Thursday, January 26, 2012

A Helpful Article About PTSD

The Brain, Brain Chemistry, and PTSD W.E.Krill, Jr. M.S.P.

PTSD is all about brain chemistry and what happens to the brain during and immediately after the critical, traumatic incident. Essentially, the chemicals that flood the brain during the trauma do so in order to help the person to survive the event, either by running away, or fighting furiously. A third option, to submit to the trauma also has brain chemistry implications. In some individuals, once the brain goes through this chemical ‘rewiring’ to survive the trauma, the wiring stays that way.
When a person has experienced a traumatic event, and depending on their unique brain chemistry, they may or may not have after effects of PTSD symptoms and behavioral signs. This means that two people can experience the same trauma, and one may come out with PTSD, and the other will not. Science may be getting close to predicting who may and who may not develop symptoms, since recent research and study in this area is gaining more information on just how the brain and brain chemicals are involved, and how the process that creates symptoms works
The parts of the brain that are most involved in PTSD are the amygdala, hippocampus, medial front cortex, thalamus, hypothalamus and the hypothalamic-pituitary-adrenal axis. Along with these, chemicals in the brain such as noradreneline, dopamine, serotonin, the opiod systems, insulin, and cortisol all play complex roles in the PTSD symptom producing process. This complexity is why there has not yet been developed an effective medication to help those who suffer from PTSD to gain relief from all of their symptoms.

Recent research shows that chronic stress of the traumatic type may shrink the hippocampus, and actually kill neurons there, as well as drastically slow down the growth of new neurons. In addition to this startling finding, the ‘wiring’ of the brain’s neurochemical systems become over sensitized, and this results in the symptoms commonly seen in PTSD. The complex chemical-neurological reactivity affects parts of the brain that are all about learning, memory, and fear conditioning. This is why child PTSD victims (as well as adults), for example, may have difficulty with learning as easily after the trauma. They also may have fragmented memories of the trauma, or even new events, as well as problems recalling facts. They may even have dissociative memory problems, meaning they have gaps of moments or even days in their memory

One important chemical that is being debated in research right now is cortisol. The debate is over its role in producing symptoms in those with PTSD, as the role is not yet fully understood. Cortisol is a hormone that is produced in the adrenal gland. It is sometimes called the ‘stress hormone’ because it tends to increase blood pressure, blood sugar levels, and has an immunosupressive effect. For people who are not PTSD, it actually helps restore homeostasis (calmness) after stress. But in some people who have PTSD, there seems to be a lower base level of cortisol production to begin with, and when cortisol is released, their bodies have a hyper-sensitive reaction to it; that is, the cortisol does not work in them like people without PTSD

When a person is under chronic stress, such as in battle, or a child who is experiencing serial abuse, or a victim of a hostage situation, there is a prolonged cortisol secretion, that over time, may drastically alter what is considered ‘normal’ cortisol levels. In the average person, cortisol levels are highest in the morning, and lowest a few hours after sleep begins. These facts have broad reaching implications regarding behaviors like sleep, getting a PTSD child up and out the door for school, or being calm enough or alert enough to carry out every day tasks


Since cortisol acts to increase the blood sugar level, insulin production may increase as well, and go into an overdrive situation along with the other chemicals rushing into the PTSD victim’s body. The extra insulin can then crash the blood sugar, signaling the hypothalamus that glucose (the brain’s only source of energy) is being starved from the brain, which in turn triggers a message to the adrenal glands to increase adrenaline, and the cycle of high stress symptoms begins again. The whole bio-chemical process, once begun, travels at lightening speed.

There may be in fact substantial differences of the chemical reactivity between people who have PTSD or the sources of the PTSD symptoms, as there may also be specific brain chemicals that effect specific symptoms from the PTSD symptom cluster. Though there is no research to directly support the supposition that the more often and longer that this bio-chemical process cycles and repeats the more static and less treatable PTSD becomes, the development of co-morbid mental health conditions and persistence of PTSD symptoms over time is well documented

The good news is that research on how PTSD works in the brain is moving forward, there is hope that the rewired bio-chemical system can be rewired one more time through therapy to help people regain the life they had before their traumatic event.

