depression – Page 2 – Coming Back Home

Spouses want to know: “He doesn’t want to talk about his PTSD”

Published on September 22, 2013August 2, 2022 by Dr. Dee Rajska, C. Psych6 Comments

Well, hello again, everyone!

Today’s question is: “He doesn’t want to talk about it [his PTSD], or tell people. But I don’t think he has anything to be ashamed of, and I think it will help people understand why he is acting this way. What should I do?”

First, a disclaimer: I usually try to write in a way that applies as widely as possible. This time, I’m answering a reader’s question, so not everyone might relate. I know that not everyone who has PTSD is male, or married. If you have a different question you’d like me to answer in a post, please let me know.

This reader’s point of view goes sort of like this:

“Honey, you have nothing to be ashamed of; you didn’t choose to get sick, this happened to you. It’s no more shameful than a physical injury. I want to tell people so that when you need your space, they can be more understanding.”

Makes perfect sense, right? So – why is her husband (and maybe yours) so adamant that he doesn’t want anyone to know?

Because being able to talk about it happens at a point in his healing called acceptance, and he’s not there yet.

Because he’s still used to being Superman, and it’s hard to wrap his head around the idea of being this “sick guy” who needs to be fussed over.

Because he’s sick and tired of being sick and tired, and talking about it just reminds him when sometimes, he’d just like to forget.

Because talking about a problem is the way we women naturally tend to cope. Guys like to fix things, and if they can’t fix it, they don’t want to talk about it.

Because facts and feelings are two different things – so his head may understand that this illness is not his fault, but he may still feel shame, guilt, and anger at himself for “allowing” this to happen to him. He may feel broken or weak, and helpless that he can’t just “buck up” and shake this thing off.

If he’s sick enough that he can’t work right now, he may be struggling with the fact that he can’t work to provide for his family.

If his illness has led to out-of-character temper outbursts that have frightened you and the kids, he may have feelings of shame and guilt about that, too.

And thinking about it all is just so painful and overwhelming, that he just can’t. Not because he’s being to be stubborn, but because it’s all just too much.

So… That leaves you, the spouse, in a bit of a conundrum: his behaviour is different, and maybe he can’t attend family functions, so friends and family are asking what’s wrong. Yes, it would be a lot easier if he was ready to talk about it – but he’s not there yet, and pressuring him won’t speed his healing process.

So – what do you do?

You take care of you. This is tough on you – so get support from other spouses who can relate, and consider getting some counselling yourself, to help you cope.

You can be helpful by doing other things, like offering a smile or a hug. If he’s okay with it, maybe the two of you can talk with his therapist about what might be fun, trigger-free things for the two of you to do as a couple, or things to do as a family – because making life seem a little more “normal” might be just the ray of hope that both of you need to see that life can go on.

I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

“I know I’m safe, so why am I still freaking out???”

Published on September 19, 2013August 2, 2022 by Dr. Dee Rajska, C. Psych3 Comments

This question is important, and it comes up a lot.

Okay – for me to explain this, you’ll have to imagine that your brain is a grapefruit.

(Hey – it’s either that, or this becomes a hard-core neurobiology lesson where I start throwing around Latin words that are harder to pronounce than my last name…)

…So – we’ll go with the grapefruit then?

The peel of the grapefruit is the “gray matter”, or cortex. It’s got all your smarts – this is where you analyze, make decisions, set priorities, and so on. You’re conscious only of the stuff that the gray matter does: the other parts of your brain do their thing behind the scenes, like an autopilot.

The fruit part of the grapefruit is the “white matter”. It’s a messenger – it sends ideas back and forth and makes your brain work quickly to translate a thought into an action.

The grapefruit’s got a few seeds in it. One of these seeds is a little thing called the amygdala. (This will be the only Latin word I’m throwing out there today, promise.) The amygdala sets off your fight/flight/freeze reaction, in response to anything that reminds it of a threat. It’s a reflex, so it doesn’t ask your permission before it goes off.

So – how is it that you can realize that everything’s okay, but still find your body reacting like you’re in danger?

