The Trend Known as Trauma

The word trauma seems to be tossed around a lot these days. Post traumatic stress disorder, or PTSD, being one of the leading reasons. And it seems like everywhere and everyone has PTSD or some other form of trauma. It can be overwhelming to hear about it and even harder to talk about it. Trauma is scary and can be so devastating to so many.

Unfortunately with widespread coverage there often comes a feeling of desensitization to the words and their meaning. The more you hear about trauma and PTSD, the more it seems to become this catch-all trend, and slowly people start to become complacent to what it means and what it does, and even feeling bored of hearing about it all the time.

But trauma is not some trend we can all forget about when the next thing comes along. Suffering trauma is serious and can be life-altering, even life-ending.

Trauma is typically associated with war and violence. And as we are now learning it affects our first-responders -firefighters, paramedics, and police- who so heroically run towards the disasters that the rest of us run away from. And the trauma that these dedicated, brave people fight, day-in and day-out, is nothing to be dismissed. They are witness to some unspeakable tragedies that we can’t even imagine. And the doctors and nurses who care for the victims of these tragedies, and so many others, are also heroes in everything they face and contend with, day-in and day-out. It is truly astounding what they endure.

The trauma that all of these professionals suffer is without question horrible and devastating. Theirs is a unique experience that the vast majority of us will never have. Whereas their traumas may include blood and guts, broken limbs and broken families, and life and death, they aren’t the only ones to suffer trauma.

One of the hardest things about trauma is that it can happen to anyone, anywhere, at any time. And what is a passing event for one, may become a trauma for another. It is totally subjective. Trauma can be a one-time event, or it can be repetitive exposure, or chronic to the point of becoming a part of your daily life, with the trauma occurring over and over and over again.

What’s important to remember is that trauma isn’t just about car accidents, war, and violence. It isn’t necessarily explosive or graphic. Trauma can be in someone’s words or behaviours as they speak down to you or insult you or intimidate you. It can be a threat or a near-miss. It can be in the illness that takes down you or your friend, or it can be alone in a quiet room as someone you love passes on. It can be with our families or friends, or it can be with total strangers. It can be something we saw coming or something we didn’t. It can be something that marks the world or it can be something that marks only us. And it can be something that can be seen or it can be something we will never see. Trauma can be so insidious that it isn’t until months or years later that you even are aware you have been traumatized.

Trauma doesn’t care if you’re young or old, what religion you follow, or where you work. It doesn’t care if you’ve had a good childhood or if you’ve never known your parents. It doesn’t care where you live or who your friends are. It doesn’t care if you’ve had other traumas or if this is your first. Trauma either happens or it doesn’t. Period. And it can be something big and loud, or it can be something small and quiet.

I get this can mean that trauma paints a very broad stroke, colouring almost everything, because it kind of does and that can be scary. No one wants to suffer trauma. It’s a devastating thing that can tear you apart. And as much as the trauma has ravaged your insides, it’s possible that it can be healed. And it starts with recognizing you’ve been traumatized in the first place.

For some, this first step may never be taken. It may just be too much. Everyone is different, and so is how they cope. For some, this step may be the only one they take. And for some, this may be the first step of many. It’s up to you how you proceed, or if you choose not to. Trauma is painful and talking about it can be just as painful. Be patient with yourself, whether you talk about it or not.

You don’t have to tell everyone, you just have to start with yourself, and then you can work your way out as needed. Talking about it is probably the biggest step, and most likely will be the one that will bring the most healing. It’s hard and painful and it is the only way to heal.

Keeping it to yourself will only make things worse. And if you don’t believe me, consider your own trauma that you suffer with, every day, sometimes all day, and even at night while you’re asleep. Whether you call it trauma or not. Whether you admit it out loud or not. Think of the flashbacks and difficult emotions that plague you. Think of the nightmares and dreams that haunt your sleep causing you to wake up terrified and convince you that you will never sleep soundly again. Think of the moments that fear grips you and it feels like you most certainly will have the life squeezed from your lungs. Think of the days you can’t stop thinking about it and how dark and scary all those swirling thoughts are. Think of the way your body reacts and freezes into positions so tight that your muscles ache. And then think of keeping all of that inside your one body and mind and how it is all being torn apart.

