PTSD and the science behind why you can’t just “get over it”

This question comes up a lot. If it’s something you ask yourself, please read this. If other people ask you why you aren’t over it yet – please share this with them, and maybe it will help them to understand.

Trauma memories aren’t like other memories – they don’t fade over time. Every time you think of them, they feel like they just happened yesterday (or worse – like they’re happening now).

Here’s why, in a nutshell:

Think of your brain as having two main parts:

Part 1 is your “Thinking Brain”. The thinking Brain is smart, rational and fact-based. We’re conscious of the thoughts it comes up with. It plans, organizes, and problem-solves.

When it stores a memory, it’s like a librarian – it organizes by theme and date. So, its memories of your senior year of high school might include the music you liked that year; the person you had a crush on; the part-time job you worked; and, oh dear, that goofy haircut you had that was so stylish back then. Remembering these memories feels like you’re looking through an old photo album – there’s a distinct sense of “me-now” remembering what happened to “me-then”.

Part 2 is your “Threat-Response Brain”. We’ve talked about this one before, here, here, and here; it’s not smart, it’s not rational, and you’re not consciously aware of what it thinks.

Your Threat-Response Brain stores memory very differently – and it does so on purpose.

Pretend you touched a hot stove once, as a small child; you burned your hand and cried.

To be good at predicting future threats, your Threat-Response Brain needs to know that “hot things hurt“. Time and context don’t matter: you don’t want a Threat Brain that thinks “Yeah, I hurt myself on a hot stove – but it was Grandma’s old gas stove, back when I was a kid, and she was cooking breakfast; I’m an adult now, in my house, making dinner, and my stove is electric, so let’s try touching it, because maybe it’ll feel good.”

Yeah – that really wouldn’t help much, now would it?

The way the Threat-Response Brain works is: “Every time I see/hear/smell something that reminds me of the time I got hurt, there might be danger.” The threat brain also generalizes to similar threats – so, if you hurt yourself by touching a hot stove, you don’t need to also touch a hot iron, and stick your hand in a campfire – your threat brain learns that hot = pain.

This is why memories of trauma stay fresh and vivid in your mind, even years or decades later: they are kept in a different part of your brain than other memories. The point of the Threat-Response Brain is to protect you – so it makes sure you remember danger as if it had just happened.

So – how do you cope with this stuff, when it gets triggered? You use grounding skills. Remind yourself that feeling triggered means that your Threat-Response Brain is reacting to a memory – it doesn’t mean that you’re in danger now. Tell yourself, “my threat-response brain is reacting right now because this looks/smells/sounds similar to my trauma – but that was years ago, and I’m here now, and that’s not happening anymore.” This helps you refocus on the here-and-now.

To fine-tune your Threat-Response Brain’s reactions, there are no quick and easy tricks I can teach you in a blog post – but, there are specific therapies out there (EMDR or cognitive processing for example) that can help with that.

Please feel free to share this post, and any other on this blog, with anyone who might benefit.

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 M & C Charbonneau, and I’d like to thank them for generously allowing me to use their work. Please do not copy photographs from Coming Back Home without permission.

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“Why do I push people away when I need them the most?”

The title of this post is a question that was sent to me a little while ago; it comes up often enough, and seems to be something that a lot of people can relate to.

When we’re at our loneliest and most vulnerable – precisely when we need support the most – often seems to be exactly the time when we work the hardest to push people away. It doesn’t seem to make any sense, and we often kick ourselves for acting this way.

There’s actually some important reasons why we tend to act this way.

One is reflex: when we feel hurt and vulnerable, our defenses go up. When that happens, it’s harder to trust and let people in.

Two is history, especially childhood: When we’ve been hurt, our antennas go up and we find it a lot harder to trust; so the more lonely we feel, the more vulnerable we feel. When we feel vulnerable, our instinct is to not trust because we’re afraid of being hurt again. It’s a vicious cycle – we feel alone, so we feel vulnerable, so we push people away,  which makes us feel alone, which makes us feel vulnerable, which makes us push people away…

Three is culture, especially if you’re from a military background: you’re used to being tough and doing your best to act even tougher. Trying to let your guard down to let someone else actually look after you makes you feel… Vulnerable. You don’t want anyone to see you when you’re hurting, so even though you really need them to be there for you, you push them away.

The trick to breaking the pattern is:

One, understand that your reflex is making you feel less trusting – it’s colouring your outlook, and making you more crusty and prickly than you normally would be. So, know that the reason you’re pushing people away is because you really need them.

