PTSD…My Own Private Hell

Post Traumatic Stress Disorder (PTSD)

I have debated about doing this particular post for a long time. Even before the birth of Simplicity Redesigned, when I was still in the “planning” stages of this blog, I weighed the pros and cons of doing this one post. Why the internal battle? Simple really. It means I literally have to bare my soul to you, the reader.  I would love to pretend that I no longer care about what people think in regards to my PTSD, but I would be lying to you. It affects those closest to me, just as much as it affects me. Most people do not understand it, often downplaying it or completely ignoring it all together. I hid it pretty well for the first 2 yrs. The 3rd yr was a whole other story….

Let’s begin with the basics….

PTSD stands for Post Traumatic Stress Disorder that affects millions of people. It is an anxiety disorder that is often developed after a person experiences or witnesses a traumatic or life threatening event(s).  Most people experience “Fight, Flight, Freeze” responses to these traumatic or life threatening events.  However, in those that suffer from PTSD,  the switch that turns off the “Flight, Fight, Freeze” response is damaged or changed. Never really shutting it off.  As a result the person is usually always in flight or fight mode. Often filled with anxiety, unease, frightened, or having a sense of always being in danger.

“Fight, Flight, Freeze”

What is “Fight, Flight, Freeze? The guys over at How Stuff Works describe it the best I have ever seen… Here’s the link if you want to dive deeper into it.

http://science.howstuffworks.com/life/fear2.htm

To produce the fight-or-flight freeze response, the hypothalamus activates two systems: the sympathetic nervous system and the adrenal-cortical system. The sympathetic nervous system uses nerve pathways to initiate reactions in the body, and the adrenal-cortical system uses the bloodstream. The combined effects of these two systems are the fight-or-flight freeze response.

When the hypothalamus tells the sympathetic nervous system to kick into gear, the overall effect is that the body speeds up, tenses up and becomes generally very alert. If there’s a burglar at the door, you’re going to have to take action — and fast. The sympathetic nervous system sends out impulses to glands and smooth muscles and tells the adrenal medulla to release epinephrine (adrenaline) and norepinephrine (noradrenaline) into the bloodstream. These “stress hormones” cause several changes in the body, including an increase in heart rate and blood pressure.

At the same time, the hypothalamus releases corticotropin-releasing factor (CRF) into the pituitary gland, activating the adrenal-cortical system. The pituitary gland (a major endocrine gland) secretes the hormone ACTH (adrenocorticotropic hormone). ACTH moves through the bloodstream and ultimately arrives at the adrenal cortex, where it activates the release of approximately 30 different hormones that get the body prepared to deal with a threat.

The sudden flood of epinephrine, norepinephrine and dozens of other hormones causes changes in the body that include:

• Heart rate and blood pressure increase
• Pupils dilate to take in as much light as possible
• Veins in skin constrict to send more blood to major muscle groups (responsible for the “chill” sometimes associated with fear — less blood in the skin to keep it warm)
• Blood-glucose level increases
• Muscles tense up, energized by adrenaline and glucose (responsible for goose bumps — when tiny muscles attached to each hair on surface of skin tense up, the hairs are forced upright, pulling skin with them)
• Smooth muscle relaxes in order to allow more oxygen into the lungs
  
• Nonessential systems (like digestion and immune systems) shut down to allow more energy for emergency functions
• Trouble focusing on small tasks (brain is directed to focus only on big picture in order to determine where threat is coming from)

All of these physical responses are intended to help you survive a dangerous situation by preparing you to either run for your life or fight for your life (thus the term “fight or flight”). Fear — and the fight-or-flight response in particular — is an instinct that every animal possesses. Freeze is when you are “stuck” in the situation. You can not move away.

Told you they nailed it! Onto the next set of basic info….

General Classifications of PTSD

Abuse

• Mental
• Physical
• Sexual
• Verbal

Catastrophe

• Accidents
• Natural Disasters
• Terrorism

Violence

• Animal attack
• Assault and Battery
• Domestic Violence
• Rape

 Combat

• Death
• Explosion
• Gunfire

Medical Emergency (Still being researched.)

