Mindfulness: Learning to Observe Without Judging

As I was saying a couple of posts ago – mindfulness is about learning to be fully present in the moment.

Tall order, I know. Hey – it’s a skill. You know how you develop skills? Through practice.

One of the things that often keeps us from being fully in the present is a tendency to constantly critique what we’re doing and how we’re doing it: chances are, whatever you do, there’s a little voice in the back of your head. Let’s call it The Critic. When you’re trying to do something, The Critic may offer up all sorts of unhelpful commentary:

“Seriously? What’s taking you so long? Do you realize how many other things you need to get done today? You’re already running late! You’ll never get it all finished at this rate – so you’ll have to do some of it tomorrow. You’re already late for tomorrow – you’ve just ruined the whole week!!!”

The Critic quickly fills up your head with unpleasant thoughts coming at you a mile a minute; when you’re drowning inside your own head, it’s hard to focus on what you’re actually trying to do. Your brain is spending a great deal of time and energy bullying you and slowing you down.

So – one important step toward mindfulness is learning to silence The Critic.

How do you do that?

You remind yourself that The Critic doesn’t help you get things done; it just fills your head up with negativity and worry, and slows you down and distracts you.

Start by just trying to notice The Critic when it starts coming at you. When you get good at doing this, you might be shocked at how it criticizes your every move.

Then, once you get good at noticing that it’s happening – start responding. Basically, every time you hear The Critic inside your head – tell it to go pound salt, and tell yourself to go back to paying attention to what you’re doing.

Sounds pretty simple, right?

Yeah – well, simple and easy are two very different things – and this will take lots of practice.

Then, mindfulness is basically paying attention to what you’re doing as you’re doing it, without The Critic commenting on your every move.

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Please feel free to share this post, and any other on this blog, with anyone who might benefit.

I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted.  The photo gracing today’s post was taken by M & C Charbonneau, and I’d like to thank them for generously allowing me to use their work. Please do not copy photographs from Coming Back Home without permission.

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“Why do I push people away when I need them the most?”

The title of this post is a question that was sent to me a little while ago; it comes up often enough, and seems to be something that a lot of people can relate to.

When we’re at our loneliest and most vulnerable – precisely when we need support the most – often seems to be exactly the time when we work the hardest to push people away. It doesn’t seem to make any sense, and we often kick ourselves for acting this way.

There’s actually some important reasons why we tend to act this way.

One is reflex: when we feel hurt and vulnerable, our defenses go up. When that happens, it’s harder to trust and let people in.

Two is history, especially childhood: When we’ve been hurt, our antennas go up and we find it a lot harder to trust; so the more lonely we feel, the more vulnerable we feel. When we feel vulnerable, our instinct is to not trust because we’re afraid of being hurt again. It’s a vicious cycle – we feel alone, so we feel vulnerable, so we push people away,  which makes us feel alone, which makes us feel vulnerable, which makes us push people away…

Three is culture, especially if you’re from a military background: you’re used to being tough and doing your best to act even tougher. Trying to let your guard down to let someone else actually look after you makes you feel… Vulnerable. You don’t want anyone to see you when you’re hurting, so even though you really need them to be there for you, you push them away.

The trick to breaking the pattern is:

One, understand that your reflex is making you feel less trusting – it’s colouring your outlook, and making you more crusty and prickly than you normally would be. So, know that the reason you’re pushing people away is because you really need them.

Two, realize that you got hurt back then, and this is now. It’s important to remind yourself that not everyone is like the person/people who hurt you; it will take work to slowly allow yourself to let people in.

UPDATE: Since it was published, this post has been one of the most read on this blog, and many readers have asked me to write more on the topic. Here’s a link to part 2 on this topic; here is part 3.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Holidays, Part 3: Why is it so hard at this time of year?

So – how’s everybody doing?

Look folks – there’s a million reasons that this time of year is so hard on people. But in a nutshell, here’s how it works: the rest of the year, you may be struggling. You may have PTSD, or depression, or a disability or chronic pain. Even if you don’t, you might have financial worries, or your marriage might be teetering on the brink, or you may be estranged from your family. Hey – your life might be like a country song, and you may have checked off everything on this list and then some…

But, the rest of the year, it’s easier to see that other people’s lives aren’t perfect either, even if it feels like they aren’t struggling anywhere near as much as you are.

