Our own version of normal

Seattle writer Naomi Steinberg, who lives with bipolar disorder, posted about living with mental illness yesterday.

I read an article in The Seattle Times recently about the kids, who, while toddlers, survived the Oklahoma City bombing in 1995. They are teenagers now. Most have permanent injuries: burn scars, hearing loss, developmental disabilities, PTSD. One boy has had five major brain surgeries; the last put a plate in his head. He also suffers from seizures and wears a full ankle brace to school everyday. When interviewed, his mother said, regarding her family, “We have our own normal.” I read that and felt like a light bulb just switched on. “I have my own normal.”

So do I. Yesterday when Richard and I got back from Atlanta, we drove over to the construction site to check on the progress of our house, and we had two close calls on the way back, one while trying to make a left turn (my favorite!) and the other while coming to a stop at Highway 70 and Miami Boulevard, when a car in front of us abruptly swerved into our lane. As I was frantically groping for my anti-anxiety medication, Richard said, “I’ll take you home,” changing our plans, which had been to go grocery shopping together and then grab dinner. He knew I had to get somewhere quiet, away from any more potential shocks to my system.

That’s my normal, and it is what it is.

Posted in PTSD, anxiety. Tags: . 1 Comment »

Ouch

A loss is a loss, and it hurts, but damn, our boys gave us a game and it was a good time. ‘Til next year boys, and thanks for the season. My heart appreciates the workout even if my cardiologist does not. Go Pack!

Bowl Forecast: 58 and cloudless

So we have come to it at last! I’m blogging to you from my sister’s living room in Atlanta, where last night Richard and I watched NCSU alum Philip Rivers punk the Denver Broncos 52-21 to take their division title. In about an hour and a half we’ll be hitting the road to Birmingham, waving at any Wolfpackers we see on the way. Yesterday we saw about ten cars of Wolfpack faithful on their way down at the same time we were.

Good times. This is my first bowl game, and I’m really excited to watch all the pageantry, cheer my head off, and smile along with our boys. I hope they enjoy every minute of this game no matter what happens. They deserve it. And after so much anguish and bad coaching in the past? So do we.

Extreme Measures

Sometimes people ask me why I can’t just “get over it,” and I can understand if people voice, or think and do not voice, this opinion when it comes to child abuse sufferers into their adulthood. I don’t hold with excuses for bad behavior. But that’s not quite the same thing.

I was watching William Shatner’s new show, Raw Nerve, the other day, and he had (Judge) Judy Sheindlin on. She was adamant that while abuse may be a reason for the committing of a criminal act, it’s not an excuse. When you hurt someone, you submit yourself for judgment, and abuse is not an excuse if you choose to hurt someone. I believe this just as strongly as she does. No matter what has happened to you, if you pass it on, you are responsible.

That said, complex PTSD is not something that I can just forget about or “get over.” And I don’t want to sound like someone with a chip on my shoulder when I explain that PTSD is like fallout. It’s the consequences of what happened to me. It’s a disability, just as sure as an amputation done to save someone’s life from gangrene, or the sickness from chemotherapy administered to save someone’s life from cancer. PTSD is what’s left from the extreme measures taken by my body to save myself from the abuse I suffered as a very small child.

When I was about three, or four, my father forced me to fondle him, among other things, but my brain and my body were too young to defend me from such a horror. So instinctively, extreme measures kicked in. The red alerts were sounded, the walls were shut down, and my brain insulated me from what was happening. My brain failed to register what was happening in my long-term memory as an entire memory, as the only defense mechanism I had available. Although my instinctual fight-or-flight response kicked in, I was physically unable to fight or flee, so my body shut down, failing to react to what was happening because it had no frame of reference for it. My mind and my body went, well, possum. And then it happened again, and again. The result was heightened fight-or-flight response—as if I can’t turn my internal alarms to off—combined with an absolute inability to flee.

