Depression meets PTSD. Crash.

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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.

 

Restraint

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In the summer of 2001, I overdosed multiple times.  Some of these stories are described in other blog posts.  After the last of that series of suicide attempts, my psychiatrist put me on a Form (sectioned me, 72 hour hold).  He refused to release me from the hospital unless my parents came to collect me.   I remember my father driving down to pick me up.  I don’t really remember being released, but I ended up back home at my parents house, many hours away in another city.   The past few months felt like a bad dream.

I remember my parents had hidden all the pills in a bag in their bedroom closet.  I remember that there wasn’t a lot of trust, and for good reason.  I tried to relax, but the thoughts of self harm were propelling me forward.  I was caught in a vicious cycle, medication induced self destruction.  I would feel unsafe, hurt myself, go to the hospital seeking safety…then after a few days panic, feel trapped and beg to be released.  It went on over and over.  I always wanted to be where I wasn’t, I was chasing the feeling of safety, of quiet in my mind, of escape.

I remember walking up to the plaza by my parents house.  I bought an exacto knife at the dollar store and sneaked it into the house.  I was always buying, hiding, and throwing away tools during those years.  I often hide them in various places for safe keeping.  Intellectually I knew that having them in the house was the opposite of safe, but somehow their presence simultaneously calmed and panicked me.   It’s rare, even today that I don’t have something hidden.  Even though I don’t use the tools, I sometimes feel compelled to buy and keep them.   Sometimes I’ve called friends and asked them to help me throw them out.  I’ve handed them over to therapists and doctors.  I’ve hidden them and felt ashamed.  Even writing this brings up a feeling of shame inside me.  This is the power of addiction, the constant push and pull between the promise of safety and the threat of disaster and destruction.  Back then, I thought I was in control.  I thought the cutting kept me in control, but in reality the urges controlled me completely.

I had the knife at my parents house, I cut myself with it.  Deeply, but not deep enough to require medical attention.  I told my parents and asked them to take me to the hospital.  I told them I felt suicidal and I wanted help to control the urges.  I remember sitting in the ER waiting room, in a different city.

I don’t remember everything that happened.  I remember talking to a Dr, I was sitting on a stretcher, it wasn’t a special psychiatric emergency, just a regular bed.   The doctor agreed to admit me.  Then nurses came and gave me a gown, they took my clothes and items and put them into a white bag with a plastic drawstring labelled “patient belongings.”  This was different, the anxiety began, “why are they taking my things?”  Apparently this was the protocol at this hospital.

I was taken up to the 4th floor, to the Mental Health Unit.  It was a different layout and different style that the hospital I’d been in only a few days before.  It seemed larger and was laid out more like a large rectangle, rather than a long straight line.   I was shown to my room.   Outside the room was a cupboard and the nurse locked my things in there.   I was allowed to keep my teddy bear, but not my clothes.  In this hospital there were 2 beds to a room and each room had it’s own bathroom with a toilet and shower.

I stayed in the hospital for a few days.  It was the last week of June.  A few friends came to visit me.  I was given my clothes back and allowed to leave the hospital on passes.   During one of the passes I went to visit the psychologist who had treated me as a teenager.   To be honest the appointment was not helpful.  I don’t think she had a good understanding of me.  She didn’t understand why I was sick (because I’d been abused) and she didn’t understand why I was cutting myself and suicidal (because of the abuse and the medication cocktail).  I felt that she shamed me and threatened me to stop my acting out.  I don’t really remember exactly what was said.  I only remember feeling desperate when I left.  I think my parents dropped me back at the hospital.  I was in the lobby of the hospital, where there was a pharmacy and I considered buying a giant bottle of the medicine I had been told would kill me if I overdosed again.  I felt hopeless.

