Welcome to My World

What an exceptional time to be alive. The world interconnected in a waking nightmare, with the worst (most likely) yet to come.

Coronavirus, COVID-19, novel coronavirus, SARS-CoV-2, The Rona (in Australia anyway), whatever you want to call it, has brought the world to its knees. It’s invisible, it’s not biased, it's deadly and we still have no way to beat it. The best strategy is not to contract it in the first place. Wash hands, quarantine, wash hands, stay away from people (at least 1.5m), wash hands, don’t touch your face, wash hands, cough and sneeze into your elbow, wash hands - oh I said that already. I need some hand cream pronto!

The other side to all this is the mental impact and toll this is having on us. There’s still stupid people out there living in their own bubble thinking they can’t be affected nor do they have any social responsibility to others – let’s leave those fuckwits out of this. No doubt the rest of us living in reality and particularly being in the vulnerable part of the population, have clued into our own sense of mortality and existentialism, if we hadn’t before. (How can you not be when coverage and infection are so widespread; or simply just by sensing the eerie vibe out there?)

I was talking to a friend a few months ago who unfortunately had a very bad car accident. She thankfully survived with minimal bodily damage. The accident should have been fatal but thank whatever out there, dumb fucking luck, it wasn’t. I could tell immediately that she was just falling over the edge into the long dark spiral of PTSD (she was approximately 4 weeks post-accident, which is the common amount of time before PTSD kicks in). She was frantic, contemplative, shell-shocked, in disbelief, depressed yet elated. I just listened to the outpouring of information. She couldn’t comprehend that the night before the accident could have been the last time she ever tucked her daughter into bed. What can you say to that, to any of it? Most times the best thing to do is shut the fuck up and listen. Unsubstantiated meaningless niceties, wisdom or positivity don’t cut it. My husband piped up eventually to break the desperate silence. He told her if anyone can understand how she feels, that I can. I know down to the deep dark core of her soul exactly how she feels. I’ve been her. I should have died at least twice now (fuck I’m losing count) from a congenital heart defect and cardiac arrest, but I didn’t. I’ve been on this PTSD train before, toot toot all aboard. Perhaps I should have reveled in the fact that out of my friends, I wasn’t alone anymore. Instead I was sad that she must go through this. The only thing that gives me some solace is that I’m available to her if and when she decides she needs me.

People experiencing this pandemic in quarantine from their own houses doesn’t compare to having a near fatal car accident, or cardiac arrest. But what these experiences have in common is that they force people to pause, to take stock, to reflect on themselves, their lives and the world around them. I feel confident that most people out there whether you've been directly affected by COVID-19 or not – yes I’m talking to you – have now experienced this moment: where a sudden existential dark emptiness casts over your mind and seeps into the middle of your chest to take residence in your soul. It’s that dreaded moment of dawning, or rather setting, where you realise within the being of your cells that one day, you will die; and at the same time just how precious and finite life really is. It’s one of the truest and breathtakingly bittersweet moments in one’s existence. The first time I felt it I must have been no more than nine years old. I was sitting on the grey carpeted floor in my bedroom contemplating all that is life. Naturally I came to that unsettling conclusion. And just like most people, I shook it off and kept going about my business.

We all know this truth intellectually, but to understand it in the depths of your soul is something else. It’s the unique experience reserved for people having gone through a near death experience, having been in war, tending to the sick and dying, being the sick and dying. And now it’s for the masses, televised and transmitted to your lounge room 24/7.

All the things you’re feeling now, during this pandemic, that’s me, feeling those things and having those morbid thoughts all the time.

Welcome to my world.

It’s a waking nightmare we’re all living, it’s difficult to comprehend our new reality. You distract yourself and go to sleep and try to escape it and maybe you’re lucky and you do. With my PTSD, there’s no escape. I’m living trapped in this endless cycle of mental and emotional exhaustion where at times the only choice is to become numb. I stay awake to try to distract myself from thoughts of death, what if scenarios and that creeping existential dark emptiness that keeps seeping through me trying to drown me every chance it gets. I’m too scared to go to sleep in case I don’t wake up again. Eventually when I do sleep, my anxieties and fears pervade my sleep to form nightmares. Sometimes I wake suddenly in the middle of the night gasping for air to violently, as quickly as possible, fill my lungs to know that I’m alive; and then I’m too scared to go to sleep again because I’m so grateful to be alive and terrified of dying all at the same time. When I wake up for good, I’m thoroughly spent, zombified, groggy, fatigued. Having more sleep to fend off the fatigue makes it worse because the nightmares are so vivid and visceral, they exhaust me further and for longer.

