How do I not get taken down by PTSD?
June 22, 2014 9:29 AM   Subscribe

I am experiencing acute PTSD symptoms after a variety of different traumas, most recently an incredibly toxic roommate/landlady situation which I am now out of. I am looking for suggestions on behavioral changes to implement, therapeutic techniques, and books that might help.

My PTSD is taking on a lot of forms. Here are some of my major symptoms:

-Avoidance. I am not doing a lot of things I need to do, like finish getting my things from the old apartment, because of avoidance coping. (I have tried finding someone to go with me without luck and I cannot afford to hire someone.)

-Lack of self-care. I am letting basic hygiene slide, plus I had to sign up for a reminder service to be reminded to take my meds.

-Indecision. I get totally stuck with even the most basic choices and often have to force myself to narrow down my options in order to make up my mind.

-Constant panic/dread. I feel like my heart is racing and I always have this sense of impending doom.

I can go into more detail about any of the above or my other symptoms if that would be helpful. Other things to know:

-I am in therapy weekly with a great therapist. I don't know if she does EMDR, but I read that suggestion in an old thread and am open to it. (I did it about ten years ago for different issues)

-I am also hopefully going to be starting up acupuncture soon, which is great because I have been having a handful of physical symptoms as well, all of which I've had checked out medically.

-I live in Madison, WI. I am already hooked into Journey Mental Health and am looking into Yahara House.

-I am extremely limited by my finances, especially since I live on SSDI (my primary diagnosis is bipolar II). I get state assistance for my healthcare.

-I have been trying a lot of breathing and meditation work, but it doesn't usually help that much.

-Re: suggesting books and resources, a lot of books seem geared towards certain traumas. I do not have a combat history or a history of being in an abusive romantic relationship. I do have a history of sexual trauma, but I don't believe that is the central concern right now.
I can give more info as needed about any of this.
posted by mermaidcafe to Health & Fitness (11 answers total) 11 users marked this as a favorite
The VA's National Center for PTSD website is very very helpful, and not just focused on combat trauma. The section on Self-Help and Coping might be a good complement to working with your therapist.

While EMDR is held up as a good way of clinically healing trauma, there are many other equally good ways of clinically healing trauma. The most important part of doing trauma work in therapy is working with a therapist who has training and experience in working with trauma survivors (that is, technique matters less). I have also talked to a few therapists who do or have done EMDR, and they all said, in various ways, that it works most effectively for a client working through one single discrete traumatic incident, and that such clients are very very rare. All this to say: If your therapist is helping, and has experience working with trauma survivors, don't sweat the EMDR part of it.

The PTSD Coach app is an amazingly helpful tool (and it looks like it's available for use on a computer as well as a smart phone/tablet). You can tell it you're experiencing X symptom (nightmares, insomnia, panic, anxiety, etc.) and it will walk you through various coping mechanisms (breathing exercises, listening to music that you've uploaded, looking at photos you've uploaded, suggesting that you call a friend, etc.); after each suggestion, you can say if it helped or not, and it will suggest another thing if you still need help. It also lets you track your symptoms weekly, which can help you see what's getting better and what still might need some time.

My other suggestion would be, as much as you can, to make sure all your healthcare providers (therapist, primary care doctor, psychiatrist if you have one) have releases to talk to each other. I would be worried about the symptoms of the Bipolar Disorder getting exacerbated by the PTSD, and that's absolutely medically manageable but you want to make sure that everyone's on the same page in treating you. (And if you are not seeing a medical doctor/psychiatrist, I would add that as task #1 on the list.)
posted by jaguar at 9:55 AM on June 22, 2014 [12 favorites]

I hate PTSD flares. What helps me is not glamorous:

1. Above all things exercise. I know it might be hard and sound dumb, but when you are continually getting kicked into fight-or-flight mode, exercise really helps clearing adrenaline. For me daylight as early as possible, outdoors, moving to where it is work but I am not completely out of breath, helps. Swimming is good too.

2. Limit Internet use. The feisty, always-something-going-on nature of the net does not help me. Reading is better.

3. Eat at regular intervals, with protein, so as not to let my blood sugar work against me.

4. If at all possible, connect with friends in person for a walk or decaf coffee. Hugs and listening are really great. If you can't, consider something like volunteering with dogs or cats.

5. Lists to try to start getting things feeling more in control. Just having when bills need to be paid, etc., helps.

6. As you are doing, therapy and meds.

7. If you just moved, it will take time for your space to feel safe, esp. in these circumstances. Try some decorating even if it is just moving things around or getting a cheap plant, garage-sale placemats, etc. things that tell you this new place is yours, and different from any bad ones.

