Sunday, 1 June 2008

Catching you up (4)

(Selections from June, 2008)

I'm beginning to see what finely sharpened swords 'normalcy' and 'sanity' are. As the weights of depression lift, there's nothing to slow my mind down, and I can't tell what I like less -- questioning what I have done and am doing, or questioning why I am here at all...

The best part of my parents' visit was when they were with someone else.

I wish I could be more ashamed about that, but what I'm really ashamed is how I have to lie when I tell people how my holiday was. I hate gritting my teeth and stomaching another 'oh bless, I'm sure they loved it and had fun' ...knowing full well that I'm damned if I do tell the truth (people can't handle the truth) and I'm damned if I don't (I can't handle lying). What's ironic is that I'm only in this situation now because I've never been able to tell people the truth about my experiences, though no one has actually ever asked.

As awful as the trip was for me, it was a superb learning experience. Now having tools to recognise what's going on with me emotionally, I can see my triggers more clearly. When my parents started fighting, I started shutting down. Once in lockdown mode (utterly numb), it was painfully hard to pay attention to them (anyone really) and respond to them positively. My body just wanted Fight or Flight, and this isn't said for poetics.

It was incredibly difficult to get through it. I did everything I could, waiting for the adrenaline and cortisol to wear off, but, as expected, the effects still haven't fully gone. And I'm left battling the physical illness that comes as a wave of intense stress passes and left fighting the realisation that it will be a long road to see my parents as parents. Worse yet, because I have taken the lead sheet of ignorance off my own mother's eyes, she's falling into depression. Is depression better than ignorance? Will she stop trying to be a token mother now that she's realised she never was a real one?

Moreover, why is it still my responsibility to keep everything and everyone together? Why do I feel culpable for my parents' decisions?

I had my first 'wakening' years ago near the equator. At the time I thought it had everything to do with the equator, but really it had more to do with the distance between me and everything I've learned to fear. There is nothing in a rainforest I feared as much as home, truly. So for the first time in a long time, I calmed down.

Depression or Mania, none of it is ever 'just in the mind' and I defy anyone who says so. My body transformed this past week; my whole body reacts to my triggers. My whole body fights and shuts down, in a myriad of ways.

So, I have post-traumatic stress disorder. I have had PTSD for almost a decade now, untreated. I have no memories of my parents as parents. I have no memories of intimacy and trust. I have no memories of being anything but a rational, sometimes ignorant, but mostly capable adult, who is only now recognising and respecting what are clear disabilities. Moreover, I have memories laced with fear and loss and anger. I have my trauma and I have me.

In documenting this discovery, it's clear I need one thing before I start treatment.

I need to grieve.

----

My 'lifespan' in a certain place with certain people is about 1-2 years, give or take some stressful episodes. It's easy to say I just have wanderlust, but in examining my emotions it's clear that the way my body stores memories is dysfunctional. I have the growing need to stop something because the accumulated memories become washed in fear, and no one likes flashbacks that involve their current manager.

The anxiety builds, and surely there is a threshold. How much can I tolerate? I am starting to walk on my toes again, wondering how long it will be before I hit another stressful episode and want to run again...

This is why I am seeking treatment. I am tired of running. There is something wrong inside me that I want to fix. I want to be able to store my memories without pain. I want to be able to face conflicts and stressful situations without worrying that these relationships and roles will be scarred forever with flashbacks and anxiety.

----

The lady who promised to find out where I was on the waiting list and to confirm that the therapist had received my referral? She must not exist anymore, because I haven't heard a word. It's been two weeks since then, at least, so I called the team again and spoke to a very tired woman who had no recollection of my situation and couldn't see a referral anywhere. She explained to me, patient but tired, that the waiting list was Very Long, as though it were reason enough for them not to assure me I even was on it at all.

Which is all, in the end, I really want confirmation of, since every time I call to check I don't seem to be.

So I'm waiting, again, for someone to confirm with me. This lesson in patience and trust is almost therapy in itself.

----

Still playing the complacent waiting game.

My moods and sleep have been the most stable since I started, but I'm emotionally-aware enough to recognise the signs of a stressed body. The effects of adrenaline can take days to go away, allowing the body to be hyperreactive and sensitive well beyond what is cognitively required.

It's all well and good to be stable when everything is going well, but I'd like to be stable when the bottom drops out. I'd like to be stable as I can during PMS, and I'd like to get in a single conflict without feeling like everything in my life is ripped out from under me. I still haven't written my goals on the board. Still haven't listed the things that bring me out of melancholy and give me purpose and drive. Still haven't figured out what brings the stress down.

But I have been taking my vitamins and supplements. I've been more or less active. I've kept up a reasonably healthy pace at work. And I'm much more intimate/open with key other people. Truthfully, without a test, you would have no idea how much maintenance goes into being me.

