PTSD Triggers: Crowds

So – while we’re on the topic of triggers, let’s talk about crowds. From what I gather, most of you are not big fans of crowds.

Like I keep saying, PTSD is basically your brain’s threat-alert system, kicked into high gear without an “off” button. So – you’re constantly trying to size up all possible threats.

Say you’re in a room with one door, one window, and one other person. That’s not bad; you can scan window-door-person, to look for possible threats.

Now say you’re in a bigger room, with ten people. Keeping track is much harder, and it’s easier to get overwhelmed.

It goes up to a whole new level if you’re in a grocery store, a mall, or a football stadium. Now, there’s just no way to keep track of it all. Just thinking about it, you might start to feel your heart rate speeding up a bit – that’s your reflex, getting ready to fight or flee.

Take a moment. Breathe. You’re not there right now.

See what just happened there? That feeling started, even though you were just thinking. Thinking is not dangerous – but your survival reflex is so strong, that just thinking about it makes the danger feel SO real.

When we start to feel like that, we interpret that feeling itself as a sign that there’s danger. If we can’t quickly scan our entire environment, we start thinking the danger must be real, only we can’t see it.

Feeling tense/nervous/uneasy does NOT mean that you’re in danger – it just means that your threat-detection system is reminded of danger.

…That little fact right there folks – that is the key to the universe.

When you’re dealing with PTSD, having that feeling that tells you, “Oh no, major danger is coming” does NOT actually mean that anything is coming.

It just means that your threat-response system was reminded of danger.

Remember Dave the Zebra, and his red flowers? Well – crowds are sort of like your red flowers.

So – how do you cope?

Remind yourself that, as soon as you start to think about crowds, your PTSD will start to act up. This is not because thinking is dangerous, or because crowds are dangerous; it’s because PTSD reacts to reminders of danger.

Heading into a crowd, you’re going to feel anxious/tense/wound up. You may even start imagining all kinds of horrible things that could go wrong, and all those things might feel very, very real. Feeling and thinking this way does not mean that you’re in danger, or that awful things will happen. This is a normal part of PTSD; it is to be expected. This is unpleasant, but not dangerous.

Repeat this information to yourself frequently; with consistent practice, it will get easier. (You’ll probably still not like being in crowds, but it will get easier to cope with 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 the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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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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Your Deployment, Your Family, and… THEIR Trauma

Since we’re already on the topic of all the different kinds of trauma that can result in PTSD, I was thinking… let’s talk about families.

As we were discussing in the last post – a “traumatic event” is any situation where you’re exposed to actual or threatened harm.

As we discussed, “actual or threatened” means that even if it doesn’t end up happening, being genuinely scared that it would happen can still impact you.

It doesn’t have to happen to you; it can be something that happens to someone else, while you’re helpless to stop it.

Even if you aren’t there when it happened, learning the gory details of what happened to someone else can mess with you.

So – let’s take a minute to put this together:

Say you’re deployed. Your family stays behind. They spend months on end being bombarded with media reports about the horrible events happening in the place where you went.

You face dangers every day; they’re too far away to be able to do anything other than feel helpless and hope that you come home in one piece.

…what’s happening to your family here – that’s trauma. It’s not the sexy kind of trauma that makes for a great story, but it’s still trauma.

Now, that does NOT mean that your family will automatically get PTSD just because you were deployed – but, it’s trauma, so it certainly might impact them.

Your family might feel pressured to outwardly say nothing other than how proud they are of your service. They might face a barrage of well-meaning friends and strangers offering all sorts of comments – everything from, “You must be so proud!”, to, “That’s crazy! Don’t you watch the news? They get blown up all the time over there!” (This was actually said to the spouse of someone I know…)

To you, deployment is part of your job; to them, it’s hard not to take personally. Privately, your loved ones might feel rejected and abandoned. They might feel angry and resentful that you would leave them behind, to go to some far-away place and risk getting hurt or killed, and leave them worried about your safety for months on end. They might also feel guilt if you made it home safe and other families weren’t so lucky.

So – on top of the emotions that you might bring home – your family members may have some concerns of their own to throw into the mix.

All that can make for a challenging adjustment to family life.

So – how do you get through it?

You try to be understanding of each other. You went through a lot; so did they. It’s not a competition. You’re a team;  adjusting to life after deployment is teamwork. Communication is important; try to talk about your feelings. Try to listen to family members talking about their feelings, without getting angry or defensive.

Most importantly, recognize when you need help adjusting, and reach out for it – whether you need individual therapy, family or couples therapy, or a bit of each.

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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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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 and Sexual Dysfunction

So – guess what we’re talking about today? (Go ahead, check the title again). That’s right.

*Disclaimer: This is a really broad topic, so I won’t be able to cover everything that’s relevant. The question was originally asked by a female spouse of a male veteran. 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.

In person, some of the patients that I work with find this really awkward to discuss.

