Sharing strategies to help with PTSD

[PamelaR]

One of my biggest learnings has been - PTSD is not like a broken arm. When you break your arm, it mends. PTSD is with you for life. It took me ages to recognise that I'd been triggered. Some of the simplest things - like going to the shopping centre at the beginning of winter and seeing the multi-colour shirts - red, blue, black squares. The hardest part for me is identifying the trigger because the pacing heart, the sweats, the panic, the fear doesn't happen immediately. It happens after I walk out of the shopping centre.For the first few years after being diagnosed with PTSD I was hell bent on identifying the trigger. Now - I don't worry. I simple accept I'm triggered - do my breathing, relaxation to beautiful music, write down my feelings and emotions, talk with my husband. Let him know I've been triggered. Most times my cats won't come near me while I'm working through a 'phase', but they certainly know when I've come out the other side. They come and give me lots of comfort and love. The down side of how I manage is to drink alcohol - to stop the feelings and emotions. It doesn't work, but it helps go to sleep. I'm not recommending drinking as a strategy!!

I have had 2 excellent psychologists that helped me. It's important to find someone other than those close to you to talk to. One was very good at helping me identify what was happening - e.g. being super alert, wanting to save or please people. Recognising these things helped to build better relationships with my work colleagues and my friends. I have conversations in my head - oh, you just want to please because something has frightened you. Then I say - you're okay, you're safe, you can say what you need to.

Basically, the strategy of self talk in a challenging way - I challenge what I'm doing, what I'm thinking. But I also recognise the little girl who screams out when things happen and comfort her. Very important to know she hurts terribly and needs comfort. The comfort she never received as a child.

[labradoodle]

hi Karen Pamela and Bindi. Karen I know what you mean about being physically sick. It happens to me as well you see someone or something is said in a conversation and bam it just hits me. Personally I have a bottle of water with me its like my security blanket when I can feel it building up I take a small sip try to divert my mind and as Pamela has suggested get your breathing under control by counting. When I was first diagnosed everyone GP psychologist Beyond blue all say breathe just breathe. They all make it sound so easy but once you get into the habit of diverting your mind it does work. I don't know if you have tried mindfulness a very good one is Smiling mind it's a free app the instructor is an Australian male very clear and easy to understand try the adult program it gives you great tips. I have had stressors all week but have managed to get through tomorrow is a new week we all have ups and downs hopefully this will be a good week. Stay brave Labradoodle

[PamelaR]

Hi Labradoodle. Thank you for sharing your experiences with breathing and about the Smiling mind app. Great to hear about it. I must have a look!

Your support of others is also extremely welcome. Thank you so much.

I love the idea of your security blanket - the bottle of water and sipping to divert your attention. All good stuff. My mind has a way of diverting, but I probably won't share that. It's not one I'd recommend. Though I'm sure there a lots of ways - that Smiling app is sounding really good. I frequently play games on the computer - that is one of my more shareable diversions.

Stressors at work are difficult, I have had quite a few of them during my working career. Some of the strategies that were given to me by a pscyhologist early on was to visualise the people who cause you stress in unseemly situations (use your imagination. Sometimes you end up trying to stop yourself from laughing). If the situation is more about your work, then I found talking with co-workers about the stressor to help. For you, it might be the stress of vehicles - that is a hard one. You might like to talk with someone about exposure therapy. It can be successful for some.

Yes, it is a new week and it will be good for you.

PamelaR

[Ggrand]

Hello Labradoodle, Pamela and everyone else,

Thankyou both for your good tips, I havent tried taking a sip of water to distract I will try that.... I use the breathing but forget to start counting the breathes, I will have to try to remember the counting.

Pamela, you made me smile, about your stress buster, of seeing people in unseemly situations, i wonder if it would work imagining my Pysch in this way, maybe it will make talking to her easier. I rang my Pysch on Friday and asked to change my appointment from this coming Tuesday, to the Tuesday of the following week.

I am so happy that your Pysch visit went well and you seem to be able to talk to your Pysch with confidence, I hope everything works out for you and you continue healing.

Kind thoughts

Karen.