• Stroke
• Heart Attack
• ICU Patients

Here are 3 great links if you want to research more about it…

http://www.medscape.com/viewarticle/470032_1

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151883/

http://www.hopkinsmedicine.org/news/media/releases/ptsd_symptoms_common_among_icu_survivors#.

Types of PTSD

After DAYS and NIGHTS of research over the past 3 yrs, this is what I have found to be the types of PTSD and the easiest way to classify it all into laymen terms…

Acute PTSD~Symptoms last less then 3 months

Chronic PTSD~Symptoms last 3 months or more

Delayed Onset PTSD~Symptoms appear usually 6 months after a traumatic event.

According to the National Center for PTSD there are 5 main types of Post Traumatic Stress Disorder:

If you want to check out their site to learn more, here is the link.

http://www.ptsd.va.gov/
Normal Stress Response: The normal stress response that occurs when healthy adults who have been exposed to a single discrete traumatic event in adulthood experience intense bad memories, emotional numbing, feelings of unreality, being cut off from relationships or bodily tension and distress.

Acute Stress Disorder: Characterized by  panic reactions, mental confusion, dissociation, severe insomnia, suspiciousness , and being unable to manage even basic self care, work, and relationship activities. Relatively few survivors of single traumas have this more severe reaction, except when the trauma is a lasting catastrophe that exposes them to death, destruction, or loss of home and community.

Uncomplicated PTSD: Persistent reexperiencing of the traumatic event, avoidance of stimuli associated with the trauma, emotional numbing, and symptoms of increased arousal.

Comorbid PTSD: (Comorbid is either the presence of one or more disorders/diseases in addition to a primary disease or disorder, or the effect of such additional disorders or diseases.) Layman terms….PTSD and another disorder or disease. Comorbid PTSD is usually associated with one or more of the following; depression, alcohol or substance abuse, panic disorder, and other anxiety disorders. The best results are achieved when both PTSD and the other disorder(s) are treated together rather than one after the other.

Complex PTSD: AKA “Disorder of Extreme Stress”.  Found among individuals who have been exposed to prolonged traumatic circumstances, especially during childhood (childhood sexual abuse). These individuals often are diagnosed with borderline or antisocial personality disorder or dissociative disorders along with the PTSD. They often exhibit impulsivity, aggression, sexual acting out, eating disorders, alcohol or drug abuse, self-destructive actions, intense rage, depression, panic, fragmented thoughts, dissociation, and amnesia.

Symptoms of PTSD

According to the National Institute of Mental Health, there are 3 main categories of symptoms most people exhibit .

Re-experiencing symptoms:

• Flashbacks (reliving the trauma over and over, including physical symptoms like a racing heart or sweating)
• Bad dreams
• Frightening thoughts

Re-experiencing symptoms may cause problems in a person’s daily life. They can manifest from the person’s own thoughts and feelings about the trauma. Words, objects, or situations that remind them of the event can also trigger re-experiencing.

Avoidance symptoms:

• Staying away from places, events, or objects that are reminders of the experience
• Feeling emotionally numb
• Feeling strong guilt, depression, or worry
• Losing interest in activities that were enjoyable in the past
• Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

 Hyperarousal symptoms:

• Being easily startled
• Feeling tense or “on edge”
• Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

Children and Teen Symptoms: 

They may develop disruptive, disrespectful, or destructive behaviors. They may also exhibit the same symptoms as adults. Sometimes they may also include symptoms:

• Bedwetting after they are already potty trained
• Forgetting how or being unable to talk
• Acting out the scary event during playtime
• Being unusually clingy with a parent or other adult.

Here are some other common examples of symptoms not listed above from Helpguide

Their link in case you want to check them out

http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm

• Anger and irritability
• Guilt, shame, or self-blame
• Substance abuse
• Feelings of mistrust and betrayal
• Depression and hopelessness
• Suicidal thoughts and feelings
• Feeling alienated and alone
• Physical aches and pains

Diagnosing PTSD

Please understand that not everyone that experiences something traumatic will develop PTSD.