Then – along come The Holidays. Christmas carols start playing nonstop on the radio, and suddenly – it seems like all these other people start getting happy and excited about the holidays. It feels like overnight, the whole world took a magic happy pill or something.

It feels like everyone but *YOU* got the happy pill; they’re all suddenly excited about the holidays, and you’re still feeling exactly as awful as you were before.  Only now, seeing how happy everyone else seems just makes you feel all the more alone. It was easier to blend in and mask your misery somehow when everyone else was just “okay”; when they’re this happy, it might make you feel like you just stick out like a sore thumb. And it all just reminds you of how much you’re hurting.

…And that, in a nutshell, is why this time of year is so hard on people who are struggling to begin with.

So – what do you do about it?

First – and most importantly – realize that this feeling, like you’re all  alone and no one else understands how you’re feeling – that’s part of how depression messes with your head. The fact is – $11 billion was spent on antidepressants last year, and they were the most frequently dispensed medication.

Folks – that’s a whole lot of people who don’t feel happy, and they all feel worse at this time of the year.

You are far from alone. But, depression makes you feel alone. It makes you feel lonely; but, it also makes you want to crawl under a rock and be all alone.

So, coping is a gentle balance – it involves not pushing yourself to do too much, but also not feeding the depression monster by giving in and just crawling under a rock.

There’s no quick, easy fixes – especially at this time of year. But, it’s a seasonal thing, so it’s especially important that you don’t stop doing things that were working for you before, and reach out for help when you need it.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Murray Chappell, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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Getting Through the Holidays, Part 1: Make a Plan

When you’re dealing with PTSD and/or depression, the holidays can be especially difficult, for a number of reasons:

  • Family: you may have loved ones who don’t really understand what you’re going through. They might try really hard to make you happy because it’s the holidays. When that fails, you might feel guilty, and they might feel underappreciated and resentful;
  • Gatherings: being in a group of happy people might make you feel like an outsider. You don’t feel how they’re feeling, and seeing happy people can be all the more excruciating when you’re hurting.
  • Survivor’s guilt: if you’ve lost buddies, you may feel undeserving of celebrating the holidays with your family when others don’t have a chance to celebrate with theirs.
  • Trauma anniversaries: if the bad stuff happened around the holidays, you may find yourself even more on edge at this time of year.
  • Crowds are hard enough when they aren’t filled with frenzied holiday shoppers.

This is by no means a list of everything that comes up around the holidays, but it’s some of the more common concerns.

Here’s the thing: you’re here, you’re reading this post, and that’s already a good step forward. Let’s take some time to think about it and problem-solve, to try to get you through the holidays as smoothly as possible this year.

First – give some thought to what the holidays were like last year. What were the biggest trouble spots for you?

  • If a relative tried to “cheer you up” and then felt hurt or upset that it didn’t work, please send them this post. They need to know that it’s not their fault, or yours. You can’t make depression or PTSD take a break for the holidays.
  • If big gatherings are difficult: (1) go to smaller gatherings; (2) don’t attend every single thing you’re asked to do; (3) use coping strategies, like going outside for a few minutes of relaxation; offering to take the host’s dog around the block; or leaving when you need to, rather than just sitting there and punishing yourself.
  • Plan ahead what you feel up to this year, and what you don’t. Don’t participate out of a sense of duty and obligation; skip what you need to skip.
  • The holidays can be a really lonely, isolating experience. Please realize YOU ARE NOT ALONE. This blog has 15,000 readers – that’s fifteen thousand readers who can relate to how you’re feeling. So while you’re avoiding the big gatherings with your relatives, reach out to a battle buddy. If you don’t have one, reach out right here.

Hey – all I want from Santa this year, is for all my readers to still be around in January. And he’d better deliver.

Please reach out when you need to. 

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Murray Chappell, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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PTSD and the Experience of Anger

Today I’d like to tell you about anger, PTSD, and what happens when you mix the two together.

First off – please know that I’m not trying to make anyone feel ashamed about their symptoms. Anger can be hard to talk about – which makes itimptant to discuss. A lot of people who have PTSD struggle with anger, and I’d like to tell you a bit about why.

For people who don’t have PTSD, anger can happen in small doses. People who don’t have PTSD can feel… mildly annoyed. They might roll their eyes, let out a big sigh, make a face, and maybe even mutter something under their breath. And then, they do something that totally baffles those who have PTSD – they shake it off and move on.