Talking to someone can help to relieve that pressure. It may not fix everything right away but it is a start. Most likely you might need to recruit some professional help, and that’s okay. There’s nothing wrong with seeking help, from professionals and from loved ones. Whatever you need to do. It’s your life at stake and that is worth fighting for.

The only thing worse than suffering a trauma is suffering alone. Seek support and help. And if this one person can’t help you or won’t support you then keep looking. If this one doctor isn’t listening or that doctor doesn’t believe you then find another doctor. And don’t stop until you get what you need. There is support and help out there. And you deserve to get it.

You deserve to be healed. You deserve to have your traumas healed. No matter how dark and deep they are. No matter what. You don’t need any reason or permission. You are you and you deserve to be healed. Trauma can break you, and it often does, and healing can be hard and painful, and it is possible.

To all those who have endured trauma and to all those who will, I sincerely hope you find your way to healing.

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A Meds Dilemma

One of the meds I just started a few weeks ago is really helping to bring my mood back up. Not in a dazzling, ray of sunshine, bring on the day kind of way, more like okay maybe today won’t completely suck kind of way. I’ve taken it in the past and it was helpful to me then as well. So I know my track record with this med is relatively successful. And by successful I mean it doesn’t give me suicidal thoughts or tendencies, I usually don’t have any headaches or stomach issues as side effects, and it actually does more good than harm.

The problem is, it does affect my anxiety. A lot. It raises the baseline of my anxiety to a high moderate level so that I’m constantly feeling pretty anxious, and feeling a bit on the edge. Not a jittery, pace the room kind of anxious. More like a can’t relax enough to relax kind of anxious. As tense as my neck and shoulders are normally, they are even more so with this med.

And my susceptibility to panic attack increases. Whereas before I may have had a shot at managing the anxiety before it becomes a panic attack, now I’m lucky enough if I get a warning with enough time to intervene before the panic attack hits. If I’m already in the panic attack, it lasts longer and feels way more intense.

Just yesterday I had high anxiety for most of the morning, and it crept higher and higher until an hour or so later I had a panic attack, having to abandon my lunch and make my way home. And it lasted all the way home. It was awful. And it is the third panic attack in just the last several days.

Lately I’ve been better able to cope ahead and manage my anxiety to a level that allowed me to get some things done and go out every now and then. Of course, my mood was low enough that getting things done was low on the list of things to do, and going out was even lower but when I would the anxiety was mostly manageable.

Enter my dilemma. Do I continue to take the med so that I can continue to have an elevated mood, and just endure the anxiety as best as I can? Or do I stop the med altogether, significantly reducing my anxiety and bringing my mood back down?

It’s kind of a tough call. Because this anxiety is brutal. It is near constant and so intense it startles me. And then there’s the thing that the med actually does help me. As anyone struggling with illness and going through different treatments knows, the quest to find a med that works can be long and tiring, and can often lead nowhere. It is nice to want to get out of bed in the morning. Well, maybe want is a strong word. More like, I’ll get up and we’ll see how it goes. Which is more motivation than I’ve had in a while so…

My psychiatrist is thankfully working on this with me, letting me see if the benefit does outweigh the downside. She’s kindly offered to help me work on managing the anxiety so that I can continue on the med to see if the elevated mood is enough. Plus she was kind of enough to give me a script for an anti-anxiety med for when the panic attacks are really beating me down.

So is the anxiety worth the slight mood elevation that I get with this med? I mean if it gave me real pep and a get up and go kind of benefit that might be a little more persuasive in staying on it. I’d be much less depressed and maybe even productive. With this med, I’m not there so I’m not sure if it is worth it.

I’m thankful that I have a doctor willing to work with me on this instead of just writing off scripts and leaving it at that. Hopefully the anxiety can be contained and I can keep the elevated mood. We’ll see…

Wishing

I wish I made people happy. To have someone excited to see me and show it, I think that would be so great. I also wish I inspired people. To maybe have someone achieve something and that I inspired them to do it or to get there, I think that would also be great.

