Recently, I have noticed an uptick in the severity of my PTSD symptoms and my coinciding depression. It's starting to make me worry a little bit that not having a functional group to attend is slowly eroding my ability to cope and adversely affecting the effectiveness of my coping mechanisms. Or...It could be just a temporary uptick because of the uncertainty surrounding my upcoming TBI evaluation. Either way, it's decidedly annoying and not something I am handling well.
What to do? I am going to have an individual therapy session this week and I plan on talking to my therapist about my concerns and my frustrations with not having a group to attend. My PTSD is fighting to get through - the anger, the depression, the nightmares, and the insomnia. I also have been dealing with a higher than usual level of hypervigilance. Most nights I toss and turn so badly that I end up sleeping in my recliner, uncertain as to why I don't feel safe - I just don't.
What's even more frustrating is that there is a very clear dichotomy in my life. Everything is going so well with my non-profit and my plans for it. The more I work at it, the more I feel fulfilled and stable. When I have days where I don't have time to work on it, I feel a hair's-breadth from snapping at people. Today would be a prime example. I had to go to work early and I have not been able to do anything for my non-profit. I knew I wasn't going to have the time when I woke up this morning and it made it exceedingly difficult to deal with people at work. I am not even certain what ticked me off so much - they just did.
So, time to hold it together and hope I can figure this out. I only have ten more days to go until my TBI eval, so we'll see how it goes. I guess we'll see if I can hold myself together until them Fingers crossed.
I have been trying and trying to write this blog post and every time I start to write it, I can't seem to get anywhere. Honestly, the whole prospect of TBI has been a lot to wrap my mind around and I have been having issues with my PTSD as a result. It scares the hell out of me. What makes it worse is that I don't even know if it IS TBI - and that's what's killing me right now. If it's not TBI, is it because I am not getting good sleep? Or could it be that my brain chemistry has changes drastically and my med cocktail is out of wack? What if it's all three or none of the above? It's driving me nuts and I haven't been able to concentrate at all. My ability to focus has gone right out the window.
Then there's the PTSD. As a result of all of the added uncertainty and fear, I have been struggling to keep emotionally involved with my wife and daughter. Granted, when I start to withdraw, I have been able to catch myself and pull myself back from becoming a cave-dweller, but it scares me that this whole situation has had such an adverse effect on my ability to cope with aspects of my PTSD that I have managed very well over the past six months.
The TBI evaluation cannot happen fast enough. It's amazing how uncertainty can throw my life into total disarray. If anyone has any brilliant suggestions on how to work through this, I am all ears.
Well, I had another session with my individual therapist today. We did a lot of talking about my recent realizations about being black and white about everything. We still haven't come anywhere close to a work around or work-through. One realization that I did make was that survivor's guilt plays a huge role in setting the standards I hold myself to (and my inability to forgive myself for not being good enough) and why I can't forgive others for disappointing me (well, violating my trust is more accurate). There's a lot more to this that I still have to work through, that's for sure. One of the things she told me is that she's concerned that because I need to have people fall into one category or another (Trusted or Not), I may try to force people to fit into those narrow categories, even when they don't belong there.
We talked about this for the vast majority of the session and she asked me if there was anything else bothering when I unintentionally dropped a bomb on her. I could tell it concerned her greatly because her demeanor went from relaxed and attentive to focused and intense. Here's the situation:
Last week, Thursday night into Friday, I lost a day. What do I mean by that? I went to sleep a little after midnight and the next thing I remember coherently is waking up and realizing I have to be at work in 45 minutes - work started at 2PM. I slept for over 12 hours. I remember nothing in the interim. The next thing I remember clearly from that night is helping to clean the slicers at the end of the night. I know interacted appropriately with my coworkers, but I have absolutely no sense of the passage of time for that night. None. I have no idea whether I was asleep all that time either.
I drove home that night wondering whether I was going to be walking into a shitstorm at home. I had no idea. After talking about this with my therapist today and seeing how concerned she got, it raised some alarms in my head and I ended up not working on the newsletters I wanted to send out today - I could barely concentrate on writing this blog post. So I decided to take a break and watch a movie or two. I couldn't concentrate on anything and it was starting to ratchet up my anxiety something fierce.