You might wonder, why can’t I do that?

We’ve discussed before how PTSD is basically a threat-response reflex that doesn’t have an off switch. So, PTSD makes you feel like you’re always under threat, and anger is a big part of how you fight back. And because reflex works on the principle of “better safe than sorry“, PTSD doesn’t leave much room for getting “a little miffed”: when you have PTSD, you’re more likely to respond quickly, and more forcefully than you would if you didn’t have PTSD.

Here’s what you can do about it:

– One, understand it: realize that PTSD works like a magnifying lens for anger. Basically, this means that where other people would get a little miffed, if you have PTSD you’re more likely to get outraged, and to stay that way for a longer period of time compared to someone who doesn’t have PTSD.

– Two, now that you understand it, use that knowledge to help yourself control it. When you get upset over something, get in the habit of asking yourself, how big of a deal is this? Rate it on a scale of 1-10. Remind yourself that ten is extreme stuff, like life-threatening danger. When you’re feeling relatively calm and you don’t have too many distractions, sit down to give some thought to the kinds of annoyances that you encounter most frequently. Then, once you’ve had some time to rate these, give some thought to how you might want to react to express your frustration with a three or a six. If you aren’t sure, think of how others react, or ask someone you trust to help you.

– Three, keep practicing your relaxation, every day. Over time, it will help to decrease how severe your PTSD is, which will make it easier to control your anger even more.

It will definitely take work. You’ll have to re-learn how to be a little annoyed. And, you’ll have to practice relaxation to help with diffusing your anger more quickly.  But – if you work on it, there’s a good chance that things will get better.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

 

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PTSD Triggers: Trauma Anniversaries

As far as triggers go, few are as powerful as the anniversary of your trauma.

You probably start to tense up a bit just thinking about it. As the date gets closer, you might get this sinking feeling, like you’re a sitting duck and there’s no escape.

To cope with that feeling, you have to realize that even though you can’t stop the calendar, there are things you can do to cope.

Whether you feel uneasy, tense, nervous, anxious… You’re feeling that way because an anniversary is a reminder. Realize that your feelings are unpleasant but not dangerous.

Use your grounding skills to ground yourself in the here-and-now:

What year did that stuff happen? What year is it now? How long has it been since this happened? Asking these three questions is an important part of reminding yourself that the memory is “back then”, and you are in the “right now”, and there is lots of time separating you from that memory. The memory is a painful one, but it can’t hurt you. Your memory is back then. You are here now. It’s over, and you are no longer in danger.

– Where are you now, as compared to where you were back then? What’s different in your life now, as compared to back then? These are different ways of making the point in your head: That was back then. I am here now; now is different from then; and I am no longer in danger.

It helps to do things to keep busy, especially things that are different from what you were doing on the day when it happened. When the memory starts to creep up, remind yourself: “Right now, I’m home, the year is [now], and I am [doing whatever you’re doing right now]. That happened back in [whatever year], and I was [wherever], and I was [doing whatever]. Right now is different from back then. That’s a memory. I dislike remembering it, but it can’t hurt me anymore. It’s in the past. It’s over.”

Sometimes, your trauma anniversary is not just about something awful that happened to you – it may also involve the loss of someone you care about. If that’s the case, then you may also be overwhelmed with feelings of loss and grief for the person or people you lost on that day. You may think about all the good things that have happened since that they missed out on.

It’s healthy and natural to have feelings of grief. Too often, we think that acknowledging a loss is the same as depression, so we try to avoid healthy, appropriate grief.

So give yourself permission to grieve. Realize that the day will be hard on you; take it easy on yourself. Plan ahead of time to do things that ground you and give you comfort.

When it’s over, take an inventory: what did you do that helped, and what will you do differently next year? That way, hopefully coping might get a little easier from one year to the next.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

This post is shared to mark my own trauma anniversary, and dedicated to the memory of my cousin Pete. We miss you buddy.

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PTSD: Dissociative Symptoms

Holy feedback!

As soon as I put up the last blog post, there was a stampede of comments and emails saying, “Yes! Talk about this more!!!”

Okay.

So we left off talking about how the “freeze” response is part of the fight/flight/freeze reflex. It’s how we defend ourselves when we can’t fight or run away; it dulls the pain of whatever is happening.

