Overcoming everything to start anew

June 23, 2008 12:00 PM

TraumaFilter: what worked for you in overcoming PTSD, anxiety, depression?

I've recently been diagnosed with PTSD, GAD, and depression (not my first depression diagnosis), and am seeing a therapist for CBT, EMDR, and hypnosis. Due to time and financial constraints, I can only see her for these every other week, because my two children (teens) and the three of us as a family are also having sessions (2 sessions a week is the limit my budget can handle).

I am not taking any prescription medication on a regular basis because my therapist doesn't approve, on the basis that they can be habit-forming and wants me to try homeopathic alternatives instead, which I don't trust. She's the 6th therapist/counselor I've seen in my life, the first I've been able to open up to, and I'm not optimistic about finding a better one, particularly in my area and on my insurance. I approached my GP over 3 years ago about my anxiety and she dismissed my concerns, insisting, "It's perfectly normal; everyone feels that way sometimes," and prescribed me first Pamelor for the depression (which did nothing) and then generic Wellbutrin (which raised my anxiety sky-high and didn't level out after months of taking it).

Because some of my trauma is medical, it is very difficult for me to go to a doctor, much less raise such concerns, and especially to assert myself in the face of disagreement. I do smoke pot sometimes to help with the anxiety, but only a little, as I do not like to feel out of control and don't want to be truly "stoned." I rarely drink alcohol. I have a friend who gave me a few of her Xanax and I have taken 1.5 of them, half at a time, over the last few months, when I was otherwise going to have to leave work because I was absolutely incapable of coping, but they are my absolute last resort because who knows when/if I could get more.

I'm having a really hard time making it through each day, doing my job, taking care of my kids as a single parent, trying to manage household stuff. I've had a series of triggering events over the last few years, each one leaving me in worse shape than the last. It's been several months since I went through an entire day without flashbacks. I frequently cry, seldom over current events, and it's become tremendously difficult to get out and socialize even with people I've known for a long time and feel safe with. I have diffuculty focusing well enough to watch a movie or read a book, much less meditate. I enjoy nothing. I am exhausted, physically and emotionally. The constant influx of adrenaline leaves me drained. I have no one to take over any of my tasks for me, to provide relief at work or home. The kids do help out with chores, some, with lots of management by me.

Background, if it matters: 37 year old female in the U.S., particular traumas in my case involve child abuse, alcoholic parents, rapes and forced sodomy (multiple perpetrators and incidents over a period of years -- none under the category of "child molestation" or "incest": I was at least 15 and unrelated to all perps), domestic abuse (physical, psychological, and sexual by one partner, psychological only by another), medical traumas, and physical assault. I've never been protected by anyone, from anything.

So, with all this in mind, what do I do? What worked for you in overcoming anxiety, depression, and/or PTSD? What can I do with the other 335 hours between therapy appointments that can make my days more bearable? How do I reduce or eliminate the flashbacks and crying jags? How do I rebuild my concentration? How do I overcome the panic and flight instinct that keeps me from socializing? How do I make life worth living (no, I'm not suicidal)?

Throwaway email: [e-mail]

posted by anonymous to human relations (23 comments total)

Look into EMDR Therapy. It may sound strange, but approach it with an open mind.
posted by Brandon Blatcher at 12:19 PM on June 23

I have a friend who gave me a few of her Xanax and I have taken 1.5 of them, half at a time, over the last few months, when I was otherwise going to have to leave work because I was absolutely incapable of coping, but they are my absolute last resort because who knows when/if I could get more.

I'd never recommend to a stranger that they buy prescription drugs from an illegal, foreign, internet drug source. Nope. I'd never do that.

But knowing I have a backup supply/source for the drugs that help me maintain an even keel, is wonderful peace of mind to me. At least, it helps ease some anxiety.
posted by IAmBroom at 12:34 PM on June 23

Another sexual assault PTSD survivor here; EMDR saved my bacon, so I'm particularly glad you're pursuing it. It can definitely help, even though all I was able to get out of my therapist was "it works but no one knows why."

One thing that I've found helped with flashbacks (I say "helped" because fortunately it's been quite a while for me), is to verbally describe my immediate surroundings, to myself or someone else, in minute detail until the flashback recedes a bit.

Mefimail me if you need to talk. We're in your corner here!
posted by tigerjade at 12:38 PM on June 23

What can I do with the other 335 hours between therapy appointments that can make my days more bearable?

I know it's a common response, but are you physically active? Your post didn't mention exercise, which is a well-established way of alleviating some of the symptoms you describe. I'm sure as a working single parent your schedule is full, but the feeling of physical pleasure and relaxation that comes after exercise may be the type of experience you need more of.