I expect to be triaged at the end of July by the mental health team, making it a full four and a half months since I first was referred. I'm not even sure I'll even believe in my diagnosis by the time I see a professional, as I have been so successfully managing it. I'm worried that by the time I actually do meet someone, we won't connect, I won't open up, and/or I'll be so convincing that I can manage just fine on my own.

Sometimes, charisma is damaging.

My problem is that I exist on the extremes. The PTSD is derived from disregulation in the brain. While it may not be possible to change my immediate physical and emotional reactions without specialised therapy (CBT, etc), it is possible to rely on my own cognition to control the effect these emotions have on me. Similarly, it is great to have such a keen empathy, but I need to learn how not to feel responsible for everyone's feelings.

There is a state beyond numbness that doesn't leave me paralysed with emotions, and we'll find it.

How I reacted to some of my traumas is a black box to me still. Why did I internalise everything? Why didn't I point fingers when I had the chance? Is it really just 'pride' or is there something more complex at work? Some clue to my strengths and weaknesses? Some idea of my natural level of emotional intelligence?

It's hard to piece out what might be 'me' when those years are so well intermingled with grief. I have to think in terms of what a grieving child would do. Who a grieving child might be.

And I have to be diligent, not complacent.

Read on the NHS Choices Blog.

Thursday, 1 May 2008

Catching you up (3)

(Selections from May, 2008)

Despite reassuring me excessively that she would definitely send my referral letter before she left the office (for another job) that week, my GP didn't send it.

The disappointment leaks in me like a heavy treacle syrup.

It was hard for me to seek diagnosis and treatment for my PTSD / mental health. Now it's my responsibility to make sure I don't get lost in the system? I've been lost in the system for decades; it's a sore subject for me. It's hard accepting that the one person you tried trusting with this part of you ended up failing you, too. I don't know where the strength to keep pushing for help despite these disappointments is coming from, but I'm characteristically numb.

--

I don't understand what I'm going through.

I just left a place with major triggers for my PTSD, but in returning home I feel more empty. It seems that as my life becomes more stable, my own mind is letting go. Two serious emotional and visual hallucinations (delirium) in the past few months plus constant dreams (nightmares?) filled with anxiety … plus feeling like I'm dying, literally dying, every time I wake up now? I never felt like I was dying before, when I was more sick, when I was constantly stressed, and when I was fighting everything.

I can see how people who feel like this all the time become suicidal; it's an awful thing to feel. But I know it will go away, no matter my increasing fear that someday it won't (and what would I do then?).

--

The administrator for the mental health team called me today to let me know she's still chasing up the counsellor for my referral letter, does not know my place on the waiting list but has not forgotten me. She's been extraordinarily kind and thoughtful, and I was happy to express gratitude to her for it. It has helped to quell some of my anxiety and fears and distrust towards the team.

I've been reading up on PTSD and listening to Naked Scientist. Explained the details of the delirium to my husband and remain constantly amazed at his steadfastedness. The stress must be loosening its reigns, because steadily my cycle continues.

No, addendum. I amaze myself. I continuously push for a better life, inside and out. I seek help. I achieve wellness, no matter the setback. I have hope. Any doctor or therapist should be lucky to work with someone like me, because I'm trying and because I care.

--

This is the best I've felt in weeks. My moods have been rapidly oscillating between agitated depression and melancholic depression, but I haven't felt remotely manic in a while. This is, all things considered, a very good thing. I've been self-managing depression for a very long time now; when my mood approaches mania, I feel less prepared for the consequences.

It's times like these that I realise quite seriously how much I 'settle' for day-to-day with my moods. It's so easy to feel something and attribute it to whatever has happened that day. But my mood is rarely, if ever, reactive. I need to be even more aware of my feelings and what they mean in context of my choices.

Learning more about PTSD, step by step, brings its own grief, but that is how therapy works, uncovering small patches of a larger picture, until we can see more clearly who we are.

I still don't know where I am on the waiting list, and I still don't have my referral letter. But I am taking my vitamins and supplements regularly, my house is reasonably tidy, I've managed my workload with extraordinary efficiency, and this is the first holiday I've had in years that hasn't begun with a headache and a tense knot in my stomach. That must be huge, because this holiday is spent entertaining my parents, and they are my biggest trigger.

But these are challenges I can handle; I've not gotten here without handling them, and each time gets easier.

Read on the NHS Choices blog.

Tuesday, 1 April 2008

Catching you up (2)

(Selections from April, 2008)

I'm a baby at all of this, so please don't be offended at anything I say. I don't know the right words and everyday I learn something about myself or the world that makes me question what 'normal' is.

Post-traumatic Stress Disorder (PTSD) took years for me to really accept it enough to get help for it, and even then it took me breaking down in tears when the doctor questioned my stress levels for it to come out in the open. I spent weeks deliberating how to approach a doctor about it; how to start a conversation about my trauma that barely even fit the DSM... to the point of writing out a whole document, weeks to fill a piece of paper, finally realizing the extent that it has been affecting my life, my whole entire life.