Tuesday, November 8, 2011

Searching For the Reason I feel so SAD

I met with my psychiatrist last Thursday and told him, again, that I have Seasonal Affective Disorder.   He's not legalistic about it, but he's of the opinion that SAD is indicative of Bi Polar Disorder.  My friend M suggested I Google:  "Is Seasonal Affective Disorder a form of Bi Polar Disorder?"  So, I'm going to do that now...

I found nothing definitive.  To sum up what the experts and bloggers on the net are saying, most people with SAD have some form of depressive illness OTHER than SAD.  However, there is a difference between seasonal bi polar and SAD.  Two different things.

The reason this matters is my doctor wants to prescribe Lamictal--a mood stable-izer.  But I've read that SAD is due to lack of seratonin, and SSRI's are what help that.  Shouldn't I just up my dose of Celexa?

Or should I be open to the fact that I need to change my thinking?  I AM a workaholic, after all.  And I am recovering from trauma in ACA.

As I moped around today, picking up dog doo and wondering what other kind of work I could find to distract me from my sadness, it occurred to me:

"What if these symptoms are psychological?  What if  you are expecting too much of yourself and your environment?  What would "S" do in your situation?"

"S" is a neighbor of mine.  She is attractive and petite, the mother of a six year old girl and a medical professional.  She is extroverted and rather a party girl.  In other words, she is nothing like me.  But  I use her as a role model because she is unconcerned with perfection.  Her house is often a mess.  Her leather Coach Hobo has a stain on it.  Her car is a mess.  Her yard is pretty scraggly.  But she has a lot of fun.  She goes to parties and posts smiling, laughing pictures of herself on Facebook, and wears fashionable clothes and lots of makeup (compared to me, that is.  She never looks overdone or tacky.)


I sit in my equally lovely, equally imperfect home and think striving thoughts.  "How can I make this room look better (with no money and no energy, btw,) and how can I make the garden perfect and maintenance free?"  And  "How can I buy new clothes I can afford without leaving the house," (because I have no energy to shop.) In the meantime, I don't enjoy the birds at the feeder or the lone lavender plant beginning to bloom or the roses coming back or my dog and cats lying in the sun. Or the fact that I do have a few rather nice outfits in navy blue that help me feel pulled together.

When I'm honest, I have this undercurrent of "I'm going to get caught being lazy and mom or dad are going to call me "fat" and "lazy" and I'm going to get in trouble,"  within me at all times. My parents never could abide imperfection in their surroundings or in me.  Like them,  I close down a part of my psyche--the part that accepts and really sees the world as it is.  I shut down my ability to see the beauty that is mine.  I over-focus on all the work that must be done in order to get my life to an "acceptable" state.

When I consider this internal phenomenon, I venture that my depression and tension are shields from the fear of being caught and punished for being imperfect.  While I feel tired, lazy and unmotivated, I am not relaxed.  My  muscles are ready to ward off blows.  Are these muscle MEMORIES?  Is it the horror of my childhood of beatings and shouting episodes coming back to be felt and released?

If so, I don't need another medication.  I need therapy and more meetings and more support from others who have mood disorders with a traumatic component.  Discernment is hard, but it is an important element for me.  The correct "diagnoses" is more likely to result in appropriate treatment.  Don't you think?

Friday, September 23, 2011

My husband had a counseling appointment tonight.  He came home all cryptic and quiet, like he had this immense secret--and he knew that I knew he had this secret--and he wasn't gonna tell.  No way.  No how.


I'm glad this therapist has awakened a sense of the privileged and personal within him.  And I guess I'd be giddy too if I suddenly discovered untold wealth within my being.  I've had moments like that and I like to be left alone to enjoy them.  That's why I am in my dark, closeted office, trying to muster up my own sense of secretive sacredness.  


Its lonely when your lover meets himself, or God.  You just know "there's someone else," that you are no longer the tree he sits under for shade and refreshment and wisdom.  The feeling is not unlike his having an affair, I would imagine, though I am less threatened by this "other."  But, should I be?


Who is my "other"?  Am I giving sufficient attention to the imaginative, childlike, wonder-ful, awesome aspects of my life?  


