Saturday, November 5, 2016

How I got confirmation of, if it makes sense, PTSD

In September this year I got extremely depressed.  I started staying with my parents because I didn't feel safe alone.  I expected the depression to lift in a few days but it didn't.  Then a few weeks, but no.  So my therapist and I agreed I should do an intensive outpatient therapy program, group therapy for three hours Monday through Friday.  I've been doing that for a little over three weeks now.

I feel better.  I'm on a new med and I'm on higher doses of my old meds.  I've worked through a lot in therapy.  It's the kind of stuff any person could use but that you don't realize is missing until all your usual tools for getting through life are gone.  It's like we're all carrying around our lives in boxes, keeping everything together, and then you get depressed and those boxes disappear.  And you realize how disordered and imbalanced and incompetent we all are.  And you can't swap in new boxes because depression won't let you, so you have to figure out how to organize yourself and your life in a way that you can carry it all without a box.  If that makes sense.  That's the best I've got so far in explaining the intensive outpatient program.

My therapist thought some of my anxiety might be due to epilepsy or migraines because some of it seems neurological, not psychological -- feeling like I'm lying down when I'm not, for example.  There were times when I literally felt like I didn't have a head.  But my psychiatrist and the psychiatrist who oversees IOP agree that these moments, which include moments of extreme terror, are not neurological but are instead dissociation, derealization, depersonalization.

I never understood my psychiatrist's terming this experience "dissociation."  To me, dissociation is the mind separating from the body in order to cope with trauma.  I have no trauma to point to.  So I said as much to the psychiatrist attached to the outpatient program, and he said there doesn't need to be a traumatic trigger -- sometimes the trigger is extreme anxiety.  But as we spoke about it, I came up with, "I don't know if this makes sense, but with the pain, I find I go through tiny little PTSD events, terrified of peeing, of setting the pain off, of" -- okay, I can't write this out now.  I need the compartment I'm in right now.

But the psychiatrist agreed with me.  I needed to hear that my PTSD explanation makes sense.

That my terror might be neurologically based was both frustrating -- another health problem -- and possible relief -- there's nothing inside me that will break from it; it is just an illusion.  That the terror is probably psychological is not the most welcome conclusion.  I do feel like the terror will break me someday.  It has, actually -- I spent a month confined to the house due to agoraphobia, unable even to get the mail because the world would start tipping sideways when I did.  To fear that it will break me again is normal, I tell myself.  But that doesn't allay my fear.

I wish I were better able to explain the continuous tiny PTSD the pain brings.  All I can say now is that I can't believe this is my life.  I'm staying with my parents because I don't want to see my future.  I had depression and anxiety before the pain, but I believe I would've stabilized and gotten better without the pain.  The pain is a monster.  It is trying to kill me.  I am trying to ignore it.  I'm doing it for the people I love because on a personal level, I can't defend this life.

I am safe.  I am okay.  I am in therapy five days a week and it is helping.  I'm focusing on the present because the future is blank.  I can't believe I've made it this far without collapsing.  It used to give me hope, a sense of pride, something or other to look at myself and see how strong I have been.  Now all of that doesn't matter.  What has it gotten me?  Here I sit, in pain.

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