Somehow I managed to go back upstairs to the ward without incident.  I remember a few days later I wanted to leave, as was my usual pattern.  It was the weekend, I believe it was July 1 and I wanted to go home to see the fireworks.   I did as I would have in the other hospital, starting convincing them I was okay.  But somehow it backfired.  They didn’t believe me and they said I couldn’t leave until my doctor returned the next day.  I started panicking and becoming angry.   They told me they were holding me involuntarily because they thought I would just leave.  I was crying and banging my head.  I went into the washroom in my room, took off my earring and scratched my skin with the sharp end.  It wasn’t even enough to draw blood, just to cause pain and leave angry looking scratches on my body.   I remember being at the nursing station.  I was given a cup with liquid medication inside.  I was told it was Nozinan, a medication I’d used for panic before.  I drank it and soon after I realized something was wrong.  I became extremely drugged and when I asked the nurse had given me 5 times my usual dose.  They took away my clothing again and gave me a hospital gown.

Before I fell asleep or settled into my bed I realized what had happened.

I’d been chemically restrained.

They didn’t want to deal with my acting out and so they drugged me.

I felt betrayed, I felt scared.  I felt like I couldn’t trust anyone and I felt like my life was out of control.

The next day my doctor returned and agreed to release me.  The only useful part of that hospital admission was the doctor switched my medication to one that I still take today.  One of the few I’ve found over almost 20 years that actually makes me more, rather than less, sane.   For that I was thankful.

I soon went back to my home.  The cycle continued.  Looking back I realize an important lesson.  It’s not possible to keep someone else safe.  If someone is determined to harm themselves they will find a way.  Short of restraining someone and drugging them, it’s impossible.  The person has to want to help themselves, and they have to find both a purpose for living and a direction to move toward.  A goal, a passion, a reason to fight.  This is unique and can’t be forced or given to someone.  Believing in myself happened over time.  The psychiatric system is a crisis management system and nothing more.  The true help I’ve received over the years has come from other places entirely.

 

Scars.

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What is it like parenting two children when you are a psychiatric survivor?

Pretty damn scary.

I remember when I first got pregnant and for the first 2 years of parenting my kids, my biggest fear was that someone would call Children’s Aid and report me as an unfit parent.  I worried that my first baby would be taken from me at birth.  You might ask why would someone whose baby isn’t even born worry so much about being an unfit parent?

My body is covered with scars from self inflicted wounds.  I was terrified someone would see this, make assumptions about me, and consider me a danger to a child, especially my child.

I’ve been parenting for almost 10 years now and so far this fear has never materialized.  I still worry about being considered “crazy” and thus “dangerous” and thus “unfit.”  In fact, this is the weapon my ex-husband has used against me since the time I began leaving him.  Just accusing someone of being crazy tends to impact the way others view that person.  My ex-husband took moves out of Dr. X’s playbook and began telling everyone, including the children’s health professionals, our neighbours, the kids’ school AND Children’s Aid that I had borderline personality disorder.

Despite the fact that my own doctor and many other doctors have testified that I do not have borderline personality disorder, this label is still haunting me 15 years after it was first, incorrectly, applied by Dr. X.

Let’s just break this down for a minute.

In the days of insane asylums, a man could have his wife committed against her will since she was essentially his property.  I’m sure asylums were full of women who were wrongly diagnosed as “hysterical” or something, just because they spoke out against the men in their lives.  Maybe they were being abused and dared to say something, maybe they didn’t conform completely to patriarchal societal standards, but one way or another they were put away.

The days of asylums are gone, but the stigma of diagnoses like borderline personality disorder remains.

It’s a very convenient excuse to deflect responsibility for perpetrating abuse.  “Oh, she’s crazy don’t you know.  You can’t believe her story because she’s mentally ill!”

Sound familiar to anyone?  Yes, accusing survivors of being “crazy” is an aspect of rape culture.  Survivors are not crazy.  They are speaking a truth that many in society do not want to hear and thus they are labelled, marginalized and stigmatized.

Every spring when the weather gets warm and t-shirts start to appear, my fear returns.  In the winter I can usually “pass” as “normal.”  My scars are safely hidden under layers of winter clothing.  In the summer, I stand awkwardly with my hands behind my back when I meet new people and when I pick the kids up from school.  I keep a cardigan at work to throw on before meeting with service users.  I see the scars myself, day after day, and sometimes it triggers me and makes me think about a time in my life I’d rather forget.