But I didn't have that paper with me, in that doctor's appt. And I still couldn't say a word about my trauma. I didn't need to say a word; just the mere possibility I might have to talk about it with someone, some stranger, sent me into tears, made me look away, gave me piercing headaches, and increasing stomach pains. I remember that day. Though we said very little, I must've made quite the spectacle. Something wasn't right. Something more than PTSD. She didn't say it out loud, but the implication was clear. I disagreed.

It's utterly terrifying to me to think i honestly could be bipolar. I really am not sure I'm ready to acknowledge anything more serious than PTSD (esp. something that requires medications). But now that I'm away from so many triggers, and all of these new and scary aspects of me come to light...

Reading those personal stories on the Black Dog site hit it home. Some of the accounts were just so similar to how I feel and think and live. All of these aspects of my life that I've accepted as part of me and coped with and learned from ...all of these thoughts and emotions I've managed... it's really hard to believe it isn't normal. That this isn't what everyone feels, all of the time. That everyone else isn't storm-chasing for most of their lives. It's a shock, pure and simple. I had an idea of what mental illness was, and it wasn't me. I'm thoughtful and sad and lazy, not depressed. I'm energetic and determined, not manic. I'm good at anticipating people's opinions and empathic, not paranoid and hypersensitive. I'm creative, not delusioned. I was strong. I am strong. But people come in all varieties of strong, even people with bipolar.
----
It's twenty years since I first moved home: the easiest trigger to name. I could build the scene from scratch, looking at the white board with red smelly marks. Pros and Cons. My brother, our little Action Man, sat on the edge of the bed looking at my father for cues of what to feel. He didn't understand; he couldn't possibly know. I folded my arms, slender and pale. The list meant nothing to me. My eyes welled; my heart beat so fast. NO. I shouted, filling with anger. My mind raced: NO NO NO. My father became a stranger, stealing me away.

I ran into the bathroom and locked the door, buried in the yellow lights I would learn to hate so much.

Nearly 10 years old, and that is one of my first real memories of my father. Life became much more complicated after that day, and it is easy to ignore what came before it. But those years also hold the key to why leaving home was so hard in the first place. I wish I could remember more of my parents then. It's not my memory; I've always had an impeccably detailed, visually rich account of events, and the first decade of my life is no different. In fact, owing to the idealization of that childhood that trailed my 10 year old self through puberty, I remember more than I should.

I remember my grandmother, my aunts, and their houses. I remember the woods, every inch of the streets. I flew there again and again, every night, chasing happiness. I remember each and every name of all the friends I ever had; my cousins and my neighbors. I remember their faces, frozen as they were, at the end of the decade. I remember schoolwork, learning mathematics, and my advanced reading tutor. I, most of all, don't remember them. My parents.

It's a notable absence.

My father was young when I was born, barely finished with college. There are rumours he had a problem with alcohol in our early years. He was a stranger to me, always off on business. My mother, perhaps she was depressed or bewildered with her first child, having been a unplanned, later pregnancy herself. She was always quick to tell us she never liked children. Of course not us, though, of course she loved us, she was less quick to add. I don't remember her either. She worked, possibly harder than my dad, and so we were left with other people to make memories with.

And then the stomach aches came. I remember sitting at the table staring at my plate in silence, my insides knotted and head pounding. "Maybe if you ate your dinner, your stomach wouldn't hurt." Tinged with frustration, my parents left the table. I spent a lot of dinners sitting in silence. I stopped drinking milk, blaming the stomach aches on lactose intolerance. I still don't drink milk. The stomach aches stopped 8 years later, at the approximate time I stopped eating with my parents. Why does 9 years old seem impossibly young to be researching reasons for stomach aches? I'm still that 9 year old. I'm still researching the reasons for stomach aches.

I'm a solution person.

My father, he's a problem person. As in, he had a real knack for finding problems with everything. His problem: I didn't respect him. He points clearly at the tree diagram illustrating the theoretical principles of a parent-child relationship. My solution: Earn it. Smack. His solutions, albeit rare, tended to shut me up faster, so eventually I just shut up entirely. And so my clearest memory of my young father was watching him switch, in the matter of seconds, from treating his 10 year old daughter like a business colleague to pushing her across the room.

In the peripheral vision of my memories, I can see the pain and frustration in their eyes. They knew full well what a strange creature I was, the heart and needs of a child carrying the weight of an adult mind. I was a brilliant, acutely aware little girl, and it would have been difficult for any adult to know how to talk to me. But the very last thing a child ever needs is words. My own poor parents were children themselves when it came to knowing and loving me. And so I've become the self-made dam in this inherited waterfall of frail attachment, virtually neglected and then stolen away by strangers called Mum and Dad.