What I thought was strangest was the timing. Everything was going well. My PTSD symptoms were wll-managed. The only thing I can think of is that it happened the night after I talked to the consultant about incorporation and foundation documents for the non-profit and I had a funding proposal that I put before a local veterans group for consideration. I was extremely excited. I was thinking that maybe my body doesn't know how to tell the difference between excitement and fear. I know my adrenalin was pumping like crazy.
Unfortunately, the end result was the same - I lost a day.
So now, I have to track when this happens to see if there is a pattern. I did some looking online and the specific information about the symptoms of TBI seem to fall in line with some of the issues I have with short-term memory, loss of sense of time, anger, etc. Anyone out there know more specifics or resources online that articulate this better? I don't want to pee up a tree and send doctors looking for ghosts if there's nothing to this.
I am so frustrated, encouraged, worried, angry, disillusioned and exhausted all at the same time. This past week and a half has been ridiculous. Every time I would be ready to sit down after thinking through things that have transpired, something else would happen and I would delay the blog post and process the new insight. Well, I can't hold this in anymore, so I am going to break this down by associated emotion.
Frustrated: I just found out today that in the span of a year I went from perfect reading on my blood screenings to being pre-diabetic and borderline high cholesterol. I feel like no matter what I do to better take care of my physical health that the PTSD is slowly killing me and it frustrates the hell out of me. What do I have to do to get these train wreck of health problem after health problem under control? Live like a monk? Deny myself all pleasures? Develop workout anorexia? Starve? GAH! I want to throw things in frustration but the inanimate objects don't deserve that kind of abuse.
Worried, Exhausted: My daughter is seriously sick for the first time. Bronchitis and bronchiolitis. She woke up Friday night crying and coughing, post-nasal drip, and a fever. I didn't sleep from Friday night until Monday night when her fever finally broke. With already being on heightened alert after the bombings in Boston, I started thinking that something was seriously wrong with my daughter's health. I was the youngest and never was around sick kids so I had no idea that this kind of sick was normal. I never really got sick. I remember having the pukes once as a kid and mild fevers a few times, but that's it. I never got strep, maybe bronchitis once, chicken pox was only three or four spots and a fever. I had no idea it could be this bad and not be life-threatening. I was relieved Monday night and was looking forward to catching up on some sleep on Tuesday. The cough was resurgent Tuesday night. My daughter didn't pass out until after 5AM Wednesday morning and didn't sleep at school either. Needless to say, I'm worn a little thin right now.
Angry, Disillusioned: I went to group today, looking forward to talking with them about stuff. Very shortly into group, the new therapist told me I could not blog about what I learned in group anymore. I got very angry as blogging about what I learn is at the core of my ability to cope. I explained to her that I have never once violated anyone's privacy and only bring up things that I learn and have worked through as a result of going to group. I told her that I had received express consent from the group members before I blogged about it. My previous group doc had signed off on it and over the course of the past year, it has become an integral part of my therapeutic process. She still refused even after directly asking the members of the group who all said they were fine with it. When I stated if no-one has a problem with it...
She raised her hand straight above her head and said she had a problem with it. That behavior, in and of itself, was exceptionally unprofessional. I got really angry and told her that I would no longer be part of her group. She professed to not understanding why it had to be that black and white for me. New flash, moron. Everything is black and white with veterans with PTSD. The fact that she didn't know that, combined with her extremely confrontational attitude illustrated to me that the 'new hires' at the VA are 'warm bodies'. I continue to wonder if she got her degree out of a cracker jack box. It took me eight years to try group therapy again after my first horrible experience. What I have come to recognize is that aside from Doctor Casagrande, I have never had a client/doctor relationship at the VA that I felt was constructive. When I talked about it with my father tonight over dinner, he made an incredibly astute observation: "She doesn't care about the welfare or privacy of the veterans in the group. She doesn't want to see herself critiqued online." Wow. Boy did that hit home. Her refusal was all about her ego.
