PTSD

The Voice.

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I’ve been feeling very young recently.  I feel like Ana is around more than I am.

There is a book (which I haven’t yet read) which talks about structural disassociation and describes the experience of having an “apparently normal part” and one or more “traumatized child parts.”    My apparently normal part seems to be quiet this past few weeks and Ana, my traumatized teenage part is very loud.

Sometimes when Ana is around I do things that don’t make a lot of sense to my apparently normal part.  And my apparently normal part doesn’t make sense to Ana.

I was trying to figure out if there were any particular triggers, anniversaries or memories surfacing for me recently, ones that would bring Ana to the forefront.

Next week will be the anniversary of when I first started being abused.  It will also mark the one year anniversary of this blog!

I started reading through an old journal from 2001:  the year I first was hospitalized, the year I tried to kill myself multiple times and the year I began cutting daily, sometimes multiple times a day.

Reading the journal, my 2001 apparently normal self seems extremely young.  But even at that time, I clearly identified having  a traumatized child part.  Back then I called it healthy me and little girl me.  I also called it “the voice.”  I’ve found multiple segments where I speak about “the voice”  and I recognize what she is saying as Ana.

February 21, 2001

“The sensation of hunger is not an easy one for me.  It is frightening.  Like I feel afraid of losing control of myself. And yet I know that the E.D is out of control.  It is a part of me that often deceives and betrays me.  I know that in the end, though it feels comfortable, it cannot be trusted.  The voice which tells me not to eat, tells me to cut my skin, to smash my head against a wall, to step out in front of traffic, all sorts of dangerous and hurtful things.  It speaks to me in persuasive ways.  It is a part of me and yet foreign.  My ally and my enemy.  My strength and my destruction.  But after so many years it is the way I know.  A method of ridding myself of unwanted feelings…I feel like a stranger in my own life.”

I don’t know what to do to help my traumatized child part heal.  What does Ana need?

The answer that comes to my mind is love.

She needs love.  She needs acceptance.  She needs to be believed.  She needs to feel safe. She needs to be forgiven for all the years of self abuse.  She needs to forgive her own body.

But I rail against it.  My apparently normal adult self doesn’t feel capable of parenting an angry teenager.  Ultimately, she is me…both the apparently normal adult self and the traumatized child parts are me.

Even in 2001, I can read in my journal signs of this inner battle.  The battle between health and self destruction, between hope and despair.  I’ve been fighting for a long time.

I can read myself trying desperately to convince myself that my engagement was a good idea.  That I loved my partner.  That my own PTSD and issues were the root of the stress in our relationship.

March 18, 2001

“I miss having him around me and yet I’m also afraid of our intimacy.  He is at the same time my motivation to get well and my trigger to feel upset.  The strong emotions I have toward him complicate and simplify my life”

I can read my younger self trying to convince herself that things would be okay.  I can read between the lines that a deeper part of her knew the relationship was wrong and unhealthy.  I can read how I desperately continued hurting myself, longing to be SEEN. Truly SEEN and accepted for who I was.  I can read my self blame, self hatred and confusion.

And a good part of this fight has been internal, between parts of myself that can’t seem to make peace, forgive and start again.

I feel like an imposter.

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Some days I don’t feel like I belong.  I feel like an imposter in my own life, or like my life doesn’t belong to me.  It’s a disorienting feeling and very difficult to describe to others. When I’m depressed or coping with PTSD symptoms I often feel like I’m faking it.  Like I’m pretending to be something I am not, or I am not what I am supposed to be.  I don’t fit in anywhere, even within my own life,which I struggle to believe is actually MINE.

During the workday, I help abused women.  I’m a counselor, a support worker, a health care professional, a peer supporter, and I help others.  I believe that I am good at most aspects of my job, especially those related to support work.  I have slowly developed some confidence that I can help other women.  That my experiences may have some meaning because they have given me the skills to deeply connect with others who are living with abuse, trauma and the impacts of violence.

But it’s incredibly disorienting when I leave work and am forced to deal with abuse, trauma and the impacts of violence in my own life.  Sometimes I feel confused, sometimes I feel like my life can’t really be this bad, this difficult, this out of my control.

Sometimes I feel like I’m living inside a public service announcement for domestic violence awareness.  How can I truly help others, when my own life is still being impacted by an abusive ex-partner?  How can I truly help myself?  How can I separate the past from the present, the triggers from the actual risks?   How do I stop this terrible helpless, disoriented, exhausted feeling?  Can I be a good support worker if I can’t solve the problems in my own life?  If I don’t follow my own excellent advice?

Last week I was at a doctor’s appointment with my children and my ex-partner.  It was very difficult and very triggering.  The doctor was asking the kids questions that they obviously couldn’t honestly answer with their father sitting in the room.  I felt a deep sense of pain and discomfort.  I wanted to tell the truth to the doctor about what my kids are struggling with, but I knew that if I said too much it could have impacts on my kids’ safety with their father.

The doctor asked questions about “do you feel safe?” and “do you have thoughts about harming yourself?”  On one hand, I was glad to see that this doctor was asking mental health and abuse screening questions.  On the other hand, I felt panicky and unsafe because the situation was so impossible.