I am in the midst of writing a book.  I spend two to three hours thinking, fiddling...sculpting this collection of essays and ideas into an outline.  I am frustrated at every turn.  I have no muse in this work.  Writing is easy.  It's the fiddling, the shaping, the setting that drives me crazy.  This is why I have never attempted a book before.  Articles and poems are easy.  You can see them all laid out there on a page or two or three.  But 300 pages worth of words?  How can I herd all that information into a neat little pile that someone would want to read cover to cover?


That part of my brain that sits outside and looks at birds or leaves or pine cones or insects is inside, out of the breezes so they don't blow my pages away.  "Concentrate" my inner sculptor whispers to the child writer player, who would rather collect new ideas than try to mold existing ones into something useful.


My spirituality is wrapped up in this process, like it or not.  I don't know myself until I write my thoughts down.  And when I do that, I see God, too.  Not a religious"God" who forces me to stand on my tip toes,striving and reaching.   This is a cosmic creator God who appears, then disappears, like a fairy, leaving a trail of sparkly dust and a whiff of other-worldiness.  


I saw him today when news broke about neutrinos that travel faster than the speed of light.  I saw him when I watched What the Bleep Do We Know and learned about quantum physics for the first time.  I see him when I feel my feelings and inhabit my own life.  Why don't I do that more often?


Indeed, I am being called to my own sacred-secret-privileged-personal life.  Though I've always had one, it needs to change now.  I'm not sure what to do...but that is part of the fun.  The path is more philosophical and scientific than I would have predicted in my youth, but I suspect I will end up in a similar place.

Thursday, September 15, 2011

The Pause that Refreshes


Work work work work.  Give give give give.  Clean clean clean.  Cook.  Feed animals.  Write, even.  


I've long known I'm a workaholic.  And thought ACA addresses my addiction by rooting it out from the depths of my childhood, sometimes I need to be reminded that I do, indeed have an addiction.


Never mind that for now, though.  I am writing to record the insights I got from taking a pause before diving into my day.  (Well, sort of.  The cat diarrhea all over the living room had to be addressed--before breakfast, even.)


As one who struggles with religion and Higher Power time (prayer and meditation...even those words trigger me,) I never associated my morning pause to read affirming books, plan my day, and drink tea as a spiritual thing.  For the past few days, I haven't even done it.  No wonder I've been so squirrelly!  


In my liberal, legalistic spiritual formation, prayer was either a rigid duty to be performed no matter how you "felt," or a touchy-feely meditative sitting that I could neither touch nor feel.  I failed at anything the least bit esoteric.  I called myself "Yoga's Problem Child" since I was such a bane to my first Yoga teacher.  Pilates is more my style.


But reading books (not necessarily "spiritual" ones,) that tell me its OK to be an introvert, or feel my feelings, or write what I know, or be audacious about selling my writing...could that not be my "Higher Power time?"  I mean, it does refresh me and set me on a realistic course for the day.  It helps me set my priorities so I'm not trying to get "everything" done, it helps me feel better about being "me" and not trying to be like "everybody else" out there working in an office.  I'm me and is OK to be me.  So I will choose to associate these wonderful times with my Higher Power.  


No more "prayer and meditation" for me.  Instead, I will take HP Time...the pause that refreshes.

Sunday, September 11, 2011

Heeding the Warnings

For about a month now, I have been feeling impatient, stressed, burdened, and pressured.  Life, for sure, has its ups and downs, but I can see that an extra burden I'm carrying is becoming the proverbial straw that will break my back.  It is the  ACA meeting I started.


The endeavor has been a source of great satisfaction because I've seen a handful of people come and get hope from ACA.  When you are "in charge" of one of its meetings, you have different eyes.  You are not just a fellow sufferer.  You are a fellow sufferer offering a medicine.  When someone takes that medicine and his/her symptoms improve, well, that just feels amazing.  


But I've been in the "in charge role" for almost half a year now.  I've done my tour of duty.  My heart would love to serve another tour, but I am not equipped for that sort of leadership, long term.