Complex PTSD. The fallout is a heightened sense of threat combined with an inability to actually flee from stress. Most people with PTSD look like they are stone cold sober in the middle of a trauma. That isn’t actually the case. They are fighting combat on the inside. They just can’t move. So they stay in the trench. And later, the shrapnel that they have taken ricochets.

Just like fallout. From extreme measures.

Posted in PTSD, anxiety. Tags: . 3 Comments »

PTSD from Car Accidents, or why left turns and stoplights are a bit tricky

While few studies have been done on the link between car accidents and PTSD, the last study sponsored by the National Highway Traffic Safety Administration (NHTSA) in 2000 found that as many as 40% of people seriously injured in a car accident suffered post-traumatic stress disorder symptoms during the first year of the crash. Luckily with treatment most of those sufferers can move forward without long-term damage, but about 5% of seriously injured car accident victims will still suffer from PTSD five years or more after the original accident. 

And, if the victim already has PTSD? Well, you know they say when it rains, it pours …

In the spring of 2004 Richard and I were struck from behind by a woman who was rushing out of a gas station into traffic on Glenwood Avenue north in Raleigh. We were stopped in traffic, and the impact forced our Toyota Corolla to collide with a large Dodge SUV stopped in front of us. My seat belt and seat broke and I was trapped in the car. Upon admittance to the hospital I was diagnosed with whiplash and contusions, and underwent physical therapy for three months for my injuries. The psychiatric treatment is still ongoing.

The wreck was my third in Raleigh; the first two involved turning left in traffic and being struck by vehicles coming from the other direction. One, which took place on Walnut Street in Cary, was probably the most traumatic of my life and involved being crushed by the steering wheel, severe bruising of my chest, an extended hospital stay, and worst of all, the mistaken belief that I had killed someone for several hours because the person who I collided with had gotten out of their vehicle, so that when I looked over I saw an empty truck and thought the person had been thrown from their car and was dead.

To this day when we are stopped at a light I can feel an impact in my right shoulder, and when I have to turn left I anticipate breaking glass and impact from the front. Even thinking about it now makes me anxious, and I am safe in my living room with a cat curled up on the arm of the couch, warm at my shoulder purring at me. In diagnostic terms it’s called “a deepened sense of threat.” It’s perfectly illogical. But it’s a door I can’t close, ever. In my less lucid moments I want to throttle my dead father for starting all of this. But my father is only dust in the wind.

Posted in PTSD, anxiety. Tags: . 3 Comments »

Elevated Heart and Respiration Rates Seen in PTSD Sufferers: Study

The December 2008 issue of the Journal of Clinical Psychiatry has published research by an Australian team that found two definitive risk factors for post-traumatic stress disorder (PTSD): elevated heart rate and elevated respiration (breathing) rate.

Over a period of nearly two years the researchers studied 955 patients admitted to Australian hospitals after traumatic events who were then evaluated for PTSD as well as major depressive disorder (MDD) three months later. They found that the 10% of patients who were subsequently diagnosed with PTSD from the traumatic event all exhibited significantly higher heart and respiration rates than non-PTSD trauma victims.

Patients who exhibited heart rates of at least 96 beats per minute after the traumatic event, and respiration rates of at least 22 breaths per minute, were at least twice as likely to develop PTSD. Researchers concluded:

Elevated heart rate and respiration rate are predictors of subsequent PTSD. These data underscore the need for future research into secondary prevention strategies that reduce acute arousal immediately after trauma and may limit PTSD development in some individuals.

This is good news for the future because it means psychiatrists and physicians may soon be able to pre-treat for PTSD and avoid lifelong cases of complex PTSD like mine.

Posted in PTSD, anxiety. Tags: . 1 Comment »

5 Ways to Survive Suicide

According to the World Heath Organization (WHO), for every suicide there may be 20 suicide attempts, and in 2000 there were one million suicide deaths. This represents a mortality rate of one person dying every 40 seconds somewhere in the world.  And a person who has made a serious suicide attempt is between 20 and 50 percent more likely to succeed than one who has not.