Simple – the realizing that there’s no threat is coming from the peel of your grapefruit. But, at the same time, one of the seeds (your amygdala) is reminded of a threat, so it’s reacting as if you were in danger. Two different parts of your brain are doing two different things, at the same time.

It’s really important to know that this is how your brain works. If you don’t know, you might end up doing one of two things:

1. Telling yourself, “I should just suck it up and stop being so (bleep)ing scared, and what the (bleep) is wrong with me?”.

Yeah… Cause that’ll help, right? Fear is part of a reflex; beating up on yourself for it is sort of like blaming yourself for letting your toenails grow; you didn’t have a choice, so quit blaming yourself, it’s not your fault. Plus – talking to yourself this way just makes you feel shame and guilt, which feeds your depression. Do yourself a favour, and remind yourself that you are not to blame for your reflex.

2. The other option is that you start thinking, “I’m feeling so nervous that there must be something to be scared of and I’m just not seeing it”.

…If you want a quick, easy recipe for freaking yourself right out, then telling yourself that there are invisible dangers that you cannot sense is a good way to do it…

However, if you want to help yourself relax instead – then remind yourself that you’re feeling nervous because a very primitive part of your brain is being triggered to think of a threat; it’s not very smart, so it can’t tell the difference between real and imagined threats.

So, how do you try to stop it? You tell yourself that it’s just your threat reflex sounding a false alarm; then use your relaxation skills to help yourself to relax. (Yes, this is exactly why I keep droning on about how important it is to practice relaxation regularly…)

It’s simple – but simple and easy are two very different things. You’ll need a lot of practice to make it a habit to think this way, but once you’re successful, it will be a helpful tool.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

Spouses want to know: “Why isn’t the medication helping?”

Published on September 14, 2013July 12, 2022 by Dr. Dee Rajska, C. PsychLeave a comment

Today’s question is, “If my husband is medicated, shouldn’t we see some signs of him getting better?”

Great question, and thanks for asking!

…And you might be frustrated that I don’t have a quick, easy, one-size-fits-all answer.

First of all – let me just clarify: as a clinical psychologist, I don’t prescribe medication. That doesn’t mean that I’m opposed to medication; I have some patients who won’t take medication no matter what, and I respect that. I also work with others who consider their medication to be an important part of the mix that works with for them. I respect whatever path to recovery is the best fit for each individual person.

So, you might wonder, what is it, exactly, that medication is supposed to help with? Well – it depends on the diagnosis and the type of medication Antidepressants do something very different than anti-anxiety medication, for instance.

In general, meds are supposed to dial back your symptoms. Finding the right dose often takes a bit of trial and error; antidepressants in particular can take up to six weeks to build up in your system and start to make an impact. And you need to start off at a lower dose and gradually build it up to the dose that you need, to give your body a chance to adjust. So, it can take a while to get to the point where the medication has its full effect. When it comes to finding the best medication for you, it also might take a bit of trial and error – you may need to try a few different medications before finding the best one for you. So, medication might seem like a quick solution, but like anything else – you need to hunker down and arm yourself with a lot of patience, because it might take a while.

The other issue is, pills don’t give you skills: they don’t teach you to understand what’s happening to your brain, or where it comes from or how to cope with it.

So – in a nutshell, it may take some time before you start to see a difference. You might have to try a few before you find the right one. And medication alone is frequently not enough to change behaviour.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

Depression: Defending Yourself Against The Bully Inside Your Head

Published on September 3, 2013August 2, 2022 by Dr. Dee Rajska, C. Psych1 Comment

So – how ya doin’, folks?

Has your depression magically disappeared from the couple pearls of wisdom I shared last week?

No, of course not. I hope you didn’t expect it to. Because if you read last week’s post and thought, “That’s easy, I can do this overnight”, and then started beating up on yourself when it didn’t work out that way – folks, that’s just your depression messing with you again. Digging yourself out of depression takes a lot of practice and hard work.

See – depression would be hard enough to deal with on its own. To make things worse, it often travels with friends, like PTSD or chronic pain. Or, you might be dealing with the trifecta: depression, PTSD and chronic pain.