I remember a time years ago, when I went with my then husband to the emergency room for a migraine.  The triage nurse asked me “do you feel safe in your home?”   The question made me pause, stop and think.  I knew that I didn’t feel safe in my home, but I also knew that answering honestly would cause something to happen.  My husband was sitting only a few feet away.  I didn’t know exactly what the “something” would be.  I hesitated for a second and answered “yes,” the only real possibility in that moment.

But I was thankful that the question was asked, because on a different day, or for a different woman that question could have been the permission and the space needed to disclose domestic violence or sexual abuse.

Health care professionals MUST ask these difficult questions.  They must ask their patients about thoughts of self harm, thoughts of suicide and experiences of violence.  They must ask if their patients feel safe at home.  These questions are vital and open a potentially life saving door.

But if the professional doesn’t have a clear plan as to how to handle a disclosure, they can do more harm than good.

Don’t ask a question you don’t want to know, or aren’t prepared to know, the answer to.

Don’t ask if someone feels safe, unless you are prepared to help them find safety if the answer is no.

Don’t ask someone if they feel suicidal unless you are prepared to support them, connect and hold space for them.

Don’t ask about abuse unless you are willing and able to support, believe and validate that potential disclosure.

Please, don’t ask questions unless you are willing to help or do what is needed to find help.

Sometimes it’s not enough just to believe someone.  Sometimes that person might need concrete help and support.  Health care professionals need enough time and enough resources to provide this help.  They shouldn’t be rushed in their jobs, they should be given adequate time and privacy to complete interviews.  They should have training in trauma informed care.  They should have resource lists, with shelter numbers, sexual assault centres and other options available.  And they should receive specific training around handling disclosures related to violence.

It was so triggering for me to be in a situation where these questions were asked in front of my abuser.  Where I knew my children didn’t have the ability to speak freely.  This situation was not conducive to health.  When in doubt, children could be interviewed alone.  Or if the doctor sense there is something complex going on, they should follow up. In a timely manner!

I know this doctor could sense the tension.  I did get the impression that she believed and could tell that I was afraid.  I didn’t feel like she did harm or had ill intent.  But I’m still constantly frustrated how many adults, doctors and counselors “believe” my children, and “believe” me, but have either no power, or no will to actually intervene to influence change.  The systems that have the power to intervene don’t believe (or are too slow) and the systems that do believe, ultimately have little power to impact the situation.

It means something to be believed.  But if the dangerous situation is allowed to continue indefinitely, it makes it difficult for survivors to trust.  It makes it difficult to feel safe and supported, anywhere.  It makes it more and more difficult to continue to disclose and continue to ask for help.  It makes me feel crazy.  It makes me feel like an imposter in my own life.  Where nothing makes sense and what I know to be right and fair and good is not able to transpire.  Where I can’t effectively protect myself or my children.  Where I help others by day, and feel panic, helplessness and fear each night.

 

Firsts.

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<trigger warning for graphic descriptions of self harm and eating disorder>

I’ve been thinking a lot about the “firsts” of my mental illnesses.  We all have memories of the first time we did certain things or had certain experiences, but for people who have chronic mental health struggles over a number of years, not all “firsts” are positive memories to celebrate.

When I was experiencing my “firsts” of mental illness I was a teenager.  I was 15-17 years old and I didn’t have any idea that my experiences were those of specific mental illness, let alone what those mental illnesses might be.  I thought that I was going crazy.  I thought I was the only one.  I was afraid to tell others what I was experiencing internally.  Until I was diagnosed with PTSD when I was 20 years old, most of my “firsts” made little sense to me.

The first time I experienced what would become anorexia I was about 16 years old.  I’ve written about it in another blog post.  I was physically sick and hadn’t eaten for a few days.  I felt mostly better and wanted to go to school.  I remember my mother telling me I had to eat something if I was going to school.  I took a granola bar and started walking down the street to meet my boyfriend at the time and to catch the bus.  I remember feeling light, empty and powerful.  I remember feeling the sense of white, blank emptiness that I now associate with disassociation.  I felt like I could take on the world.  I felt like I could survive without food and that I’d actually be more powerful.  I loved that feeling and I chased after it in various forms for the next 20 years.  I believe this moment is the one I chose anorexia as a coping technique for the sexual and emotional abuse I was living with.  At that time I wouldn’t have identified it as an eating disorder, nor would I have identified my relationship as sexually and emotionally abusive.  It was just a feeling I had, of realizing that disassociation was more comfortable than pain.

I remember the first and one of the few times I tried (unsuccessfully) to purge after panicking about eating.  This I described in another blog post.  I remember crying and sitting shaking on the floor of the downtown public library.  My crime?  Eating a whole cookie rather than half of one.  I remember I had been reading books about eating disorders, secretly, trying to figure out what the heck was going on.

I remember my first panic attack.  I was in Grade 12, 17 years old and extremely ill from anorexia.  I was attending school despite the fact that my weight was well under 100 pounds at close to 5’9″.  I remember feeling driven.  I remember feeling an intensity of moving forward that wouldn’t allow me to slow down or calm down.  I had to keep “doing” and trying to be perfect at everything.  I had to follow all my rules or something terrible would happen.  I remember there was one day I had a math test.  I believe it was Grade 12 Calculus or some other horrible subject.  I had been doing well in school despite my illness.  But that day somehow my brain just wouldn’t work.  I remember sitting in the classroom, the desks were arranged in rows, one in front of the other with the blackboard at the front.  I remember all the numbers and letters swimming around on the paper.  I couldn’t breathe.  I couldn’t think of how to solve the problems because everything was spinning and I felt like I was being crushed.  I felt nauseous and I realized that I was about to cry.  I remember bolting out of the room and into a stall in the girls bathroom.  I remember sitting there crying, shaking and feeling terribly upset that I couldn’t do the test.  My thoughts were racing around and I just wanted to go home.  I remember another student from the class coming in to check on me (it was a male teacher).  I remember being somehow glad she was there even though I was embarrassed.  I made up some excuse about being sick and not being able to write the test.  I think I went home.  I wouldn’t have known at the time that it was a panic attack, but it was and it was probably related to extreme lack of nutrition and just pushing myself too hard on no fuel.