I used to be the go-to person. I’m not the go-to person anymore. Except maybe for my family. Sometimes I miss being the one people turned to. I’m not always able to help anymore. Sometimes I can barely help myself.

I guess I just feel forgotten.

Between a Revelation and a Panic Attack

I am tired. Bone-tired. Physically, emotionally and mentally tired. Just everything tired.

I have spent years struggling with mental illness, with and without diagnosis, misdiagnoses, and varying degrees of treatment that were and weren’t effective. I’ve tried to hold myself together to keep a job and friends and I mostly managed to do it for a while. Until the bottom fell out and I broke.

The times where I’ve been able to hold it together get shorter and shorter and farther and farther apart. I’ve mostly come to accept that. Although at times that acceptance is nowhere to be found. It’s a work in progress.

With each time I have fallen down the dark hole I have done whatever I can to try and get better. There is only so long that I can tolerate feeling so miserable before I have to do something about it. I think this is the only good time my inability to tolerate uncomfortable feelings has worked in my favour. It has pushed me to look for solutions and work my way back.

The downside to this is that it has been tiring. And frustrating. And fruitless. A lot. Struggling with any mental illness is hard, and it’s made even harder when treatment is either nowhere to be found, or it’s found and it isn’t working. When there are multiple disorders battling it out inside me it means having to find multiple solutions. And finding multiple solutions is even harder than finding just one solution.

The disorders not only compete to take me down, they also compete to keep me there, so finding solutions that will silence all of the monsters is near impossible. It gets confusing and frustrating when I try to treat all of my disorders at once. I’ve tried treating them separately, and one at a time, and it was kind of a mess. Stuff would overlap or cancel other stuff out and at times I lost track of what I was trying to treat.

The good news is it isn’t always a lost cause. Of the many solutions and ways to recover I’ve found over the years, a number of them have actually helped. I’ve even had several major insights, epiphanies if you will, that have definitely been worth the wait. So it’s not all bad. I’ve found that treating the disorders in clusters has been most helpful and some of the gems I found, I’ve actually managed to retain and still use today.

The thing is though, I am really tired. I’m tired of trying. It’s so hard to try and find ways to manage or recover from mental illness. And the days when nothing works I can’t help but feel that things will never get better. Trying to find a solution and treatment takes a lot of time and effort, and then actually getting the treatment usually means months-long waitlists that more often than not have been anti-climactic and leave me back at square one.

When, and if, the treatment seems promising then there is the issue of maintaining it. By me and by the doctor or program. With the doctor, I am subject to how often they can see me and whether or not anything actually comes out of the appointments besides a prescription. With a program, I stand a better chance of learning skills that I can actually apply in daily life, that is if I get into the program (I’m currently still on two wait lists for two programs, hopefully I’ll hear about one of them soon). And then there’s me, I get easily discouraged, and whether it’s a bad day or several appointments that don’t immediately show me results, I lose interest and hope and therefore my effort goes down, fast.

I try to keep hopeful for as long as I can and mostly I succeed. I just feel so frustrated. The hours and days and weeks and months and years of waiting and hoping and trying and failing and trying and succeeding and trying and finding nothing and trying and making enough progress to keep me trying is so hard. Especially when the bad days sometimes slap me right in the face. Is it all for nothing? Is there a light at the end of this tunnel? Or is it just the start of a whole new tunnel?

Who knows. So far I haven’t given up, at least not for good. Yet. So I guess I’ll just keep trying and keep hoping and maybe one day I’ll be okay.

Getting a Mental Illness Diagnosis: Good or Bad?

Being diagnosed with an illness, mental or physical, can come with a whole host of thoughts and emotions. It can feel like your world is crashing down as you sort through what the diagnosis means, in terms of treatment and prognosis. Or it can feel like relief and understanding, explaining symptoms and behaviours, and now you can get down to business and get better. It can hurt or it can harm.