----
Apparently, my childhood self got a teacher fired.

I don't even remember what she said that angered everyone. I certainly didn't complain about anything. But a classmate told their mum, who was shocked enough to ask my mum how I was doing, who of course said fine, why do you ask, and then she heard. And that's the story of the only time my parents acted on someone abusing me, and I didn't even know, since they never talked to me about what I experienced or how I felt.

I can guess why I didn't remember. By that point I'd already experienced loads of abuse. What was one single attack from a teacher? Normal, I suppose. Nothing out of ordinary, anyway. But it was enough to make my classmates blink, even the ones that were happy to abuse me themselves, and enough to make one of them tell their mother. Enough to make that mother think about me -- probably the most anyone ever did.

Maybe my memory of what the teacher said will make its debut someday.

My mum reminded me that my parents went to a parenting class a year or so after that, to give them some skills in motivating me to do my homework or the dishes on command. They met with my guidance counselor. She screened me as well. The verdict? I had sufficient coping mechanisms and nobody needed to worry. My mom doesn't remember what the coping mechanisms were. None of them discussed it with me. I do remember my meetings in the counselor's small, windowless room. She leafed through papers and glanced at me intently. I was terrified of what I'd be blamed for, and steeled myself for the interrogation. I suppose I can add 'consummate actress' to my ever-growing list of talents. I'm starting to believe that list is my coping mechanism.

I'd like to tear it up and start over.

I got confirmation on what I was like as a baby. It's worse that I thought. I was perfectly independent. Never cared who was around and never needed anyone. Never complained. It all rolled off my mum's tongue with a happy grin. I blinked my shock away. She really, even now, has no idea. Not a single clue that none of that was normal, just a contentment that she had such an easy, brilliant baby who never needed a thing. I've not had a single positive attachment in my entire childhood. Might as well etch a personality disorder on my face.

Did you know that one of the clues of an attachment disorder is a charming child?

I've heard these disorders described as a disability. Have I been disabled my entire life? I witness my small cousins becoming embroiled in the same abuse and misguided neglect, all of that creativity, sensitivity wasting away, and I can't help but feel useless again. They are one in millions growing more 'disabled' everyday.
I've told the third person about my probable diagnosis of PTSD. First my husband, second my manager, and third my mother. It came out the only way it could: while I was driving. Completely distracted and blessedly protected from looking her in the eye, we casually discussed the obvious lineage of PTSD in our family and broached, for the first time in our lives, the fact that we are strangers. I didn't discuss my trauma, though she asked.

I'm not sure I ever will, with her.


Read on the NHS Choices blog.

Saturday, 1 March 2008

Catching you up (1)

(Written March 2008)      


I've spent most of my life trying to piece together the puzzle that is me -- everything from introspection to formal education to academic research. I’ve never been sick enough to warrant hospitalization. Never been depressed enough to consider suicide. Never been paranoid to the point where I couldn’t leave the house. Never been anxious enough that I couldn’t breathe. Never been angry enough to hurt others. Never been shy or awkward enough to be antisocial. If mental well-being were simply a game of hide and seek, I would be world champion, training since I was 10 years old.

So I must have been simply.. unlucky.

It’s a terrifying project, to look back, and refrain from thinking that it could have gone differently. My life has been a series of unfortunate events, and I feel as though I slipped through the cracks of human reality as a 10 year old girl. I want to shake every adult that passed through my life and ask them why they didn’t help me. I want to tell them, each one, “that girl needs your help” .. her vocabulary is better than yours, but no 10 year old should have to rationalize long-term abuse on her own. She is a good, smart girl, reading and discussing modern cancer research with you, but she hasn’t learned a single thing about love. And her trust in you is slipping, slipping away.

I want to yell back at my father. No, scratch that, my father’s father. Or maybe his father, whichever father started the tradition, whichever family couldn’t cope and passed on the violence and stress to their children. I want them to seek therapy, so I wouldn’t have to, now.

It would have been okay. I could have been okay, if it were just my dad. If my mom were more confident, if I hadn’t been forced to move and start the grieving process anew in several schools. I would’ve been fine, maybe just unlucky, except my peers passed their own anger on me, too, and suddenly the only safe place was the library.

Would so many years be anything but empty, if I had just broken down, once? If I had been crazy enough, violent enough, angry enough, depressed enough, once? How is it possible that I made it to my late twenties, married with a successful career, and I still feel the same 10 year old girl, torn between innocence and disbelief?

This is me breaking the ice, and in my case it’s pretty thick. I never said a word about any of my trauma. Not a single thing, not to anyone, and it gets harder everyday, especially the good days, because all of us know, we just want to move on. But I can’t move on, while I’m still terrified of passing IT on, like my father passed IT on, my teachers and my peers.


Read on the NHS Choices blog.