For the past ten years I have beaten this statistic, along with the other 50 to 80 percent of the population of people who have attempted suicide and survived. I don’t know how they do it, I can only tell you how I have managed and hope that you will see some light among these few crumbs. The darkness lingers, but the sun shines in the morning.

  1. Build a support network of people who want to see you live. When I got out of the hospital the hardest tasks I faced were calling my sister and my friends and telling them I had tried to kill myself. Facing their reactions opened my eyes to the pain I had caused them and the simple matter that someone who kills herself does not make all the pain simply go away. She transfers that burden of pain onto the friends and family who have been trying to help her for so many years, and that pain may cause more death. Suicide continues cycles of violence. It turns the wheel of karma and burdens the world with more pain. There is no relief that way. Every friend begged me to call them if I ever thought of doing it again. I have made use of that outlet several times since then. Many times before I lingered in the mistaken belief that my friends did not want to hear my sorrow. But I forgot that I was not giving my friends and family a chance to love me, and those missed connections were the very things that could have nurtured me with the strength to fight my mental illness. I don’t make that mistake any more.
  2. Build a relationship with a mental health professional and follow your therapy. I have had several doctors through the years but in the past few years I have been very lucky to have found a caring doctor who has helped me make real progress understanding my PTSD, its root causes, and what it takes to cope with my anxiety and depression on a day to day basis. I take my medication like I’m supposed to and I keep my husband informed of my doctor’s instructions, and I always know my doctor’s number should things get dicey. Acknowledging that you need support and that you bear a mental illness is not weakness; it is strength. It is the ones who think they can manage their own brains that are the fools, and while I joke that I can’t imagine how anyone makes it in this world without a little anti-anxiety medication, I know that as much as I wish I didn’t need my meds, they help me maintain my over-sensitive system. Without them I’d be a shaking wreck responding to every tree branch shiver like a mortar round. Trust me on that one.
  3. Spend time with animals. This may sound simple but my cats save my life. Being with them brings me peace every single day because they love me no matter what crazy shit is in my head and what crazy shit comes out of my mouth, and they always want to be near me. There is nothing like unconditional love to make you feel whole, and you can’t get it from humans, they don’t have the patience for it. But pets are patient and they expect so very little in return. They also seem to sense when you are distraught and know when to offer extra support. Also, caring for another being takes you out of your own selfishness and gives you a purpose in life.
  4. Become involved in something greater than yourself. Volunteering to help other people, in whatever small way you can, can help you overcome your own illness because it takes the focus off of you. Not only does it distract you from your own problems, but giving of yourself freely brings you back more joy than you can possibly imagine. I have been involved with Mothers Against Drunk Driving for several years now and though what I do for them is very minor, in the long run, providing my small talents to them brings me back so many, many gifts. Trust me, helping out will heal your heart.
  5. Find the things that make you laugh and insist on doing them often. My husband and I love being together and going to ball games, and we tease each other and have a good time. Richard has a wicked sense of humor and we like to laugh, and I make a point to get off my butt and go out with him as much as I can and enjoy our time together. When we go to a game, I refuse to be negative or talk about mundane crap at all—I force myself to focus on the game and be as close to 100% present as I can. I scream, I yell at the refs, I cheer every play, and I enjoy the game a thousand times more, I think, than the people I see who seem to sit there moping or worse, texting (!) stuck in their own little worlds. Be here now. It’s a simple thing that can be hard to execute at times, but if I focus on it and make it a goal—just living in the moment—I find the times goes by and later, only later, I realize I’m happy.

And I’m happy a whole lot more than I’m sad. And thoughts of death just don’t enter my head that much. Which means I’ve changed. And if I can do it, anyone can.