I still worry that people will view me as an unfit parent because of the coping choices I made.  But I wear t-shirts, because it’s hot outside in the summer.  I won’t hide under clothing everyday for the rest of my life.

If you have used self harm to cope, don’t be ashamed.  You survived and that is the most important thing.  Your scars tell the story of your survival.  If I could tell you a hundred times that you aren’t crazy I would.  But honestly, I’m spending a whole lot of energy reassuring myself that very same thing these days.

My scars tell my story.  Sometimes I wish my story was different, or that I had the privilege of having an invisible mental illness, but that isn’t my reality.

And believe it or not, some people think my scars look pretty damn cool.

 

Post-it notes

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Possibly one of the saddest moments in my entire story revolves around a post-it note.

During a particularly dark time in my life, sometime in early 2011, I wrote a series of 3 suicide post-it notes.  This is something I haven’t really shared with anyone.

I was completing my Master in Social Work, I was about to start my final placement.  I was working as a Teaching Assistant, attending classes and taking care of my kids.  On the outside I was functioning, but on the inside I was consumed with depression.  Looking back, I know a good part of the darkness was being caused by my increasing unhappiness within a sexually abusive marriage.  I began to feel like I had exhausted every option for recovery, every medication, every type of therapy, every treatment program and as a parent of two young kids I felt I had even fewer options.  I felt trapped and disconnected from myself and the ones I loved.

I don’t remember why I was upset or what happened that day, I do remember I wanted the pain to stop.  I was home alone, the kids were at school or daycare.  I saw a pad of yellow post-it notes one of the kids had left in my bedroom.  On it I scrawled three separate notes, one for my husband and one for each of my kids.  The notes basically said “I love you ___” and had a heart drawn under the words.   They looked like innocent little notes, the kind family members leave for each other to wish them a happy day.

But to me those were the most tragic post-it notes in existence.  In that moment where nothing was really making sense, I was saying goodbye.

I did hurt myself that day, but I went to the hospital to get it taken care of.  I didn’t tell the hospital staff about the post-it notes or about my despondent thoughts.  I let them fix me up and I went home.  I rarely discussed my suicidal thoughts in the Emergency Room unless I wanted to be admitted to the hospital.

When I got home my family was there and so were the post-it notes, unassuming and cheerful yellow papers.  But seeing them reminded me of my dark plans.  I hated those post-it notes with great passion.  They made me angry every time I saw them, but luckily anger was at least a feeling and not just numb emptiness.

The post-it notes stuck around the house for months before I finally threw them away.  I won’t ever forget them though.  They are a symbol of just how little anything ACTUALLY makes sense when you are severely depressed.  Things that seem logical in the moment are completely ridiculous and nonsensical when you are feeling brighter.  Choices that seem like the only option are revealed as unhelpful and fatalistic when you are recovered.

It’s important to hold onto this realization.  When you are severely depressed you are not thinking clearly.  When you are starved from an eating disorder you are not thinking clearly.  When you are triggered and in the middle of flashbacks you are not thinking clearly.

Don’t make decisions that could harm you or someone else when you are not thinking clearly.  Chances are you might regret it when you are calmer.   If possible focus on grounding and self care, or get help from others if you realize you are not thinking clearly.

Suicide wouldn’t have solved the problems in my life, it would have passed them on to my children, my parents and my close friends.  I can say this now, but I know for a fact that in a dark place I just won’t care.  The only thing I will think about is getting the pain to stop.

Luckily, in recovery, I know that depression is temporary and impulses to harm myself are passing thoughts.  Suicidal thinking and gestures are symptoms of depression and PTSD for some people.  Thinking about suicide can be a normal coping reaction to surviving violence.  Just thinking about suicide is not necessarily dangerous.  Sometimes it can be a way of feeling in control of something, which is actually a method of self preservation.  It is necessary to challenge the self destructive behaviours, but I try not to judge myself for the thoughts.

At the end of the day there is no difference between a person who sometimes thinks about suicide and one who does not.  There is not a special “crazy” class of folks who contemplate dying.  Suicide doesn’t discriminate.  Anyone can have the thoughts and it doesn’t make them weird, dangerous or a person to be feared or shunned.