It takes time, work and kindness to oneself to unravel this cycle, to fight the PTSD and come out the other end as a highly functioning human being; to seek out the light as you move away from the darkness.

Another friend’s mother suddenly passed away about a month ago overseas. She had visited Australia some months prior where I distinctly remember my last interaction with her. I had gone to pick up my daughter from their place and she asked if I wanted a coffee. I wasn’t particularly in the mood for a drink but accepted regardless because I thought to myself I’m not sure when, if ever I’m going to see her again. Probably a morbid thought for the average person, but this is now my modus operandi, it has been most of my life, but more pronounced since my first cardiac arrest. Most interactions I have, I make a choice to treat it as being potentially the last one. Because one thing my congenital heart defect and cardiac arrests have taught me, is who the fuck knows what’s in store for any of us? As shocking as the news of her passing was (she was super healthy and active, nor too old), I was grateful we had that coffee together where I got to find out about her life and love of bike riding through nature, that essentially, I shut the fuck up, listened and got to have a genuine connection with her over that handful of minutes. All it takes is a pause, to be authentic and show someone that they matter, that they’re just as human as you are. A smile, a laugh, an inquiry or some banter with the checkout person in the supermarket to make a difference and to potentially make a person’s day, or yours one day down the track. To live without regret that you’ve said and done everything you’ve wanted to, that you’ll be remembered as that kind person, not the asshole. For me it’s simple: it’s to tell my family and friends I love them when we chat, or when the mood strikes; to hug them just that little bit longer and to take in their scent (creepy I know, but you take what you can when your immediate family lives abroad and interstate); the weekly phone call;  it’s the good morning in passing; the kiss, hug and eye contact hello when my husband gets home from work; and it’s the kiss and hug goodnight as I tuck my daughter into bed. If you're wondering, I smell her also, the most out of all people, my husband a close second. They’re the only things I can control and that matter the most to me because when the end comes, we can only hold on to the memories we made and the last interactions we had with people.

The world is so strange right now. It’s scary but it’s also beautiful and hopeful. Breathe in the air, it means you’re alive. Hug your loved ones or yourself, because you love them. Talk less and listen more, because we’re always learning. Take joy in the micro things because as big as the world is, we should all just stay home in our little universe for now. And remember, you’re not alone, we’re all in this together and we’re taking it one day at a time. As for today, I’m glad I’m still here. This is our world now.

Rhythmic composition in yellow green minor (1919), Roy de Maistre

Helping Someone with PTSD

The content for this post is from Helpguide.org

Helping a Loved One or Family Member with Post-Traumatic Stress Disorder

Image courtesy Before It's News

When someone you care about suffers from post-traumatic stress disorder (PTSD), it affects you too. The symptoms of PTSD aren’t easy to live with, and the changes in your loved one can be downright terrifying. You worry that things won’t ever go back to the way they were before. At the same time, you may feel angry about what’s happening to your family, and hurt by your loved one’s distance and moodiness. It’s a stressful situation all around—one that can leave you feeling overwhelmed, even as you try your best to stay strong. The most important thing to know is that you aren’t helpless. Your support can make a huge difference in your partner, friend, or family member’s recovery. But as you do your best to care for someone with PTSD, you also need to take care of yourself.

Understanding the impact of PTSD on family & relationships

PTSD can take a heavy toll on friends and family members, and relationship difficulties are common. It can be hard to understand your loved one’s behavior—why he or she is less affectionate and more volatile. You may feel like you’re walking on eggshells or living with a stranger. You may even be afraid of the person. The symptoms of PTSD can also result in job loss, substance abuse, and other stressful problems that affect the whole family.

