anxiety

Vulnerability Hangover.

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I’ve been feeling generally better over the last month.  I cut my hair short and have been expressing my gender in more neutral and androgynous ways.  It feels lighter and more authentic.  I waited a long time to cut my hair and I don’t regret it.  It’s a pixie style cut and since I got it I’ve felt less self conscious and physically awkward.  I’ve had some days where I felt more confident, less hesitant and less full of self doubt.  It’s felt good.

Since getting custody of my children, after a four year long court battle, there have been slow positive changes.  My kids are happily settled into new schools.  I get to spend more time with them.  Their mental health is generally more stable.

It’s Fall, the leaves have started changing and the world around looks beautiful.

But today I woke up with an intense and familiar feeling: that I’m taking up too much space.  The desire to take up less space is tightly bound together with my battle with anorexia.  The feeling of wanting to disappear or be invisible means that I’m more comfortable when my weight is lower.  I feel internal pressure to be thin, thinner or eat less, not because I care so much what I look like, but because the sensation of taking up too much space becomes unbearable.  I don’t feel like I deserve to eat enough to take up my full amount of space. Restricting food and controlling weight symbolically feels like taking up less space.  I’m not sure how to describe the feeling.  Worthless? Shameful? Self critical?  Useless?  Annoying?

I could go on, but I think you get the point.  It feels awful.

Over time I’ve noticed that there is a pattern to the days I feel this intense desire to take up less space, hide or disappear.  Days when my body feels wrong, too big…too much!  These feelings are linked to trauma and abuse, to my boundaries being crossed and to me pushing myself, challenging myself to do more (i.e take up space).

I posted on facebook today about feeling like I was taking up too much space.  Someone I know referred to it as a “vulnerability hangover” and they were exactly right.

Yesterday, I took on a piece of very personal advocacy work.  I attended a mediation meeting with an organization that has not played a positive role in my family’s lives.  I was scared.  I felt alone.  I felt threatened and scared.  And yes, I felt incredibly vulnerable.  I’m not able to write very much about the meeting, because it was confidential.  But it lasted many hours and I left feeling disassociated and numb.  I wasn’t upset, but I wasn’t fully present either.   I didn’t really want to talk about it.  I just wanted to sleep.

I woke up this morning and I felt like I was taking up too much space.  I wanted to hide and disappear.  I felt like crying through most of the day.  I felt irritable and angry over tiny things.  I felt stupid and useless.  I felt like I wasn’t going to be able to do a good job at anything.  I was doubting my abilities.

The familiar feeling of not being important was racing through my head.  Feeling like nobody likes me, that people merely tolerate my annoying presence.  Like a buzzing fly which someone feels too guilty to swat dead.  I felt too big.  Too much.

It was incredibly helpful for this person, who I don’t even know that well, to point out that the strong feelings were likely related to how vulnerable I was yesterday.  How exposed I felt.

So, today I have a vulnerability hangover.  It feels awful.

But I’m hoping that the advocacy was worth it.  That it was more effective and healthier than staying silent.  I’m hoping it makes a difference in another family’s lives.

I spoke my truth.  It was risky and terrifying, but I did it.  I wanted to run away, but I didn’t.  I faced some fears and came out the other side in one piece.

Just hungover.

You are fine…until you aren’t. Life with PTSD.

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Today was a rough PTSD day.  Sometimes that’s the way it is with PTSD, you are fine, fine, fine…until you aren’t.  And then you real aren’t!  Nights like this I love my medication so hard.  Nights like this I don’t even consider the choice of going off psychiatric medication.  Nights like this I know that I’ve been staying up too late, not listening to my body, pushing myself further than I can reasonably go, ignoring early warning signs and just generally not trusting my own inner wisdom about what I can handle.

I dropped the kids off with their Dad this morning.  That’s always difficult.  It always lowers my capacity and PTSD coping bar by easily 50% by 9AM.