I have learned there are different types of leadership.  I have always felt I was a good leader because I have a commanding presence and an ability to communicate clearly.  I am also compassionate and I possess a desire to help others.  But those gifts are not the same gifts needed to be  a thriving group facilitator/leader.  Facilitating takes tact, and a detached personality and a natural affability and sense of humor.  These, I lack.


A facilitator must organize or delegate with relish.  They must love being sought out by several people at once and putting out little fires.  It's not complicated.  It's not difficult.  But it is an art. Some people's brains are wired such that they can enjoy a mini circus atmosphere on a regular basis. They think its fun.   It drains me.  So I'm hanging up the keys.  


Resigning my little post without guilt is one of the boldest self-care moves I've ever taken.  Sure, I have the inner critical parent shaming me, telling me I'm letting people down.  "You're just a big quitter!"  she says.


Ah, but there's quitting, and there's quitting.   I am quitting after fulfilling a responsibility for a respectable length of time.  I am quitting because I have better knowledge of myself.  I am quitting in a peaceful manner.  I am quitting to pursue activities that don't drain me.  I am quitting in order to serve more effectively.  


I will no longer be another role model for a volunteerism motivated by, "Well, no one else is doing it, so I've got to do it."  I imagine a great many bake sales, neighborhood associations, political causes, and 12 step meetings might not happen if this motivation were eliminated.  I think that's O.K.  Why create jobs that no one wants to fill?  Haven't we all had enough of being herded  by worn out, resentful, anal-retentive, pinch-faced, committee members?  


If one can't do a job with joy, I say, don't do it.  So, I'm following  my own advice.  I'm heeding the storm warning sirens that are howling inside my belly.  I came to ACA because I ignored the sirens.   I was suicidal and I didn't know why.  Now, though, I know why.


It has been a pleasure to serve for a short time.  I will continue to serve in other ways.  And ACA will be better for it because I worked the program and wrestled with the Laundry List Trait 6:


"We have an over-developed sense of responsibility and it is easier for us to be concerned with others rather than ourselves; this enables us to not look too closely at our own faults, etc."


The Solution is to become your own loving parent.  Indeed.  Thank you, ACA.

Friday, September 2, 2011

Inner Infant

To the outside world, the life I'm living probably looks very much like that of a depressed person.  But I know depression.  This is not depression.

I feel sad.  That's true, but my sadness has undulating quality to it.  It is alive.  Depression is rock solid and immovable.  I can pay attention to the sadness and it tells me things.  At times it even morphs into joy.  Yet its a joy very much grounded to sorrow, like a balloon held to earth by a bag of sand.

I have let go of a need for a joy that flies and floats.  I'll save that for the dessert of the afterlife.  In this life, the heaviness in my gut is my source of life.  It is me, in fact.  I have run around ignoring me for almost half a century because I felt guilty for being so unsociable.  

No thanks, don't want to go to that wedding on September 10.  Can't make your dance recital, sorry.  I have no desire to go to the office Christmas party this year.  I'm going to have a quiet Advent full of solitude and wonder.

This will be the first Fall season where I will honor my need to nip the invitations in the bud.  I will also nip my desire to throw parties and have people over.  Maybe one person to share dinner, but no New Year's party.  No Christmas Tea.  I just don't have the energy to focus outside myself this year. 

Sure, I dream of wearing a gorgeous, comfortable outfit, mingling and giving gifts.  Sure, I want to be a "part" of things.  But it feels very much like I'm 9 months pregnant and the mother of a newborn at the same time.  I need to let the baby kick.  I need to let the other baby cry and hold her on my lap.  When both are asleep, I clean out a closet or something.  Yes, the adult part of me is very much alive.  The adult woman that writes and wants to have an impact and to be seen.  But with two infants to care for, I just must forgo that life for awhile.  Getting a baby sitter won't give me the energy I would need to get dressed and go out.  I'll hire a baby sitter so I can relax at home!  

Recovery folks might accuse me of "isolating."  Church people could construe my behavior as "selfish", or "sinful" even.  But I'm taking my chances.  No other voice in this world or the next has the Truth or the answers I seek.  If the kingdom of Heaven is within, God is seated right there in my stomach.  Talk about a pregnant pause!  I am pregnant and I am pausing, thank you very much!  