I remember the first time I cut myself as a coping technique for stress.  I was about 18 years old.  I had just started taking SSRI medication for depression and anxiety after about 2 years of fighting with my parents and my doctors.  I never wanted to take medication.  I think deeply and instinctively I must have known that my mental health problems were situational, but that knowledge was too terrifying to face, so I blocked it out.  The first time I engaged in cutting I  used a pair of scissors that I kept in my bedroom.  I used to make just one small cut.  I would do it once a week in the exact same place, just under where the band of my watch lay.  So I could hide it carefully.  It was ritualistic, very controlled.  I don’t remember exactly why I started doing this.  It became part of my routine as I gained weight and somewhat normalized my eating behaviour. I needed something else to help block out the memories of the abuse.

I remember the first time I considered suicide.  I was probably about 17 years old, but I might have been 18.  I remember being at a party at a friend’s house.  Radiohead OKComputer was playing in the background.  Music I always associate with the “saddest of the sad” times.  It was raining outside.  I remember sitting on the couch looking out the back sliding door.  It was dark outside, evening.  The rain was falling really hard and there was thunder and lighting. I felt like I was in a trance.  Looking back I realize this was also an example of disassociation.  I remember feeling incredibly alone and disconnected. I was AT the party but not part of it.  I remember being at home that evening.  My bathroom had green tiles.  Small square tiles with white grout.  I remember just sitting there staring at my razor.  Thinking about cutting myself, thinking about dying and ending my life by opening up my veins.  I just sat there for a long time thinking about it.  The images of the green tiles and the emptiness of that moment are burned into my memory.

I remember my first flashback.  I was 18.5 and with my first love, my first real connection after the abuse and the severe anorexia.  I remember we were in my bedroom and we were kissing.  It was consensual and I wanted to do it.  He was lying on top of me. I think he might have been about to unbutton a piece of my clothing or something like that.  Suddenly I was crying and shaking and it wasn’t him there.  It was my ex boyfriend, who had so many times taken off or unbuttoned my clothing when I’d clearly said now.  It was him on top of me and I was afraid.  I had no idea what a flashback was, I didn’t know I had PTSD.  I just had an intense physical reaction to what was happening.  My boyfriend stopped immediately.  I remember him leaving the room briefly to give me space.  I remember feeling scared and embarrassed.  I don’t really remember the explanation I gave to him.  Some of my memories are less clear, but I think over time I had told him that my last relationship had been difficult.  I don’t think I fully understood myself at that time that it had been abusive, and that this type of reaction was a normal one for survivors.

I remember the first time I cut myself deeply enough to need stitches.  I was 20.  I was at university.  I remember buying the craft knife at the university book store. I remember walking home.   There was  a bridge on the campus and for months I thought about jumping off it every day.  I knew that I was going to cut deeply.  It was planned and premeditated.  I remember disassociating and thinking only about the injuring.  I remember wanted to make sure it was deep enough to need stitches.  I remember walking to the hospital which was on the campus.  I walked across a field to get there.  It was May or June.  I remember the doctor stitching up the wound.  It was a medical student and I remember feeling afraid.  I remember the resident coming to check the work and commenting that the stitches were incorrectly done.  I remember wondering why the resident didn’t fix them, but I assumed that because the wound was self inflicted they thought I didn’t care about scars.  In the end that wound healed badly and caused me chronic pain until it was fixed about 7 years later by a plastic surgeon at that same hospital.   I remember feeling nothing.  I remember feeling nothing about the injury and having no emotional or physical reaction until the day I went to the health clinic to have the stitches removed. I fainted when the doctor took them out.  My body felt the trauma suddenly and all at once the disassociate wasn’t there.   From then on I always took my own stitches out so I could control the process and do it in a way that I would not feel as much pain.  The ritual of the whole thing was an important part of the process of disassociation for me.

It’s a sad list.  Really sad.  Because some of these firsts are clearly in my mind that pleasant memories I would like to remember.  The way that PTSD stores traumatic memories and erases positive ones is deeply frustrating.  Because the long term consequence of disassociation is memory loss, and rarely losing the memories I wish would disappear.

Picture was drawn in September 1999

 

 

 

Internalized Stigma.

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Stigma causes me to make terrible choices.  Internalized stigma is dangerous to my health.  This is what I learned over the past few weeks.

Why do I feel so many complicated feelings about taking an anti-psychotic medication, but completely different feelings about taking arthritis medication?  The answer is internalized stigma.

Mental health stigma has taught me to be ashamed that I take psychiatric medication.  Internalized stigma causes me to think that I shouldn’t take the medication, that I should try to stop taking it as soon as possible, that I’m weak and somehow not good enough because I need medication to stay functional.  Basically, stigma lies.