I had a difficult phone call at work.  Had to support someone around a type of abuse experience that I find triggering.  I dealt with it well, but it lowered my capacity bar by another chunk.

I met a friend for coffee this evening.  There was a traffic mess and the person was late.  While I was waiting, a car with a souped up muffler purposefully back fired it, reving the engine suddenly right in front of me.  I was looking at my phone and the loud noise and vibration startled me a LOT.  Before my heart stopped racing, the car back fired again.  I jumped again.  I almost burst into tears.  My PTSD coping bar was now at 0-5%.

This level of startle response is NOT a warning sign of PTSD issues for me, it’s one of the clear signs that I’ve been ignoring warning signals for a while.  When I feel like crying after being startled in an otherwise safe situation, PTSD is on the scene in a major way.  It’s time to get safe, do some grounding, probably get home and away from crowds.

But I didn’t listen.  I had plans to see a show later and I knew it was no longer the right choice.  The sign said there were “loud noises and flashing lights.”  The self aware voice inside me said “Not tonight.  This isn’t going to work tonight”  but I ignored it.  I pushed myself.  I tried to be “normal.” I tried to have a full PTSD tank, when it was really running on fumes.

The person I was meeting there was in a different space, relaxed and ready to enjoy the show.

I needed some help to get grounded and attempt the experience.

I didn’t get it.

I was already inside the show.  There were strobe type flashing lights which I know can trigger migraines for me.  My anxiety got worse.  I started to feel trapped and afraid.  I didn’t know what to expect and my anxiety was escalating.  I knew a panic attack was coming.  Generally, there’s a tiny bit of warning before it goes to 100km panic.  I have a few moments where I’m thinking clearly enough to know I need to exit.  I need to get outside NOW.  I need to be outside 5 minutes ago.

I can feel my chest tighten.  My breathing is coming faster.  I can feel the panic rising and rising like a tsunami wave of fear.  I start to walk as fast as I can without running.  I don’t know how to get out.  I just keep walking forward, sliding past people.   Mentally I know that if the tears start before I get outside then I’ll need help to get out.  I don’t want to ask a stranger for help.  I don’t want to slow down.  I know I need to get outside NOW.  My chest is painful, the tears are in my eyes.  The dizziness is starting. I feel like it’s taking forever to find the door in the darkness.  I feel embarrassed.  I feel ashamed.  I feel afraid.

My hands are on the door, I can see the outside and then I’m out.

I’m hyperventilating now.  Walking as fast as I can.  Crying and breathing in choked breaths.  So dizzy.  I want to slow down, catch my breath, but my feet keep going forward.  I’m downtown, in the dark, alone.  I pick up my phone and dial a friend.  He picks up.  I’m sobbing now, into the phone not able to speak.   He’s asking me what’s wrong.  I’m still walking, trying to catch my breath, manage to blurt out “I’m having a panic attack!”   He knows I’ll be okay, I’m not in physical danger, just emotional.  He speaks in a soothing voice, encouraging me to breathe, until the tears subside enough for me to speak.  I’m gradually slowing my breathing now.  It’s taking a focused effort, but I’m doing it. My chest hurts so much it feels like it might explode or collapse or both.

I walk around for 20 minutes before I’m calm enough to drive home.  The panic subsides but I know it’s only a tiny distance away.  I’m not sure if it will stay away, or return, out of control, taking me back down into tears.

I get home safely.  Take my pills as soon as I’m in the door.  I know that within 45 minutes I’ll feel calmer, so I start typing this as I wait.

I’ve noticed that abelism towards mental illness looks like this:

Folks can understand the triggers I have which are directly linked to the violence.  They understand how to be careful with sex.  They understand why I can’t fall asleep unless I’m alone.  They understand aspects of PTSD.  But they don’t REALLY understand.   A lot of people don’t understand that any situation where I don’t know what is happening, feel out of control, feel a sense of danger or feel that my environment is too unpredictable can be a trigger and can remind me of the feelings of being abused.