Let’s put this together with some information we have from before, about how reflex learns: it learns that any reminder of the trauma is a sign of danger.

So – a reminder of your trauma might set off a “freeze” reaction.

Here’s what it feels like: you might feel like you’re not really in your body so it’s not really happening to you (this is called depersonalization); or you might feel like the whole thing is a dream, a movie, or happening in slow motion like it’s not real (this is called derealization). You might feel like you’re just losing chunks of time – ‘waking up’ and not knowing how you got to be wherever you are (this is called, WTF just happened to me?).

Here’s what it feels like to have PTSD do this to your life: it’s terrifying. You feel like you have no control over your mind or body. You want to do everything you can to grip onto reality, but you get sucked into this rabbit hole. You might feel angry at your mind for betraying you this way.  You might feel guilty, weak, and ashamed for not being “strong enough” to somehow hang on tighter and not let this happen to you. It can leave you feeling traumatized again and again, every time it happens, because being helpless to stop yourself from dissociating can remind you of being helpless to stop your trauma when it happened. You might feel depressed, useless, worthless.

…Boy, sounds like fun, doesn’t it?

Lookit – I’m not gonna try and tell you that getting out of that hot mess is easy, quick, or painless. It’s none of those. If your PTSD includes this stuff, research suggests that, as far as PTSD goes, you won the bleeping jackpot.

What makes it worse is, every time it happens, you might feel disappointed in yourself, like you should be stronger. This just erodes whatever self-respect you have left. You’d never say stuff like that to a buddy to encourage them when they’re struggling…

You need to start by realizing that this happens to you because you don’t feel safe; so, how you start to fix it, is to work on increasing your sense of safety.

The ability to feel safe is like a muscle – and yours is, well… It’s not so strong. You strengthen it with exercises – stuff like relaxation. Grounding skills. These are your drills: practice this stuff. Be patient with yourself. What you’re trying to accomplish here is very hard work, so give it time.

Finally – you know that fine print I put at the end of every post? You know, the stuff that none of you ever read, because you don’t think there’s anything important under the pretty picture?

Yeah; it says that this blog is not a substitute for therapy. If you’re dealing with PTSD with dissociative symptoms and trying to fix it on your own, it’s a bit like trying to perform open heart surgery on yourself. I’m just sayin’ – there’s help out there. Go get some.

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~ Dr. Dee Rajska, C. Psych.

I’d love to have you share your thoughts, comments, and questions – but before you post, can you take a quick peek at the guidelines? Thanks…

If you’d like to get more updates from me, you can find me on Twitter and on Facebook.

Fine print: Reading this blog is a good start, but if you’re having a hard time, it’s no substitute for getting actual help (like, therapy). It takes a different kind of courage to admit to yourself that you’re struggling, and to seek help. Getting help is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

Really fine print: Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Larry Jaipaul, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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PTSD: Reflex and The “Freeze” Response

…You know I’m all about feedback, right? You know this is YOUR blog, and I’ll write about whatever you need?

Well – my stats tracker thingy tells me somebody ended up on Coming Back Home by Googling “PTSD + Freeze response”.

And I thought, Huh – I don’t really have a good article on that. I mean, if I was Random Google Person, I’d be a little disappointed.

So – good suggestion, Random Google Person! This post is for you!

If you recall from previous discussions, PTSD is basically a survival reflex stuck in a loop with no off switch. This reflex has three parts, depending on what kind of threat you’re up against:

fight is where you respond to a threat by beating up on it. Military training works to strengthen this part of your survival reflex.

flight is where you run for the hills to get away from the threat.

freeze is what you do when neither of the above is an option.

In this post, we’re going to discuss the freeze response, the way it happens in the face of an actual threat. Next post, we’ll talk about dissociation, which is what happens when the “freeze” reaction gets stuck, like in PTSD or dissociative disorder.

It’s like this: imagine a goldfish.

It’s in a fishbowl. The cat just jumped on the table and stuck his paw into the bowl. What’s the fishy gonna do?

He’s can’t fight off the cat, and he can’t run away, because he’s in a fishbowl. Poor little fishy. The cat is about to enjoy some fresh sushi.

So – what does the fish do? He freezes; freezing helps him feel less pain, both physically and emotionally.