You mentioned that meditation is difficult for you, but stick with it. Everyone likely runs into the same challenges you described, and it's also an excellent way to reduce the anxious and burned-out feelings you mentioned.

I know those sound like stock responses, but every little bit helps. Even the mildest sense that things are getting better, or at least not getting worse, can do wonders.
posted by Adam_S at 12:40 PM on June 23

I am not taking any prescription medication on a regular basis because my therapist doesn't approve, on the basis that they can be habit-forming and wants me to try homeopathic alternatives instead, which I don't trust. She's the 6th therapist/counselor I've seen in my life, the first I've been able to open up to, and I'm not optimistic about finding a better one, particularly in my area and on my insurance.

you're right not to trust homeopathic alternatives (because they are nothing more than water) and if she's recommending homeopathy, then she is not someone you should be listening to when it comes to making medical decisions. this doesn't mean that you need to throw the baby out with the bathwater - if she's helpful to you as a therapist, then that's great - but she doesn't have any right to discourage you from exploring evidence-based medical treatments.
posted by moxiedoll at 12:45 PM on June 23

Ack! Someone gave you Wellbutrin when you had anxiety problems? Please tell me you're not still seeing this GP.

I could tell you what "worked" for me, but I am totally not done working through it yet, and I would never recommend my path to anyone.

What helped an awful lot was this book. There are a bunch of guided imagery exercises in there, some programs you can do on your own or with a therapist. The text is really big in those sections and you really only have to read a couple of sentences to get the gist of it. I only worked on the exercises on my own just reading what was there instead of making a tape for myself or anything, and I usually spaced out halfway through. But if you can focus on sitting there for just a minute, that's one minute that you're not panicking, and that's progress.

What helped me most was just reading the first half of the book, which gives a lot of technical details of PTSD, like what makes people more "at risk" than others, physical signs (sufferers have low cortisol levels, not high, oddly enough. It's why you flip the hell out at the tiniest stressful situations, because your system gets flooded). The whole "thesis" is that talk therapy doesn't work for PSTD because (excuse the amazon/copy paste) "trauma damages the left brain, which is language oriented, and talking about the trauma can actually worsen symptoms. Imagery, on the other hand affects the right brain, the seat of the emotions" and when you use your imagination, daydream, do the exercises.. you're confronting the trauma. I don't know if it's a heaping pile of bullshit, but it worked for me, so I believe it.

It appealed to me a great deal because it justified what I was feeling (my family failed miserably at being supportive). Something about it just clicked for me (maybe because I'm really into neurobiology. I don't know), and it made me stop concentrating on thoughts like, "shit, I have PTSD, I'm broken forever and I'm going to freak out at some guy in the grocery store that is in my personal space and end up being that girl who punched an 80-year-old man."

I'd also recommend Jon Kabat-Zinn's "mindfulness" CDs to pretty much anyone dealing with anxiety. You totally can't concentrate, but then you realize that you just feel calmer by listening, and if you do it regularly, it becomes a learned behavior.

I found both of these at my local library.

I don't know where you live, but is it possible to file for disability (it sounds like you're having trouble doing your job) or get some assistance from a service that deals with disabled people? I know it sucks to slap the "disabled" label on yourself, but you need to do something to take some pressure off yourself.

Tips for your doctor: did you mention that you're skeptical about the homeopathic treatment(s)? Is there a reason why you can't try an SSRI instead of sedatives? You sound ambivalent about staying with your current therapist - if you have the energy, try calling some other ones that are local and ask if they'll let you pay on a sliding scale.
posted by giraffe at 12:48 PM on June 23

Exercise.
posted by togdon at 12:51 PM on June 23

Another rape/CSA survivor/PTSD sufferer - 37 years old also. I am better. Not great but better. Here's what I do:

**Prescription meds helped. A LOT. If your therapist thinks you shouldn't be taking meds, you need a new therapist. He or she should want anything that means you become better able to deal with the shitty things that happened to you. (sorry if that's too blunt but I get very angry when people try to force their beliefs, esp. non-scientifically founded beliefs, down other people's throats.)

**Also, I use a coping bank. I carry it around with me every day.

**I have the PTSD workbook and use it as often as I need to.

**When I was having major flashbacks and terrors, I used some grounding techniques (bottom of the page).

**I have a journal that I also carry around with me just to get out of my head and onto the page some of what I'm carrying around.

Hope this helps. I hope you find the healing you deserve.
posted by Sophie1 at 1:02 PM on June 23 [3 favorites]

prescribed me first Pamelor for the depression (which did nothing) and then generic Wellbutrin.