Encouraged: I got the money into my account from the crowdfunding and started the ball rolling. I also got all four of my first choice board members and they are a perfect fit to effectively govern the non-profit. I have started the process of incorporating and have gotten the landing pages for the websites up and running and am incredibly proud of the landing page for Support No Stigma. I still can't believe I have been so fortunate to be surrounded by such good people in my life. Honestly, I think that the love for my family and the good works I do on here and now in forming my non-profit are the only things that have kept me from institutionalization. Especially over this past week.
So there you have it. What a ride, huh? It's all about the timing. Individually, any one of these issues would have been manageable. The fact that timing crammed them all together in a seven day span almost put me under. All I know is I am relieved and grateful that I am still here. A year ago, things would have played out very differently.
Boy was I glad to have off Sunday. I talked in my previous post how the Boston Bombings had really triggered my PTSD. Well, I did what I said I was going to do and I turned off the news.
Too bad it made absolutely no difference whatsoever.
Every day I went to work, people wouldn't stop talking about the latest developments in the bombings. Yippee. Everyone knows I am a veteran and this situation was the first time I wished people didn't know. Everyone wanted my opinion on the situation. Everyone wanted to tell me about it and hear what I thought. People kept on telling me they were afraid it wasn't over - that something was going to happen again, and soon.
Not exactly the type of thing I needed to hear. So, work became trigger after trigger. The only thing that's kept me from hiding in my hole is my love for my family and my advocacy work. The gym has TVs suspended in front of every piece of cardio equipment. Any guesses as to what was on every one of those TVs?
I couldn't escape it until Sunday, my day off. I took a break from things all morning and early afternoon and just spent time with my wife and daughter. We met my sister-in-law and her two Blue Tick Coon Hounds and we went for a walk in the local park. It was really nice just to get away and enjoy a cool spring day. I felt revitalized and came home and got to work on website design for the non-profit.
So what happens now? I need to rethink my strategy for coping with this and not getting triggered at work. I can't keep this up or I am going to exhaust myself. I guess I can talk about it in group therapy this week and see what we come up with.
I don't think I need to recount what happened yesterday. When I heard about it from my father when I got home from work, I had to (and I mean HAD TO) see what was going on.
The descriptions, the blood, first-hand accounts, everything, triggered my memories of stuff that I had seen and been through over in Iraq. The second I knew I was triggered, I slammed shut my computer and I walked away and tried to do stuff that would take my mind off of what had happened up in Boston. I succeeded pretty well and was able to go to bed at a fairly normal hour. Then the nightmares came. They weren't so bad that they woke me up, but it was an endless cycle of suffering and emotional pain. When my alarm went off at 0600, I didn't get out of bed. I barely made it to work and I knew that I was going to be anxious as all hell.
And I was. An hour in, I had to pop an extra anxiety med to keep my self going. Another hour later, another.
Wash, rinse, repeat for five straight hours. I didn't have any more with me and I knew that my anxiety was still getting worse. I gutted it out but told my boss that as soon as the evening shift came in at two, I had to leave. To his credit, he didn't question it. He thanked me for gutting it out today. I think he knew that something was really rattling my cage.
So, I came home and I unwound. I took another pill and ended up passing out in my recliner, only to be woken up when my wife and daughter got home. I still feel triggered, but I am hoping that is something that I can work through with my individual therapist and group therapy tomorrow. I guess we'll see,
This is where I want to do a little explaining. Why was work so hard for me?
Everybody, and I do mean EVERYBODY was talking about it. The customers, the employees, everybody. Everybody had a theory about who did it, why, how, everything. To make matters worse, I came into work and the flags were still at full mast. It just tweaked me that much more. I immediately went to the store manager and asked him if he knew why the flags weren't at half mast. He said he'd look into it. Thankfully, the next opportunity I had to check, they were or I think I might have lost it. All in all, it was one conversation between two customers that I overhead that almost made me blow a gasket:
CustA: You heard about that Boston Shit, right?
CustB: Yeah, that's what happens when you let those dirty Arabs into our country.
CustA: I know, man. They already got a Saudi in lock-up.
CustB: They should have just let that sand-N****R ass bleed.