[PamelaR]

Hi Karen and everyone else

Good to hear I made you smile Karen. It's an interesting thought about how to visualise your pysch LOL!! I'd propose you find a new psych. Though I do know there are difficulties because of where you live and availability of therapists. These days though you could skype with someone. I know there are on-line counselling services available. Have a think about doing a google search to see who's available. Of course they would have to provide the service under a MHP so you didn't have to pay anything.

Thank you for your kind thoughts regarding my progress with my psych. He gave me a lot of homework. It was funny, he asked if I needed it printed out. I said no I could access it online. However, it can't be saved and you can't put the answers in online. So I had to print it - almost a ream of it LOL. Slowly reading and working my way through it. It's a relatively new methodology for helping people with MH issues. It's called metacognitive therapy. Once I understand what it's about I can share some of its tips etc.

Kind regards

Pamela

[Elizabeth CP]

I'm wondering if others have effective strategies for PTSD related to natural disasters. The difference is that the people related to my trauma were helpful not the cause of the trauma. Staying away totally from the situation although easy at the time makes it worse later. I moved OS for a year after Black Saturday. After returning I found things worse than they had ever been. Previously burnt trees were fine as long as there was no actual risk of fire but after returning to Aus I found myself reacting badly to burnt areas even when raining.

[Guest8901]

Hi Pamela, and other contributors here,

Pamela you said on my thread that I could ask some questions of you here. So I hope thats still okay.

As you are aware, I was officially diagnosed with PTSD today. I'm a little confused however, because she mentioned that she was of the opinion that I have either Complex or Chronic PTSD. Sorry I cannot recall which she said now. So 2 questions on that subject:

1. Is Complex PTSD the same thing as Chronic PTSD?

2. And is there such a thing anyway?

The reason I ask is because I have read other peoples threads and some say they have been diagnosed with Complex PTSD, some say they have chronic PTSD. And yet as far as DSM, neither actually exists. So how can you be diagnosed with it?

My psych said that I had the initial trauma (sexual assault) a long time ago, but that I have experienced ongoing trauma (domestic abuse) since then. None of this really makes sense to me. I thought PTSD was PTSD?

Another question I have which you may be able to help me with. My psych said that you cannot actually 'cure' long standing PTSD. But you can, in her words, 'take the edge off it' by learning your triggers, learning coping methods, understanding whats happening, etc. In your experience, is that the case?

Of course I would be interested in other contributors views and advice on this too. I am on a steep learning curve right now, and just trying to make sense of everything.

Pamela, I'm sure I will have other questions over the coming days. Hope you don't get tired of me asking.

Thank you in anticipation.

Amanda

[PamelaR]

Hi Amanda

Thank you for posting - you are absolutely most welcome here. It's been a bit of a tough day for you i'd imagine.

You do ask the tough questions of me. I just need to let you know - I'm not a psychiatrist, psychologist, counsellor, social worker, mental health worker. I worked with psychologists during the late 1980s and 1990s and know they used the DSM. When I was diagnosed with PTSD, major depression and anxiety around 2013, they never used an 'adjective' to describe the PTSD and they never referred to the DSM.

I've just had a look to see what's happening in that space. It would appear from Psychology Today, the DSM is under question by SOME in that profession due to the lack of distinction between psychology and psychiatry.

Complex PTSD the same thing as Chronic PTSD the same thing

And is there such a thing anyway.

Amanda you specifically point out that neither are included in the DSM.

To be honest, I don't want to make any distinction for you. My thoughts are why not talk with your psychologist to discuss your concerns about the different terms - complex vs chronic??

In addition have a look at what Liah Greenfeld Ph.D. has to say in Psychology Today, 2013 about the DSM - The Modern Mind. The real problem with mental health - are they hereditary? Specifically:

......psychiatry and psychology consider the human individual as their subject. Biology, in distinction, studies the organic world. The environment of the human brain is far more complex than that of the stomach and lungs, or than the environment of the brains of other animals. Mental health professions pay no attention to it, and no revision of the DSM will make them improve their ability to help the mentally ill.

About long term prognosis for PTSD - again this is a question for your psychologist. I have a differing opinion to some. Again it comes down to the different methodologies each health care professional uses. The methodologies can differ which means there maybe different outcome beliefs.

My personal experience is - I have worked at reducing my triggers significantly so that I am no longer triggered by these. I do know though, there are some unknown triggers that do rear their ugly head every now and then. I have to deal with these as they occur - then I'm back on track.