They don’t understand that in the moments when a panic attack is happening, the danger is real to me.  Logic doesn’t stop the fear.  Intellectual reasoning doesn’t stop the fear.  Being impatient with the person doesn’t stop the fear. The only way to stop the fear is to be believed and validated and gently helped through grounding techniques like breathing (or whatever the person finds helpful).  Or when it’s really bad, just holding space for the person until the panic attack ends.

In those moments of panic, telling someone to “just calm down” is like telling a person who uses a wheel chair to “just walk.”  In those moments of panic, PTSD is a disability.  It’s a real physical and physiological reaction based on experienced trauma that has changed a person’s brain.  Just as a wheel chair can help some folks with physical limitations get around,  grounding skills can be a vehicle to help someone with PTSD get around.  Without these skills and coping techniques many things just aren’t accessible or possible.

Someone having a panic attack or flashbacks isn’t doing it on purpose.  They aren’t misbehaving.  They aren’t lazy or controlling or seeking attention.  Their brain is literally misfiring.  The person is experiencing a safe situation as an extremely dangerous one.  If the panic attack and flashbacks are happening at the same time, the person might not be fully present in the moment, they might be in the past or mentally re-experiencing the time of the original trauma or abuse.

A lot of the time PTSD is an invisible disability.   A lot of the time when I tell people I’m not okay or I’m struggling it’s not visible on the outside.

Panic attacks can be visible or invisible.  For me the scariest ones are the visible ones, where I know I’m acting erratically, because then I feel shame AND panic.  These scary ones are most likely to happen when I’ve missed too much sleep and when I’ve been ignoring early warning signs and pushed myself too far.

Another thing about panic attacks and flashbacks is that when you have them, you start to be afraid of having them again.  I’ve learned to live with flashbacks and anxiety, but when I have severe panic attacks with flashbacks the physiological hyper arousal can take 5-7 days to fully diminish.

If someone you know experiences flashbacks or panic attacks, a compassionate response can be extremely beneficial.  I know it’s hard to be patient all the time.  Nobody is perfect, but your response in these moments of high anxiety can make all the difference.  Even if it doesn’t fully relieve the anxiety, it can reduce the guilt and shame and fears of rejection.  Some people with PTSD, myself included, have a deeply held internal belief that they are freaks or crazy.  Treating someone compassionately can help counteract this negative internal PTSD dialogue.

I’m going to bed.  Hopefully I can sleep this off.

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Justice.

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I took this photograph today.   I lived in this city most of my life and I’ve never been drawn to look at this sculpture before.

Justice.

This statue embodies exactly how my life feels at this moment.

Grey. Solemn.  Frozen in time.  An unknown, robed figure holds a sword over me, about to make decisions that will alter the course of my life and the lives of my family members.

I feel like one wrong move and the sword will pierce my heart and all will be lost.  I’m walking on a tight rope, on egg shells, on the edge of where the ocean meets the land, on a wire at a circus…fill in the metaphor or analogy of your choosing.  I’m barely breathing.

Justice for who?  How is this justice?  Years of my life spent trying to prove things that seem self evident.  Years of him being believed and me seen as crazy, or potentially crazy.  Years of my privacy being breached and shattered to the point I’m hardly sure what privacy means anymore, except to trust no one.  Is this justice?

Interpersonal violence doesn’t end the moment she walks out the door.

Domestic violence doesn’t end when she leaves.

Family violence doesn’t stop when the relationship is over.

She might be physically safe now, but she still looks over her shoulder.  She still watches herself.  She still fears that anything she says or does might get her or her children into trouble.  She lives in fear of SOMETHING happening, even though she doesn’t always know what that vague threat might be.  She rarely sees him, but he impacts almost every aspect of her life.  He calls her crazy.  He tells her kids she is crazy.  He tells anyone who will listen that she is crazy.

But if she is crazy, than every survivor is crazy.