Yup. This shit brings out the best in people, don't ya think? I almost didn't walk away. All I can say is this:
If you are a veteran who has been triggered by this bombing, don't watch the fucking news! Just leave well enough alone. If you don't trust yourself not to, ask your family or spouse for support in this. It makes things easier when I am not constantly re-triggering myself. It's not that I don't care, it's that I care to much and the feeling of helplessness, not being able to do anything to help kills me. I know you know what I mean.
So there it is. Avoid triggers and avoid people you know that are ignorant and hateful. Now I am calling it a day and I am going to spend time with my wife and daughter who I suddenly find even more precious than I did yesterday.
OK, so what's the deal? This week started off with me being a huge bundle of anger and anxiety. I was anxious about my psoriasis, work, my fundraiser. My anger was resurgent, causing me to have to use a lot of energy to keep it in check. My psoriasis was so bad that I had to be removed from handling food. My fundraiser was only half way to the minimum I needed and there were only seven days left.
Things were so off course that I couldn't remember to do even the little things that had become habit over the course of the previous months (washing dishes, drying the shower, folding my laundry). I caught myself thinking on Tuesday. If this is the reward I get for trying, why should I bother? I was as disheartened by my situation as I can remember being, compounded by the fact that I was seriously working to turn the corner.
Then I got REALLY angry. I mean blind rage, hatred filled, anger. Who was it directed at? Myself. It was like the part of me that has kept me going all this time had seen and heard enough. The thoughts that went through my head weren't pretty but they sure as hell snapped me out of it. I was able to channel that anger and regain my motivation, albeit with a little bit of a darker edge.
Then Wednesday came.
My fundraiser had a banner day and it now sits at $700 over the minimum I needed to start my non-profit. My psoriasis flare-up receded back to it's normal levels in the span of 12 hours, without explanation.
And Then Thursday:
The dermatologist decided to put me on Enbrel. I start this coming week. I initially expressed concern about how the injections would compromise my immune system but he told me that it suppresses the immune system in a targeted way that can leave people open to increased risk for infection, but if you don't have a history of chronic infections, it shouldn't be an issue. I thought about it and about all of the people I know who have seen dramatic results. Hey no harm no foul, right? Might as well and see what happens. If it doesn't work as advertised, I just cycle off of it, no harm done. The kicker: this ridiculously expensive regimen won't cost me a cent because my psoriasis didn't manifest until after starting military service and tearing up my knees and elbows in basic. Since it is service-connected, it's covered.
So here I sit. I talked to work and they said I was good to return to my old job and they recommended working with my area manager to create a contingency for future flare-ups. Again, going out of their way to accommodate my service-connected disabilities. And I'm still angry.
What. The. Hell.
Granted I recognize that my anger actually served a purpose this week and pushed me through a difficult spell, but I'm good now. Can it please go the fuck away? It is exhausting and I don't have time to be a zombified husband and father. If anyone has any ideas, I'm all ears.
When the week started, I thought it was going to be a good week. Overall, it was. I went to the gym a few times and started getting myself used to the feeling, did cardio on the nice weather days toward the end of the week.
Wee little problem: The more active I became, the more my anger flared back to life.
Needless to say, this worries me greatly. I didn't read about that in the small print when I signed on to get myself back into shape and improve my overall health. It just doesn't make any sense. The harder I worked out, the stronger the anger became. I am wondering if that was one of the underlying reasons I was putting off getting back into shape. It really makes me curious if I knew, on some level, that the exercise and weight training was going to bring back certain things that I wanted to leave behind.
I guess it's time to work through it. I am going to the gym a little later today and I am going to push myself to physical exhaustion to see if I can find an end to the anger or if it just makes me tired. I am hoping that I finally feel like I can safely let the anger out now that I have a constructive outlet. The problem becomes containing the anger when I am not at the gym. I have to be able to maintain my stability at work and at home or this is not going to work. It's not going to be an easy balance to find, but they offer Tai Chi at the gym as well and I am hoping that I can use the forms and breathing to channel my energies more effectively and coherently, rather than wanting to lash out at whatever's closest.
Some of my downtime this past week, I have been reading the book I was asked to review and I found myself unable to really devote my attention to it. My mind kept on wandering back to all of the things that were making my anger flare up and what I could do to contain it:
It seems like I have more to work on than I thought. It feels a little overwhelming, honestly. So...
