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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How to cope with chronic suicidal thoughts…

People who don’t struggle with chronic suicidal thoughts sometimes imagine suicide as the type of crisis that happens in the movies.  And it can happen this way, but not for everyone.  You know the cliched scene (we’ve all seen it) someone loses their job, breaks up with their partner, makes a terrible mistake, suffers the loss of a loved one etc. and they spend a dark night contemplating ending it all.   Maybe they reach out, a friend comes over, makes them tea, stays up all night and talks them through it.  Or maybe they are taken to a hospital emergency room, where staff admits, them and they are released a few days later, on medication and thankful that they are still alive.

Yes, single episode suicidal crises happen.  They are terrifying and frightening and can be medical emergencies.  If you are struggling with this type of crisis, you are not alone.  Suicide is a permanent solution to a temporary problem.   There is help available, even though reaching out can be scary.

But what if this isn’t your experience.  What if, like me, you struggle with chronic suicidal thoughts, on and off, for decades?   What if suicidal thoughts and suicidal impulses became, during times of trauma, part of your coping mechanisms?  What if suicidal thoughts, ironically and paradoxically both threaten your life and help keep you alive?  What if it isn’t just “one long dark night”?  What if it isn’t something that a trip to the local emergency room and a short psychiatric admission can even touch?  What do people like me do when they hit a rough patch?

It’s complicated.  It’s complicated for a number of reasons.

  1. It’s very hard to even talk about suicide.  It’s not an easy subject to bring up.  I’m always afraid that people will either overreact (ie. treat it like the suicidal crisis described above and call emergency services) or under react (and ignore my disclosure or not offer support).  Let’s face it, most people aren’t comfortable talking about suicide.  If someone asks me: “How are you doing today?”  they don’t want to hear “Actually I’m dealing with suicidal thoughts at the moment, thanks for asking.”  It’s just not something I can say.
  2. If I do disclose that I’m having suicidal thoughts, most times people just sit there awkwardly.  Try to figure out if I’m joking or serious.  And then change the subject.  Meanwhile, I’m sitting there, just as awkwardly, feeling guilty for making the situation awkward and not just saying “I’m fine.”
  3. See point #1.  Talking about suicide is a societal taboo.  I’ve had these thoughts for 20+ years.  I’m still alive and I’m still finding it difficult to talk about them.  There is something about this that doesn’t quite make sense.
  4. There is an incredible amount of shame related to this societal taboo.  This means that not only do I feel suicidal, I also feel ashamed about it.  I also feel afraid about the consequences that could occur if people find out and misunderstand what chronic suicidal thinking means (aka…911 calls, police, hospitals).
  5.  Suicidal thoughts are not a “cry for help” or a “way to get attention.”  Most of the time I deal with suicidal thoughts alone and people aren’t even aware that I’m having them.  Even when I do disclose, I generally minimize how bad they are.  I try to cope by myself as much as possible.  Self harm has also been a very private thing in my life.  For something to be a “cry for help” generally other people need to actually know about it!  It would be more accurate for me to describe the suicidal thoughts as a way to gain control, the ultimate control, over an overwhelming or out of control situation in my life.  It’s also related to obsessive compulsive thinking, and in that way can be circular and very difficult to control.  Sometimes I have intrusive thoughts about suicide that are obsessive and not related to anything in particular in my life.  They are disturbing to me and they are  unwanted, arriving in my brain suddenly and then leaving.

So how do I cope with these chronic, obsessive suicidal thoughts?  I use some combination of the methods below, depending on what type of thoughts I’m having, how long they last and how severe they are.  It can be helpful to make your own “safety list” with various ideas that you can use when your suicidal thoughts make an appearance.  I suggest that you create a variety of coping ideas, because chronic thoughts of self harm are very persistent and won’t likely go away with the use of just one distraction or grounding technique.  If you are lucky enough to have a supportive partner/friend you can give them a copy of your safety list and they could help you use some of the skills in a crisis situation.  For some folks, taking medication or calling a support line can be items on their lists.

  1. Delay. Delay. Delay.
  2. Distract. Distract. Distract.
  3. Remind myself of reasons why I need to stay alive (aka my kids)
  4. Listen to nature sounds on Spotify.
  5. Get in a safe space (aka my bed, under lots of warm blankets, away from anything potentially dangerous.  This works best for the most severe thoughts when other techniques may not be safe)
  6. Take a walk outside, ideally in nature.  Breathe, move my body.
  7. Drink a hot beverage (tea, hot chocolate, coffee)
  8. Reach out to a trusted friend (I may or may not tell the person I’m struggling)
  9. Blogging (others may use journaling, art or other creative outlet)
  10. Helping others, volunteer work, helping a friend in need (this works very well for me, but caution as it can lead to burn out if this is your only coping tool)
  11. Disassociate or zone out (ensure that it is safe to do so)
  12. Pay attention to your environment.  Count things you can see, feel, touch, hear.  Ground yourself in the present moment.