Recently I started an alternative treatment which was helping me to sleep.  Because I was able to fall asleep, I decided to reduce my anti-psychotic medication.  I don’t need this!  I can function without it!  I’ll be fine as long as I’m still sleeping!  I feel okay!  What could go wrong?

As it turns out, a lot could go wrong.

Within a week of reducing my prescription medication, I was having multiple panic attacks a day, having paranoid thoughts, thinking that I was seeing my ex everywhere, afraid to leave the house and almost impulsively quit my job!

I was physically sick, dealing with a lot of triggers and somehow I thought it was going to be absolutely fine to reduce my psych meds!

I’m going to blame this on stigma.

I’m also going to blame stigma for how long it took me to realize that the change in medication was directly linked to my crisis state.

I mentioned it to my psychiatrist over the phone.  We talk very infrequently since I’ve been stable for the past few  years.  He told me to take the medication.  He told me that I have so much going on and so much stress that I don’t need to justify to anyone that I need the medication.  He said, just take it.  Just take it and don’t worry about it.

I thought about it and I realized he was right.  Why was I fighting so hard to reduce the dose of a medication that wasn’t causing me terrible side effects and, in fact, was reducing some of the most unpleasant PTSD symptoms (panic, paranoia, seeing things as a result of flashbacks)?  Why was  I judging myself so harshly?  Why was it more important to reduce the medication and not be “dependent” than it was to keep my job?

The answer was that it wasn’t more important.  That I didn’t need to judge myself.  That I needed the medication to keep the symptoms at bay.  Yes, the anti-psychotic medication (as it’s name implies) was ACTUALLY keeping me functional and not on the edge of psychosis!

I started on the higher dose that night.  Within 2 days I was back at work, within 4 days the panic attacks were reduced and almost back to “normal” levels.  Within a week, I’m feeling more hopeful and less terrified.

These pills help me.

Yes, I’ve had horrific experiences with psychiatry and psychiatric medications.  Yes, some of these drugs have made me worse and almost killed me.  Yes, there is a social stigma associated with anti-psychotic drugs.

But I’m going to work on not internalizing this stigma.  I’m going to work on accepting what is.  Accepting my current limitations.  Accepting that PTSD is a brain injury and it’s logical to take medication if it helps balance things out.

So next time I start talking about decreasing my medication, please remind me to re-read this post.  Please remind me that my health is more important than stigma.  That I’d rather be functioning and medicated, than in crisis and able to say that I don’t take any medication!  Remind me that going off my medication is NOT a good idea right now.  And maybe be gentle with yourself too…do what you need for your recovery.  Do what you need and don’t let judgment (by self or others) get in your way.  You are the expert in  your own healing.  Trust that.

 

Sick Days.

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I’ve been home sick the past few days and sick on and off for a while now. It’s really difficult sometimes to separate physical and mental health symptoms.  Everything is all blurred together and it’s hard to tell when to push myself harder and when to rest.  This past week has been an explosion of physical and mental health struggles that are creating a storm of symptoms and have forced me to (uncharacteristically) stay in bed.

I haven’t met very many people who understand the complex intertwined experience of having both physical and mental health issues simultaneously.   Most doctors aren’t very trauma informed and also struggle to validate that both physical and mental health issues can occur simultaneously, and be either linked, not linked or both linked AND not linked to each other!

One of the things I’ve been coping with in the past few weeks is a urinary tract infection.   Obviously, an infection is caused by bacteria and isn’t a mental health issue.  But I was also really triggered in the past few weeks and this made me extremely reluctant to seek medical care.  I was afraid to go to a walk-in clinic, afraid to see a doctor, afraid to be examined.  This was linked both to past trauma around the medical system AND generally high levels of panic and anxiety related to stress with my ex and my kids experiencing abuse.   Thus I waited for over a week to go to the doctor, by that time my symptoms were much worse and I felt pretty awful physically.

This is an example of how physical and mental health issues can be both separate and linked at the same time.  The infection itself was physical, but my avoidance of the doctor was mental health and trauma related.   Of course you might also argue that my high levels of stress and anxiety also generally lower my immune system and make it harder for me to fight off infections.

By the end of last week I was on antibiotics, but I also developed a sinus cold.  I had a migraine related to receiving a nerve block to treat the migraines, but the sinus congestion put pressure on the nerves that were being treated.   My anxiety was causing panic attacks and making me afraid to leave the house for fear of running into my ex.

Thus again, my high levels of stress probably didn’t help any of these physical issues that I was dealing with.

When someone has an infection, generally they are advised to rest.  But resting is difficult when you are also struggling with severe anxiety and panic attacks.  My head gets filled with worries about work and what I’m missing and what people think about me being away and creating all sorts of worries and fears, many of which are not realistic.

Anxiety causes me to feel like a failure.  It causes me to feel like making a mistake is a terrible thing which can’t be recovered from.  It causes me to feel like everyone around me hates me and thinks I’m doing a terrible job.  Or worse, they think I’m faking being sick to avoid responsibilities.  A lot of my irrational worries centre around feeling like nobody believes me and that nobody likes me.

Experiencing abuse, and extending periods of emotional abuse, as well as abuse within systems, has lead me to fear and avoid conflict of any kind.  I want everyone to be happy all the time.  I get very anxious when there are disagreements and I’ll often apologize even when I’m not sure I have done anything wrong.   I’ll do what I can to avoid conflict, because when interpersonal conflict levels are high around me, my anxiety levels feel unbearable.  Because ongoing interpersonal conflict is a trigger.  I try to keep people around me happy because I want to feel safe and BE safe.