A person must have all of the following for at least 1 month before being properly diagnosed by a trained medical professional:

• At least one re-experiencing symptom
• At least three avoidance symptoms
• At least two hyperarousal symptoms
• Symptoms that make it hard to go about daily life, such as school or work, be with friends, and take care of important tasks.

Want to learn more about PTSD from the National Institute of Mental Health….Check out their link.

http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml

Finally treatment options….

First thing you have to do is admit that something isn’t right and that you need help to get through it. The faster you do this, the quicker you can began to heal.

Post-traumatic stress disorder treatment often includes both medication and psychotherapy.

The Mayo Clinic offers these options as the best way to treat PTSD. Check out their link if you want more info.

http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246

Medications
Several types of medications can help symptoms of post-traumatic stress disorder improve.

• Antipsychotics. In some cases, you may be prescribed a short course of antipsychotics to relieve severe anxiety and related problems, such as difficulty sleeping or emotional outbursts.
• Antidepressants. These medications can help symptoms of both depression and anxiety. They can also help improve sleep problems and improve your concentration.
• Anti-anxiety medications. These drugs also can improve feelings of anxiety and stress.

You and your doctor will need to work together to figure out the best treatment, with the fewest side effects, for your symptoms and situation. Be sure to tell your health care professional about any side effects or problems you have with the medications, as you may be able to try something different.

Psychotherapy
Several types of therapy may be used to treat both children and adults with post-traumatic stress disorder. You may try more than one, or combine types, before finding the right fit for you. You may also try individual therapy, group therapy or both. Group therapy can offer a way to connect to others going through similar experiences.

Some types of therapy used in PTSD treatment include:

• Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck — for example, negative or inaccurate ways of perceiving normal situations.In PTSD treatment, cognitive therapy often is used along with a behavioral therapy called exposure therapy.
• Exposure therapy. This behavioral therapy technique helps you safely face the very thing that you find frightening, so that you can learn to cope with it effectively. A new approach to exposure therapy uses “virtual reality” programs that allow you to re-enter the setting in which you experienced trauma — for example, a “Virtual Iraq” program.
• Eye movement desensitization and reprocessing (EMDR). This type of therapy combines exposure therapy with a series of guided eye movements that help you process traumatic memories.

So, there you have it. The basics in black and white.

My Own Private Hell

Now I guess it is time for me to tell you about my own private battle with PTSD….I have Compound MTHFR. It means that I am genetically wired to produce and throw blood clots (especially when my body feels stressed). This time, I started throwing clots while I was pregnant with my daughter in November of 2009. I was on the highest dosage of Lovenox (blood thinner) allowed. Yes, I have thrown clots in the past. I lost my son while I was pregnant with him in 2006 due to blood clots. On November 2, 2009, I gave birth via a C-section to my 3rd amazing daughter. I had MANY complications during my pregnancy. I was considered Extreme High Risk.

Within the first month after my daughter’s birth, I noticed it was hard to walk up a flight of stairs with out getting winded. I just assumed it was caused by the 200 lb weight gain I had from the pregnancy. Told you I had complications. I started to notice other things around the same time. Extreme tiredness. I was getting winded from not only walking up the stairs but now down the stairs. Then I started feeling what I thought was anxiety. I had never had any anxiety issues before so I was not 100% that that was what I was feeling. I was exhausted. This was my 3rd child, I was overweight to an extreme and had a hard time healing from the C-section. Hubby was working crazy long hours. My middle daughter was in after school activities that I had to get her to and from as well as my oldest daughter. All this with a newborn. And I was left to deal with it all. I assumed it was postpartum depression to be honest. My daughter was now 3 months old and it was getting worse. Understand that I was still on the heavy dosage of blood thinners.

I went to my family doc who told me it was more then likely exhaustion and postpartum depression. She pulled my Hubby outside into the hallway of her office and told him to help out more. I was prescribed Xanax. My doc decided at the last second that she wanted to run a couple of tests on my lungs. My oxygen stats were down. Hubby was going in for a vasectomy that Friday. My tests were scheduled for the same day. There was a huge mix up with information about my tests and I decided to walk out and reschedule for Monday (as in like less then 3 days away). Hubby got “fixed” and I got worse almost immediately.