I don’t think we are crazy.  I think the entire system is broken and set up for us to fail.  We don’t have a justice system, we have a legal system.

Wake up.  Justice doesn’t exist for women like me.

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.

 

International Women’s Day

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There was a call today for “a day without women” as a protest against President He Who Shall Not Be Named.  Women were encouraged to stay home from work or to wear red in protest.  It’s also International Women’s Day.

I decided to wear red, but I didn’t stay home from work.  I challenged the patriarchy by going to work today.  Helping women.  It was important for me to go to work today, because I’ve been struggling a LOT the past few weeks. Last week I was tempted to quit my job, and just accept that I’m not “able” enough to pass as normal, not “able” enough to continue working, too sick to keep pushing through.

But I realize that the patriarchy wants nothing more than for me to fail.  My abuser wants me to fail, I think he wants me to crash and burn and commit suicide.

So for me going to work today was an act of defiance and resilience.  It was me overcoming the panic attacks as I got ready, left the house and drove to work.  It was me ignoring the negative self talk which was telling me that everyone hated me and that I should just quit.  It was me saying that I won’t give up, I won’t give the system the satisfaction of seeing me fail.

Failure isn’t an option.  I have to be “well enough” and “able” enough to keep going forward.  I need to do it for my children and for people who are depending on me.  I know I could be replaceable at work, but my kids only have one mother.  So I’ve decided to take better care of myself, to rest and to try to move at a pace that is sustainable and won’t exhaust me to the point of panic and wanting to quit my job.   I’m going to do the best I can, but that best might not be what others are able to do.  Right now, I have to do what I am capable of, what I am able to, and stop judging myself against standards I’m not always able to meet.

So for International Women’s Day, I left the house.  I battled panic attacks but I did not let them stop me.  I tried to focus on my ability rather than my DIS-ability.  I did my best and for today, maybe that was good enough.

Pin featured in photo by Rachael House http://www.rachaelhouse.com

 

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.

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.

Why Women Don’t Leave

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If I knew  what leaving meant, I probably would have stayed.

I was naive, and I’m glad.  I’m glad that I left and that I’ve been forced to fight, but nobody should have to fight this hard to be believed.

As I walked into the court house yesterday, over three years after leaving, my first step was to check with the information desk to find out what court room my matter was being heard in.   I checked the list and realized that we were scheduled in a small motions room, rather than a full sized court room.

Why does that matter?  Why does the size of the court room matter so much that I’m writing a blog post about it?

I rode the elevator, arrived at the correct floor and met my lawyer.  My anxiety grew and grew as I thought about the room.  I could feel panic starting, my body was tensing, all the preparations I’d done for the day were quickly flying out the window.

I opened the door of the courtroom just a crack and peered inside.

It was as I’d feared.  A small motions room, a large conference table filled the room, with the judge’s dias at one end and a small witness box to the side.  The whole room was not much bigger than an average sized dining room.   A conference table, with 3 chairs along each side, spoke of mediation, settlement, concord, agreement and discussion.

All I could think about was this:

This is the reason why women don’t leave.  Women don’t leave because they don’t want to spend two days, trapped in a tiny court room, sitting face to face with their abuser, unable to speak or move, except on the judge’s schedule.

What could be more triggering for a survivor of violence?  Not only do I have to sit in the room with him, I have to sit in an assigned chair (no choice), I have to sit quietly (I can’t speak),  I can’t stand, move or stretch to ground myself and I have to listen to various people speak about traumatic experiences in my life as if I was not there.   If I react emotionally in any way, he will see me and he will have power over me.  If I cry, he will have power over me.  If I get angry, he will have power over me.   It’s a situation of power and control and lack of options and I have no choice but to stay in it.

Luckily today I have support person with me, otherwise I feel like I wouldn’t even be able to sit in that room.  Every part of me screams NO!  I don’t want to go in there.  I want to rebel!  I want to fight! I want to yell at everyone that this system is unfair, unjust, unhealthy and re-traumatizing.