Not sure how helpful I've been Amanda.

[Guest8901]

Hi Pamela, and thanks for your response. Yes you have been helpful, definitely. And of course I am aware that you are not a MH professional. It is your personal experience that I was interested in mainly, and you've kindly provided that. Yes I will ask my psych next visit what she meant about Complex or Chronic PTSD. Firstly which was it? And secondly if either actually exist.

Are there different degrees of PTSD do you think? I see that some people are diagnosed with PTSD from the loss of a pet. Others from war experiences or repeated childhood SA, which must be horrific. To me they simply do not seem comparable. Losing a pet is not something life threatening, and is not something out of the ordinary. Most people have lost pets. Are some people just more sensitive to different stimuli than others? Or is PTSD becoming the new RSI? I'm interested in your opinion.

My psych spoke to me yesterday about triggers, of which I can identify many. She also spoke to me about 'grounding' and how its so important to bring yourself back to the NOW when you experience nightmares and flashbacks. I recall that Karen has a thread about grounding, so I will try to find that and read up on it for some more tips.

Something else my psych mentioned yesterday was that nightmares often become worse for many people in summer, or during hot spells of weather. So she said its very important to try to stay cool at night. So for the rest of summer, I'm going to leave the air con on at night as well as continuing to use the ceiling fan!

Amanda

[PamelaR]

Hi Amanda

So pleased the information I've provided is helpful. You ask some very good questions!! Thank you for asking.

Are there different degrees of PTSD do you think?

I think you've really answered the question yourself by the examples you have given. What I learnt very early on after I recovered my memory and from the first book I read about healing (can't remember author's name) is -

It's not so much about what happened (e.g. a pet dying, someone exposing themselves on a bus, a veteran returned from the war, a rescue / recovery worker, a policeman, paramedic, adult who was sexually abused or ritualised abuse as a child), it's how your body, mind and soul respond.

The way each of these areas responds is similar across all people who experience what they perceive as trauma. The responses differ in intensity though, and imo these differences may relate to other factors such as their cultural background, religious beliefs, their life experiences, their current circumstances, their support networks (or lack of support networks), their self esteem, self worth.

... is PTSD becoming the new RSI?

Ahhh. Well, repetitive strain injury was first diagnosed in about the 1980s. Its had a hard time over the years as employers and employees argue about what is and what isn't real. Along with some doctors supporting patients they diagnose with RSI and other doctors not diagnosing or refusing to diagnose RSI. It has been vicious. Personally, again I believe that people with RSI respond differently. Some are able to manage their injury while others struggle. I think people struggle especially when they have other things happening in their lives. So again, this is similar to what I've said above for PTSD.

My first experience with someone with RSI was back in the 1980s. I had returned to work after long service leave to find that one of our previously valued employees, who was also a friend of most of the office, had become almost a leper because she'd claimed RSI. It wasn't a very nice environment. She had no support from anyone. It ended up that she was placed in the area I managed to manage her return to work. It was difficult situation because most of the office did not believe her.

The same thing happed with 'repressed memories'. There's been years of debate about is it or isn't it real.

What I've learnt is - if it feels real for you then it is real, whether it is PTSD or RSI. No one can take that away from you. Believe me it took me years to believe it was.

[PamelaR]

Hi Amanda

Just realised I didn't finish responding to your post. You mentioned

....Grounding... - yes, I can relate to grounding. It helps to keep you in the now, present and to reduce the disassociation (detachment) that may happen when the triggers have caused a anxiety overload. How do I ground - literally by focussing on my feet, legs, body. In fact I do a yoga asana pose - mountain pose and the upward salute. Breathing my breath.

...Nightmares...worse during summer..... Yes, once I started this process, I found nightmares and flashbacks became more intrusive. I don't think i experienced this just during summer though. It was anytime, anywhere, cool, hot, warm. I think i see though where your psychologist is going with that thought. There is lots of work done on the weather impacting people's mental health. In the tropics its called mango madness, or going troppo. It particular occurs during the build up when it feels like it's going to rain, but it doesn't. When you get days and days of this in a row. I lived in the tropics for about 18 years - until my body couldn't take the heat any more.... In those days I never had air conditioning in the house, it was only when i lived in South Australia that I had it. Now i couldn't live without it.