Two, realize that you got hurt back then, and this is now. It’s important to remind yourself that not everyone is like the person/people who hurt you; it will take work to slowly allow yourself to let people in.

UPDATE: Since it was published, this post has been one of the most read on this blog, and many readers have asked me to write more on the topic. Here’s a link to part 2 on this topic; here is part 3.

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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 the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Panic Attacks: Where They Come From, What They Are

Happy New Year, everyone!

I hope your holidays went well. Before you put them behind you, take a quick inventory: what helped you get through the holidays this year, and what didn’t? Taking a few minutes to review this will help you do even better next year.

Now that the holidays are behind us, let’s switch gears, and talk about panic attacks.

There’s a lot to say about panic, so – if at the end of this post you have more questions than answers – hang tight. I’ll cover more in the next post. And the one after that.

If you have PTSD, chances are pretty good that you also have panic attacks. Panic attacks and PTSD are caused by the same reflexhttp://drdee.ca/2013/05/31/ptsd-the-role-of-reflex-part-1-how-reflex-works/. When it senses a threat, your heart rate speeds up, your muscles tense up, you get a shot of adrenalin and you deal with the threat. And then when the threat’s over, if this reflex is working properly, your adrenal glands stop pumping adrenalin into your bloodstream, and you get to feel calm again.

Like PTSD, panic attacks happen when the “off” switch on your threat-response reflex breaks down. Reflex starts to misfire, basically. The triggers for panic attacks aren’t always obvious; often, panic attacks might seem like they’re happening for no reason at all.

A panic attack is one of the most intensely unpleasant things that can happen to you.

I’m going to describe what a panic attack feels like. If you get a lot of panic attacks and they are easily triggered, take a moment now to remind yourself that you’re not in danger; look around the room, take a few slow, deep breaths.

When you’re having a panic attack, you might feel like you can’t breathe; your heart starts pounding like it wants to jump out of your chest; your chest feels like it’s going to explode; you’re shaking, sweating, tingling, numb, hot or cold; you feel dizzy, light-headed or faint; you feel like you’re choking and like you’re going to throw up. It might feel like it’s not real, and you might be (understandably) scared and thinking you’re going to die or go crazy.

Look – I’d love to write a whole book right now, in this blog post, to explain all the biology of how and why they happen, and how you’re going to beat them. That’s going to take a few more posts on my part, and a lot of practice on your part (and hopefully, some real help, because a blog is not a substitute for actual therapy. And if you’re dealing with panic, then I’d really like you to go get some therapy).

What I need you to know for right now, is that panic attacks are not dangerous. Panic can’t make you go crazy, it can’t make you have a heart attack, and it can’t make you die. It is totally, completely awful to deal with. It feels like an eternity, but it usually lasts somewhere between 10-20 minutes for most people. And then it’s over, and you’re exhausted but in no danger.

That’s important information to keep in mind. Because when you have panic attacks, you end up spending a lot of time dreading the next panic attack. So – work on reminding yourself that panic attacks can’t actually hurt you, even if they feel really awful. That’s the first step to taking back your life.

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 M & C Charbonneau, and I’d like to thank them for generously allowing me to use their work. Please do not copy photographs from Coming Back Home without permission.

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PTSD Triggers: Crowds

So – while we’re on the topic of triggers, let’s talk about crowds. From what I gather, most of you are not big fans of crowds.

Like I keep saying, PTSD is basically your brain’s threat-alert system, kicked into high gear without an “off” button. So – you’re constantly trying to size up all possible threats.

Say you’re in a room with one door, one window, and one other person. That’s not bad; you can scan window-door-person, to look for possible threats.

Now say you’re in a bigger room, with ten people. Keeping track is much harder, and it’s easier to get overwhelmed.

It goes up to a whole new level if you’re in a grocery store, a mall, or a football stadium. Now, there’s just no way to keep track of it all. Just thinking about it, you might start to feel your heart rate speeding up a bit – that’s your reflex, getting ready to fight or flee.

Take a moment. Breathe. You’re not there right now.

See what just happened there? That feeling started, even though you were just thinking. Thinking is not dangerous – but your survival reflex is so strong, that just thinking about it makes the danger feel SO real.

When we start to feel like that, we interpret that feeling itself as a sign that there’s danger. If we can’t quickly scan our entire environment, we start thinking the danger must be real, only we can’t see it.

Feeling tense/nervous/uneasy does NOT mean that you’re in danger – it just means that your threat-detection system is reminded of danger.

…That little fact right there folks – that is the key to the universe.

When you’re dealing with PTSD, having that feeling that tells you, “Oh no, major danger is coming” does NOT actually mean that anything is coming.