Suicide survivors walk among us.

Sometimes the best thing you can do for a friend who contemplates suicide is to allow her to talk about her thoughts and impulses and listen without panicking and without judgment.  Validate her, let her know that you are sorry she is feeling SO awful that she feels life is hopeless.  Allow her to explore the thoughts with you, or encourage her to talk to a counselor, support worker, crisis line or doctor.  It isn’t your job to save her, it’s your job to be her friend.  Thank her for trusting you.  Let her know you care. By letting someone talk about suicide, you are reducing shame and creating a connection.

Connection is the opposite of depression.

Misdiagnosis.

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This is the piece of paper I was given as a “formal” diagnosis back in 2001.  It was the first time I learned about PTSD.  It was also the first time I was misdiagnosed with Borderline Personality Disorder.  In reality, my PTSD is severe, my current Dr told me it was one of the worst cases he had ever seen.  But Dr. X, in his wisdom, after knowing me for a only a few months decided the impact of my trauma was “mild” and instead the main factor in my illness was untreated borderline personality disorder.  As far as I can see, this assumtion was made due to my self cutting behaviour.  He failed to take into account that before being abused I had no mental health problems.  He failed to take into account that self harm and anorexia are common coping techniques for sexual abuse, especially in young women.  He failed to notice that my out of control self harming behavior and suicide attempts began only AFTER taking a cocktail of psychiatric meds. He failed to see that I have almost none of the diagnostic criteria for BPD, except the self harm.  I had long term friends, stable relationships in my life.  I was not impulsive or risk seeking, except with regard to the self harm.

Over the next few months Dr X also placed a value judgment on this misdiagnosis of Borderline.  He was the first person I talked to about the sexual abuse, and as such I trusted him and looked to him for support.  This was a mistake.  I didn’t have a choice as to what psychiatrist I saw, he was the one assigned to me.  He gradually saw me less and less in his individual practice.  I would show up for appointment only to find he had left for the day or was on call in the ER.  Then he changed his practice to work solely in the urgent psychiatry clinic.  The only way to get an appointment was through the ER.

I had no family Dr and nobody to renew, monitor or change my medications.  He told all the psychiatrists at South Street that I was borderline and so they would not take me on as a patient.  He refused to give me a referral to a community psychiatrist and I had no family doctor.  I felt betrayed.  I felt rejected.  I felt worthless.

I started to use the ER on a regular basis, mainly after cutting myself.  I would ask for a psych consult about 50% of the times I cut myself.  I would ask the doctor on call to please assign me a regular psychiatrist to follow me.  I begged.  I pleaded.  I was rejected.  I was sometimes given an appointment at the urgent psychiatry clinic, where I knew I would see Dr. X again.  No way to break free, systemic barriers and misdiagnosis kept me trapped.  The more I protested, the more I harmed myself, the worse the situation got for me.

The treatment that I received at South Street was appalling. I know I am not the only one and I know this hospital is not the only one with issues.  Women survivors of childhood sexual, emotional and physical abuse are often misdiagnosed with borderline, a diagnosis I see as basically a wastepaper basket label.

I remember during my second last year at South Street, 2003, I attempted suicide again.  This time I cut myself extremely deeply, diagonally across my arm.  I remember lying on the floor in the hallway of the apartment I shared with my boyfriend.  I was dizzy, almost blacking out.  I felt the quiet empty feeling in my head and I tried to decide whether or not to keep pressure on the cut or let it bleed and let myself give in to the pull of unconsciousness.  I lay there for a while, I’m not sure how long.  I finally decided to go to the hospital.  I think I took a cab, but I’m not sure.