Freezing might feel like time has slowed down; like what’s happening isn’t real; or like he isn’t really there. The goldfish might feel like he’s floating above his body, watching the cat enjoy his sushi.

Feeling this way is a normal reaction to a situation of extreme, life-threatening danger, where you can’t fight and can’t get away.

If you’re a goldfish who’s about to get eaten by a cat, feeling like you’re floating above your body and the whole thing is not really happening is less terrifying, which is why our reflex is built this way.

But – suppose just as the cat is scooping up the goldfish, someone comes along and screams, startling the cat. Poor little fishy lives, but is scarred by this near-death experience: he might get stuck in this “freeze” reaction. He might end up with severe PTSD, and symptoms that we call dissociation. We’ll talk a bit more about that in the next post.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Sexual Dysfunction and Relationships, Part I

*Disclaimer: This is a really broad topic, and I’m not a sex therapy expert, so unfortunately, I won’t be able to cover everything that’s relevant. Most of my patients are male and heterosexual, so I’m addressing the topic from that perspective. I don’t mean to leave anyone else out, I just try to stick to writing about what I know.  

So… Judging by the number of pageviews on the last post, it looks like some of you find it less awkward to discuss sexual dysfunction on the blog than in person.

Good – you need to have access to this information, even if you feel too embarrassed to ask about it face-to-face.

You know, I briefly considered writing the last post about Dave the Zebra. I thought, maybe that would be less awkward for people?

However – Dave the Zebra is actually named after Dave the Dude. I value my friendship with Dave the Dude. Somehow, he didn’t like the idea of putting his name in the same sentence as sexual dysfunction, in a blog read by thousands of people. Go figure, eh?

Well – let’s talk about it. (Dave the Dude, you can relax. I’m keeping you totally out of this…)

In the last post, we talked about how and why PTSD can mess up your sex life.

Today, we’re going to discuss how the mess in your sex life can have a ripple effect on the rest of your life.

Sexual dysfunction messes up your relationships, starting with the relationship that you have with yourself.

(Hey – can we try to focus please? I’m talking about the emotional relationship with yourself – not the five-knuckle-shuffle relationship with yourself! …Not that there’s anything wrong with that…)

Look – who you are in bed is part of your identity. You don’t need to go through life being Mr. Don Juan – even if you’re a relatively vanilla kind of dude, you have a sense of how your plumbing works and what you enjoy doing with it.

When that changes, it can have a big impact on how you feel about yourself. We live in a culture where, as a guy, you’re supposed to be obsessed with sex, or so the media would have you believe. So a lot of guys end up feeling like they’re somehow less of a man when stuff like this happens. You might feel angry and ashamed, and try not to think about it.

If you’re a single dude, this might really have an impact on your confidence about getting into a new relationship. You might question whether a woman would want to be with you, if things don’t quite work the way they used to.

(Answer: yes, the right woman would still want to be with you. The right woman would love you for your sense of humour, your smile, and whatever else it is that makes you awesome in her eyes. And you can sweep her off her feet with flowers and chocolates and kisses and dancing and backrubs and… Well, when it actually comes to sex, most women like all that stuff that most guys rush through to get to the main course. So, serve up a really good appetizer, and she won’t really miss the main course, you catch my drift?)

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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Spouses Want to Know: PTSD vs. Depression

Today’s spouse question is: “My husband went in to see the psychologist to see if he had PTSD and the answer was ‘nope, but you are in a major depression.’ He doesn’t seem depressed, but his character has DEFINITELY changed over the last few years. Can it be one and the same?”

This is a really important question. New research suggests that depression in men is not very well understood. This means that men who are depressed may not “seem depressed”.

We tend to think of “depressed” as basically meaning the same as “sad”, along with feelings such as guilt, shame, and worthlessness. But women may find it easier to acknowledge these feelings; new, gender-specific studies suggest that when guys feel depressed, they’re more likely to get mad about how they’re feeling. They can get irritable, angry and more aggressive; they can show risk-taking behaviour that’s out of character for them; and they can try to numb out their feelings by throwing themselves into their work, or developing other addictions, like drinking, drugs, gambling, or sex.

What makes it more tricky to diagnose is that PTSD and depression often happen together. As if that isn’t complicated enough, addictions can be pretty common with PTSD too. But, what makes PTSD unique is that it typically also involves symptoms of re-experiencing trauma (either through nightmares or unpleasant memories that can’t be controlled), as well as symptoms of avoidance (avoiding stuff that reminds them of the traumatic things that happened).