Well – look on the bright side: this is a blog! You don’t have to ask this stuff in person! All the answers, none of the awkwardness!

The research is pretty clear that there’s a link between PTSD and sexual dysfunction. Most studies show that in veterans with PTSD, about 8 to 9 out of every 10 have some sort of sexual dysfunction. That’s much higher than combat veterans without PTSD, and higher than veterans with other mental health diagnoses. “Sexual dysfunction” can be a whole list of different problems – including having less sexual desire; erectile dysfunction; premature ejaculation, or inability to reach orgasm.

8 to 9 out of every ten. That means that, if you have PTSD and you don’t have some sort of sexual dysfunction – you’re the exception.

If you didn’t know that before, then it’s important that you know this about your body, and what PTSD can do to it. It’s not you, it’s not your fault, it’s not because you’re doing something wrong. It’s not your partner’s fault either. Add it to the long list of things you dislike about PTSD.

But – let’s talk about how and why this happens, and then, most importantly, let’s talk about what to do about it.

First, the “why”: remember that PTSD is survival reflex on overdrive; remember how we talked about reflex making all your big muscle groups tense up? Yeah – apparently, your survival reflex doesn’t consider that part of your body as a big muscle… Go figure.

Basically, reflex thinks that anything that doesn’t help you fight or flee is a waste of energy.

PTSD also makes you feel anxious and hyper-alert pretty much all the time, and that makes it hard to get in the mood and stay in the mood for long enough. Many people who have PTSD also feel disconnected and detached from loved ones, and that can make it hard for both partners to get in the right headspace. Increased anger and irritability can also put a damper on your relationship, and that can make the physical part of your relationship suffer too.

…Sounds pretty bad, huh?

Yeah… I know…

It can get better. Not magically, overnight better, but slowly and with some work – it can get better.

(Yes, pills can help. Talk to your doctor about getting some. But don’t expect pills to be a quick, easy, magic cure-all.)

First – go to therapy, and work on learning to manage your PTSD. When you learn more about how to manage your symptoms, this will make a difference.

Next – consider couples therapy. Especially if you’ve been struggling with this stuff for a long time, chances are there’s a lot of misunderstandings and hurt feelings from both of you that are driving a wedge between you. Couples therapy may help you to reconnect and feel closer, and that might help.

Third – don’t give up. Don’t lose hope. As long as you’re willing to try, things can 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 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, Withdrawing, and How to Respond

Today’s question is: “What’s the best way to deal with withdrawal by a spouse with PTSD – call them on it, or what????”

As luck would have it, just as I was sitting down to write this post, I also received the flipside of the question:

“My wife more or less just gets mad at me when I leave the room to cool down; she says I’m running away to hide… How can I help her understand?”

If you’re the spouse of someone who has PTSD, it can be lonely and frustrating to be married to someone who keeps pulling a disappearing act. Even at the best of times, you might feel rejected and pushed away. At the worst of times, when your partner takes off while the kids are screaming and dinner’s burning, you might feel downright abandoned that your partner isn’t pulling their weight.

An important part of how you cope is to get some support for YOU – whether that means therapy, peer support, family or a babysitter to help if you have young kids, whatever you might need. You’ve got a lot on your plate, and you need to be able to vent to someone who won’t judge you or your partner.

As a spouse, you have every right to feel angry and frustrated – BUT, remind yourself that you’re angry and frustrated with your partner’s illness, not with your partner. If your partner is withdrawing because they are overwhelmed or triggered, this is very different from running away because they’re a lazy, selfish jerk who won’t lift a finger to help out, or because they don’t care about your feelings. Don’t confuse illness with selfishness; don’t treat one as if it was the other.

On the other hand, the stuff that’s going on inside the head of a person with PTSD is more than most of us can imagine. If it sometimes seems like your spouse with PTSD is only going through the motions of day-to-day life, it’s because at that moment, that might be the best they can do. Chances are, they realize that they aren’t there enough for you, and they carry a lot of guilt and shame about not being able to do more. They may be feeling helpless, worthless, and angry that they can’t do more to beat this thing. Feeling this way doesn’t help them get a leg up on coping – it just pushes them down more.

The best way to try to cope is together, as a team. Realize that you’re not angry at each other – you’re both angry at the PTSD, and at what it’s doing to your family. Thinking this way puts you on the same side, and that makes it easier to support each other.

Here’s some statements to try out:

Spouse of person with PTSD: “I know you’re doing your best; I’m not blaming you. I just hate that this happened to you. I hate that it gets in the way of things you would like to do.”

Person with PTSD: “I hate that it gets so bad that sometimes crawling into my shell is all I can do. I wish I could just shake this thing off. I know it’s not fair to you.”

Hug each other. Support each other. It won’t magically fix things, but it will get easier if you and your spouse feel like you’re on the same team, and you have each other’s back.

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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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Spouses want to know: “Will he always have PTSD?”