Why Christmas Sucks

My blog goes kind of dark this kind of year. It’s because the holidays are hard for me. Many of my holidays consist of very bad memories. Memories of being alone because I was forced to be, and being alone because there was no one else to be with; memories of painful family arguments, toys breaking, glass breaking, food being thrown against walls, harsh and angry words and threats, spankings and much, much worse; recriminations, tears, poverty, and pain. To be honest, it has only been in the past six years, during my time with Richard, that I can truly say that my Christmases are now happy and bright, every year, and that there is no longer any thing to fear. But the memories are there, also bright, and speaking of them—well, speaking of them brings out a darkness that may be better left behind. However, it has been ten years since my suicide attempt, and that is a good anniversary, believe it or not. It is good to be able to say that I am a survivor and one of the very, very few who has not attempted to do it again. I have made promises to people to get help if I think about it again, and I have a network of friends to call should that blackness take me again, and I have Richard, and much to live for. But there was a time when I did not, and it is always with me this time of year.

I tell you this now more as an exorcism exercise for me, and also in the hope that if someone reads this who is thinking those same black thoughts this year, and thinks there is a better way—I promise you that suicide is not the answer.

I had been on a downward trajectory ever since suffering a grade 4 concussion that had kept me out of work for five weeks and was still affecting me. I had problems every night I had to balance the nightly accounts at my store, and it sometimes took me ten tries to get two tapes that came out to the same total so I could go home for the night. When I typed on a computer the keys I had known by touch since the age of eight were strangers, and gobbledygook spilled out on the screen. I had screaming headaches and nightmares full of blood and mutating creatures who grasped me in the dark. And the great mawing depression I had fought against for over fifteen years was winning.

I’m not sure when I started thinking again of killing myself. I told myself I had things to live for—my father was in my life now, one of my sisters had just had a baby and my other sister was pregnant with her first child—but all I really felt was superfluous, unconnected, as if I was made of mesh. I could not see any road in front of me that would see me out of the darkness I inhabited. I looked every day on the internet for an answer; I combed libraries looking for new careers, schools, convents. I thought about trying to be a teacher, but I felt hollowed out. I couldn’t feel any desire to really connect with the world; nothing gave me hope. I knew I was in despair, but I couldn’t bring myself to even care about that.

I was taking amitriptyline for depression since the concussion and my doctor upped the dose; it helped me sleep like a zombie. I asked for a demotion from my manager’s position and was given one, and transferred to a store closer to where I lived with a male friend whom I had moved back to NC for in the hopes of renewing our relationship; hopes that were dashed. My friend had taken a job in Charlotte, the farthest he could get away from me, I thought. I talked little, ate less, and walked through my life like the dead. And then I started courting danger.

I remember long car rides home from Summerfield to Winston-Salem on back roads late at night, when I would turn the headlights off and drive in the middle of the road as fast as I could, waiting for one of the many illegally detoured shipping trucks to slam into me head-on. I remember running off the road into a field one night and sitting there for over half an hour, crying, alone in the middle of nowhere, wondering how I had gotten there. One night in December, maybe fifteen days or so before Christmas, when my friend was stranded in Charlotte in an ice storm and wasn’t coming home, I saw my chance to end things, and tried fashioning a hose from the exhaust pipe into my car. But as I was fashioning up the garden hose my friend’s dog kept playing with me, refusing to let me leave her alone, and her incessant barking frustrated the silent, dark, cold demise I had pictured in my head. I gave up and went back in the house, but shut the heat off, hoping that I’d at least get sick. Something that would at least change my state somehow; change something, anything. I thought about throwing away all of my i.d., walking to a homeless shelter and pretending to be someone else. One night I even walked four miles, and then turned around and came home. During the entire journey back I walked in the middle of the road, but not a single car came down the deserted stretch and hit me. I couldn’t even die right.