So getting diagnosed with a mental illness…is it a good thing or a bad thing?

On the good side, having a diagnosis can help in terms of knowing what treatment may be most effective. It can help your GP or your psychiatrist know what, if any, medications may help ease or reduce your symptoms. It can also help when finding support, whether in groups with facilitators or through social media. Finding those with similar experiences and the same diagnosis can go a long way to helping you feel like you are not alone and that what you’re experiencing is more common than you might think. Others who share the same diagnosis can also offer support, tips, advice and suggestions on treatments or medications that may have worked for them.

On the bad side, there can be a stigma that accompanies your diagnosis that can lead to misunderstanding, exclusion, miscommunication, and even being ostracized, including from health professionals. It can also be a trauma in and of itself as you try to navigate the waters of treatment and support, particularly when both are in short supply. Your diagnosis can even make you ineligible for treatment or social services among other things as most programs require certain criteria to be met. And it can leave you feeling boxed into a certain expectation of how others may expect you to think, feel, and act. This can be particularly hard when your symptoms are not “by the book”.

Let me think this out.

How effective is it to have a diagnosis? Is it mandatory? Should it be mandatory? Should it be on an ‘as needed’ basis? Does it help? Or does it make things worse? If a diagnosis is necessary then what if you are misdiagnosed? Or what if you are given no diagnosis at all? What if your symptoms are all over the place and don’t fit into any one category or disorder, does that mean you don’t get a diagnosis because you don’t ‘technically’ meet the criteria in the DSM? What if you only have six of the ten symptoms of a disorder, does that mean you aren’t still struggling with this particular disorder? Does that mean you shouldn’t be given any treatment for that disorder? What if your symptoms fluctuate enough that on any given day they can either be drastically increased or reduced, making a diagnosis applicable on one day but not on the next?

The fluidity and impermanence of our experiences and our symptoms means that a diagnosis should be just as fluid and impermanent. Our symptoms and our behaviours can ebb and flow. Some days we may have all of the symptoms and some days we have none. Some days we are several disorders and some days we are one disorder. Some days we may even have no disorder at all, though I imagine those days are extremely rare for the vast majority of us.

We can go months, even years, without exhibiting most symptoms with maybe one or two floating around us most of the time. We can have all the symptoms bombard us every day, all day for months or years on end. Or we could just be all over the place with our symptoms, which most of us experience.

If our symptoms and disorder are not all up in our face all day, every day, does that mean we aren’t struggling or suffering? Do we have to be struggling every single moment of every single day in order to retain a diagnosis? What if we can’t? Does that take away the diagnosis? If we are able to work and interact with friends more often than not, does that mean our struggles and suffering at home at night alone are any less hard or debilitating? And we are a diagnosis by night and not by day?

I can appreciate that having a diagnosis can be very helpful to a professional, as this is often used as the starting point of what happens next, and where to send the patient next or what treatment to give them. However, I feel that this may be a little overestimation by professionals, and here’s why…

1. A diagnosis is only as effective as it can be applied to the patient. If the patient doesn’t exhibit all of the symptoms or even half of the symptoms of a suspected disorder then the patient may be dismissed for that particular diagnosis or even misdiagnosed altogether, hindering understanding and treatment.

2. Diagnosing a patient only on presenting symptoms at the time may exclude considering other disorders the patient could be struggling with simply because a specific symptom is not present in that moment.

Any illness, whether mental or physical, is not always a textbook case. In fact, I would venture to say that most illnesses rarely present as a textbook case. And it doesn’t mean that whatever is in front of you is all it will ever be. Illnesses are very fluid in how they can present. They are subject to a number of factors that can contribute to its severity, fluctuation, and length. Things can often change at the drop of a hat, and this is something a lot of professionals fail to take into account.

I think that there should be a slightly broader approach taken when discussing symptoms and their severity. Even taking a month or two of experience into consideration when asking the patient questions can go a long way to getting a better idea of what the patient is experiencing than going by a week or two. Or going by what symptoms are happening today.