Depression often sets in after something bad has happened in your life: stuff like going through a trauma; suffering a serious injury that changes how you can live your life; losing your job; losing a loved one; losing your marriage. You know, all the stuff that they write country songs about…

Then – just to be mean – depression starts comparing the new, not-so-improved you to the old you. And then, it starts nagging on you about how new-you should be able to live up to all the stuff that old-you was able to do. It keeps telling you how it’s so simple, and what’s wrong with you, you should be able to just suck it up, pull yourself together, and get on with it. And if you can’t do it, then depression starts telling you that you’re worthless, useless, and you should feel guilt and shame.

Honestly – depression is feeding you a bunch of… um, fresh manure.

When you can’t do the stuff you used to do because you’re sick, it’s healthy to grieve that loss. If you love to swim and you missed a whole summer of swimming because your leg was in a cast, you might feel frustrated and disappointed. But there’s a difference between those feelings, and calling yourself stupid and lazy for not making your bone heal faster. There’s a big difference between disliking the circumstances, and unfairly blaming yourself for them.

Depression also doesn’t give you any credit for how hard it is to actually live with depression. Stop for a second and consider that there are days when you deserve a medal just for getting out of bed.

Imagine you’re watching speed skating on TV (why speed skating? It just popped into my head, and it’ll work with my example, so let’s just roll with it).

There’s a bunch of guys racing and they’re all ridiculously super fast. And then, waaaaaaaaaaaaaaaaaaaay behind them, there’s this one dude who’s going so slow, he’s barely putting one foot in front of the other.

Oh – except he’s carrying a backpack, filled with 500 pounds of rocks.

So – who do you respect more, the bunch of dudes at the front, or the one guy managing to stay on his feet with the giant bag full of rocks?

(Hint: Vote for the guy with the rocks, he’s pretty incredible.)

And if you vote for him – try to also realize that all the stuff you’re dealing with is a lot like carrying around a bag with 500 pounds of rocks. And try to respect yourself a little more.)

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Benjamin Yost, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

More on Depression: The Bully Inside Your Head

Published on August 28, 2013July 11, 2022 by Dr. Dee Rajska, C. Psych8 Comments

So – last week, we talked a bit about depression.

(Well okay – I talked about depression; I seem to do most of the talking around here. You know I welcome your comments, right? Feel free to start a discussion…)

Anyhow – I was saying that your brain runs on juice, and that depression sucks out all the juice that makes your brain run.

Basically – depression is like a big bully inside your head. It sits there and calls you names. It tells you stuff like “you’re useless”, or “you’re worthless”, or “you’re not good enough”. It compares the person you are now to the “old you”. It tells you to feel guilty and ashamed of who you are now.

Depression is so good at messing with you because not only does it tell you all that stuff – it also makes you believe that nonsense.

Don’t get sucked in!!!

Unless this is the first post that you’ve read on this blog, then you probably realize by now that I repeat myself when I have something important to say. I said this last week, but I’m saying it again: Depression is an illness; it would be great if there was a “juice gauge” on the side of your head, like a gas gauge in your car, so you could actually see when your brain is running low on juice – then it would be easier to accept that depression is real.

Sadly, there’s no juice gauge. Instead, you’ll just have to trust me. (I’m some chick you met on the internet, so trusting me has got to be a good idea, right?)

Depression is an illness, not a choice. Here’s a couple of ways to fight back:

– “if it were a physical illness“: Ask yourself this: If you were physically ill and not able to get stuff done, would you be saying nasty stuff to yourself about it? No, of course not. You’d be annoyed and frustrated that you’re sick, but you wouldn’t blame yourself. Well, depression is a physical illness – it’s a juice deficiency, and that part is physical. You didn’t ask for this. So try to quit beating up on yourself about it.

– “if it were happening to a friend“: Ask yourself this: If one of your friends were struggling with this, would you be telling them that they’re useless and worthless? If you have peer support, you probably know some buddies who struggle with this stuff. When they do, you probably tell them you’ve been there too, to take it one day at a time, and to do their best and take it easy on themselves.