Hang in there!
posted by warriorqueen at 9:59 AM on June 22, 2014 [8 favorites]

Oh wow that app is awesome jaguar! Txs from me too.
posted by warriorqueen at 10:01 AM on June 22, 2014 [1 favorite]

EMDR made the worst of my PTSD symptoms just melt away. It was amazing. I can't recommend it enough. I am still a jumpy person but it's more of a cute quirk than a "oh sockermom ran into the bathroom and hid again because someone slammed a door shut" type of thing.

Do you have a PTSD diagnosis from a medical professional? That might be helpful. Some of the things you describe may be PTSD but some may not be related to it so piecing out what things targeted PTSD therapy like EMDR could help you treat would be an important first step I think.

Good luck. Sorry you're going through this.
posted by sockermom at 10:03 AM on June 22, 2014

Also: don't beat yourself up for things like signing up for a reminder service for meds. That's awesome and I hope you can look at that action and say "I figured out a way to do this part of my self care, go me" instead of saying "ugh I can't believe I need a reminder service now, what is wrong with me."

You are obviously working really hard on this and on taking care of yourself in general. It's obvious from this question. You might not be where you want to be yet but you are working on it and that alone is a tremendous victory. Be kind to yourself, darling. You're doing a great job even if it doesn't feel great.
posted by sockermom at 10:08 AM on June 22, 2014 [6 favorites]

Breathing exercises and meditation totally don't work for me either, they actually make my symptoms worse, but I spent a long time trying to make them work because I'd read they were supposed to help.

What I did was make a list of things that actually do work. For me, these were things like watching cartoons or something mindless, taking a hot shower, or lying under a bunch of blankets. The things that work for you will be yours, and will be totally idiosyncratic. If you start compiling these things, especially in moments when you are feeling more okay, it might be a big help for when you are having a hard time and it's difficult to think clearly about what might help.
posted by ITheCosmos at 10:12 AM on June 22, 2014 [2 favorites]

Going from what sockermom said, when I was laid out after a trauma, I worked on just doing two things every day, and taking my medications counted as one of those things. So, meds and a shower. Or meds and a walk. Or meds and dealing with one paperwork/bureaucratic task. After a month or so, I moved up to three things, then four, at which point it started to feel like I was living my life in an almost-reasonable way again and I stopped counting. But I always tried to give myself a break if I had at least taken my meds for the day.
posted by jaguar at 10:14 AM on June 22, 2014 [8 favorites]

Can you talk to your pdoc about meds? I have PTSD (though not as bad as I used to) and meds got me from filing for SSDI to working. But it took a lot of them. Even now, I'm still on a low dose of Klonopin to keep my anxiety in check.

Don't be ashamed to beat yourself up (yeah, easier said than done, I know) for needing a reminder service. I happened to pick up a to-do list app for free that really helps. I have to put everything in there, including meds, showers, brushing of teeth for a total of about 15 discrete tasks. What helps is that it is gamified with levels which helps keep me interested.

I wish I could second the breathing/meditation/exercise thing, but in all honesty, I can't. Relaxation type stuff just leaves me too much in my head and flashbacks are more intense since I feel like I let my guard down. Exercise gives me anxiety/panic attacks (though I've realized they're most likely related to hypoglycemia).

Diet. Plenty of protein and good fats along with fruits and veggies. I'm trying my hardest to limit my carb intake. I don't know that it is helping, but it certainly can't hurt.

Animal therapy. I love my kitties. One is a dunce and the other is a princess. But they both comfort me in times of need. Can you volunteer at a shelter or help a friend with their dog?

Acupuncture... perhaps I'm biased, but I wouldn't waste your money. There is nothing in the world of science that would give it support. I had it done a few times for chronic pain. Didn't help in the least (nor did the nasty herbal stuff the Korean "doctor" gave me).

All in all, just be kind to yourself. Keep up with your therapy. Journal if you can. Keep in touch with your docs. MeMail if you want to talk.
posted by kathrynm at 10:48 AM on June 22, 2014 [1 favorite]

kathrynm, can you give the name of the to-do list app?
posted by bunderful at 5:27 PM on June 22, 2014 [2 favorites]

Bunderful, it's called Carrot. It's iOS only I think. It's usually a paid app, but I happened to see it on Apps Gone Free one day and snagged it.
posted by kathrynm at 6:41 AM on June 23, 2014

One thing that helped me with horrifying nightmares was soothing myself by telling myself it was my unconscious working through stuff I couldn't face in the day.

There's exposure therapy too but look up arguments for and aganist.
posted by tanktop at 8:51 AM on June 23, 2014

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