It’s hard not to take the symptoms of PTSD personally. When someone you love is distant, anxious, or angry all the time, your relationship suffers. But it’s important to remember that the person may not always have control over his or her behavior. Anger, irritability, depression, apathy, mistrust, and negativity are common PTSD symptoms that your loved one can’t simply choose to turn off. With time and treatment, they will get better, but it’s a gradual process.

Tips for coping with PTSD in the family

• Be patient. Getting better takes time, even when a person is committed to treatment for PTSD. Be patient with the pace of recovery. It’s a process that takes time and often involves setbacks. The important thing is to stay positive and keep at it.
• Educate yourself about PTSD. The more you know about the symptoms, effects, and treatment options, the better equipped you'll be to help your loved one, understand what he or she is going through, and keep things in perspective.
• Don’t pressure your loved one into talking. It can be very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Instead of trying to force it, just let them know you’re willing to listen when they’re ready.
• Take care of your emotional and physical health. As the saying goes, put on your own oxygen mask first. You won’t be any good to your loved one if you are burned out, sick, or exhausted.
• Accept (and expect) mixed feelings. As you go through the emotional wringer, be prepared for a complicated mix of feelings—some of which you’ll never want to admit. Just remember, having negative feelings toward your family member doesn’t mean you don’t love them.

PTSD & the family: Social support is vital to recovery

It’s common for people with PTSD to withdraw from their friends and family. While it’s important to respect your loved one’s boundaries, too much isolation is unhealthy. Your comfort and support can help a person with PTSD overcome feelings of helplessness, grief, and despair. In fact, trauma experts claim that receiving love from others is the most important factor in PTSD recovery.
Knowing how to best demonstrate your love and support, however, isn’t always easy. You can’t be your family member’s therapist, and you can’t force him or her to get better. But you can play a major role in the healing process by spending time together and listening carefully.

Why someone with PTSD might be reluctant to seek support

• Being afraid of losing control
• Feeling weak or ashamed
• Not wanting to burden others
• Believing that others won’t understand
• Wanting to avoid thinking about what happened
• Fear that others will judge or pity them

How to be a good listener

While you shouldn’t push a person with PTSD to talk, you can let them know you’re available for them. If they do choose to share, try to listen without expectations or judgments. Make it clear that you’re interested and that you care, but don’t worry about giving advice. Leave that to the professionals. Instead, do your best to simply take in what they’re saying. Never underestimate how much the act of empathetic listening can help.

A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Instead, offer to talk as many times as needed. And remember, it’s okay to dislike what you hear. Some of the things your loved one tells you might be very hard to listen to. But it’s important to respect their feelings and reactions. If you come across as disapproving, horrified, or judgmental, they are unlikely to open up to you again.

Communication Pitfalls to Avoid

• Giving easy answers or blithely telling the person everything is going to be okay
• Stopping the person from talking about their feelings or fears
• Offering unsolicited advice or telling the person what he or she “should” do
• Blaming all of your relationship or family problems on the person’s PTSD
• Invalidating, minimizing, or denying the person’s experience
• Telling the person to “get over it” or “snap out of it”
• Giving ultimatums or making threats or demands
• Making the person feel weak because they aren’t coping as well as others
• Telling the person they were lucky it wasn’t worse
• Taking over with your own personal experiences or feelings

PTSD & the family: Tips for rebuilding trust and safety

Trauma alters the way a person sees the world, making it seem like a perpetually dangerous and frightening place. It also damages people’s ability to trust others and themselves. Anything you can do to rebuild your loved one’s sense of security will contribute to recovery. This means cultivating a safe environment, acting in a dependable and reassuring way, and stepping in to help when needed. But it also means finding ways to empower the person. Smothering someone with PTSD or doing things for them that they’re capable of doing for themselves is counterproductive. Better to build their confidence and self-trust by giving them more choices and control.

Fight or Flight

Following a major life event, there are good and bad things about life moving on as per normal. Normality can offer a good distraction; a reason to keep going; or a good escape from the seriousness of recent events. Alternatively, it can be such a good distraction, that you never get a chance to deal with your emotions to then be able to move on and live a new kind of normal. It's so easy to get caught up in existing and functioning, that we don't permit ourselves the mental or physical space needed to deal with our emotions.

