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

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.

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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: “Will he always have PTSD?”

You may have gathered from the title of today’s post that I’m throwing something new into the mix. A few days ago, a support group for spouses asked me to answer a few questions about PTSD. I’m grateful for their permission to post the answers here, so everyone who might be wondering about this stuff can jump into the discussion.

Of all the questions they asked, I wanted to address this one first because I get asked some form of it almost every day – people ask, “Will I ever get better?”, or “Will I always be like this?”

I’d love to give you a money-back guarantee that everything will be just fine.

The honest answer though, is that how much better you will get (or your spouse or loved one will get) depends on a number of factors. Some of them we can predict; others, we can’t.

Single trauma events in an otherwise mentally healthy person, treated quickly after the event, tend to have the best outcomes. In many cases, people can make a full recovery from these types of injuries.

On the other hand, if you’ve had decades of trauma, and it’s taken several years to find a knowledgeable practitioner that you feel comfortable working with – it’s gonna be a longer, steeper, more grueling climb uphill for you. That doesn’t mean that you can’t do it, and no one has a crystal ball that can predict your specific outcome. In fact, my personal experience is that some of the patients who came to me in the worst shape are the ones who have made progress in leaps and bounds, once they’re given the right tools to do so.

Most importantly – even if you can’t be fully cured, you can get better. In many cases, you can get a lot better.

Nothing we do in therapy can take the awful thing(s) that happened to you and make them unhappen. However – how those experiences impact you now, is something we can work on. If you have a lengthy trauma history, and it’s hard for you to trust or hope, then that work might need to happen very slowly and very gently, so it doesn’t overwhelm you. If you’re a spouse trying to be supportive, it may be hard to be patient, because for the first while it might seem like therapy isn’t making any difference.

Here’s your best bet for trying to get better: find a skilled, patient, knowledgeable therapist whom you feel comfortable working with, who won’t give up on you. Let them know when the tools they give you don’t work for you – getting better is a partnership, and finding what works for you can take some trial and error.

Good therapy has two parts: tools that help you manage your symptoms, and ways to try and heal your trauma. If you and your therapist have a good partnership and you are willing to work hard on your recovery, then you will start to see a difference.

It might take a long time and a lot of hard work to get a lot better. But, “a lot better” might mean that you can manage your symptoms most of the time, and the stuff that happened might not bother you as much anymore. Worth a try, no?

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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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Depression: Defending Yourself Against The Bully Inside Your Head

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.)

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 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.

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Strategies for Coping with Nightmares

Unfortunately, nightmares are part of PTSD for many people. They aren’t easy to get rid of. However, if you get nightmares, here is a list of things that you can do to try to make them a little easier on yourself:

– Did I mention that relaxation is really good for you? I did actually; so many times that you might be getting tired of hearing it. I even posted a relaxation exercise here. Some people felt triggered by that one (and I thank them for telling me), so I posted a different one here. I keep talking about relaxation because it’s good for you. Try to do some every night before you go to bed. It will make you less tense, and if you’re less tense you’re less likely to have nightmares.

– Anniversaries of your trauma events are likely to be particularly difficult. But, any days when you’ve been triggered, upset, stressed, or even excited (in a happy way), you’re more likely to have nightmares. Knowing this, you can work to compensate: on days like that, try to do more to relax before going to bed than you normally would. Then, as you lie in bed, take some time to look around the room, and remind yourself that you’re home, and that you’re not in danger. Putting this thought in your head right before you fall asleep will make it easier to bring yourself back into the here-and-now if you do wake up with a nightmare.

There’s a couple of things you can do to set up your bedroom to make it easier to cope with nightmares:

– Keep the room dark enough to sleep, but leave a small nightlight on to make it easier and quicker to orient yourself if you wake up from a nightmare.

– Keep the space uncluttered; have a couple of objects around the room that will help you to quickly and easily orient you to the here and now. Any object that you didn’t have at the time that the trauma happened can work; that way, if you do wake up with a nightmare, you can quickly scan the room to know where and when you are.

– Use your grounding skills: usually, waking up from a nightmare means waking up drenched in sweat. Lying in bed, drenched in sweat and shivering will do absolutely nothing to help you recover from your nightmare. So get up, run to the bathroom, and splash some water on your face. Get in the shower, and have a nice warm relaxing shower. Lavender-scented soap is also relaxing. Put on warm dry pajamas. Turn on soft, relaxing music. Fix yourself a cup of tea or warm milk (or another beverage that soothes you). The idea at this point is to soothe and comfort yourself, to help yourself recover as quickly as possible, rather than allowing the suffering to continue.

If you tend to have the same nightmare over and over again, there’s a type of therapy for that.

If your nightmare is overwhelming and terrifying to even think about, please don’t try this on your own – find a qualified mental health professional to help you.

The treatment involves writing out your nightmare in detail, with a different (positive) ending. You basically train yourself to re-imagine the nightmare with a positive ending, and then train yourself to take control of the nightmare. This takes a lot of work to do successfully, and it’s hard to do by yourself. So please reach out to get some help if you need 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 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.

 

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