But that isn’t an option.  Instead, I sit in the room.  I clench my hands together as tightly as I can underneath the table.  My whole body is shaking, as it does as I’m trying desperately to process trauma that is overwhelming me.  I try to tremble in a way that is not noticeable, or could be interpreted as shivering from the cold.  I try to breathe.  I write notes and doodle continuously.    I try to tune out and disassociate enough to be able to stay sitting in the room, but not so much that it’s obvious, or that I can’t stay focused.   I listen to what is being said, but I try to detach myself emotionally from it.  I try to put myself into a frame of mind where I’m observing someone else’s life.  But it doesn’t really work.

As the day wears on, the oxygen in the room starts to disappear.  I feel like I can’t breathe.  I have a harder time sitting still.  My leg starts to shake,.  my body trembles again, almost imperceptibly.   I try to fidget just a little, but in a way that doesn’t come across as anxious.   I start to feel panicky, like I need to run out of the room.  All my muscles start to hurt from holding them tense, from shaking, from sitting still, from being unnatural and on edge for hours at a time.   The time that goes too slowly.  I feel like I’m in a place where I will never escape back to reality.    I’m stuck in court world, no windows, no escape, it’s own set of rules and rituals.  I’m a stranger in a strange land.

And right across the table from me.   Emotionally nonreactive, as if this whole ordeal is uneventful and ordinary, sits my abuser.  Calm and collected and emotionally blunted.   And I feel a sense of confusion.   Who is this stranger?

How did we get here?   It’s a blur of months and years.  It’s a blur of “just get through this next few months.”  It’s a blur of “just keep going for the kids.”  It’s a blur of coping and surviving.

This is why women don’t leave.

Because the process of leaving doesn’t end the day she walks out the door.

Survivors need compassion when they can’t leave because it’s too hard.

They need help to leave because it’s too hard to do alone.

And they need help, patience, compassion and validation long after they leave.  Because the process of leaving can be as traumatic as the relationship itself.   Because it’s too hard to do alone.

Depression.

/ hopeforsanityblog / 8 Comments

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Depression doesn’t always look the same.  Sometimes it is most clearly described by how I feel when it lifts.  When I’m depressed I’m not actually myself and when the depression lifts I wake up and I’m me again.

When I’m depressed, I am physically exhausted by social contact and social situations, but at the same time I don’t always want to be alone.  One of the reasons social situations are so difficult is because social anxiety is a symptom of my depression, and depression is fueled by my social anxiety.

Over the past few weeks, interactions with others leave me drained. Probably because half the time I’m spending with people I’m hyper aware of whether or not I’m behaving appropriately.  Because depression blunts and numbs some feelings and amplifies others, I’m constantly monitoring myself and thinking:

“Am I acting normally?  Can this person tell I’m acting?  Am I smiling enough?  Am I smiling too much?  What should I do with my hands?  Stop picking at your skin! Remember to make eye contact!  Not too much eye contact!  Stop fidgeting!  Is my facial expression appropriate for what they just said?  Make sure your face is responding like a normal person! That was a joke, laugh.  But don’t laugh too much.  Did that sound stupid?  Do they hate me?  Did I make a mistake?  Is my facial expression appropriate?  Oh my god, did I even hear what she just said? Smile.  Act normal“

After a short interaction I’m exhausted and I want to flee to a place where I can just be.   This usually means being alone.  I’m completely relieved to be alone.  I often hibernate under quilts and blankets where I feel safe.

But then the loneliness hits.  I text.  Texting is much easier than phone calls or in person hang outs.  When I’m texting I just have to think about the words and not all the other complex social dance behaviours that I’m sure I’m completely mangling.  Texting is safe.  Texting breaks isolation, without crowding me or making me self conscious.