It just means that your threat-response system was reminded of danger.

Remember Dave the Zebra, and his red flowers? Well – crowds are sort of like your red flowers.

So – how do you cope?

Remind yourself that, as soon as you start to think about crowds, your PTSD will start to act up. This is not because thinking is dangerous, or because crowds are dangerous; it’s because PTSD reacts to reminders of danger.

Heading into a crowd, you’re going to feel anxious/tense/wound up. You may even start imagining all kinds of horrible things that could go wrong, and all those things might feel very, very real. Feeling and thinking this way does not mean that you’re in danger, or that awful things will happen. This is a normal part of PTSD; it is to be expected. This is unpleasant, but not dangerous.

Repeat this information to yourself frequently; with consistent practice, it will get easier. (You’ll probably still not like being in crowds, but it will get easier to cope with it.)

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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 the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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PTSD: Dissociative Symptoms

Holy feedback!

As soon as I put up the last blog post, there was a stampede of comments and emails saying, “Yes! Talk about this more!!!”

Okay.

So we left off talking about how the “freeze” response is part of the fight/flight/freeze reflex. It’s how we defend ourselves when we can’t fight or run away; it dulls the pain of whatever is happening.

Let’s put this together with some information we have from before, about how reflex learns: it learns that any reminder of the trauma is a sign of danger.

So – a reminder of your trauma might set off a “freeze” reaction.

Here’s what it feels like: you might feel like you’re not really in your body so it’s not really happening to you (this is called depersonalization); or you might feel like the whole thing is a dream, a movie, or happening in slow motion like it’s not real (this is called derealization). You might feel like you’re just losing chunks of time – ‘waking up’ and not knowing how you got to be wherever you are.

Here’s what it feels like to have PTSD do this to your life: it’s terrifying. You feel like you have no control over your mind or body. You want to do everything you can to grip onto reality, but you get sucked into this rabbit hole. You might feel angry at your mind for betraying you this way.  You might feel guilty, weak, and ashamed for not being “strong enough” to somehow hang on tighter and not let this happen to you. It can leave you feeling traumatized again and again, every time it happens, because being helpless to stop yourself from dissociating can remind you of being helpless to stop your trauma when it happened. You might feel depressed, useless, worthless.

…Boy, sounds like fun, doesn’t it?

Look – I won’t try and tell you that getting out of this is going to be quick or easy. If your PTSD includes dissociation, research suggests that, as far as PTSD goes, yours is bigger and harder to heal.

What makes it worse is, every time it happens, you might feel disappointed in yourself, like you should be stronger. This just erodes whatever self-respect you have left. You’d never say stuff like that to a buddy to encourage them when they’re struggling…

You need to start by realizing that this happens to you because you don’t feel safe; so, how you start to fix it, is to work on increasing your sense of safety.

The ability to feel safe is like a muscle – and yours is, well… It’s not so strong. You strengthen it with exercises – stuff like relaxation. Grounding skills. These are your drills: practice this stuff. Be patient with yourself: this might mean that, for now, don’t purposely put yourself in circumstances that you know will be overwhelming for you. What you’re trying to accomplish here is very hard work, so give it time.

Finally – you know that fine print I put at the end of every post? You know, the stuff that you never read, because you don’t think there’s anything important under the pretty picture?

Yeah; it says that this blog is not a substitute for therapy. If you’re dealing with PTSD with dissociative symptoms, it’s extremely difficult to try and heal that on your own. Please consider getting help to give yourself the best chance of recovery.

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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 the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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PTSD: Reflex and The “Freeze” Response

…You know I’m all about feedback, right? You know this is YOUR blog, and I’ll write about whatever you need?

Well – my stats tracker thingy tells me somebody ended up on Coming Back Home by Googling “PTSD + Freeze response”.

And I thought, Huh – I don’t really have a good article on that. I mean, if I was Random Google Person, I’d be a little disappointed.

So – good suggestion, Random Google Person! This post is for you!

If you recall from previous discussions, PTSD is basically a survival reflex stuck in a loop with no off switch. This reflex has three parts, depending on what kind of threat you’re up against:

fight is where you respond to a threat by beating up on it. Military training works to strengthen this part of your survival reflex.

flight is where you run for the hills to get away from the threat.

freeze is what you do when neither of the above is an option.

In this post, we’re going to discuss the freeze response, the way it happens in the face of an actual threat. Next post, we’ll talk about dissociation, which is what happens when the “freeze” reaction gets stuck, like in PTSD or dissociative disorder.

It’s like this: imagine a goldfish.