I had been cruising dating sites for over a year but not seriously, but it must have been the coming holiday season that brought out the desperation on the message boards; the computer became my tenuous hold on another life as I began relationships with unavailable people. One who answered lived in Raleigh; he was a divorced computer programmer who seemed to share the same interests I had, and I drove to meet him a few times. We quickly began a sexual relationship and he asked me to move in with him, and I made plans to leave my roommate and the job I had come to hate to move in with a guy I barely knew and find a job in a city I knew nothing about. As I had done in Chicago, I was going into another situation without any guards, resources or helps, but I didn’t care. I hated my life and everything in it, except for my cats. My life seemed forfeit, and nothing really mattered to me. I pretended things did matter, but they didn’t. I wanted, every day, to die. I told myself I could learn to love this man, and that we two broken people could become whole again if we managed to patch each other up.

I packed up and moved to Raleigh, ignoring the objections of my close friend and roommate that I was making a mistake, and quickly found a merchandising job. The pay wasn’t too bad, the hours were alright, and I didn’t have to be nice to people. I could go into a store, work a merch plan, take breaks when I wanted, stay in my own head, talk to no one most of the day, and go home when I was done. I liked that. But my relationship was rocky. My new boyfriend was a drinker, and when he drank, it seemed to me, his personality changed. I didn’t know then that he was bipolar, and that he drank to self-medicate, but that the drinking made his symptoms worse. He didn’t know at the time he was bipolar either, although he had taken medication for depression and been admitted to a psychiatric hospital after attempting suicide the year before.

Another thing I did not know about him then was that he had been arrested the year before for breaking a restraining order prompted by his ex-wife after he had attacked her. What I did know is that some weekends my boyfriend was euphorically happy, and he said I was the cause of it. He’d spend like crazy, buying things for his new house—a new TV, a stereo system, a fish tank, jewelry for me—take me out to dinner, and on and on. Then the next week he’d sink to a despair I couldn’t shake him out of, come home and go straight out to the garage and work for hours on something out there, or go upstairs to his computer room, lock the door and turn up the stereo loud, working on something into the late hours. We developed a horrible routine I came to dread; he’d come home on Friday night, we’d grill out for dinner, and then he’d drink a six pack and end up in the computer room playing loud music until 1 or 2 in the morning, after which time he’d wake me up and pick a fight.

The fights started out small but became major dramas, with us ranging all over the house when I attempted to get away from him. If I went to another room to avoid talking to him, he’d bang on the door and yell until we “talked it out.” But talking involved literally hours and hours of him going over and over the same subject, and there was no way out of the labyrinth of his mind. Nothing he said made rational sense at those times, and no tactic I took helped. If I agreed with him, I was placating him but not really understanding; if I disagreed I was being a bitch and had to be knocked off my pedestal; if I tried to reason with him I was being stupid. On and on. We’d be up all night on Fridays, and then sleep in late on Saturdays, which he’d spend making it up to me all day by cooking elaborate dinners or taking me out somewhere.

I began to think of leaving, but I had no money saved. I couldn’t even afford a down payment on my own apartment. I had gotten myself into something awful. The fights began to grow violent, and I began to despair. I began to think that I was in the situation that I deserved. I realized there was no one I could call to get me out of the situation I was in. My mother had stopped talking to me because I had been talking to my father, and my father was broke, had been out of work for seven years and was barely making it in his own personal hell. My old roommate didn’t have the financial means to rescue me, and I had burned bridges at my old job. I couldn’t go backwards and there seemed to be no way forward. I didn’t know what to do. I had headaches all the time, I was gaining weight, and I couldn’t sleep. One night while we were fighting, I just gave up. I realized I could just end it, and it could be all over, right then. So I took all my pills. I had a brand new prescription of amitriptyline, sixty pills, along with some of my boyfriend’s Valium, half a bottle of Tylenol PM (about twenty tablets), and some Serzone pills. I took them all, then calmly told my boyfriend what I had done. As I laid there on the bed, waiting, I realized that I really didn’t want to die. But now I would get some help. Everything kind of faded away, and all I could feel was a kind of white noise around my heart, as if my life were enclosed in cotton. My mouth became completely dry, as if every cell in my body had been drained of liquid.