When I’m lonely and depressed, I start to believe I’m literally the only person on the planet who doesn’t have plans at that moment.  All logical reasoning to the contrary is dismissed by my social anxiety brain.   I start to think that nobody likes me, that I’m boring or annoying, that I’ve said terrible things to offend everyone I know.  I feel jealous about the plans and social gatherings of others.  And yet, ironically, I often cancel plans or say no to things I am invited to.   The contradiction of depression is frustrating and impossible.

Depression is panic attacks in crowded places.  Panic attacks about choosing food, or anxiety about eating around other people.   Depression is feeling “fat” when my body hasn’t changed. Depression is anxiety that everything I say or do might get me into trouble or make my situation worse.  Depression is reading my emails over and over and over and over, obsessively, worried that I made a mistake, said the wrong thing or was oppressive.   Depression is paranoia that the email was accidentally sent to the wrong person, somehow ruining my life.  Depression is knowing I have to do something at work, but feeling incapable, afraid and ashamed to ask for help, thus procrastinating and avoiding.

Depression zaps energy.  I’m literally exhausted almost every minute of the day.  It’s not something that can be fixed by more sleep.  Though less sleep makes it much worse.  My body feels heavy and I struggle to get out of bed in the morning.  My bed feels warm and safe in the mornings, but physical pain and stiffness in my body prevents me from lying down for too long. Sometimes I’m drained and have to lie down after taking a shower in the morning.  But somehow I push through it.

I feel like robot, automatically going through the motions of my day.  I check each task off against a mental list.  Breakfast, check, kids to school, check, commute to work, check.  Each day moves through a series of tasks to be completed.  I’m always counting time until the next time I can be alone and rest.  I’m often watching the clock, but I’m never comforted by it. Then after about one day of a weekend alone, I’m lonely and waiting for my kids to return.  It’s a terrible feeling, like you have nothing to look forward to, but are always looking forward to something unimportant.  Maybe the next day will be brighter, maybe the next _____ will break the cycle, maybe I’ll wake up tomorrow and feel better.

Depression is being unreasonably and intensely irritated by innocuous things.  Like the sound of someone chewing near me.  I could scream.  My whole body is tense, I can hear every sound.  Depression is losing patience in a split second, in situations I would normally be able to cope with.  Depression is feeling frustrated when people repeat themselves or take a long time to get to the point of their stories.  Depression is hating myself because I know I’m not being as kind as I should be.  Depression is losing my temper at my children, when they are barely doing anything wrong and my rage is uncontrollable like a volcano, then dissolves into guilty desperate tears.  Depression is intense compassion fatigue.  Not having enough energy to have empathy for others and then beating myself up with self judgment afterwards.

Depression means rarely living in the moment.  Depression is being caught in a tangle of awful memories from the past, or absorbed in worries or thoughts about the future.  Or more often, ping ponging back and forth between memories and worries.  In the moment, there is often zoning out, disassociation, numbing and that floating feeling of being something less than human, unable to connect with anyone.  Feeling like my essence of humanness is just beyond reach.

Depression is either crying too much, or (this time) not being able to cry at all.  Depression is either all the feelings right at the surface every single minute, or all the feelings pushed down and boxed up into controlled spaces inside me.

Depression is the darkness in the Fall and Winter months.  Depression is waking in the dark, coming home from work in the dark and forgetting what the warmth of the sun feels like.  Depression is like sitting at a dirty window, watching the normal world proceed just outside my grasp.

Depression is feeling suicidal, obsessing about death and dying.  Sometimes it is destructive impulses, or sometimes, wishing I hadn’t been born at all.  Sometimes it is a passive thought of just not wanting to be alive.  And then the torturous, trapped feeling of knowing that suicide is no longer an option.

Depression is boring.  Like this blog post feels boring.

It’s a world without light.  Depression is obsessive, recurring thoughts.  Depression is feeling like a bore to others, feeling self-obsessed, immature and uninteresting.  Depression is feeling unlovable and like you will always be alone.