Unfortunately, in the real world, conflict is unavoidable.  Disagreements are part of life.  As the saying goes, you can’t please everyone all the time.

But I want to!  I need a lot of reassurance from people around me that I’m doing an adequate job.  I need reassurance that conflict isn’t dangerous.  I need reassurance that people believe me, that they believe I experienced abuse, that they believe I’m trying my best.  I need reassurance so badly because my internal dialogue is so self critical and judgmental.

I know it’s not the responsibility of those around me to constantly reassure me.  I know I’m an adult and I have to take responsibility for my own feelings and fears.  The difficult part is that while I’m experiencing ongoing abuse and conflict which is outside of my control, my self esteem is constantly being eroded and challenged.  I need reassurance because I haven’t yet learned to fully believe and reassure myself.

I believe this is very common for survivors who have experienced long periods of gaslighting or complex emotional abuse.    It’s hard to build up a stable sense of self when you are being confused, beaten down and made to feel like you are crazy and nobody will believe you.

Survivors need a lot of patience.  Sometimes you might get frustrated with me.  Sometimes you might feel like I’m being unreasonable.  Sometimes you might not understand why I’m SO upset over something SO little.   Please remember that it’s not little to me.  My reaction could be related to feeling triggered and that trigger is making me feel like a failure.   If you have the energy and patience to reassure a survivor, please do so.  She might need to hear thousands of times that you believe her and that you don’t think she is crazy.

I need to hear it a thousand times.  Especially on weeks like these where I feel crazy, broken and like a failure.

Being physically and emotionally sick at the same time isn’t a lot of fun.  Taking sick days when you are struggling with severe anxiety and PTSD isn’t fun.  It’s not relaxing.  It’s not “a break.”

I guess sometimes we have to carry on, try to move forward, even if we don’t believe or have faith that everything will work out for the best.

Be Your Own Hero.

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It’s been a difficult time for me.  I’ve been waiting 90 days+ for the verdict in my family law trial.  I’m experiencing a lot of triggers and finding it harder to stay positive and optimistic about the future.

Quite frankly, it is terrible for my mental and physical health to have contact with my abuser.  It upsets me, it triggers me, it causes flashbacks and disassociation, it confuses me, gaslights me, makes me doubt myself, my abilities, makes me feel crazy and like nobody believes me.

Unfortunately, he is the father of my children and I can’t just go no contact.

It’s awful.  It’s awful being told I have to “get along” with someone who treated me so badly.  It’s frustrating being told by many institutions such as the kids school, the CAS and some doctors, that I should be more neutral, not let my past impact me, that he’s a loving parent and basically a good person.

Hold on a minute….basically a good person?

That’s what I told myself for years.  It’s just sexual abuse.  It’s just the sexual stuff, he’s otherwise “basically a good person.”  Telling myself that kept me locked into the relationship for years longer than I should have stayed.

Someone who doesn’t believe in consent is not “basically a good person” they are an abusive person.  He is an abusive person.

Privilege in society allows abusers to “pass” as basically good people.  They know how to act, to charm, to make their victims look crazy or unreliable or unbelievable, they know how to discredit others, they know how to tell different lies to different people to suit their needs.  Most abusers can make you think they are basically good people, but in reality, the signs are there that they are not good people.

The saddest part is that because abusers are expert liars and manipulators they can often convince everyone who might be able to help you, that they are good people!   So the abuse they perpetrate goes unnoticed and unacknowledged by anyone who might be able to support or rescue you.

Suddenly, they are “basically good people” and you are perceived as mentally ill and crazy.

Abusers gaslight the system.  That, combined with the societal privilege, rape culture, and patriarchy, allow them to pass unseen, and unnoticed through our world, abusing people as they please and not being stopped.  In a parallel experience, the survivors are believed less and less, as a web of lies is spun about them by the abuser to those around her who might assist her in escaping.

This is what I’m experiencing in my life.  It’s been 3.5 years since I left my abuser but I’m still locked in a web of abuse.  Very few people within the “system” believe me, and those who DO believe me and my kids, are seen as biased!  It’s an unbelievable, frustrating and maddening situation.

The more I protest, advocate and fight for myself and my kids, the more I am labelled radical, crazy, not neutral, too angry etc.

So what are my options?

I feel like the only option is to be my own hero.

At the end of the day, my ex-partner would like nothing more than for me to fall into a crisis and commit suicide.  He wants me to kill myself so that he can be right.  So he can prove that I’m crazy and that I don’t care about, and have never cared about, my kids.  He won’t stop punishing us until he reaches this goal.

But it’s been 3.5 years, and generally I’m more mentally healthy than I was before.  Generally, I take care of myself.  I’m working full time.  I’m becoming more confident in myself and my career.  I have some supportive friends and a supportive family.  I’m not falling into a crisis.

I won’t let him destroy me.  I’ll stay alive as long as I can just to spite him.

I’ll be my own hero, if nobody else will step up to protect my kids.  I’ll protect them and myself and do everything in my power to survive.

Survival is the best revenge.

If you are experiencing abuse, be your own hero.  Believe yourself.  Support yourself.  The rest will slowly follow.

Can’t make everyone happy.