It’s in a fishbowl. The cat just jumped on the table and stuck his paw into the bowl. What’s the fishy gonna do?

He’s can’t fight off the cat, and he can’t run away, because he’s in a fishbowl. Poor little fishy. The cat is about to enjoy some fresh sushi.

So – what does the fish do? He freezes; freezing helps him feel less pain, both physically and emotionally.

Freezing might feel like time has slowed down; like what’s happening isn’t real; or like he isn’t really there. The goldfish might feel like he’s floating above his body, watching the cat enjoy his sushi.

Feeling this way is a normal reaction to a situation of extreme, life-threatening danger, where you can’t fight and can’t get away.

If you’re a goldfish who’s about to get eaten by a cat, feeling like you’re floating above your body and the whole thing is not really happening is less terrifying, which is why our reflex is built this way.

But – suppose just as the cat is scooping up the goldfish, someone comes along and screams, startling the cat. Poor little fishy lives, but is scarred by this near-death experience: he might get stuck in this “freeze” reaction. He might end up with severe PTSD, and symptoms that we call dissociation. We’ll talk a bit more about that in the next post.

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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 the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Spouses want to know: PTSD and Sexual Dysfunction

So – guess what we’re talking about today? (Go ahead, check the title again). That’s right.

*Disclaimer: This is a really broad topic, so I won’t be able to cover everything that’s relevant. The question was originally asked by a female spouse of a male veteran. Most of my patients are male and heterosexual, so I’m addressing the topic from that perspective. I don’t mean to leave anyone else out, I just try to stick to writing about what I know.

In person, some of the patients that I work with find this really awkward to discuss.

Well – look on the bright side: this is a blog! You don’t have to ask this stuff in person! All the answers, none of the awkwardness!

The research is pretty clear that there’s a link between PTSD and sexual dysfunction. Most studies show that in veterans with PTSD, about 8 to 9 out of every 10 have some sort of sexual dysfunction. That’s much higher than combat veterans without PTSD, and higher than veterans with other mental health diagnoses. “Sexual dysfunction” can be a whole list of different problems – including having less sexual desire; erectile dysfunction; premature ejaculation, or inability to reach orgasm.

8 to 9 out of every ten. That means that, if you have PTSD and you don’t have some sort of sexual dysfunction – you’re the exception.

If you didn’t know that before, then it’s important that you know this about your body, and what PTSD can do to it. It’s not you, it’s not your fault, it’s not because you’re doing something wrong. It’s not your partner’s fault either. Add it to the long list of things you dislike about PTSD.

But – let’s talk about how and why this happens, and then, most importantly, let’s talk about what to do about it.

First, the “why”: remember that PTSD is survival reflex on overdrive; remember how we talked about reflex making all your big muscle groups tense up? Yeah – apparently, your survival reflex doesn’t consider that part of your body as a big muscle… Go figure.

Basically, reflex thinks that anything that doesn’t help you fight or flee is a waste of energy.

PTSD also makes you feel anxious and hyper-alert pretty much all the time, and that makes it hard to get in the mood and stay in the mood for long enough. Many people who have PTSD also feel disconnected and detached from loved ones, and that can make it hard for both partners to get in the right headspace. Increased anger and irritability can also put a damper on your relationship, and that can make the physical part of your relationship suffer too.

…Sounds pretty bad, huh?

Yeah… I know…

It can get better. Not magically, overnight better, but slowly and with some work – it can get better.

(Yes, pills can help. Talk to your doctor about getting some. But don’t expect pills to be a quick, easy, magic cure-all.)

First – go to therapy, and work on learning to manage your PTSD. When you learn more about how to manage your symptoms, this will make a difference.

Next – consider couples therapy. Especially if you’ve been struggling with this stuff for a long time, chances are there’s a lot of misunderstandings and hurt feelings from both of you that are driving a wedge between you. Couples therapy may help you to reconnect and feel closer, and that might help.

Third – don’t give up. Don’t lose hope. As long as you’re willing to try, things can get better.

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.

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Spouses want to know: Physical Symptoms of PTSD

Hello again!

Our next question is, “Does PTSD have physical side effects?”

The answer is, yes, absolutely.

Now – before I get any further into this topic – I want to check in with how you’re doing reading this.

If you didn’t know about physical side effects, you might be thinking, “Great. As if PTSD wasn’t bad enough, now I’ve got a whole laundry list of physical issues to worry about too…

Hey – I hear you. What can I say – I’m not pretending to be the bearer of good news here.

But – you know what? This is your body we’re talking about. Knowing this means you’ll know what to expect, what to talk to your family doctor about. That gives you more control of your health than not knowing.