And to the naysayer voices in my head that are afraid that I'll "always be this way", I say:  "So what.  Perhaps God designed me to be a hermit.  Maybe this is just a phase.  But even if it isn't, I'm going to listen FOR THE FIRST TIME IN MY LIFE."  I can't go on anymore ignoring this desire to pay attention to my deep, inner, self.

Saturday, August 6, 2011

Just a Wee Shame Attack

I started a ftf ACA meeting in April.  It has been one of the best learning experiences of my life.  But I'm here to say, I'm weary of doing most of the work myself.


The good news is, I think we have a good core of people who feel safe enough to step up and take over in turn. The bad news is, it hasn't been soon enough.


Last night, I lost my cool.  Oh, not in any overt, raging way.  But in that sinister, undercover, ACA way that damages me and others without us knowing what hit us.


I was tired, forgot my watch, the a/c wasn't working, 2/3 of the people were late, G's little therapy companion animal was noisy, K spilled her coke, and we ran over time.  Even though it was time to close, G wanted to share "just one more thing." So she did, but my annoyance was palatable.


I tried to act calm and let it go.  Then KT, concerned about us running over time, asked if she should read the closing.  I said, "It's up to you."  She still wanted more direction.  So I smiled my sweetest smile, spoke softly and said,


"Be your own loving parent and make your own decision."


OUCH!


KT handled my cut and my apology with grace.  She is adept at accepting and noting people's humanness.  But 15 hours later, I'm still swirling in my shame.


I called another friend from the meeting and she said she didn't notice my veiled sarcasm.  What was more helpful to me, though, was her question:


"How would you have handled it differently?"


In the uncertainty that was the end of last night's meeting, I wish I would have said, "I'm tired and don't want to make any decisions.  Can someone else direct what we do from here?


And I would NOT HAVE   PUT ON THAT DISGUSTING SACCHARINE SMILE!


Thank you, ACA, for the tools to help me grow past stuffing my feelings under pressure.



Tuesday, July 26, 2011

Motown and My Father

Normally, my afternoons at Starbucks are pleasant and inspirational.  I can sit as long as I want, read the paper, blog and listen to their eclectic, off-the-radar music collections.  


Sunday, though, I was triggered because they were playing Marvin Gaye.  Upon hearing "Let's Get It On," my heart became shrouded in lonely, gray, tones reminiscent of the polluted, overcast skies of my childhood home in New Jersey.  


My father was a huge Motown fan and I grew into young adulthood loving it myself.  Today, though, I despise it, with the exception of early music by the Jackson family.


Part of my loathing of such music is the heavy emphasis on sexual freedom.  Consider these lyrics:  


You don't have to worry that it's wrong
If the spirit moves you, let me groove you good
Let your love come down
Oh, get it on, come on, baby

Do you know I mean it?I've been sanctified
Hey, hey Girl, you give me good feelings, so good
Nothin' wrong with loveIf you want to love me

Just let yourself go


The entire song is about a guy trying to get a woman into the sack.  Then there's another song my father just loved:

Me and Mrs Jones, we got a thing going on
We both know that it's wrong
But its much too strong, to let it cool down now...

 My father subscribed to the messages of those songs and lived them 
out.  I was constantly exposed to a parade of his girlfriends, pictures of naked woman and his lewd comments about them all.  Add that to the fact that he disrespected my mother and constantly berated me for being overweight, and you have my sexual identity--ashamed, withdrawn, and angry.  


I am all balled up in confusion over my feelings for my dad.  I know its normal and well documented that little girls get "crushes" on their fathers (and boys on their mothers).  I don't know many facts, though, about how abuse and neglect and abandonment during that crush stage affects a woman's sexuality.


I still have dreams about a certain young man who reminded me of my father.  He treated me just as my father did, with reserved contempt, most of the time, and occasional bursts of affection and attention.  I could never be sure where I stood with him.  Trying to win him over became an addiction.  (Thank you, Higher Power, that I didn't marry him!  I suspect, that if my husband hadn't come along when he did, I might have conquered this daddy doppelganger.)