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One of the ways I’ve coped with trauma in my life is to try to make everyone happy all the time.  When I was a child I thought my role was to “be nice” and to “be a good friend” and to take care of others, pay attention to my friends’ feelings, be considerate, be polite and do well in school always.  Essentially to be perfect all of the time.

I took this to such an extreme that I thought it was my responsibility to save, fix and adapt to my abusers.  Somewhere along the way I did not learn that it’s okay to be mean to protect myself.  It’s okay not to be nice to abusive people.  It’s okay to say NO, even to scream it and it’s not something to feel guilty for.  As an adult I STILL struggle with internalizing this.

I’ve spent the majority of my life trying to figure out what part of all my traumas is my fault.   What could I have done differently?  How could I have seen it coming?  Maybe if I’d been a better friend, she wouldn’t have died.  What if?  Maybe people are mad at me?  Maybe I made a horrible mistake at work and everyone blames me.   A good portion of my internal dialogue is convinced that somehow I’m a terrible mistake.  I’m not really a good person.  If only everyone could see!  Then they’d know the truth.

So as an adult, in most areas of my life I try to be the peacemaker.  I try to listen to everyone’s side of the story.  I try to minimize or avoid conflict at all cost.  I feel incredibly uncomfortable, even panicky when people around me are angry.  And if there is a conflict, you can bet it’s somehow my fault and I will feel guilty about it.

The irony, is I support survivors of violence every day.  I’ve told over a hundred or more women that what happened to them isn’t their fault.  I’ve told friends, I’ve told family members.  Heck, I’ve even told my abusers that things that happened to them weren’t their faults.  You were a child!   You couldn’t have known!   You did everything you could to protect yourself!   You aren’t to blame, he’s an abusive person.   You were in the wrong place and the wrong time.  You couldn’t have prevented it.  Your are doing what you can to take care of yourself.  It’s not your fault.  I believe you.

But at the end of the day, I treat myself with contempt and blame.  I feel like literally everything is my fault.  Always.  I try to depersonalize.  I know intellectually that most people aren’t even thinking about me, let alone blaming me for things that go wrong.  But deep down, I fear that I’m just a flawed person and I feel panicky when I realize I can’t keep everyone happy all the time with sacrificing myself.  And even if I do sacrifice myself, people around me have their own feelings and can be mad, hurt, angry and scared and there is not a connection to me.

A lot of women grew up with the message to “be good” and not to show anger.  Angry girls get labeled bitches.  Assertive girls get labeled bossy or rude.  Angry girls are judged.  People like calm, pretty, patient and loving girls.  We are surrounded by this covert and overt messaging from birth.  The labels put on us almost before we take our first breaths.

Why do so many girls and women feel such intense guilt and even shame around saying no?  Why do so many girls and women feel that anger is an unacceptable emotion and that they are bad for having it?  Why do I feel this way?  How do I make room for myself without feeling guilty?  How to say no without feeling afraid and ashamed?

These days, the world has become a scary place.  I’ve had to take breaks from social media and the news because I’m so devastated by the hatred and violence I see.  I feel the urge to isolate myself, connect less, spend more time alone.  Because I don’t feel very safe in the world anymore.  It’s rare that I feel truly safe.  As a survivor of violence, living with PTSD I feel scared most of the time.  But current events have triggered a different level of fear.

And sadness.  Because all the caring in the world can’t fix this mess.  I could be the best person in the world and I couldn’t make all my friends feel safe.  I want everyone to be in a bubble where they feel safe and protected.

I am a good person. I genuinely help people because I care about them and I want to.  It’s not because it’s an obligation or how I was raised.  It’s not just the expectation placed on me.  I think I was always this empathetic person. I always cared deeply, perhaps too deeply.  And it’s always hurt me.

But right now it hurts too much.  I just want to say NO MORE TRAUMA and hide from the world.  My brain feels overwhelmed with conflict.  I’m afraid about everything I do, that it will somehow make things worse.  When I’m alone at least I can think and I only have to monitor myself and my environment, not other people and their reactions.  Sometimes the guilt feels too much and I just don’t want to make a mistake or let someone down.  I’m also terribly afraid of being hurt or betrayed by someone else.  Sadly, this is a lonely way to live.  I just want to be in a bubble and feel safe and protected too.

Being lonely feels safer right now.  Because I can’t make everyone happy all of the time.  Sometimes I feel like I can’t make anyone happy, ever.

I can’t even make myself happy.

Blue Monday.

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Some pseudo-scientific research has shown that the 3rd Monday in January is the most depressing day of the year.  It was even given a name: Blue Monday.

There isn’t any actual research behind this, and of course depression isn’t just caused en masse by a specific date on the calendar.  But, evidence aside, I’m tempted to agree; mid-January is an extremely depressing time of year!  Especially for folks who already live with depression, and even more so for those of us whose depression is seasonally affected (made worse by the darker winter days).

It was a stressful week, the holidays ended too soon and I’m tempted to curl up in bed and stay there until the snow melts in April.

It’s so hard to be cheerful when there isn’t any hope of seeing any green living plants for another 3 months!  It’s hard to be cheerful when it’s – 1 000 000 degrees outside every day and the roads and sidewalks are covered in ice.