Also – knowing that it’s related to your PTSD can actually be a relief. Otherwise, you’re left thinking you have this laundry list of stuff going on and you don’t know why.

We’ve talked before about how PTSD is basically a threat-response reflex gone into overdrive. So, the physical symptoms of PTSD come from this reflex being cranked into overdrive all the time.

When your body responds to threat, your heart rate goes up. When you have PTSD, your ticker’s working harder all the time. This puts you at higher risk of high blood pressure and heart disease.

Your threat-response reflex makes your muscles tense up, to help you either fight off a threat or run away. When your muscles are tense all the time, you can develop chronic pain, especially in areas like your shoulders and back. Tension also makes us clench our teeth; that can lead you to grind your teeth, meaning you might have chronic headaches and jaw pain.

Since your threat-response reflex directs all available energy towards survival, it shuts down functions that are not essential to dealing with an immediate threat. So, it will suppress your digestive system and your immune system, because these are not immediately essential when your survival is being threatened.

What this means is that PTSD can lower your immune system. You might be more likely to get infections and get sick more often.

The impact on your digestive system can mean chronic cramps or indigestion; changes to your appetite; chronic heartburn or Irritable Bowel Syndrome can also occur with PTSD.

Your threat-response reflex also leads your body to release more sugar and cholesterol into your bloodstream to feed your muscles; so, with PTSD you may have high cholesterol. Also, there is a link between blood sugar and insulin. So, there’s a link between PTSD and insulin resistance, as well as PTSD and diabetes.

How’re you doing with all this? I know… It’s quite the list of potential physical symptoms. It might be a good idea to make an appointment with your family doctor to get checked out for some of these risks.

Also, keep in mind that learning to manage your PTSD symptoms will help to lessen some of all these other concerns as well – so please keep in mind that things can get better.

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.

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

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.

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 (i.e., 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.

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Spouses want to know: “Where does the anger come from?”

I have a few more questions from spouses, and this is a really important one.

The answer is pretty straight forward: PTSD is basically the fight/flight/freeze reflex gone into overdrive, and anger is part of  the “fight” part of that reflex. You might remember that we discussed anger in this post.

Well then… that would make for a really short blog post, wouldn’t it?

If you’re reading this, then anger has probably had an impact on your life. I’m going to talk about it in more detail below, and that might be hard to read.

So – don’t go any further if you’re having a bad day and don’t need to be reminded of how anger has made life worse. Save it for another day. Otherwise, find a nice quiet spot where you won’t be disturbed. Set aside time to do a relaxation exercise when you’re done reading this – here‘s one that I’ve posted previously. Here‘s another.

Gee, I’m being a little bossy today, aren’t I?

If you’re just waiting for me to tell you to go pee before you read on, don’t worry. I’ll restrain myself.

 

Ready?

Okay.

If you’re a spouse, then you need to know where the anger does NOT come from: it doesn’t come from you, or what you said, or because you’re making the wrong thing for dinner. It’s not coming from the kids playing too loudly. It isn’t your fault. It’s easy to lose your confidence and start to blame yourself.

It’s also easy to get frustrated and blame your spouse – the anger is not coming from him/her either.

Look – you didn’t marry an idiot. (Well – if you did, then, this blog can’t help you with that…)

But – if you didn’t marry an idiot, then your spouse didn’t just magically become an angry jackass overnight for the fun of getting under your skin. PTSD makes a person feel like they’re under attack all the time, and anger is part of the reflex of reacting to threat.

PTSD is an injury. Anger is one of the ways that this injury hurts. It hurts anyone who might be on the receiving end of that anger – spouse, kids, random clerk at the grocery store.

It hurts the person with PTSD; they don’t choose to act like this, and a moment after they say something hurtful, scream at someone, or put their fist through the wall – they feel terrible about it.

As the spouse, you feel caught between trying to understand that this is an injury, but also feeling frustrated and angry that they can’t just cut it out.

Understanding is the first tool in making things better: the person with PTSD needs to understand that their anger is coming from their PTSD, and not from anything you did. So the solution is to manage their anger, not manage you. And as the spouse, you also need to know that their anger is coming from their PTSD, and not from them being a jerk. So the solution is to help them manage their anger, and to take care of yourself, because this is a lot for you to deal with too.

 

How’re ya doing? I warned you – it got a little heavy. If you feel a bit like this post punched you in the gut today, please take a minute to look after yourself. You don’t even have to scroll back up to find the hyperlinks to the relaxation exercises – here‘s the woods. Here‘s the water.

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 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.

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