You may have gathered from the title of today’s post that I’m throwing something new into the mix. A few days ago, a support group for spouses asked me to answer a few questions about PTSD. I’m grateful for their permission to post the answers here, so everyone who might be wondering about this stuff can jump into the discussion.

Of all the questions they asked, I wanted to address this one first because I get asked some form of it almost every day – people ask, “Will I ever get better?”, or “Will I always be like this?”

I’d love to give you a money-back guarantee that everything will be just fine.

The honest answer though, is that how much better you will get (or your spouse or loved one will get) depends on a number of factors. Some of them we can predict; others, we can’t.

Single trauma events in an otherwise mentally healthy person, treated quickly after the event, tend to have the best outcomes. In many cases, people can make a full recovery from these types of injuries.

On the other hand, if you’ve had decades of trauma, and it’s taken several years to find a knowledgeable practitioner that you feel comfortable working with – it’s gonna be a longer, steeper, more grueling climb uphill for you. That doesn’t mean that you can’t do it, and no one has a crystal ball that can predict your specific outcome. In fact, my personal experience is that some of the patients who came to me in the worst shape are the ones who have made progress in leaps and bounds, once they’re given the right tools to do so.

Most importantly – even if you can’t be fully cured, you can get better. In many cases, you can get a lot better.

Nothing we do in therapy can take the awful thing(s) that happened to you and make them unhappen. However – how those experiences impact you now, is something we can work on. If you have a lengthy trauma history, and it’s hard for you to trust or hope, then that work might need to happen very slowly and very gently, so it doesn’t overwhelm you. If you’re a spouse trying to be supportive, it may be hard to be patient, because for the first while it might seem like therapy isn’t making any difference.

Here’s your best bet for trying to get better: find a skilled, patient, knowledgeable therapist whom you feel comfortable working with, who won’t give up on you. Let them know when the tools they give you don’t work for you – getting better is a partnership, and finding what works for you can take some trial and error.

Good therapy has two parts: tools that help you manage your symptoms, and ways to try and heal your trauma. If you and your therapist have a good partnership and you are willing to work hard on your recovery, then you will start to see a difference.

It might take a long time and a lot of hard work to get a lot better. But, “a lot better” might mean that you can manage your symptoms most of the time, and the stuff that happened might not bother you as much anymore. Worth a try, no?

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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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Strategies for Coping with Nightmares

Unfortunately, nightmares are part of PTSD for many people. They aren’t easy to get rid of. However, if you get nightmares, here is a list of things that you can do to try to make them a little easier on yourself:

– Did I mention that relaxation is really good for you? I did actually; so many times that you might be getting tired of hearing it. I even posted a relaxation exercise here. Some people felt triggered by that one (and I thank them for telling me), so I posted a different one here. I keep talking about relaxation because it’s good for you. Try to do some every night before you go to bed. It will make you less tense, and if you’re less tense you’re less likely to have nightmares.

– Anniversaries of your trauma events are likely to be particularly difficult. But, any days when you’ve been triggered, upset, stressed, or even excited (in a happy way), you’re more likely to have nightmares. Knowing this, you can work to compensate: on days like that, try to do more to relax before going to bed than you normally would. Then, as you lie in bed, take some time to look around the room, and remind yourself that you’re home, and that you’re not in danger. Putting this thought in your head right before you fall asleep will make it easier to bring yourself back into the here-and-now if you do wake up with a nightmare.

There’s a couple of things you can do to set up your bedroom to make it easier to cope with nightmares:

– Keep the room dark enough to sleep, but leave a small nightlight on to make it easier and quicker to orient yourself if you wake up from a nightmare.

– Keep the space uncluttered; have a couple of objects around the room that will help you to quickly and easily orient you to the here and now. Any object that you didn’t have at the time that the trauma happened can work; that way, if you do wake up with a nightmare, you can quickly scan the room to know where and when you are.

– Use your grounding skills: usually, waking up from a nightmare means waking up drenched in sweat. Lying in bed, drenched in sweat and shivering will do absolutely nothing to help you recover from your nightmare. So get up, run to the bathroom, and splash some water on your face. Get in the shower, and have a nice warm relaxing shower. Lavender-scented soap is also relaxing. Put on warm dry pajamas. Turn on soft, relaxing music. Fix yourself a cup of tea or warm milk (or another beverage that soothes you). The idea at this point is to soothe and comfort yourself, to help yourself recover as quickly as possible, rather than allowing the suffering to continue.

If you tend to have the same nightmare over and over again, there’s a type of therapy for that.

If your nightmare is overwhelming and terrifying to even think about, please don’t try this on your own – find a qualified mental health professional to help you.

The treatment involves writing out your nightmare in detail, with a different (positive) ending. You basically train yourself to re-imagine the nightmare with a positive ending, and then train yourself to take control of the nightmare. This takes a lot of work to do successfully, and it’s hard to do by yourself. So please reach out to get some help if 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 welcome 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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