I took two weeks off over Christmas.  I was burnt out and exhausted.  I was grateful to have the time off, but it wasn’t enough.  It’s very difficult to relax on demand.  During the second week of the holiday break I took a vacation on my own.  While I was away I walked for hours every day, as much as 20 km per day.  I took photographs of all the beautiful green plants and I stood by the ocean.  I walked and walked and walked to clear my head.  It seemed amazing that plants, flowers and trees were growing and blooming in January and that the air was warm instead of freezing my face.

Since I came back I’ve been struggling.  Work has been stressful and I don’t have any more certainty or answers in my personal life.  I’ve been having a lot of memories, flashbacks and PTSD symptoms.  A year ago this week my family law trial started and my PTSD has always been very sensitive to anniversaries of traumatic events.

Since I stepped out of the airport last weekend, into the -25 C air, whenever I’ve felt overwhelmed I’ve been thinking of the images from my vacation.  Specifically, the lemon trees.  Inside my head I’ve been saying to myself, “lemon tree, lemon tree, lemon tree”  like a mantra.  Visualizing the yellow fruit and the succulent plants surrounding it.  Trying to bring back the warmth into this frozen, cold, blue world.

I’ve never been particularly good at positive imagery.  My mind is exceptionally skilled at recreating negative, scary or traumatic imagery!  But something about this lemon tree seems to be working for me.

It’s a grounding technique I’ve taught to my service users at work, but one I’m not good at using myself.

So if you are feeling blue this week, dark and hopeless about the world.  Maybe try imagining a time or a place in your life when you felt safe.  An image from a vacation, a childhood memory, your favourite place to relax.  Breathe deeply and slowly and visualize that safe, happy place.  Try to imagine yourself there.  Escape, just for a moment.

Because I have a feeling this is going to be a difficult week for a lot of us.

Sending out much love and support to you all.

 

If depression were treated like a physical illness

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The holidays can be a difficult time for people struggling with invisible illness such as mental illness or chronic pain.  During the holidays we are “supposed” to be happy.  We “should” relax and have fun.  We are “meant” to connect with friends and family.  It’s happiest time of the year, right?

But what if you aren’t happy?  What if you want to be happy and connected more than anything else, but you can’t be?  What if depression is stealing the happy, the relaxing, the fun and the connection right out of your holidays?

People all around me have been cancelling plans due to the flu, a cold and other winter illnesses.  This is acceptable and even expected in the winter time.   It’s even considered polite and good manners to stay home and keep your germs to yourself.  It’s understood that you aren’t feeling your best and that you have no energy when you have the flu. It’s okay to stay in bed and eat soup and sleep for hours.  People are sympathetic and nobody expects you to just “cheer up.”

I can’t even tell people that I’m sick. I can’t cancel plans.  I can’t stay in bed.   I feel disapproving looks from people around me when I’m not smiling and when I sit quietly or lose my temper  more easily that usual.  I’m exhausted, and I won’t feel better after a few days in bed.  Even if I could spend a few days there.

It’s Christmas time and I’m living with depression and anxiety.

Yes.  I’m sick.  I’m more severely depressed and anxious than I’ve been in a long time.

I want to call in sick to life.  I’m not even suicidal, I don’t want to die.  I just want to give up on “acting normal” and “keeping up appearances.”  I can’t imagine going back to work next Monday, the thought makes me panicky almost to the point of tears.  I have fantasies about developing some serious physical illness…nothing TOO serious, just enough to get me about a month off work with no questions ask, but not SO serious that I’d be in the hospital.  I want someone to take care of everything and take all the stress away.

This is what happens when society doesn’t acknowledge mental illness in the same way it does physical illness.  People who are depressed are lowered to the point of imagining horrible illness as a reason to be “justified” in taking sick leave, or even just taking the day off to rest.

Because when you are depressed you get treated like a misbehaving, whining child when you are not happy and not feeling connected.   When you are depressed you feel like a shitty parent when you don’t want to play with your kids, or you can’t enjoy your time with them.  When you are anxious and don’t want to leave the house you have to push yourself through it, even when you don’t enjoy a single minute of the activity you are doing.

When you are depressed, a “good night’s sleep” won’t fix it.  When you are depressed, “just cheering” up won’t work.

When you are depressed, you can’t just “lighten up” or “just relax.”

Believe me.  I WANT to relax.  I WANT to lighten up.  I want to laugh with my children.  I WANT to have fun with you.  I WANT to feel connected.  I WANT to feel like more than an empty shell marching through the tasks of the day.  I WANT to have energy.  I’m fully aware that I’m not acting normally and I’m terribly self conscious about it.  I feel guilty all the time about how depression impacts me and those around me.

I didn’t ask for this, any more than you asked for that cold, flu or stomach bug.

I didn’t ask for this, any more than anyone ever ASKS to be ill.

I don’t need to be fixed.  I don’t need suggestions on how I can help myself.  I don’t need to be told to look on the bright side.  (by the way neither do people dealing with chronic physical illnesses!)

I need you to keep me company while I shuffle through this dark period.  I need you to be there for me and to not judge me.  I need you to remember that I’m sick and not malingering or misbehaving or ungrateful or lazy.  I need you to remember that I’m trying my best and sometimes MORE than my best just to get through each day.  I’m using every ounce of energy to hide the depression from you, from my kids, from everyone.

I’m in pain.  I’m tired.  I don’t feel hopeful.  The world seems like a dark place and I can’t see the end of it because my thoughts aren’t clear.  Just as a runny nose and cough are symptoms of a cold,  depression makes me think that everyone hates me, that I’m worthless and that I don’t deserve basic things.   Just as a flu causes a high fever and aches, anxiety causes me to imagine horrible things and obsessive irrational thoughts.