Walking up and down stairs brought on wheezing and sent my heart RACING. I could not even breathe without sounding like an obscene phone caller. I was almost panting. Sleeping was far worse for me! I woke up in sweat and felt like I was going to die! It got to the point that I could not control my thoughts. Nothing was making sense to me anymore. I was paralyzed with fear for a lack of better  words.  I was no longer in control of my own body. I could not walk anymore without panting because I was so out of breath. We are talking taking 2-3 steps! It felt like someone was compressing my lungs. Then the feeling of “DO NOT MOVE” hit me.  Heart racing constantly. This was all in like a 24-48 hr time frame. I thought I was losing my mind. Monday came and I could not move. I. COULD. NOT. LITERALLY. MOVE! Panic like I have NEVER known had taken over me. I could not breathe, could not MOVE. I was sweating from head to toe, as in water dripping off of my body. YUK! I made it down a flight of stairs to the main level of my home and was so freaked out. All I wanted to do was NOT move. I could hardly breathe. I could hardly think. I grabbed an ice pack and sat on my couch. Heart racing….I had to go to take the tests. I managed to make it down the stairs to the garage, where my car was parked, before I started throwing up. I was sweating so bad that it looked like I had actually sat in a bathtub full of water…with my clothes on. I had no idea what the hell was going on with me. My Hubby was the least sympathetic person I had ever met about it. Instead of trying to understand what was happening to me or calming me down, he was yelling at me and trying to figure out if I needed to be admitted to a psych ward. He chose my  testing and I chose not to seek a divorce lawyer. Panic stricken, I made it about 3 steps out of my truck before I could not move any further when we arrived at the testing facility. Now, a real panic had set in. I have never felt that way in my life. I thought I was actually going to die, right there on their sidewalk. I could not get my heart rate to slow down. My breathing was shallow, quick and wheezy. My mind was on over drive and would not stop freaking out. My stomach was doing flip flops and gurgling, causing me to throw up. And best of all was  my bowels were ready to let loose me at that very second. WTF????? I got why my Hubby was talking about the psych ward. I can only imagine how I looked. Remember this all took place in less then 48 hrs of me being “perfectly normal”! They got me into a wheelchair outside and into my testing. I was taken immediately to the hospital via lights flashing and sirens wailing, all while being told DO NOT MOVE!!! I had thrown HUNDREDS, if not THOUSANDS, of blood clots. You NEVER want to be told that you are “Impressive” by your doctor or “How are you still alive?” One clot, the size of a your pinky and the length of a pencil had lodged in my one lung. It was blocking blood flow to my heart. My body was trying to save me by not having me move. I was just not listening to it. Hence the panic attacks. After a couple of days in the first hospital, I was transported to a second hospital.  I kinda left the first hospital stumped. They were hoping that the second hospital had some better idea of what to do with me and quickly! The one thing everyone could agree on though….No one knew how I had survived this. I should have been dead. I landed myself in ICU, in critical condition, for 10 days. I was not allowed to move. I had test after test done to see what the severity of the damage was and what, if anything, could be done about it.  They decided on surgery to remove as many of the clots as they could. The rest was up to me and my makers. While in ICU, a freak snow storm hit our area. It was known as Snowmageddon. A category 3 Noreaster, that dumped about 35 inches of snow on us. The hospital was for all intents and purposes on complete lock down. The staff, already short handed because the roads were closed and no one was allowed to leave or enter the hospital, was made all the more short handed when the flu spread through the hospital and ICU unit. I was then told by my nurses, surgeons and cardiologists that I would more then likely be getting the flu. There was no way to stop it. My body was too weak from the blood clots and complications from 2 major surgeries, less then 3 months apart. Both my body and my immune system were shot. What did that mean for me? Why was everyone so worried about it? It is just the flu. Lasts a couple of days and is gone. Except that I was told that if I got the flu now, it would probably kill me. I still had clots in my lungs. My heart and lungs were damaged. My immune system was just about shot. Can you guess what happened within a week of getting out of ICU? Yep, you are seriously smart! I got the flu. They were right. It damn near killed me. I had nothing left in my body to fight with. My immune system was wiped out. To make it even better, the flu was going around BOTH my daughters’ schools (two different schools), my husband’s work, and where my Mother In Law lived. It was not all at once either! No… THAT would have been too easy. Each one was one right after the other.  We had to have my Mom (In Law) move back in with us temporarily, for the 3rd time in less then 4 months. Poor woman. I do not even think she bothered to unpack her suitcase! I got  it each and every time. While the others would be over it in like 24 hrs, mine lasted for DAYS….THE. PAIN. OH. MY. GOD. THE. PAIN! My heart and lungs throbbed. I had no idea they could actually throb! But trust me, they can and they did! I was still sore from the blood clots and the tugging in my lungs from the surgery. Every time I threw up, all I could hear were the doctors telling me “NOT to throw up. I would more then likely throw a clot and this time it would probably kill me.” followed by the pain in my heart and lungs. Praying like I have never prayed before to make it through the day, night, etc. Eventually, the season changed, then came the colds instead of the flu. They were a different kind of pain. I had a lot of issues breathing, My lungs felt heavy again. Like there was pressure on them all over again.  It would take me several months before I would stop feeling the throbbing when I moved, picked up my daughter, breathed, etc.