Depression lies.

Even if I know that depression lies, it’s not so easy as just snapping out of it.

When I’m depressed I’ve learned that the best I can do is to stay as safe as possible, sleep regularly, eat and drink regularly, self care, be patient with myself, lower my expectations of myself and just do my best.

Because depression always lifts.  It’s not forever.   But it feels awfully bleak.

Depression meets PTSD. Crash.

/ hopeforsanityblog / 2 Comments

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I’ve realized over the past three years that depression is often more of a secondary problem for me.  It’s very situational and very linked to PTSD.  By the time depression flares up, it generally means that I’ve been coping with PTSD triggers for too long and I’ve started to crash into exhaustion.  Depression sometimes means feeling literally nothing, while PTSD can mean feeling everything and things that are from the past vaulted into the present, clear as day.   This can be a confusing progression.

Lately it’s hard to tease out whether I have a whole host of mental health diagnosis or just one (PTSD) causing a host of symptoms.

Abuse triggers can lead to negative feelings about my body which can then trigger my good friend Ana…yes, PTSD comes first and anorexia is a symptom.   For me anorexia is mainly a series of obsessive compulsive thoughts and behaviours which are linked to extreme anxiety around changing my food rituals.   So anorexia comes first, and OCD traits follow.

When I have a lot of PTSD symptoms and flashbacks, I start to have trouble sleeping and I have vivid nightmares.  Sometimes I wake in the middle of the night to a full panic attack.  Flashbacks can lead to panic attacks during the day as well, and also to anxiety in crowds and enclosed spaces.  So PTSD comes first, and anxiety and panic symptoms follow.

At the end of the line comes depression.  DEPRESSION.  It feels so heavy.  Depression to me leads from coping to constant suicidal and self harm ideation in what seems like mere seconds.  For me, suicidal thoughts are often the first real indicator that I’ve slipped into depression again.  This may seem backwards, but for me the most severe symptom tends to come right at the start, even if I’m depressed for only a few days.

When I’m depressed I feel like I’m walking through a thick soup of fog.  Every fibre of my being hurts and feels heavy and leaden.  Sometimes I have to lie down after just showering and getting dressed in the morning because I feel too exhausted to continue with the day.  When I’m depressed I have no energy.  I want to crawl into bed and hide.  Unfortunately, I’m a single parent and I have a full time job.   It’s not an option just to crash.

So I keep going, but the time crawls by.  I feel unsure if I can get through the day.  I feel unsure if I can stay safe, and resist the negative thoughts.  My self esteem crashes.  I start to feel a lot of feelings from the past.  Or maybe that is backwards, maybe I feel the feelings from the past and it triggers depression.

When I feel out of control of important aspects of my life, I am triggered and I think about suicide.  This is the way my life is.  It’s been this way since I was 17 years old.   It’s both normal to me, and completely terrifying every time it happens.

The depression always lifts and these days it lifts more quickly than it ever did in the past.  The lights come on again, I see the world clearly and not through a haze.  I feel connected and I feel like I am competent at some things.  When I’m depressed I feel alone and I feel utterly worthless.  I feel like a burden and a problem and someone that people I know put up with, rather than care about.  I have trouble making small talk.  I spend a lot of time silent.  I feel an immense amount of social anxiety and discomfort in social situations, especially those involving food.  Depression, anxiety, anorexia, PTSD….it’s a perfect storm of misery.  I’m caught in the middle of a storm of symptoms and I don’t know when they will abate.

Right now I’m triggered because I’m worried about my children.  I’m triggered because of the way my ex-husband treats my children and me.  I’m triggered because this is the time of year, 3 years ago, leading up to my physical separation from him, when things were at their most tense and scary.

I’m triggered today because my daughter told me that her father’s avatar/icon for me on his phone is a piece of raw meat.  Raw chicken.   The father of my two children sees me as nothing more than a piece of meat.

Fuck.