A few days ago I told you my story and how my healing journey began. Today I would like to share with you what it has been (what it is) like dealing with PTSD for the majority of my healing journey. PTSD is a very interesting diagnosis, mainly because it actually takes something to develop it. Unlike most diagnosis, it’s not a long development period where nature, nurture, and experiences shape the forming of the diagnosis. One event, even minutes of someone’s life, can shape the way they deal with things and the way they see themselves, others, God, and the world forever.
Through being a therapist with more than half of my caseload having this diagnosis, I have found that it is very misunderstood. Most people (including myself until I was diagnosed) think they “are going crazy” when they feel these symptoms. Many are even misdiagnosed with Bipolar 1 or 2, depression and anxiety, etc. especially if they have never been comfortable to share their trauma and how it really affects them currently with a therapist. I have also found that for those that experienced childhood trauma or a trauma that happened a while before seeking treatment, may not even realize how their trauma effects them currently. They have been living with the symptoms for so long, it just becomes a part of them. A part of them they don’t realize is abnormal, has a name, and has an effective treatment to treat it.
Having these symptoms of PTSD feels shameful. The anger, the flashbacks, the nightmares, the self-hate, the relationship issues, etc. are not something that are fun to live with, let alone share with someone. You do feel “crazy” at times…especially when others don’t understand and say judgmental things to you like, “You just need to get over it”, “My friend has been through the same thing and they don’t act like this”, “You just need to go back to being yourself again”, “Let go and let God”, etc. Not helpful. Only more shame. I know personally, I would do anything to get rid of the lingering symptoms I have. Anything. And I would do anything to get my innocense and fearlessness back from the 15 year old girl I used to be. No one wants these symptoms, and once people are involved in therapy, most do work very hard to do the things necessary to lessen their symptoms.
Next, I would like to share the diagnostic criteria and share how each area still effects me and which ones I have made progress in. I hope that by sharing the true diagnostic symptoms, others who may not be diagnosed (or misdiagnosed) will feel less shame for having a name to what they may be experienced.
The first criteria (DSM-5) is experiencing trauma, witnessing trauma, learning someone close to you has experienced trauma, or a “first responder” type trauma. I should also explain that trauma is anything that may happen to someone that interferes with their ability to cope, may be (feel) life threatening, and changes the way someone views themselves, others, their spiritual life, and the world. In my previous post, I shared the majority of my trauma experiences. For those who have experienced more than one trauma experience (like myself) a “complex” PTSD diagnosis may be put in place due to many of the symptoms relate to more than one trauma and can take longer to treat due to having to process more than one experience and unique symptoms to each experience.
The next criteria (only one needed) is the trauma is re-experienced in ways such as flashbacks, nightmares, intrusive thinking, emotional reactions when triggered, and physical reactions when triggered. For me, I struggled with all these symptoms right after the relationship ended when I was 15. In times when I was experiencing high symptoms in this area I could have up to 20 flashbacks a day. I have always been easily triggered. The towns where the events happened, music that was playing, movies that we watched, certain smells, riding in the backseat of a car, seeing anyone I was close with during that time, pictures, intimacy, certain things people have said to me, can send me into a flashback. I have had nightmares since I was little (due to anxiety and a vivid imagination), but I also continue (less now than in the past thankfully), I experience nightmares about my different trauma experiences including the people who inflicted the trauma or situations where others inflict the same thing. Most of my dreams have the theme of helplessness, fear, and emotional put downs which relate to all my experiences. When triggered, I have gone into panic attacks, felt sick to my stomach, cried incessantly, left the trigger, or have gotten very angry if someone is with me because they don’t undertand my reaction. Luckily, thanks to my husband, I have been able to go back to triggers and have much less severe reactions, or at least reactions I can keep in my head without anyone knowing what I am thinking. And let’s face it, while I absolutely love the trauma work I do with my clients, some days I can be more triggered than others. In these times, I feel it is beneficial to talk with my supervisor about it and to take at least ten minutes before starting another session. This is an area that I feel is not talked about enough…how a therapist’s work personally affects them (especially if their own journey relates to a client experience). Once again, this creates shame because when it’s not talked about openly, you feel shameful for how the job effects you when the pressure and stereotypical view of a therapist is to be invincible.