3. A diagnosis should be treated as more of a guideline than a prognosis written in cement.

Illnesses are very fluid. They very rarely stay in one state for an extended period of time. Medical and mental health professionals have been trained to go by the book and anything that goes against the book is treated as either not applicable or a cue to consider a whole new diagnosis altogether. If it isn’t written in the textbook, I’m looking at you DSM, then it isn’t so.

This is hard not to hold against the professionals because this stuffs our illnesses, disorders, and issues, into very rigid, inflexible categories that may or may not always apply, and may even lead to more damage than help. To give the professionals some credit, they have to start somewhere. I just don’t think that’s where it should also end.

When I was hospitalized late last summer, I spent six weeks on the ward, and during that time I was given my BPD diagnosis. For me, at first, I was scared as hell. In part, because I knew very little about BPD and what little I did know was scary and unsettling. I found out that I was very misinformed and the stigma of it preceded me finally coming to an understanding of what BPD really was.

When I started to educate myself, with the help of my psychiatrist, I started to feel relieved; the symptoms, the urges, the actions, the behaviours, the history, all associated with BPD, finally started to shed some light on who I was and why I behaved, felt and thought the way I did. It was like having pieces of the puzzle start to fit and show me the big picture. I felt truly excited that I finally had a diagnosis that made sense and that fit.

But with the diagnosis, the understanding, and the relief, came great fear. Fear that the behaviours and symptoms that I didn’t exhibit meant that maybe I really didn’t have BPD. I had been diagnosed before, feeling understood and relieved, and it hadn’t stuck. Diagnoses that before had made sense at the start and then slowly fell apart because other stuff under the disorder didn’t add up, and so the bottom fell out and so did the diagnosis.

Then there was the stigma that came with BPD. The limited, misunderstood and vilified diagnosis of BPD that so many have come to take as gospel, including the medical and mental health profession. Those suffering with BPD were supposedly “too emotional”, “too needy”, “manipulative”, “too sensitive”, “too moody”, “unpredictable”, “irrational”, and emotionally unstable. Leading many to even give another name to the disorder, “Emotionally Unstable Personality Disorder”. A moniker which I personally take offence to as the disorder is a lot more than just having dysregulated emotions, and right away gives others an inaccurate picture of the situation. It is often assumed that Borderliners are notoriously difficult to treat and are frequently unable to obtain and hold professional help due to this “neediness” and their frequent suicide ideation.

I hadn’t even told anyone outside of my husband about my BPD diagnosis and I already felt excluded, misunderstood and ostracized. I already felt like a lost cause and I had only been diagnosed that week. I felt awful. I thought I was a lost cause. I was terrified that even my psychiatrist who had been the one to approach the BPD diagnosis in the first place would surely throw me to the curb now instead of enduring what would apparently be a long, trying road for her to try and treat me. Would she think that I was a lost cause too? Would she be put off by my disordered thoughts and emotions enough to not even want to try and help me? Would she feel exasperated if my thoughts turned suicidal and send me packing?

I was conflicted. On the one hand, I finally had a diagnosis that made more and more sense to me the more I learned about it. But on the other hand, I had a diagnosis that meant I might not be treatable. And not because BPD can’t be treated, but because a lot of professionals won’t treat BPD. I would apparently be a waste of time and resources that would be more effective on others with a more “favourable” diagnosis. What a more favourable diagnosis would even be I don’t know because I think any mental illness has its challenges when it comes to treatment.

Suddenly I was sad because I was confronted with a diagnosis that now felt like it defined me. It felt like my name melted away and was replaced by my disorder. I became a disorder to be treated, if my psychiatrist was up to it, and my behaviours and actions were now tainted by the symptom checklist. It was hard not to suddenly question everything. It was hard not to feel lost.

Was that action because of the disorder? Was that thought because of the disorder? What was me and what was the disorder? Were they separate? At what point was I influenced by my disorder? Where did my disorder end and I begin? What comes with getting a diagnosis? Fear, sadness, uncertainty, isolation, questions, relief, and hope, that’s what comes with getting a diagnosis.