If that sounds about as clear as mud, then I have one more important word of caution: diagnosing a mental health condition is not like repainting your bathroom – you can’t just read up online, figure it looks easy enough, and decide to wing it by yourself. Seriously; I don’t like to throw this around, but geeks like me spend a few years in school learning to do this…

If you are working with a professional, please share whatever relevant information that you can with them, and then trust them to do the diagnosing for you.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

 

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Spouses want to know: “He doesn’t want to talk about his PTSD”

Well, hello again, everyone!

Today’s question is: “He doesn’t want to talk about it [his PTSD], or tell people. But I don’t think he has anything to be ashamed of, and I think it will help people understand why he is acting this way. What should I do?”

First, a disclaimer: I usually try to write in a way that applies as widely as possible. This time, I’m answering a reader’s question, so not everyone might relate. I know that not everyone who has PTSD is male, or married. If you have a different question you’d like me to answer in a post, please let me know.

This reader’s point of view goes sort of like this:

“Honey, you have nothing to be ashamed of; you didn’t choose to get sick, this happened to you. It’s no more shameful than a physical injury. I want to tell people so that when you need your space, they can be more understanding.”

Makes perfect sense, right? So – why is her husband (and maybe yours) so adamant that he doesn’t want anyone to know?

Because being able to talk about it happens at a point in his healing called acceptance, and he’s not there yet.

Because he’s still used to being Superman, and it’s hard to wrap his head around the idea of being this “sick guy” who needs to be fussed over.

Because he’s sick and tired of being sick and tired, and talking about it just reminds him when sometimes, he’d just like to forget.

Because talking about a problem is the way we women naturally tend to cope. Guys like to fix things, and if they can’t fix it, they don’t want to talk about it.

Because facts and feelings are two different things – so his head may understand that this illness is not his fault, but he may still feel shame, guilt, and anger at himself for “allowing” this to happen to him.  He may feel broken or weak, and helpless that he can’t just “buck up” and shake this thing off.

If he’s sick enough that he can’t work right now, he may be struggling with the fact that he can’t work to provide for his family.

If his illness has led to out-of-character temper outbursts that have frightened you and the kids, he may have feelings of shame and guilt about that, too.

And thinking about it all is just so painful and overwhelming, that he just can’t. Not because he’s being to be stubborn, but because it’s all just too much.

So… That leaves you, the spouse, in a bit of a conundrum: his behaviour is different, and maybe he can’t attend family functions, so friends and family are asking what’s wrong. Yes, it would be a lot easier if he was ready to talk about it – but he’s not there yet, and pressuring him won’t speed his healing process.

So – what do you do?

You take care of you. This is tough on you – so get support from other spouses who can relate, and consider getting some counselling yourself, to help you cope.

You can be helpful by doing other things, like offering a smile or a hug. If he’s okay with it, maybe the two of you can talk with his therapist about what might be fun, trigger-free things for the two of you to do as a couple, or things to do as a family – because making life seem a little more “normal” might be just the ray of hope that both of you need to see that life can go on.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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“I know I’m safe, so why am I still freaking out???”

This question is important, and it comes up a lot.

Okay – for me to explain this, you’ll have to imagine that your brain is a grapefruit.

(Hey – it’s either that, or this becomes a hard-core neurobiology lesson where I start throwing around Latin words that are harder to pronounce than my last name…)

…So – we’ll go with the grapefruit then?

The peel of the grapefruit is the “gray matter”, or cortex. It’s got all your smarts – this is where you analyze, make decisions, set priorities, and so on. You’re conscious only of the stuff that the gray matter does: the other parts of your brain do their thing behind the scenes, like an autopilot.

The fruit part of the grapefruit is the “white matter”. It’s a messenger – it sends ideas back and forth and makes your brain work quickly to translate a thought into an action.

The grapefruit’s got a few seeds in it. One of these seeds is a little thing called the amygdala. (This will be the only Latin word I’m throwing out there today, promise.) The amygdala sets off your fight/flight/freeze reaction, in response to anything that reminds it of a threat. It’s a reflex, so it doesn’t ask your permission before it goes off.

So – how is it that you can realize that everything’s okay, but still find your body reacting like you’re in danger?

