i used to have to use a mouthguard the first few years after coming back. now that ive been taking real initiative in getting my ptsd treated in the past year with meds, therapy, meditation, etc, i no longer grind/clench as severely as i used to at night so ive tossed the mouthguard. but i do try to be very mindful of when i do it during the day, not the grinding so much, but the clenching, and the shoulders-to-ears tension which tightens the neck up like a mofo and causes jaw tension and headaches. i try to be constantly aware of relaxing my jaw, shoulders, and neck as often as i notice im tensing them up again. it helps to get a massage once in a while. i also do stretching and use heat packs and muscle rubs to keep my traps/neck/jaw muscles as relaxed as i can. also acupuncture is literally the most effective muscle relaxer ive ever used. anything that relaxes your muscles directly, or relaxes and calms your mind thereby causing less neck guarding and prevents the tension before it happens is great. also keep your doc and dentist in the loop with your bruxism.
also anything that gets you calm and relaxed before bed is a good thing.i make it a point to watch relaxing nature vids and listen to relaxing music before bed and actually i play them all thru the night so anytime i wake up in a panic from a nightmare ive got the music and images playing right on my computer screen and i can calm down in an instant and go back to sleep. also found that putting into practice lucid dreaming techniques is helping me to control my nightmares.
and last but not least the biggest thing i find is to refuse to allow myself to entertain combat mind. cant stop the thoughts from coming but can stop them from squatting down and building a permanent nest. like if im walking somewhere and i start going through options of how i will react if i'm jumped with with a blade or if im in the grocery checkout line running through response scenarios if the store experiences an armed robbery, the second i recognize what im thinking, i immediately practice thought stopping and refuse to allow myself to go there. i don't get into an argument with myself regarding probabilities - i.e. the actuality of such and such a scenario actually happening is low given such and such factors - because my combat mind will always win with worst case scenario. i cant argue my way out of combat mind, so instead of trying to calm myself down with all kind of rational pat answers, i just take the bull by the horns and say NO. period. i will not allow myself to go there, i will not let my mind continue to regard the situation in this manner, and I will NOT allow chain thinking. if i think: what if this store experiences an armed robbery? that's the best place to stop the whole thought chain. because one thought leads to chain thinking and pretty soon im casing the entire store to see what advantages and disadvantages it has to the imaginary situation at hand, im debating whether to retreat or confront, whether or not civilians are a priority and if so which ones, my adrenaline goes thru the roof, and its all over a situation which i am not actually in.
i have to tell myself its unnecessary to plan strategy in preparation for every possible scenario 24 hrs a day because i have the training to react appropriately in a threatening situation should i find myself in one, and thats the key: i have to ask myself not 'is there the potential for threat' but outright 'am i in a fullblown situation RIGHT NOW'? If the answer is no then i have to shut down myself from preparing for eventualities and leave the adrenaline kick and the options run-through for such a time as the scenario is actually a current actual event.
it is SO hard to stop oneself from assessing threats and preparing for all eventualities and SO easy to let combat mind take over and let your mind run wild but its detrimental and ive actualy found that what calmed my 24/7 adrenaline and paranoia, stopped me from nearly killing people every two seconds because my hyperarousal was at combat level, and has helped my nightmares and panic attacks lessen is to absolutely refuse to allow myself to assess potential threats, and to stop myself immediately once i notice myself doing it. i just say NO, STOP, ABSOf*ckINGLUTELY NOT, DON'T YOU MOTHERf*ckING DARE. no arguments, no buts, no justifications, just, 'no, stop now, no questions asked'. Doing this constantly (since I threat assess and run through scenarios constantly) has been the number 1 key that has given me any peace in my life or improvement in my PTSD symptoms.
i dont know if that was helpful at all. but i often find its better to prevent the tension outcome (bruxism, violence from severe hyperarousal, panic attacks, etc) at its root and often i find as much as i hate to admit it im the one allowing myself thru combat mind to build up the tension, adrenaline, hyperarousal, etc, in the first place instead of actively fighting it and stopping the tension overload at its route. its not simple to do, it takes damned hard work, and its not a cure-all either, but it definitely helps more than i ever would have expected.