I'm starting with the gym and making sure I get the constructive outlet for my anger worked into my daily routine. I don't see much of any other options right now. So, off to the gym I go. Maybe I'll find some more answers in the peaceful emptiness of cardio.
I knew I had been anxious about my first group therapy session with the new doc. I just didn't realize how anxious I really was. The two nights before the session, I didn't really sleep much. I was a bit of a hot mess. I arrived early as I always do. It gives me a few minutes by myself in the room to collect my thoughts.
Then the doc and the other veterans showed up and things took a turn for the worse for me. It became very clear early on that doc was going to work out. She's competent and runs the group well. She involves everyone.and does a good job directing conversation. The new doc was never the issue.
I kept on looking up and expecting to see Doc Casagrande. I kept on looking over the where he had habitually set up shop in the corner of the room. He wasn't there and it hurt, knowing he would never be there again. It's one thing to grieve on your own timetable. This was not. I had to force myself to move on and pay attention to what was happening in group. I didn't want to yet but I wasn't given a choice. It hurt like hell and I suffered for it all last night and today.
I kept on thinking, if grieving was this hard for my doctor, what the hell was going to happen to me if something ever happened to my wife or daughter? The fear intense, palpable. I have never been so scared of losing something in my life and I didn't know how to handle it. I ended up rocking and holding my head like someone kicked me in the groin. It wasn't continuous. Every time I would catch myself after a little bit and force myself to stop. It wouldn't take long before I was rocking again, unaware that I was doing it.
When I woke up this morning, my emotions were still raw and I was anxious as hell about everything and nothing, all at the same time. I kept on taking doses of my anxiety medication until it made a difference. Then, off to work I went, hoping and praying that I could make it through the day without verbally decapitating someone.
Somehow, I have made it through and it is something I am very grateful for. My wife has been worried sick about me and was concerned that I was starting to regress back into a hole. While I haven't regressed, I had to explain to her that what I was mostly feeling was grief exacerbated by my PTSD. I was just grieving. That's all. It just goes to show that, while I have gotten closure on Doc's death, being reminded of that loss can still be profound and emotionally distressing. I haven't felt his loss as keenly at any other time. It is still difficult to explain to you the depth of the loss I feel and it has overwhelmed me for the past two days. Now I have to work out all of the jumbled mess that is my thoughts and see if there's anything else or any revelations hiding in the murk.
This past Monday, I met with my individual therapist and we talked about how I feel trapped by my current situation: I am not able to make a job change easily because my family depends on my income and health insurance. I can't get to the gym consistently because my work schedule is erratic and I come home from work emotionally spent. I don't have the time I would like to pursue my advocacy endeavors because of my work schedule making it nearly impossible to meet with my colleagues. It has made me feel more and more depressed and more and more demotivated.
When I explained all of this to my therapist, she understood how this could adversely affect me but brought up one point that stuck with me and made me think: It is your choice, whether you realize it or not, to stay in that job. It is also your choice to put all of your emotional energy into your work even though you don't get paid to be emotionally invested in it. She asked me, "What do you think would happen if you chose to save that emotional energy for the other things in your life?"
Why is it the simple things that always seem to be the hardest to change? Being emotionally invested in my work has been ingrained in my since childhood. I told my therapist that and she came back with, "No, that's your job. Advocacy is your work. Put your emotional energy into that and I bet you will feel better and have more energy to find a way to get to the gym and to be there for your family".
It's a foreign idea, but makes a weird kind of sense to me. She followed this up by explaining to me that I have the ability to choose what I devote my energy to. I can't control the fact that I am currently unable to change jobs because of my financial responsibilities. What I CAN control is who benefits from my energies the most - my job or my advocacy for veterans. I have felt trapped because couldn't see any way to take control of the situation and it was causing me to become extremely depressed and unable to see any positive outcomes.
So now comes the hard part. I have to change my behavior - a behavior that has been an integral part of my professional identity since I first started working. I have to learn how to redefine what my work is so that I can devote my emotional energy to my advocacy, my health, and my family. It is definitely not going to be easy but it will be worth the effort.
As I continue my life with PTSD, I will share my challenges and discoveries on this blog.