At the hospital, the medical doctor that first assessed me actually put me on a Form.  He got a security guard to sit in my curtained area to watch over me.  I remember I was studying for my 4th year Health Sciences exams.  Somehow the irony of this was lost on me at the time.  I had just tried to kill myself, I had a security guard watching me and I was studying for a university exam in the ER.  The medical doctors fixed up my cut with stitches.  By this time the routine of receiving stitches was, just that, routine.  I had received hundreds, sometimes as many as 50 at a time.  After I was fixed up I was transferred to the psych section of the ER.  I don’t remember too much about what happened but I do remember I was told that there were no beds, that I could not be admitted.  I told them that the cut had been a suicide attempt, not “just” self harming like I usually did.  I begged to be admitted. But the psychiatry doctor was firm, there were no beds for me.  I couldn’t understand it, the medical doctor had thought I was a risk to myself, so much so he had security watch over me, but psychiatry released me.  I learned over the years at South Street that as soon as a doctor had access to my past charts I was treated very differently.  I was generally taken seriously when a health care provider spoke to me and listened to me.  When that same health care provider saw my chart, I was turned away, disrespected, ignored and mistreated.  This is what misdiagnosis with BPD means to me.

I remember being discharged from the ER that day.  I was desperate.  I still wanted to die.  I remember standing in between the double doors of the ER crying.  I didn’t know where to go or what to do.  I felt hopeless.  It was late evening, it was spring or summer and it was still light outside.  As I stood there crying a door opened, it led out to the ambulance bay right beside the place I was standing.  Our of the door came a gurney, with a black body bag on it.  The door led to the morgue which was also in the basement of South Street.  The body was loaded into a funeral home vehicle and drove away.  The image impacted me and haunted me.  I wondered if my friend Darlene was wheeled out that very same door a year before. I was preoccupied with death.  I felt scared and I felt lost.  I just wanted someone to help me.  I’m not even sure I really wanted to die at that point, I just wanted the pain and confusion to stop.

Eventually I left.  I took the bus home, back to the apartment where I’d tried to end my life a few hours earlier.

I think that people often conclude that because an injury is self inflicted, that the person chose it.  That they are not traumatized by it or impacted by it.  But I believe that self inflicted trauma also needs to be recognized as a contributor to PTSD.  I think that my experiences within the psychiatric system alone could have caused PTSD in a healthy person.  In a person who was already traumatized they were that much more severe.  Sometimes comfort and sympathy are not provided to self injuring people.  We are treated as though we “knew better” and are essentially “wasting time and health care resources” or taking away care from those who “really need it.”  I believe that every person who self harms would have chosen a different option if they felt they truly had a choice.  Self harm isn’t cool, it’s not fun, it’s not something to envy or idolize.  It’s dangerous, it’s terrifying, it is not glamorous in any way.   It leaves lasting scars.  Scars I will live with for the rest of my life, and scars that trigger memories of times in my life I would much rather forget.  I get flashbacks around my self inflicted trauma in the same ways I do to the abuse inflicted on me by others.  And because I was abused in the health care system the two are not distinct.

There is no easy solution to these problems.  People who self harm need and deserve compassion.  PTSD should be taken seriously and not dismissed as a disordered personality.  PTSD is treatable.  Believing survivors is the first step.  Yes, this means as a society we all have to step up and acknowledge that violence and abuse is much more prevalent than we ever imagined.  We need to collectively work to end victim blaming and shaming and fight rape culture.  Because powerful white male doctors, with all their privileges, labeling my personality as disordered is rape culture.  I became sick and disabled because of abuse; I’m not disordered, I am a survivor.

 

Don’t judge me. I’m coping.

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The most important thing to remember about survivors of sexual, emotional and physical abuse is that if we are alive chances are we are coping and that’s a good thing.

One way the psychiatric system as a whole fails survivors, especially women, is by labeling our normal coping reactions as “symptoms” of various psychiatric illnesses.  Please consider this: it was the situations I survived that were not normal, the ways I coped were normal healthy reactions.  I did what I had to do to survive and that’s okay.

Yes, you are normal!  No, this is not your fault!  I believe you.

If you turned to “disordered eating” as a way of coping with your trauma, you are normal.

If you engage in self harming behaviours as a way of coping, you are normal.

If you take drugs and alcohol as a way of coping, you are normal.

If you zone out or disassociate as a way of coping (either voluntarily or involuntarily), you are normal.

These are all examples of common coping reactions that women utilize to survive the abnormal and terrifying situation of experiencing abuse.