Another factor that can impact this, is time. Often it's a necessity to simply keep functioning because anything more than that is not possible, so with time, other things come out in the wash.

I was so caught up in functioning and dealing with one issue at a time, that it took me a good eight months post cardiac arrest, to realise that since the cardiac arrest I've been having nightmares every night.

I couldn't tell you specifics about the nightmares because they have always been so muddled, but the constants have been the vivid emotions I've been experiencing in them. It's always the same: violence, fearfulness, loss of control, confrontation, anger, anxiety, hatred, cruelty, hopelessness, desperation, chaos, being judged, frightfulness, frustration...amongst others. In my nightmares, I'm always pushed into situations I don't want to be in or deal with, with no choice but to haphazardly confront them.

Image courtesy of Think Inc.

To say that I've been exhausted after the cardiac arrest, is an understatement. I was constantly so tired and looking for reasons for this exhaustion, that I completely missed the obvious one: good quality sleep. It wasn't that I wasn't sleeping enough; or didn't have the ability to fall asleep. We even bought a new mattress! It was that I was having nightmares: an inescapable loop of the same, stagnant emotions in similar scenarios every single night. As a result I would wake up exhausted, in a haze and blur of confusion. I'd be cranky, impatient, unclear, unable to focus on any given task for too long, and would get worn out really easily and quickly.

So I focused on the tiredness as perhaps being caused by hypothyroidism. The (slight) hypothyroidism I've been experiencing most probably being a result of the heart medication amiodarone that I am on. There was no other logical explanation because the only thing my blood work showed were the TSH levels to indicate the hypothyroidism; and a spit test that I did showed low levels of progesterone. Essentially both tests showing that my hormones are fucked*. My cardiologist, GP and the head endocrinologist at RPAH were not concerned with my thyroid results and advised to simply keep a close eye on it.

So what next, what's the problem? No one could give me an answer. My cardiologist advised that perhaps the severe tiredness was due to sleep apnea, which is a common symptom for heart patients. So I went to my go-to guy for all things advice: my shrink. I figured he'd have a good colleague or know of a clinic he could refer me to do a sleep study. At this point I began observing my sleep looking for sleep apnea signs, but what I found instead were the constant nightmares. I told my psychiatrist about these and he was not surprised: they are a common symptom of PTSD. So we trialled a blood pressure medication which has been proven to assist PTSD patients with their nightmares. It switches off the fight or flight response experienced during sleep, giving you a chance to process and therefore wake up more refreshed and have better day-time function.

Hey presto, as expected, the medication worked overnight. The first nice dream I had in approximately eight months: and it was about my sisters. I was a little girl and they were all fussing over me and looking after me, loving me and nurturing me. The complete opposite scenario and set of emotions from my nightmares. It was exactly what I needed.

Following this I visited completely new places in my dreams. Not all my dreams were pleasant, but I no longer felt the need to escape them. In my dreams I could now control my emotions and I had choices. I could choose what I did and how I responded, and could even walk away from them or change them. This was a complete turnaround from being forced to continuously and haphazardly deal with unpleasant situations.

I took the pills for about a week and then stopped. I wanted to see what would happen when I came off them. It's been over a month now and I am happy to report that I am still visiting new places in my dreams, interacting with people and feeling more and more empowered in them. With the option of taking the medication again should I need it. I feel that even just that one week of quality sleep (minus the fight or flight hormones) was enough to kick my brain over into a new state of mind and function. I feel like a new person and enjoy each day at home with my daughter so much more now (as I'm sure she does also because I am no longer cranky). I have the ability to focus on tasks and feel much more energetic and capable of doing the things I like to do, including exercising regularly, socialising and preparing nutritious meals.

And the road to recovery continues...

What I've realised from it so far, is that the road is rocky with bumps, ditches, holes and smooth parts in between. Everyone has their own path and set of circumstances. But what I do urge all heart patients (particularly after a major cardiac event) is to not neglect their mental health and state of mind. Emotions play a major part in our healing process and capability with dealing with whatever gets thrown our way.

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*I've been doing some research on hormones and PTSD, so more on this stuff later, in another post.