I note that you apparently haven't tried an SSRI yet. Without getting into the medication/therapy debate, I would only suggest that you haven't exactly exhausted the universe of modern anti-depressant medications.
posted by pardonyou? at 1:08 PM on June 23

I take paxil and do yoga regularly, and both have been great for my GAD.
posted by All.star at 1:14 PM on June 23

from what I've been told, EMDR is pretty much just exposure therapy with expensive lights. The eye movement thing shouldn't be necessary for improvement. What worked for me, and a lot of people with PTSD, is very focused exposure treatment (usually happens under the CBT banner) by a therapist experienced in or specializing in exposure. It is usually quite distressing to go through as you're confronting your fears head on, but if you can tough it out its so worth it.

In between sessions, I find relaxation breathing (slowing down your breathing, not doing deep breaths (google breathing retraining for more info)) helpful. Progressive muscle relaxation is good too.
posted by gilsonal at 1:24 PM on June 23

Homeopathy is pseudoscientific nonsense.

As is hypnosis.

In my opinion any therapist advocating hypnosis and homeopathy, is not one that should be trusted with such a serious matter.
posted by aleahey at 1:50 PM on June 23

sweetie, you absolutely, 100% need to try some medication. as i'm sure you know, it sometimes takes a while to find a medication that works for you, but it will be worth it once you find it.

there are lots of therapists that don't "approve" of medicating away problems, but some people legitimately need them. if your shrink is helping you in a shrink-y way, stick with that person. but you should also try to see a GP or another doc who will be willing to work on finding the right drug(s) for you.

also, don't feel bad about being stressed or depressed. it is not your fault. you have bad events in your past and it seems like your current life is full of stressors and that you don't have a support system in place. work on building one of those if you can.
posted by misanthropicsarah at 2:04 PM on June 23

I would not equate homeopathy and hypnosis; hypnosis is credible with a skilled/licensed practitioner. It's very helpful to reinforce new habits or get rid of old habits.

Drugs: Xanax is addictive, but very useful for occasional use for severe anxiety and panic attacks. I carry 1 xanax, just in case. SSRIs have shown some usefulness in coping w/ anxiety.

During a panic attack, a cold wet washcloth on the face helps a lot. It stimulates the mammalian dive reflex, and the physiological effects control the panic.

I find it helpful to use affirmations to help me get through tough days. "I have the tools to cope with this anxiety"

Your therapist should be able to help you craft affirmations, exercise, and other strategies to help you cope. Music is also a great, sometimes music can lift me right out of fear, anxiety or sadness. Good luck.
posted by theora55 at 2:33 PM on June 23 [1 favorite]

Physical/emotional child abuse/cult-like situation PTSD survivor, here. I've been in CBT for the past two years, and that's about it (except for a few depression medications and psychiatric hospitalizations some 10 years ago, both of which did nothing for me), so I've kind of only just started dealing with it. I don't know much about all the various treatments/medications, so I can't be of much help there, but I can tell you a couple things that help me a bit when I know I'm on the verge of an emotional breakdown.

First off, I remind myself that I am stronger than I think I am. I may be feeling helpless and incapable, but I try to keep in mind that I'm getting done what needs to get done (work, rent, bills, etc), that I interact with people at work and, thus, am able to communicate with others (so I shouldn't fear my friends), and that I am trying to make things better (by being in therapy and such). Remembering these things helps me feel a little less like a victim, a little less "broken", in day to day situations.

Secondly, and maybe I find this more helpful than others might, but I find it important to remember that it's valid to be angry at the fact that this disorder is not my fault but I'm still the one who has to deal with it. I don't know why it helps me to know that this frustration is valid, but it does. Maybe because I've only been working on this for a couple years, so I still oftentimes don't have much of an emotional range. I don't know. But, anyway, it helps me.

But, anyway, anon, that's what I've got. Godspeed, and I'll keep you in my thoughts.
posted by The Great Big Mulp at 2:48 PM on June 23 [1 favorite]

Have you considered taking a friend with you to the GP? I totally understand how GP's can be dismissive and intimidating. Taking someone along to back you up is completely reasonable for someone in your situation.

If your therapist is helpful in other ways, it's also OK to tell her that you've listened to and thought about what she's said about medication, but your opinion differs and you've decided that medication is something you want to try. Any therapist who's unable to accept a difference in opinion from a client is definitely not someone you should be around. Your therapist should be there to help you, not to dictate what you should and shouldn't do - especially with regards to something outside her area of expertise.
posted by xchmp at 3:07 PM on June 23

My original pdoc (a great guy) recommends Keppra for ptsd. He uses it a lot for that purpose (it's an anticonvulsant commonly prescribed for epilepsy, and for me for anxiety connected to bipolar and ptsd. )

There is no shame for using medication to get stable enough for therapy to work. Keppra had no side effects for me whatsoever, was not habit forming, and worked with the first dose.