These are symptoms.   It’s not a choice.

I’m depressed and anxious.  I’m sick and that is not a choice.

I had the best holidays I could, while not feeling well or happy.

 

Not really accommodating.

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It’s frustrating trying to explain invisible disabilities to people who don’t understand disability.

It’s even more frustrating when people, places or organizations which claim to specifically accommodate or treat folks living with a specific disability or illness, don’t even remotely accommodate the symptoms of that condition.

I live with chronic, complex PTSD which has remained somewhat unresponsive to treatment.  I consider it a disability because for me, at this time, it appears to be permanent and it impacts my life on a daily basis.  It changes the way I think, act and complete tasks of daily living.  It also changes on a daily basis, which means some days I am quite simply more “able” than other days.

I recently sought alternative treatment at a clinic which claims to specifically treat people with PTSD.   This is their main focus is on helping clients with PTSD that has not responded to psychiatric medicine.

Logically, I thought that this clinic would be expert at accommodating the disability of PTSD.  Makes sense right?

I had a pretty good first experience there.  The doctor and the counselor I met with were helpful.   But the receptionist…not so much.

I had some issues with the treatment that was prescribed.  This was nobody’s fault.  But I needed to make another appointment to change the plan, shortly after the first appointment and sooner than planned.

To someone without PTSD and extreme anxiety this wouldn’t have been a big deal.  Just call, re-book the appointment and move forward.

But for me, it was a nightmare.

I felt like it was my fault.  I’d chosen the wrong plan to begin with.  They were going to think I was crazy for changing my mind.  They weren’t going to believe me about the side effects.  They were going to question me.  I felt embarrassed.  I felt ashamed.  I avoided making the call.  I invented stories in my head about how bad it would be going back. I felt angry that the plan hadn’t worked out.

I avoided calling the secretary and emailed the counselor.   He had told me I could contact him if I  had any issues and had seemed approachable.

Person with PTSD is going to choose to approach the least threatening person.  Person with PTSD (me) is going to choose email rather than speak to a person on the phone if they feel embarrassed.  The phone sometimes seems extremely intimidating to me.  What if I get nervous and say the wrong thing?  What if they say something that upsets me?  With email I can plan what I’m going to say and the response.  There is time to react calmly and clearly.

The secretary called me back.  I missed the call.

Then I avoided calling her back.  Anxiety was making the decision.

She called me again.  I missed the call.

I avoided calling her back.  Anxiety was making the decision.

My kids got sick, I had a stressful week at work, I procrastinated calling her back. I was busy with other things.  But I was also working through the anxiety, getting myself to a place where I felt I could make the call.

She left me three messages and probably about 3 weeks went by.

Today I called her back, expecting to apologize for not returning the call sooner, make an excuse about my kids being sick and then re-book my appointment.

But receptionist was cold and very abrupt.

“You waited too long to call me back.  There are no more appointments.”

I was confused.  I asked her until when.

“Until the new year”

I said that was no problem, could she book me in for January.

“I don’t have the schedule for January”

Um….okay…I was getting really anxious by this point.  I asked her to call me back in January and ended the call.

When I got off the call I was frustrated and angry.  I’d been anxious to return the call because I was afraid of being judged for needing to re-book the appointment in the first place.  I waited because of anxiety.  I waited because I felt stupid and I was judging myself.  The anxiety was related to my PTSD and anxiety is a common symptom of PTSD.  PTSD is the reason I was seeking the treatment in the first place.

I told myself the fear of being judged was irrational and that the clinic staff would understand and assist me in booking an appointment because they were there to help me.  I told myself that they would understand that someone with PTSD might be anxious about making a call and thus might procrastinate.  They might understand that someone could have a few rough weeks and not return a call.  I reassured myself.

I made the call.

But it turns out my anxiety wasn’t misplaced.  I wasn’t able to re-book my appointment.  They were annoyed that I didn’t call back right away.  And I’m now seriously questioning how well that receptionist knows how to accommodate someone living with the disability of PTSD.

It’s not about the fact that there was no appointment until January.  I’m fine with that.  I procrastinated, I wasn’t expecting to see the doctor tomorrow.  But the phone call could have been handled differently:

“I’m sorry to hear your kids have been sick and you weren’t able to return my call.  I’m glad I have you on the phone now.  Unfortunately our appointment slots are booked up until after the holiday break, but can I fit you in for the New Year?”

Another option might be

“It sounds like getting phone messages and returning calls is difficult for you, and email is easier.  Sometimes people with PTSD find calls difficult.  Don’t worry, we can book your appointments over email as an accommodation.  Let me book you in for January.”

This post isn’t about that one receptionist and this one situation.  This post is about not making assumptions about why people behave the way they do. Especially if you work in an organization providing health care services!

It’s also about realizing that accommodation for people with disabilities means more than just building a ramp (though ramps are needed too, I’m not knocking ramps!).  It means realizing that disabilities impact different people in different ways.   Accommodation isn’t always something complicated or expensive.  Sometimes it could be as simple as using email as a way of communicating, or offering choices for methods of booking appointments or receiving information.  Accommodation starts with realizing that not everyone lives life the same way you do.  We all have different abilities and that’s okay.