Simple – the realizing that there’s no threat is coming from the peel of your grapefruit. But, at the same time, one of the seeds (your amygdala) is reminded of a threat, so it’s reacting as if you were in danger. Two different parts of your brain are doing two different things, at the same time.

It’s really important to know that this is how your brain works. If you don’t know, you might end up doing one of two things:

1. Telling yourself, “I should just suck it up and stop being so (bleep)ing scared, and what the (bleep) is wrong with me?”.

Yeah… Cause that’ll help, right? Fear is part of a reflex; beating up on yourself for it is sort of like blaming yourself for letting your toenails grow; you didn’t have a choice, so quit blaming yourself, it’s not your fault. Plus – talking to yourself this way just makes you feel shame and guilt, which feeds your depression. Do yourself a favour, and remind yourself that you are not to blame for your reflex.

2. The other option is that you start thinking, “I’m feeling so nervous that there must be something to be scared of and I’m just not seeing it”.

…If you want a quick, easy recipe for freaking yourself right out, then telling yourself that there are invisible dangers that you cannot sense is a good way to do it…

However, if you want to help yourself relax instead – then remind yourself that you’re feeling nervous because a very primitive part of your brain is being triggered to think of a threat; it’s not very smart, so it can’t tell the difference between real and imagined threats.

So, how do you try to stop it? You tell yourself that it’s just your threat reflex sounding a false alarm; then use your relaxation skills to help yourself to relax. (Yes, this is exactly why I keep droning on about how important it is to practice relaxation regularly…)

It’s simple – but simple and easy are two very different things. You’ll need a lot of practice to make it a habit to think this way, but once you’re successful, it will be a helpful tool.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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Spouses want to know: “Why isn’t the medication helping?”

Today’s question is, “If my husband is medicated, shouldn’t we see some signs of him getting better?

Great question, and thanks for asking!

…And you might be frustrated that I don’t have a quick, easy, one-size-fits-all answer.

First of all – let me just clarify: as a clinical psychologist, I don’t prescribe medication. That doesn’t mean that I’m opposed to medication; I have some patients who won’t take medication no matter what, and I respect that. I also work with others who consider their medication to be an important part of the mix that works with for them. I respect whatever path to recovery is the best fit for each individual person.

So, you might wonder, what is it, exactly, that medication is supposed to help with? Well – it depends on the diagnosis and the type of medication Antidepressants do something very different than anti-anxiety medication, for instance.

In general, meds are supposed to dial back your symptoms. Finding the right dose often takes a bit of trial and error; antidepressants in particular can take up to six weeks to build up in your system and start to make an impact. And you need to start off at a lower dose and gradually build it up to the dose that you need, to give your body a chance to adjust. So, it can take a while to get to the point where the medication has its full effect. When it comes to finding the best medication for you, it also might take a bit of trial and error – you may need to try a few different medications before finding the best one for you. So, medication might seem like a quick solution, but like anything else – you need to hunker down and arm yourself with a lot of patience, because it might take a while.

The other issue is, pills don’t give you skills: they don’t teach you to understand what’s happening to your brain,  or where it comes from or how to cope with it.

So – in a nutshell, it may take some time before you start to see a difference. You might have to try a few before you find the right one. And medication alone is frequently not enough to change behaviour.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Depression: Defending Yourself Against The Bully Inside Your Head

So – how ya doin’, folks?

Has your depression magically disappeared from the couple pearls of wisdom I shared last week?

No, of course not. I hope you didn’t expect it to. Because if you read last week’s post and thought, “That’s easy, I can do this overnight”, and then started beating up on yourself when it didn’t work out that way – folks, that’s just your depression messing with you again. Digging yourself out of depression takes a lot of practice and hard work.

See – depression would be hard enough to deal with on its own. To make things worse, it often travels with friends, like PTSD or chronic pain. Or, you might be dealing with the trifecta: depression, PTSD and chronic pain.

Depression often sets in after something bad has happened in your life: stuff like going through a trauma; suffering a serious injury that changes how you can live your life; losing your job; losing a loved one; losing your marriage. You know, all the stuff that they write country songs about…

Then – just to be mean – depression starts comparing the new, not-so-improved you to the old you. And then, it starts nagging on you about how new-you should be able to live up to all the stuff that old-you was able to do. It keeps telling you how it’s so simple, and what’s wrong with you, you should be able to just suck it up, pull yourself together, and get on with it. And if you can’t do it, then depression starts telling you that you’re worthless, useless, and you should feel guilt and shame.