When it comes to mental illness, a diagnosis can be the best thing that happens to you or it can be the worst thing that happens to you. It can even be both. It all depends on where you are and what’s going on for you at the time.

Overall, I think a diagnosis can be more helpful than hurtful because at the very least it can be a starting point. But I also think it needs to happen with the understanding, between the patient and their doctor, that there is more than just the textbook classification of the disorder. And to keep an open mind, that symptoms and illnesses are subject to change. That we are more than a diagnosis, and should be treated as such.

The Neverending Quest to Know Why

A question I often ask is, “why?” I want to know why I do things a certain way. I want to know why I feel a certain way. I believe if I know why then I can fix it. I believe that “why” is the key.

At least that’s what I used to believe.

I have discovered over the years that knowing why sometimes means squat. Sometimes knowing why doesn’t change a single thing. This has been hard for me to accept because if knowing why doesn’t help me, then what will?

There have been times where I’ve discovered why I reacted a certain way or behave a certain way and then…nothing. All it did was tell me why. Which isn’t a bad thing to know. It just doesn’t necessarily solve anything. I was surprised, and a little disappointed, that knowing why doesn’t mean the issue is solved. It seemed like a logical pathway to me, figure out why something is broken and then you can know how to fix it.

Some of this time I have spent in denial, that maybe I didn’t know the whole reason why and therefore I couldn’t fix it so I figured I just needed to keep searching for the why. It’s also possible that I also used it as a defence mechanism so that I wouldn’t have to look deeper. I know I definitely used it to procrastinate doing the hard work that recovery and healing requires.

The reasons I behave the way I do, or respond the way I do, are complex. If reason comes in to this at all, then it stands to reason that solving them would be just as complex. Which means knowing why may never be answered and if it is it might not solve anything anyway.

I actually have to hold myself back from asking why this happens as well. It’s tempting to get lost in the mystery of why. Why do I feel this? Why do I do that? Why do I see things this way? Why do I respond that way? Why? Why? Why? I’m not sure I’ll ever stop searching for the answer to my whys.

I just hope I remember that not finding the answer to why doesn’t really mean anything. I may know why, I may not, and that may help me, and it may not.

Me and Love

So I learned something new about myself yesterday, I have an aversion to the word “love”.

It was the last few minutes of my appointment with my psychiatrist, and she was talking about love, and I stuck out my tongue and made that fart/splat sound to the reference she made. She asked me, as she usually does when I respond like that, what was making me respond that way. And I said the whole “love” thing, I’m just not sure about that.

I thought nothing of it. I already sort of knew I wasn’t a fan of sappy love crap. Like, whatever. My psychiatrist however, was new to this information about me, and asked why I might have a problem with “love”. I shrugged in response because I didn’t think it was a big deal. And I said as much.

Except I started thinking about love, and making random comments about love and how I felt about it, as she quietly listened and waited. And sure enough, it dawned me, I did have a problem with love. A big one.

This is one of the best things about treatment, those moments that just happen by accident. Some of the best insights can happen this way. And this one was no exception. Not only did I have a problem with love, I had a problem with the word too.

I thought of the last appointment I had with her and when I went to Chapters bookstore afterwards, I was looking for a journal, and a number of them and the word “love” on the cover, or love quotes, and I picked them off one-by-one, making faces at them, scowling at them, making the fart/splat sound, rolling my eyes and even getting irritated to the point of thinking, ‘my god does love have to be everywhere?

Well, son of a bitch. I really did have a problem with love.

What is that about?

Unfortunately, it was literally the last three minutes of my appointment so we weren’t able to further discuss it. She asked me to think about it for the next appointment and journal about it to explore what might be going on there. I’m kind of glad it happened this way because I’m actually curious now, and I’d like to think about it on my own. I appreciate my psychiatrists input for sure, but I wanted to see what I came up with first. What is my aversion to love about?

I’ve been thinking about it ever since my appointment. So far I’ve only noticed that I’m not a fan of thinking about it either. I’m guessing that’s because there’s some big stuff behind it that I’m probably afraid to deal with. Not much surprise there.

So the inquiry into my love aversion begins…