Sunday, April 1, 2012

Relentless brain.

The peaceful quiet of the night is unforgiving and it’s during that silence that I question my reason of existence at all.

There are things about PTSD that we just don’t talk about.
We don’t talk about it, because people don’t want to hear it.
They actually don’t want to hear a large majority of it – but here’s the relentless truth: one of the symptoms of PTSD is suicidal ideation. There are some days when a person with PTSD simply sits down and says “What’s the point?”. Yes, the person who is in constant fear of dying from some horrible accident some days just sits down and thinks that the easiest way of getting out of their head is to end their life.
Most of the time it’s just that – a simple thought of “I don’t want to be here anymore.” I’m well educated on PTSD and I’ve been living with it for longer than I can remember (to be honest, I don’t know a time in my life that I didn’t have PTSD symptoms) so I’m well aware of these intrusive thoughts and I know the difference between the simple thought at the end of a day and when I should fear myself. I think the thought, most likely have a bit of an attitude for the rest of the day, go to bed, and wake up ready to face the next day.
I don’t actually fear myself in these moments of defeat, but in the chaos of our PTSD brains it crosses our minds.

I can tell you it’s exhausting to be in my head, but you’d never quite fully grasp those words unless you were in my head. When I was younger I struggled a lot with this thought. I knew that my thoughts were different than other people’s thoughts and I wasn’t ever able to explain myself in ways that people understood.
It’s not that bad, get over it.
I couldn’t. And it was that bad. And I used to spend my days distracting myself by envisioning this alternate reality where I had this power to simply grab someone’s arm and project the images and thoughts from my head into theirs, so they could see what I saw.
So they’d stop telling me to stop being a baby and to suck it up and to just leave the door unlocked or the window opened.

But my imagination couldn’t become a reality so I had to continue to muddle through life with my mouth shut, suffering through the attack on my brain that occurred on a daily basis.

“Dr. Jonathan Shay, a P.T.S.D. specialist, thinks that even calling it a disorder is misleading: P.T.S.D. is an injury. There are degrees of damage, ranging from standard combat stress, which can be treated with a few days’ rest, to full-blown complex P.T.S.D., which is very difficult to treat, let alone cure. It is best understood, though, as a psychic wound, one that can be crippling, even fatal, in its myriad complications.”


One time when I was out to eat at my favorite restaurant, I was triggered by a couple who sat close by that was having a heated argument. My brain was tired that day and my defense on my brain wasn’t very strong. I immediately recognized that I was triggered and had the other person I was with distract me, but sometimes, no matter how well versed in fighting my own battle I am – it’s not enough.
I kept flashbacks at bay, but my body still reacted. The world got loud and adrenaline surged through my body as if it were needed for survival. It became hard to concentrate and by the time I left the restaurant that night, I was 100% exhausted.
My brain grasped at that memory of a trigger that lead to a memory and stored it away as valuable information. Every time that I’ve gone back to that restaurant since that day, my senses are heightened and I feel the urge to run for my life.

My brain is relentless, unforgiving. It thinks it’s doing the job that it needs to do in order to survive. It’s all it knows. Some days, it’s really hard to see the silver lining. Some days, I feel like I’m just too damn tired to wake up and do it all over again.

The other thing we don’t “talk” about is our foreshortened sense of future. Obviously no one can predict what the future holds but some people with PTSD have a problem with seeing the future at all. I wrote the following on a discussion I was having with other people with PTSD:

I'm 27 years old. PTSD has been all I've ever known, so it's not like I yearn to get back to the "normal" way that life used to be or anything - but what I wanted to talk about/ask is in regards to the fact that I can't "see" past tomorrow. 
I know that there are many people who have been living with PTSD far longer than I have and I wonder: does it get any easier/what have you done to be able to "see the future"? I know I have to go to work tomorrow and that this weekend I may spend a night with friends watching a movie and that in May I'll be an aunt again... but in reality, I expect to die this afternoon. Or on my way home from school tonight. Or tomorrow morning. (Not by my own hand, but by some wicked twist of fate) I know that I have plans that are "future based" (like a set date for an event I’m attending), and I look forward to those things but I never plan on living that long. I actually spend a lot more time thinking about it than I ever let on to. It's not something I consciously decide, it's just how it is. I can't see ever getting married or having a family or watching children grow or being retired. I WANT those things, but they don't ever feel attainable. 


I can’t look forward to a life that I can’t force myself, no matter how hard I try, to believe exists. I want it to exist. I want to look forward to it, but I can’t see it. On the rare occasion that I do see a glimpse into what “could be” I grab ahold of it and store it away as a reminder to myself that it could happen. After all, I am 27, I’ve made it this far and that’s far longer than my 18 year old self would have predicted.

Now once again it’s midnight and I’ve avoided doing all of the things that I’m supposed to get done because this nagging at the back of my mind said “get this out”, so I did.

I recently saw a neurologist at a sleep clinic, hoping he could shed some light on the subject of PTSD sleep that most doctors don’t have the slightest clue about. He wasn’t too versed in PTSD but he did understand how the brain physically works in those who have PTSD when it comes to sleep. After drilling me with various questions (sometimes repeatedly) he assured me that he 100% believed that I had sleeping problems and in the same breath told me that I was fighting a battle that I couldn’t win.

He said “Your amygdala, the fear center of the brain, doesn’t sleep when you do. It’s over active during the day and you seem to have a good awareness around that and what you can do to counteract it, but when you sleep, it’s still going. It’s overproductive, releasing unnecessary levels of adrenaline into your system at unnecessary times. It’s watching your dreams and gathering pieces of them that it deems dangerous and it’s waking you up for protection. We can’t change that.”

We can’t change it, but we can drug it. So now, once again, Prazosin is added to my drug cocktail – normally diagnosed for high blood pressure, it’s supposed to reduce the amount of adrenaline that my dear amygdala releases while I sleep, hopefully reducing the amount of times that I wake up during the night.
I’ve been prescribed this drug before, but by a doctor who had absolutely no clue as to why she was prescribing it. No one could tell me why it worked so I wasn’t comfortable taking it. So this neurologist explained the how’s and why’s and then I asked the question that had kept me from taking the risk of a new drug the last time I had possession of it.

I was afraid to take the Prazosin last time.
Why?
I was afraid it would kill me. I was afraid to go to sleep and die.
It won’t kill you. You won’t die from taking it.
Are you SURE?
Yes, I’m sure.
Ok, I’m going to trust you on this.
Ok.
And I’m also going to blog about it, so you better not be lying.
I’m not.

Suicidal ideation, foreshortened sense of future, fear of death. Confused yet? Yeah, me too. 

For more information on PTSD sleep you can visit the website for the one and only sleep center devoted to PTSD sleep here. Unfortunately it's in New Mexico and requires (for best results) that you stay either at the sleep center or live near it in order to actually benefit from it so it's officially #1 on my list of things to do if I win the lottery/publish a book.
A podcast on iTunes relating to PTSD and sleep is what lead me both to the existence of the sleep center and the drug Prazosin but I can't currently find it (I'll keep looking).


Here is a link to the article that the quote used in this post was obtained from. It talks about the suicide of a Marine who suffered from PTSD.

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