If you are coping with chronic suicidal thoughts, I hope that reading this post helps you to feel a little bit less alone.  If you don’t struggle with them, I hope it helps you to understand them a little bit and maybe allows you to help others around you who might be living with them.  Many people live with suicidal thoughts for years, it’s exhausting.  So very exhausting and nothing at all like what is presented in the movies.  But it has to be better than the alternative.  So I keep trying and keep breathing!  Keep hoping that it will get easier for all of us!

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.

 

Don’t look at me.

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One of my clearest memories of the abuse with X, is also one of the memories which triggers the most flashbacks.

It’s the reason I don’t like to be looked at, why I sometimes wish I was invisible, why I have hated my body for 20 years, and linked to why I started down the road to anorexia.

It was evening, that time between the brightness of day and the deep darkness of night.  We were in his room, listening to music and…I don’t know what words to describe it with…if it had been consensual I would describe it as “fooling around” or “making out”  but in this case those words don’t have an accurate feel.  We were alone in his room, in the dark and he was abusing me.  Sarah McLaughlin was playing on the CD player “hold on, hold on to yourself, for this is going to hurt like hell…

I remember the blinds were dark,  maybe navy blue, they were shut, but a small amount of light came in between the cracks.  The head of the bed was directly to the right of the window.  I remember the bedspread being navy as well.  There was a dark mood to the space.  So often when we were in his room, his family was home.  Technically if I had screamed, yelled, or run away, someone would have heard.  We were rarely completely alone.  But I felt so much shame, I blamed myself, I felt dirty and I felt like it was my fault.  It never really occurred to me to tell his parents, I felt they would blame me, or not believe me, that they would tell my parents, that somehow I’d be in trouble.  So I learned to disassociate, I stayed quiet, I did what he wanted.   Sometimes I said no, but I never fought back or physically resisted.  I learned quickly that my “no” meant nothing to him.

That evening, he wanted to look at me.  He made me take off my clothes, except my underwear which I always stubbornly refused to remove.  I was afraid to get pregnant and I somehow felt like keeping them on would protect me.

He made me stand across the room from him.  He lay, semi-reclined, on his bed, staring at me.  Just staring.  I felt like an object.  I felt like this one moment solidified the sense of shame that had been growing and building inside me, like dark twisty vines blocking out all the light of my once bright self esteem.  I crossed my arms across my chest, trying to hide myself from his prying eyes.  I felt his actions were motivated by lust. I didn’t feel loved or cared for.  I felt afraid and I felt ashamed.   I don’t know how long I stood there for, but it felt like an eternity before I was able to hide under the duvet again.  I don’t really remember what happened before or after.  I only remember those moments of exposure.

Years later, much more recently, I was dating someone.  The first time I took my clothes off, in my own room, safe and because I wanted to.  He looked at me, and I had flashbacks so intense that I almost passed out.  I had to sit down, suddenly on the bed.  The room was spinning, my heart was racing, I was so dizzy I felt blackness around the edges of my eyes.  And I was trembling, shaking really.    It took a few minutes of lying down for my body to return to a normal state.   This is what PTSD means to me.  The rapid trip between enjoying a sexual moment and being almost paralyzed with extreme physical symptoms.  The panic/flashback is often followed by tears, physical pain and nausea.  I sometimes have difficultly talking or expressing what is happening.

Because of this I have to take time to educate people who are going to be close to me. So they know what is needed to help in those moments when it’s difficult for me to help myself.  It’s important for others to realize that in the midst of a flashback I can’t consent, I can’t think, I can’t communicate clearly, and I need help getting grounded, or I need the space to do so myself.

I often wonder, if people who commit acts of sexual violence realize the impact they are having on the victim’s life.  I wonder, if abusers knew that years later mere reminders of the abuse could have such severe consequences.  I wonder if people would stop and reconsider pushing past “no.”  I wonder if all the law makers, judges, police and lawyers had to live with PTSD related to sexual violence for just one day, they would reconsider letting the majority of reported abusers walk free.

The abuse may only last a few moments, but the impacts can last a life time.

P.S.  Please feel free to share this blog if you are enjoying it!

I’m triggered.

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Being triggered is exhausting.

It feels like being in a constant state of fight or flight.  It feels like panic.  It feels like a reduced ability to think clearly and stay calm.  It feels like fog, a buzzing in my ears.  Everything sounds too loud, lights are too bright, smells too strong.  My clothes touching my body make me feel disgusting, fat and out of control.  Ana is screaming at me not to eat, while another part of me is saying that not eating will make me more panicked.  An internal war begins.  I feel like I’m in danger.