There are other medications out there that are useful-at any rate, I recommend you check into that as an option. Most likely it will only be temporary.
posted by konolia at 3:09 PM on June 23

(I no longer take any medication whatsoever and haven't for ages, but keppra worked well and I used it till I didn't need it. No withdrawal symptoms either.)
posted by konolia at 3:10 PM on June 23

PTSD, spousal abuse, and forced sodomy/rape here too...

I've been liking the supplement 5-HTP a lot lately for help with sleeping. I've noticed that it helps me fall asleep easier and wake in a good mood. This is especially helpful for me personally as I tend to have the worst flashbacks right before bed and very violent nightmares.

Because you're in the U.S. you can take advantage of the Family Medical Leave Act. You can take up 12 weeks off of work for a "serious health reason". I strongly encourage you to discuss this option with your doctor and pursue it if possible. You may be able to combine this option with short-term disability insurance to help cover bills.

I agree with some of the previous posters that exercise is also a great idea. Exercise will naturally improve your mood and help increase your confidence and sense of control. You may even consider taking a local women's self defense course.

Finally, these words have been invaluable to me and my recovery: "It's not my fault."
posted by tinatiga at 3:28 PM on June 23

Behavioral therapy has been effective for me when I've had mild anxiety symptoms, but for my full-blown panic disorder and GAD I needed medication *and* talk therapy. I have a marvelous pdoc who always has a new trick up his sleeve if things get weird for me, and I can call him whenever I need to. I also have a talk therapist whom I don't see that often anymore. I absolutely needed both. Also I need regular exercise along with the meds.

FYI I take Lexapro, and was lucky that the first SSRI I tried worked well for me. But there's usually one that will work, even if it's a matter of trial and error for a while. If you are anxious, a good pdoc may have you start an SSRI slowly, with a low dose every other day, as some of them can induce anxiety symptoms if you take too much too fast. Also you can keep improving on SSRIs months after you begin taking them, or increase your dosage. YMMV, of course, but that's my story. Best of luck to you.
posted by sister nunchaku of love and mercy at 5:07 PM on June 23

What worked for you in overcoming PTSD, anxiety, depression?

Xanax

I have a friend who gave me a few of her Xanax... but they are my absolute last resort because who knows when/if I could get more.

This is what your doctor is for. PTSD is difficult but the associated anxiety attacks are debilitating. Your therapist may be qualified to deliver therapy and be a good match for you, but your doctor is qualified to dish out drugs.

People tend to see their doctors first and foremost as authority figures, but your doctor works for you. If he or she is not delivering a service that is responsive to your needs, get another GP. Generally speaking, a simple "I'm seeing a therapist for PTSD and some associated anxiety issues and I'd like a short-term prescription for Xanax" will get you where you want to go.
posted by DarlingBri at 6:09 PM on June 23

I am 27 and currently undergoing treatment for PTSD, caused by a number of events, the first at age 2. I am pretty much a lifelong case of PTSD (not parental abuse, btw; some parental neglect later in life, but there are mitigating circumstances for that). The short version is stalking, chaotic home conditions, parental neglect and depression, rape, and medical complications.

Late last year a triggering event occured; since then, the flashbacks are easily triggered. I slipped into a depression that manifested as lethargy and apathy - some days it was all I could do to get out of bed. I decided to do something about it and started seeing a shrink in March of this year. I needed medication to pull myself together enough so I could face some of my demons. I'm currently undergoing talk therapy, CBT and medication.

When I have a panic attack, I breathe deeply, from the stomach, slowly in for a count of four, hold for four, out for four, pause, repeat. I concentrate only on the feel of air moving into and out of my body. That's usually enough to at least dampen the attack so that I can function somewhat. I have an area at home which is visually quiet; I have a candle, a couch, and a notebook. I light the candle, sit down, and write in the notebook when I get agitated or upset. It gets the feelings out of my head and onto paper. I keep this space as calm as possible. I practice being calm in that space, so that when I need it, I am reflexively calm (or at least, calmer).

I'm not over it yet; and some of the worst is yet to come, I think. I am hoping to be through this and mentally healthy by the time I turn 30, although I accept that it may take longer. I tell myself daily that none of the things that happened to me were my fault or my responsibility. I tell myself that I am a good person, that I am strong, and that I will get through this.
posted by ysabet at 8:49 PM on June 23

For me, lots and lots of cognitive therapy and non-narcotic prescription medications.

This seemed to get my PSTD/Anxiety/Depression into a manageable state.
posted by Schuby at 8:27 AM on June 26