About 6 months later, when school began again, I felt my body tensing. I began to clean more and worry about getting our immune systems boosted. That year we again got hit with every cold and flu that came through the schools. I was stronger this time, but the pain was still there. We got the flu again and my two youngest ended up in the hospital on IV’s with it. I was still taking Xanax occasionally and then only in a 1/4 dose. It wasn’t helping me to feel better, instead only making me feel drugged and loopy. It really didn’t do much for the anxiety, that was now a part of my everyday life. I was able to hide the anxiety and small panic attacks for the most part that yr. But I could feel the edges of myself beginning to shatter. I no longer felt whole. I no longer felt like my old self.

Summer was great that yr for me. I learned all kinds of things that we could do to boost our immune systems naturally. I felt human and honestly, whole again. My world began to unravel when the kids returned to school. I was tense again and feeling a lot of anxiety. We got sick with colds and viruses. I started to to get worse with my anxiety. I began to have mini panic attacks. I didn’t understand what was going on. I didn’t tell anyone. I kept it to myself out of fear honestly. I was afraid that I had passed more clots or that I was going to be locked up in a psych ward because something mentally was wrong with me.  I knew something had changed in me and that I could no longer ignore it. I began to feel anxiety about people entering our home, my kids going to school, Hubby going to work, all of us going to the gym. I knew that people were catching on. How could they not be. I was becoming obsessed with staying healthy. Finally I went to my Hubby and talked to him. I mean really talked to him. There were a lot of tears that begged to be finally released and to have someone understand what I had been hiding for 2 yrs. We both agreed that I had to seek outside help. We both thought I had PTSD. I felt so stupid calling it that. I was not in a war, not raped, not in a horrific accident. I had survived blood clots. How can I possibly have PTSD? I began to see a therapist. I was diagnosed with PTSD immediately. That fall, my PTSD took on a whole new life of it’s own. I could not hide it, no matter how hard I tried to. My triggers were illnesses. If you even sneezed around me it would send me into an anxiety or panic attack. Public places and outings were my enemies. Birthday parties, grocery stores, schools, and doctor offices were my nightmares. Let’s not even go there about Facebook. Everyone loves to post about being sick with a virus or the flu. I was fighting daily battles with panic attacks. I knew what I was feeling…just not the why. I have learned several techniques over the past yr that help me with my anxiety and panic attacks. Illness is still my trigger. I am still paranoid about getting the flu. This year I can actually say the word. Progress! It has been a LONG road for me. One that I do not wish on my worst enemy, if I actually had one. I am not over it yet. I am still dealing with it. In about a week I am going to be celebrating my daughter’s 4th birthday with a house full of people during the cold and flu season. Yes, I wanted to cancel the party so many times, but…

I. AM. DONE. FEELING. SHATTERED. INSIDE.

I almost died…I chose to be a survivor instead.