If someone tells me to “calm down” or “not worry,” the panicked feeling turns to desperate anger and I find it hard to keep it hidden inside.

If the trigger goes on for a long time, especially if it is combined with actual real life danger or stress, I eventually become exhausted.  I am desperate for the uncomfortable feelings to pass.

And in the desperation I always begin obsessing about self harm and sometimes suicide.  Intellectually I know that this doesn’t make sense, but it’s my brain’s default setting for  TOO MUCH STRESS!  I learned about 4 years ago that my suicidal ideation is a red flag, it’s a signal from my brain that I need to reduce my stress ASAP.  It’s not really about dying, it’s about ending the horrible painful, out of control panic feeling.  NOW.

My main ways of coping with self harming thoughts and suicidal ideation is by trying to tune out.  I do this mainly by surfing the internet, checking facebook, texting, checking my phone and also by blogging.  I find that technology is a good way of tuning out the self destructive thoughts for a while.   So sometimes, when I’m checking my phone too often, even if it annoys you, even if it seems impolite, try not to judge, I might be coping and distracting myself from negative thoughts.

Another great way of coping with triggers is exercise.  Before I developed arthritis I used to cope by running.  That was amazing.  I miss it so much.  Walking can help, getting out into nature can help, dancing can help, moving my body and letting some of the pressure release.   But when I’m at home, my go to coping during the evening (the most difficult time of day for self harm urges) is texting and internet time.

It’s hard to explain triggers to people who don’t have PTSD.  People who live with panic attacks or generalized anxiety can understand parts of it.  But PTSD triggers are a little different somehow, because they are connected very tightly with actual bad events which have happened in a person’s life.  It becomes very difficult at times to distinguish between immediate stressors in day to day life, and abuse/danger/violence.

Triggers can also be emotional.  For example one of my main triggers is feeling like I am not being believed, or even might not be believed when I’m speaking my truth.  Another is feeling like I’m going to get into trouble for doing something which is reasonable and not generally perceived as negative.  These feelings are related to gaslighting, emotional abuse and systemic/systematic institutional abuse and neglect.

When I’m triggered what I need is to get grounded as quickly as possible.  If I can’t get grounded then what I need is to keep myself safe and as calm as possible.  Sometimes this means that I want to be at home, be alone, or be with people I feel safe expressing myself with.  Staying safe sometimes means spending hours online after the kids are asleep, or lying in bed all evening because I don’t trust myself to make safe choices.   I’m not being lazy, I’m protecting myself in the best ways I have learned how.

Sometimes when I’m triggered I disassociate or space out.  I might seem emotionally distance or cold.  I might be more emotional, or my emotions might seem out of proportion with reality.  That’s because they are!  They are a reaction to reality PLUS the past trigger related to abuse and violence.

I know I’m not doing a perfect job at life when I’m triggered.  I constantly worry that others will judge me because my capacity to perform at my highest level is reduced.  My brain will literally shut down, I will have problems remembering things, trouble finding the right words under pressure, I might cry or freeze up, grow silent or suddenly angry.  I might be impatient with the kids when they haven’t really done anything wrong.  I might snap at those close to me, or not be as kind as usual.   I don’t mean to.  Believe me my level of guilt is so high that it contributes to the problem!  I know I’m not acting “normal” but I can’t help it.   Sometimes I need space to get grounded, sometimes I need others to remind me that even though it’s difficult I’m doing my best and that is good enough.

If the triggers are entirely related to the past, and no danger exists in the present, for example during consenting sex, it helps for the other person to remind me “you are safe right now, it’s 2016, you are with _____, nobody is going to hurt you”

If the triggers are related to the past, but there is some threat in the present moment, it helps to acknowledge both sets of feelings are real.  Yes, this situation reminds me of the past, that is difficult and scary.  Yes, there is some threat in the present and that is scary too.   I  might need to get grounded FIRST and then brainstorm solutions to the present situation.  Sometimes self care can play an important role in grounding.

PTSD is invisible, triggers are invisible, all this is happening inside my brain and my body is reacting.  It sometimes feelings as if the past is happening all over again.  Especially when triggers lead to flashbacks.

Please understand I’m doing the best I can.  PTSD is a difficult illness and because it is invisible it can be hard for others to understand.

Compassion helps triggers.  Everyone deserves to feel safe.  But when you live with PTSD, feeling safe can be like searching for the proverbial needle in a haystack.  When you aren’t quite sure what the needle looks like, or if it is REALLY in the haystack!  You aren’t even sure exactly why you need the needle and what you are going to do with it when you find it!

Yes, life can be confusing.  Triggers can be confusing.  PTSD can be confusing.

Tonight I’m confused, but I’m coping as I write.