What I'm getting to here is the feelings associated with all this.  I have a ball of sadness and inadequacy in my gut.  My skin tingles.  I feel exposed and shamed and not good enough.  I want to hide-especially my body.  It feels like a target for disapproving looks and words, or inappropriate sexual advances.  I associate sex with nothing nurturing or loving.  Everything about it offends me.  


I want these feelings to pass through me.  I want them to end. 

Tuesday, June 28, 2011

What is Forgiveness?

It was an evening like tonight,h 25 years ago or so.  The sun was setting, but it wasn't cooling off.  I had just finished eating dinner with my mother.  My mother who I now believe has borderline personality disorder.

I don't remember what set her off on this night.  I remember I was deeply depressed; despondent even.  Is that what triggered her homicidal rage?

My guess is she was needing attention; attention her deeply distressed daughter couldn't give her.  She yelled.  She shouted.  She hit.  Somehow, she got me up against the the side door with her hands wrapped tightly around my neck.  I was so depressed I didn't care.  I remember no fear.  I remember no feelings at all.  I must have completely dissociated-at least from her.

I was so limp and frozen, she probably couldn't have killed me.  I remember having trouble breathing.  I remember her letting go.  OK...a little terror is coming up now as I imagine what that must have been like.  I remember it--but I don't.

I do remember walking away from the door and her ordering me to clean up all the broken dishes she had thrown at me earlier in the argument.  When her violence at the kitchen sink failed to get a response out of me, I guess that just elevated her rage.

Food was everywhere.  Broken glass was everywhere.  My mother had tried to kill me.  Does a mother-daughter relationship get any worse?

This wasn't the first time she had thrown dishes at me.  It happened when I was three.  She was aiming at my father, I think, but she got me.  My dad took me to the emergency room to get stitches in that soft skin between my thumb and fore finger. I think it was the left.   There was blood that time.  And the time when I was six months old and wouldn't eat.  Why didn't those doctors report this stuff?  An infant with bleeding gums?  Come on!  What did my dad tell had happened?  Did he lie?  Did he say I was chewing on glass?

How did I survive any of this?  Or the hair pulling or the slapping or the punching or the belt beatings or the sexual abuse or the lack of privacy or the screaming?

So much of these memories are frozen deep within my body.  It has taken my two years of being away from my family to begin to feel the effects of such abuse.  I can't believe I expected myself to heal while hanging out with these people who blamed my "emotional problems" on me!

I am angry.  So angry.  I guess I am just so used to my parents trying to snuff out my feelings--my natural, healthy reactions to being wounded--that I'm not sure how to react differently to these memories.

In my mind, I'm gathering up dishes and throwing them back.  They are shattering against the kitchen wall.  The enemies are huddled in the family room, surprised at my sudden vivacity.  I'm screaming.  I'm clenching my hands as if clawing some delicate veil.  My face is upturned and in agony.  This is me.  This is my suffering.    Part of it, at least.

For it wasn't too many days after my mother strangled me that I displeased her yet again, so she destroyed my room and everything in it.  She wrote in red lipstick on the wall:

"You fucking bitch.  You've stolen everything from me even God."

Who was she talking to?

At the time, I was devastated.  I believed her, though I knew her reaction was a bit exaggerated.  With my friend J standing by, I packed up my clothes and my baby powder and moved out.  Not forever.  But for a few years.  Many years, in fact.  But I was still not done taking her abuse.  I was 45 before I said "no more."  Now, I'm 48 and I'm just beginning to learn what I need to forgive her for.

Or do I need to forgive?  I don't hate my mother.  I don't wish her ill.  I know she IS ill-deeply so. She is so ill she can't see she needs help.  How do you forgive such a one?  The best thing I can do is stay away from her.  

Monday, April 4, 2011

Ouch! Page 404

Doing service in ACA  really brings out the worst in me.  I am sensitive, protective of my ideas, immature, and so is everybody else!  (imho)

Ah, but the big red book foresaw moments like these.  At the bottom of page 404 it says:

...our groups are not perfect.  Fellow ACA members have let us down, but for the most part, we know we can trust our group to listen to us and support us when we do not feel good about ourselves.  (emphasis added)

O.K.  I won't quit.  But I will sit around a lick my wounds for awhile.  Then, I'll be back.