He immediately called 911, which saved my life. Cary EMT was there within four minutes, and my stomach was pumped within half an hour. But within a week I was right back in that situation, and calling the police to arrest my boyfriend.

I did get out of there, though. I got out of my boyfriend’s house after making a deal with his parent’s not to press charges against him, when I found out about the restraining order and the ex-wife, after he tried to beat me up when we had another fight several weekends after I got out of the psych ward, but not until I had lived with him some more and managed to total my car by running into someone the day after I got out of the hospital. The deal was enough money for me to get back on my feet, and I have never regretted making it, but taking those pills did not solve any problems. They gave me a host of new ones I still deal with today, and it took me years—years to crawl back from that night. Which only makes sense; it took me years to crawl towards it.

Now I crawl towards the light.

If you have read this and you think you still want to die, please tell someone about it. Call the Suicide Prevention Lifeline at 1-800-273-TALK.

Posted in PTSD, anxiety. Tags: , . 1 Comment »

Baylor Study Finds Changed Brains in PTSD Victims

A ten-year study by Baylor University researchers into the root causes of post-traumatic stress disorder (PSTD) that studied 100 Viet Nam veterans and their identical, non-combat veteran twins has found significant evidence that trauma stress changes the makeup of the brain.

MRI head scan by Max Brown of Sydney, Australia courtesy stock.XchngThe study, which is focusing on the links between genetics and brain anatomy to discover the base mechanisms of PTSD in the hopes of someday countering its affects in trauma sufferers, found that the ventromedial prefrontal cortex area of the brain, gray matter which activates when we make a decision, was significantly smaller in combat veterans with PTSD than in non-combatants.

“We discovered a number of abnormalities in PTSD combat veterans not shared with their twins and … we infer that the abnormality was caused by combat,” Pitman said. “One of these is increased heart rate response when the combat veteran is startled. Another example is loss of gray matter in the rostral anterior cingulated cortex, which plays a role in inhibiting the fear response.”

In addition to trauma causing a reduction in the ventromedial prefrontal cortex, researchers also discovered a genetic marker that suggests sensitivity to trauma: a smaller hippocampal volume. Before, brain researchers have noted that PTSD sufferers have smaller hippocampi than non-sufferers and theorized that the hippocampus was reduced by trauma, but in fact this is not the case for the hippocampus, as non-combatant twins also had small hippocampi. This suggests that some people are genetically more sensitive to trauma than other people, which explains why a small segment of the population responds to trauma in an extremely negative fashion while many others can walk away relatively unscathed.

Researchers’ current conclusions are that it is the combination of the stress reduction in the prefrontal cortex and the genetic marker that lead to PTSD. 

Posted in PTSD, anxiety. Tags: . 3 Comments »

Bowling

Once the news was official that the Pack was going bowling, it didn’t take long for Richard and I to decide we were going, too. The plan is to sleepover at my sister’s place in Atlanta and drive to Birmingham on game day to save some green. So, Raleigh to Atlanta to Birmingham to see the Pack at New Year’s: sounds like a great way to end the year to me.

We’ve enjoyed football so much this year, and the last game against Miami was probably the greatest, although I don’t know if that was more because my sister’s family was there, and I got to share my love of the Pack with my young nephews, or because the Pack just played so well. That morning at breakfast I had taught my nephew Ari “the easiest cheer in the world: Wolf! Pack!” and I think we had as much fun doing the cheer as watching the game. We had bought seats over by the band to accomodate everyone, and so we were up close and personal when Russell made his huge touchdown run. Unbelievable. It’s really exciting to know that the momentum this team has built is not over quite yet, and the fact that we can afford to go cheer on the Pack makes me feel like a lucky girl. It will be a long three weeks until game time!

For all the dope about the Bowl, visit Yet Another NC State Sports Blog.