuring out how to deal with the fear and still engage in the work of recovery.

2. Resistance: Survivors already feel lousy. Healing often brings on more uncomfortable experiences before recovery work is completed. Facing more pain, fear, anxiety, depression and other responses to therapeutic experiences can immediately erect walls of resistance as a survivor seeks to maintain a sense of safety. Understanding that all resistance is, at its core, fear—and then addressing the fear—clears the resistance and opens the path to healing.

3. Disbelief: Survivors, caregivers and even healing professionals are often faced with a crisis of disbelief. PTSD symptoms and their resulting behavior can look so extreme that it’s possible to disbelieve that healing can occur. This is a huge mistake for so many reasons. Every survivor has enormous healing potential; the goal is learning to access it. This is where recovery work really needs to focus; less on expectations for the end result and more on intention in every moment along the way. Belief comes from seeing change occur and this can and does happen on a variety of levels for survivors of all types of trauma whether they’ve been symptomatic for three months or 30 years.

Are there some signs a person can look for to know if a loved one is going through PTSD?

PTSD symptoms are diagnosed when they have persisted for at least four weeks and interfere with how a survivor functions professionally, personally and/or socially. Symptoms occur in four categories:

Avoidance: The desire to stay as far away as possible from anything related to the trauma, including all sensory experiences, discussion and geography.

Re-experiencing: Feeling that the trauma and/or its memories continue to occur in the form of intrusive thoughts, flashbacks and nightmares.

Arousal: Experiencing feelings of hyper-vigilance, hyperarousal, exaggerated startle response, and the feeling that danger is imminent,

Mood alterations: The development of a persistently negative perspective of the self, others and the world often punctuated by feelings of self-blame, shame and guilt.

PTSD affects a person on so many levels—emotional, mental, even spiritual—can you talk how it really takes over a person’s life.

PTSD symptoms originate in the neurophysiological changes and psychological beliefs that send us the message that we’re in imminent danger. You’re so right, these effects drill down into every cell of our bodies (which hold a memory of the trauma itself) and also into the very fabric of our identity; what makes us who we are.

The altered beliefs about our safety, justice, fairness, control and survival change the way we see ourselves, others and the world so that we approach living very differently: from a state of fear and powerlessness versus strength and empowerment. These changes create the PTSD lifestyle, one in which we desperately cope with symptoms and try to build a life despite them. All of this is extremely exhausting and can reduce a person’s ability to connect with others, excel at work, form lasting relationships or even create and sustain a productive, meaningful and satisfying existence.

What’s the most important takeaway you want readers to learn from your book?

The most important takeaways from the book are 1) you can heal; you just have to find your personal process (which the book helps to create), 2) finding your unique recovery strategy depends on trying different approaches to find what works for your unique history, trauma response and healing needs 3) recovery gains happen slowly over a period of time in which you consistently develop a daily habit of making choices and taking actions designed to address your fears, hopes, and healing desires in ways that are healthy, proactive and focused on respecting your past and your response to it even while dedicating yourself to the perseverance it requires to change your present and create a new approach to the future.

For more information, plus a PTSD self-test visit: Heal My PTSD