You say the nice stuff to your buddies because that’s supportive; you say that mean stuff to yourself because that’s depression. Talking to yourself like you’re talking to a buddy is a way to cheat depression and offer yourself some support. If you can offer yourself some support, you might be able to put some juice back in your tank, so you feel up to doing more stuff, and slowly digging your way out of depression.

Sounds so simple, right? Yeah, well simple and easy are two different things, and this is going to be a LOT of work. For a lot of folks – too much to do on your own. If you’re struggling to get better on your own, don’t just sit there and tell yourself you should be able to do this alone – that’s your depression bullying you again. Most folks can’t do this on their own, and you don’t have to. Get some peer support, and then get yourself to therapy. It’ll help you get better.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Murray Chappell, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

On the Importance of Peer Support

Published on August 24, 2013July 12, 2022 by Dr. Dee Rajska, C. PsychLeave a comment

Hi again!

Last post, I was talking about depression; so, you might think with peer support, I’m sort of jumping all over the place. I’m not; peer support is actually an important part of coping with depression. Here’s why:

As soldiers, you’re used to being part of a unit, and working closely with a group of other people to whom you can relate. That’s one of the things that makes a psychological injury all the more difficult: it’s such a lonely, isolating experience. Often, you feel like you failed somehow, and like you’re the only one who ever felt this way. You might tell yourself that you’re supposed to be stronger than this. Beating up on yourself like this is the downward spiral of depression that we were just talking about in the last post.

Dealing with this stuff on your own is like trying to fight a war all by yourself, against an enemy you’ve never been trained to fight. As a psychologist, and even as a blogger, I can try to help you understand this new enemy, and help you learn to fight back. What I can’t do as effectively, as a civi who’s never been there, is convince you that your symptoms are not about weakness or failure, it’s about what happened to you. Don’t get me wrong – I try. I repeat that stuff all the time. And you know what happens? You roll your eyes at me. (Yeah, I saw you. It’s okay.)

As far as you’re concerned, my job is to make you feel better, so when I start saying all that nice fluffy that it’s not your fault, it’s sort of like your Momma telling you that you’re handsome – you figure it’s just my job to say nice stuff to make you feel better…

It’s easier to win a war if you have buddies fighting alongside you; and that’s what peer support does. Getting together with a bunch of other folks who have been there and gone through it accomplishes what I can’t: You meet others who have been through the same kind of stuff and have had the same kind of reactions.

Depression makes you blame yourself unfairly, but when you can be understanding to someone else who’s going through the same sort of stuff, it suddenly starts to get real that, hey – it you think their symptoms aren’t their fault, then maybe yours aren’t your fault, either. Psychological injury, whether depression, PTSD, or whatever else you’ve got on your plate – it happens when you go through the kind of stuff you went through, and it happens no matter who you are.

Peer support gives you a chance to let go of the feelings of shame and guilt. And it gives you a chance to fight back as a team, which is what you’re used to doing as a soldier.

If you’re in Canada, you can find a peer support community through http://www.osiss.ca/ They provide some great services and supports, and I hope you check them out.

Online, there’s a number of peer support communities on Facebook – if you’re interested, you can link to many of these through my Facebook profile. Scroll down to “groups”, on the left-hand side.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

The Downward Spiral of Depression

Published on August 24, 2013August 2, 2022 by Dr. Dee Rajska, C. Psych2 Comments

We’re going to switch gears a little bit today.

So far, we’ve talked a lot about PTSD. But PTSD and depression often go together like peanut butter and jelly; so, we need to talk about depression.

Here’s how it works it a nutshell: your brain runs on juice. (Geeks might throw around big fancy words like dopamine and serotonin, but it’s juice, and it makes your brain run).

When you’re well, your brain has enough juice to make you feel like doing stuff. You might feel like going for a bike ride, having coffee with a friend, or picking up your guitar and strumming it. Hey – you might even feel like doing some chores around the house. (This last one doesn’t happen to me personally very often, but I’m just saying – it might happen to you). When you get stuff done, you feel proud or satisfied; those good feelings make more juice, so tomorrow and the next day, your brain has the juice to do it all over again.