Honestly – depression is feeding you a bunch of… um, fresh manure.

When you can’t do the stuff you used to do because you’re sick, it’s healthy to grieve that loss. If you love to swim and you missed a whole summer of swimming because your leg was in a cast, you might feel frustrated and disappointed. But there’s a difference between those feelings, and calling yourself stupid and lazy for not making your bone heal faster. There’s a big difference between disliking the circumstances, and unfairly blaming yourself for them.

Depression also doesn’t give you any credit for how hard it is to actually live with depression. Stop for a second and consider that there are days when you deserve a medal just for getting out of bed.

Imagine you’re watching speed skating on TV (why speed skating? It just popped into my head, and it’ll work with my example, so let’s just roll with it).

There’s a bunch of guys racing and they’re all ridiculously super fast. And then, waaaaaaaaaaaaaaaaaaaay behind them, there’s this one dude who’s going so slow, he’s barely putting one foot in front of the other.

Oh – except he’s carrying a backpack, filled with 500 pounds of rocks.

So – who do you respect more, the bunch of dudes at the front, or the one guy managing to stay on his feet with the giant bag full of rocks?

(Hint: Vote for the guy with the rocks, he’s pretty incredible.)

And if you vote for him – try to also realize that all the stuff you’re dealing with is a lot like carrying around a bag with 500 pounds of rocks. And try to respect  yourself a little more.)

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Benjamin Yost, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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More on Depression: The Bully Inside Your Head

Hi again!

So – last week, we talked a bit about depression.

(Well okay – I talked about depression; I seem to do most of the talking around here. You know I welcome your comments, right? Feel free to start a discussion…)

Anyhow – I was saying that your brain runs on juice, and that depression sucks out all the juice that makes your brain run.

Basically – depression is like a big bully inside your head. It sits there and calls you names. It tells you stuff like “you’re useless”, or “you’re worthless”, or “you’re not good enough”. It compares the person you are now to the “old you”. It tells you to feel guilty and ashamed of who you are now.

Depression is so good at messing with you because not only does it tell you all that stuff – it also makes you believe that nonsense.

Don’t get sucked in!!!

Unless this is the first post that you’ve read on this blog, then you probably realize by now that I repeat myself when I have something important to say. I said this last week, but I’m saying it again: Depression is an illness; it would be great if there was a “juice gauge” on the side of your head, like a gas gauge in your car, so you could actually see when your brain is running low on juice – then it would be easier to accept that depression is real.

Sadly, there’s no juice gauge. Instead, you’ll just have to trust me. (I’m some chick you met on the internet, so trusting me has got to be a good idea, right?)

Depression is an illness, not a choice. Here’s a couple of ways to fight back:

– “if it were a physical illness“: Ask yourself this: If you were physically ill and not able to get stuff done, would you be saying nasty stuff to yourself about it? No, of course not. You’d be annoyed and frustrated that you’re sick, but you wouldn’t blame yourself. Well, depression is a physical illness – it’s a juice deficiency, and that part is physical. You didn’t ask for this. So try to quit beating up on yourself about it.

– “if it were happening to a friend“: Ask yourself this: If one of your friends were struggling with this, would you be telling them that they’re useless and worthless? If you have peer support, you probably know some buddies who struggle with this stuff. When they do, you probably tell them you’ve been there too, to take it one day at a time, and to do their best and take it easy on themselves.

You say the nice stuff to your buddies because that’s supportive; you say that mean stuff to yourself because that’s depression.  Talking to yourself like you’re talking to a buddy is a way to cheat depression and offer yourself some support. If you can offer yourself some support, you might be able to put some juice back in your tank, so you feel up to doing more stuff, and slowly digging your way out of depression.

Sounds so simple, right? Yeah, well simple and easy are two different things, and this is going to be a LOT of work. For a lot of folks – too much to do on your own. If you’re struggling to get better on your own, don’t just sit there and tell yourself you should be able to do this alone – that’s your depression bullying you again. Most folks can’t do this on their own, and you don’t have to. Get some peer support, and then get yourself to therapy. It’ll help you get better.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Murray Chappell, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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