Criteria 3 involves avoidance of trauma-related thoughts/feelings and trauma-related reminders. This is my key defense mechanisms. Avoidance. Flight. While I am working in therapy on mindfulness and staying presence, I don’t want to even count how much of my life has been wasted due to me “zoning out”, staying way too busy, getting lost in my Disney fantasy world, and avoiding difficult emotions at all cost. Avoidance is so much of my personality, that most of the time I don’t even realize I am doing it, until Luke or someone else calls me out. I also very much have to be pushed to be vulnerable by Luke, my therapist, and even friends at times. I hate talking about sadness, shame, guilt, and the fear that still linger. I have learned that being vulnerable does have a ton more benefits than avoidance and in order to heal, you have to stop avoiding. And it can eat you alive.
The 4th criteria (have to have two of these) is having negative/thoughts and feelings that have worsened after the events including: not being able to remember details of the event, overly negative thoughts about yourself, the world, and others, exaggerated blame for oneself or others causing the event, negative affect (feelings), decrease in activities participation, inability to experience positive feelings (happiness, love, excitement), and feeling isolated. At some point, I have experienced all of these (besides details. I remember everything unfortunately). After the events, I have always had low self-esteem. I have always had a mainly “hate” relationship with my body. I am my own worst enemy and have had a pattern in the past of seeing the worst detail in everything about me and what I do. I have made some progress in this area due to not having to be a perfectionist at all times, and working really hard to thought-stop these thoughts or work on balancing my thoughts. I definitely have a lot of work to do in how I see the world. Through having healthy relationships, I have made a ton of progress in viewing how I see other people, love, intimacy, and connection. Every day I have to push myself to do anything. Staying on my couch is my comfort zone, and getting involved in activities is hard. At times I do feel isolated in my journey mainly because I do not have anyone close to where I am living who “gets me”. My friends are amazing, but unfortunately live in different states. The biggest symptom I am working very hard at improving is trying to choose happiness every day and allowing myself to feel joy and excitement. This may sound nuts, like Why wouldn’t you want to feel happiness??, but it is a struggle with whats normally swirling in my head. I will say that medication can be very helpful for this, and most of the other symtpoms.
The 5th criteria (must have two) is heightened anxiety and arousal that worsened after the event including: irritability or aggression, risky or destructive behavior, hypervigilance, heightened startle reaction, difficulty concentrating, and difficulty sleeping. Now, I have always had anxiety. It runs very heavily in my family. As a little kid, I was scared of anything and everything and had to have control of everything. After the trauma, this did get a lot worse and is still a daily struggle. I have dealt with really bad anger int he past, especially in my teen years. I would yell and scream, destroy things, hold grudges, and say and do a lot of things I regret to my family and friends. It felt uncontrollable. Luckily, anger is not something heavily felt for me anymore. Believe me, I do get angry, but it’s managable and usually once I talk about it, I’m good. Thankfully, because of my fear, I have not ever done anything risky or destructive. Yes, once I turned 21, I did of course partake in that activity you can do once you turn that age. But for the most part, it has always been controlled. I will say that in the last two years, I have recognized the fact that when I am very sad/depressed it is best not to drink because it can worsen these things and can be real tempting to drink way too much. After the event, I am always afraid of being hurt in that way again. I always am looking over my shoulder, analyzing every look a man will give me, am startled super easy, and hate loud noises (especially when my husband likes to turn the surround sound up to the top level to watch action movies). At times, I do struggle with concentration and jumping from one activity to the next without finishing the first, but this has gotten better with time passing. And lastly sleep. Ugh. Sleep has always been a mess for me. In the past, sometimes I would go 2-3 days where I would only get 2-3 hours max and those were filled with nightmares. Luckily, I have found the right dosage of medication that has been a life saver to where I do usually sleep through the night now even if I do have a nightmare.
The next few categories can be combined easily including: symptoms have to last more than a month, symptoms have to cause psychological distress and impairment, and symptoms can’t be explained by a medical condition, substance use, or medication.
So there ya have it. That is PTSD. A personal demon of mine (and for so many others) that does make the healing process daunting. Thankfully due to two amazing therapists I have had, support from my loved ones, the right medication, and most importantly self work and reflections these symptoms are far more managable now than they have been. For me, it is helpful to fully accept this diagnosis as something I am dealing with, but do have the power to improve my symptoms and the effect it has on my life. I hope that by reading this, you will have gotten a better idea of what it is like living with this, what the actual diagnostic criteria are, and will be able to support others in your life who may have this (without shaming them) if you do not deal with it personally. Thank you again for reading and coming alongside me in this journey 🙂