When you have depression, this all comes to a screeching halt. Depression means your brain doesn’t have enough juice to feel like doing anything. So, it might be a gorgeous day out, but you just can’t bring yourself to go out for a ride. You stare at your guitar; it stares back at you. You just can’t get the “oomph” to pick it up and strum the darn thing.

But – while you sit there not having enough juice to actually do anything, your head keeps making lists of all the stuff you should be doing right now. So – instead of doing stuff and feeling good about it, you’re just sitting there, feeling like guilt and shame that you aren’t getting anything done.

These feelings of guilt and shame are part of depression, and they just suck more juice out of your brain. So tomorrow, you wake up having even less energy to do anything. And, you wake up kicking yourself over having wasted the whole day today not getting anything done. And it gets worse the next day, and the next day, and next. That, in a nutshell, is the downward spiral of depression.

Okay – so here’s how we begin to turn it around:

First, understand that it is a real illness; one of depression’s strongest weapons against you is that it convinces you that you there’s nothing wrong with you, and that you’re just being lazy. So – first off, please know that depression is not laziness.

How do I know? Simple – if you were lazy you wouldn’t care that you’re not getting stuff done, you’d be happy to leave it for someone else to do. If it’s eating you up that you can’t seem to get moving, then you’re not lazy.

Look – if you broke your leg and fell behind on getting stuff done, you’d get it that this is not your fault. Depression’s more tricky than a broken leg for two reasons: one, because you can’t see it; and two, because it makes you more self-critical, so you blame yourself unfairly. But you’re not lazy, you’re sick. Beating up on yourself about it doesn’t fix anything, it just makes you more sick.

Easier said than done, I know. But, understanding is the first step to fixing. So read through this post a couple of times, soak it in, and we’ll get started on standing up to your depression.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. It’s not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

PTSD: Reflex, Roses, and Zebras

Published on June 17, 2013July 12, 2022 by Dr. Dee Rajska, C. Psych11 Comments

Hi there!

Today we’re going to put together what we’ve learned so far. To help us do that, we’re going to re-visit our new friend from last week, the zebra who was triggered by the red roses because his friend George got eaten by a lion while stopping to sniff red flowers.

Well – last week, his survival reflex learned that red flowers are dangerous (because reflex sometimes “learns” to mistake random things for signs of danger). So, his survival reflex sees the roses as a threat, and reacts automatically: before he has a chance to think, his reflex tells him to RUN!!!

Because reflex is automatic, it’s not his choice to feel this way. In fact, the conscious, rational part of his brain might be telling him, “WTF!!! Why am I freaking out? What’s wrong with me? I need to get it together!!!”

He might start worrying that he’s going crazy. He might blame himself, and think that if only he had tried harder, trained harder, or if he was a better, tougher zebra, this wouldn’t have happened to him. He might even tell himself that other zebras have been through worse and seem to be coping better, so he should just suck it up.

So next thing you know, he’s struggling not just with fear, but also with shame and guilt; that’s the foundation of not just PTSD, but depression too.

Look – the point of the story is – don’t be that zebra!!!

When you react to your own version of “red flowers”, by feeling fear – remember, fear is a reflex, and reflex is not a choice. It is not a sign of weakness or failure, any more than not preventing your toenails from growing would be a failure: reflex is not something that we can control by being stronger, by training harder, or by using willpower. Reflex has a mind of its own; it will see something as a danger, even when your rational brain can tell that there’s no risk. Conscious, rational thought is controlled by a different part of your brain than reflex, so it’s entirely possible to be reacting with fear to a trigger, while at the same time being able to realize that it’s harmless.

Knowing this information, you can start to help manage your fear: when your survival reflex goes off, rather than feeling embarrassed or angry with yourself, try to remind yourself that (1) you do not control your survival reflex, and (2) it often sets off false alarms. These two reminders become the starting point for two important coping tools: one is acceptance, which is learning not to blame yourself. The other is a thought-based grounding skill – a habit of reminding yourself that feeling fear is not a good indicator of danger, and that the fear is just a false alarm.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

**Really fine print: The content of Coming Back Home is copyrighted; please feel welcome to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.