You did the best you could at the time to survive and that was enough.  If I had known better or had other options, I might not have used anorexia, self harm and suicide attempts to cope.  Those tools worked for me for a time, until they didn’t.  When they stopped being useful to me and started causing more harm to me than good, I became motivated to learn new methods of coping.    I don’t have borderline personality disorder, I don’t harm myself to manipulate others or to seek attention.  I do it because I am a survivor of trauma, doing what survivors do best: surviving.

If you are working towards recovery be proud of yourself.  We aren’t aiming for perfection here, because it doesn’t exist.  Your best is enough.  You are enough.

I identify with the label PTSD and my experience with it is that it is chronic and more of a disability than an illness.   Living with PTSD takes an incredible amount of energy.  If you regularly hear me say “I’m tired, I’m so tired” I’m not whining.  I am fatigued and tired almost all time, some days worse than others.  And no, taking a nap won’t help but thanks for thinking of me.

Let me explain why living with PTSD is so exhausting.  It’s an invisible illness, for the most part you can’t see my struggles, but that doesn’t mean they are not real or valid.

Facts about PTSD and why it sucks away a massive amount of my energy each and every day:

  1. Even though I might be in bed for 8 hours in a given night I’m often experiencing nightmares.  Sometimes these nightmares cause me to wake in a panic attack, unsure what is real and what was just a dream.  I sometimes wake up covered in sweat, making sounds and fighting off imaginary threats.  When I wake up I often do not feel rested and I sometimes avoid going to bed at night when the dreams have been particularly troublesome.
  2. One word:  hypervigilance.  This means my danger sensors are on high alert 24/7, 365 days a year.  I can’t “just relax.”
  3. Hyperarousal and exaggerated startle response.  Every time there is an unexpected noise, or sometimes even an unexpected movement I jump about 10 feet in the air.  This is a symptom that people around me tend to notice and comment on.  Again, I cannot control it. Reassuring me that there is no danger does not stop the response.
  4.  Depression and anxiety.  Obsessive compulsive worries.  Yes, PTSD impacts my mood.  No, I can’t just “cheer up” or “think positive.”
  5. Flashbacks and body memories.  Yes, intellectually I know it happened “a long time ago” and that I’m “safe right now” but my body and my physiology haven’t caught up. I can go from feeling perfectly fine to crying, terrified and in physical pain within seconds and the trigger can be sometimes as inconsequential as a touch, a word, a memory crossing my mind.  Intense flashbacks are accompanied by panic attacks, rapid breathing, hot and cold sweats, disorientation, confusion between past and present.  After a particularly bad one it can take up to 7 days for the residual effects to pass.  And though technically, in the present moment, nothing bad has happened to me, I often feel as though the abuse has occurred all over again.  I feel exhausted, scared and sometimes hopeless about how little control I have over the memories.
  6. Flashbacks, body memories, hypervigilance etc are not the same as day to day worries.  They are not something I spend time thinking about or worrying about, it’s easier to understand them as physiological reactions, rather than connected to specific thoughts or behaviours.   This is not an intellectual problem, so no, I can’t just “look on the bright side”
  7. PTSD is often accompanied by deep shame and sense of self as being damaged, broken or somehow faulty.  Even though you might not see me this way, and struggle to understand why my self concept is so “distorted” please hear me and believe me.  I really do feel that internalized shame as a result of being abused.  Be patient with me, I can’t just “love myself.”  It’s more complicated than that.
  8. PTSD causes actual changes in your brain.  In the military it is referred to as an operational stress INJURY or post-traumatic stress INJURY and this makes perfect sense to me.  My brain was injured by the trauma I survived.  The eating issues and self harm behaviours are symptoms of PTSD, they were the ways I reacted and coped with the initial injuries.

For those of you who do not live with PTSD, I hope this explanation of my experience makes sense.

Last night I had a new flashback, to the original abuse with X, 20 years ago.  It wasn’t a lot of fun.  It led me to think about how PTSD uses up a massive amount of spoons (google spoon theory of chronic illness for more information).

I’m trying to be compassionate with myself tonight.  My hope levels are staggeringly low.  I’m tired of life, but I won’t give up.

Tonight I’m coping.  I hope you are coping too.