Living with PTSD – It’s A Long Way Down
In the first of a three-part column on PTSD, Paul Fjelrad looks at the misconceptions and reality of the condition - and how he found help.
Most of what people think they know about PTSD, is wrong.
If I said to you, “in just 5 minutes, I can teach you how to earn £1 million”, certain questions and thoughts appear immediately in your mind:
“Is this a scam?”
“How would I do that?”
“If you know this, why haven’t you done it yourself?”
The same thing happens if I reveal something personal such as, “I haven’t spoken to my father in 5 years”. You probably would want to know what went on 5 years ago, and perhaps make some assumptions on what you think happened.
So, what thoughts and questions appear in your head when I say;
“8.5 years ago I was diagnosed with Complex Post-Traumatic Stress Disorder”?
During my therapy, I took an early decision to start to speak openly about my diagnosis, and the life that led to it. Not because I wanted to embark on some crusade around mental health awareness and the associated stigma, but because it was a critical part of my healing process. For the vast majority of my life I told almost no one about the things that had happened to me, in fact, for more than 30 years I even tried to keep them a secret from myself. It wasn’t until my mid-30s that I even used the A-word, Abuse, about myself.
But I’m not going to recount that life, and the circumstances leading up to my diagnosis, here. If you wish to understand more about this, then please read my previous article, Behind Closed Doors – The ugly truth about hidden abuse, or take a look at my stories on Medium via the link below. What I am going to talk about is how it felt during my descent into madness, and how I didn’t just have to process my own reaction to my subsequent diagnosis, but also everyone else’s reaction to me talking openly about it.
So, now you’ve had a little time to think, what did you think when I made the statement above about my PTSD? What questions popped immediately into your head?
Some genuine examples of the reactions I’ve received are;
“What, like in Rambo – First Blood?”
“So, were you in the army?”
“I completely understand. I had a difficult time last year as well.”
“I don’t think people get enough credit for just getting on with their lives, without feeling the need to tell everyone about their difficult childhoods.”
…yeah, I’m not kidding about that last one, and that was from a school teacher!
But the most common response I get, by a country mile, is this;
“Really? What caused that?”
PTSD is difficult for people to understand, not only because of the lack of good information about it, but also because it typically takes 4 to 6 months to develop after the traumatic events that triggered it. Complex PTSD typically takes years, or as in my case, decades before it emerges. But in either case, once it does emerge, the consequences are devastating, and frequently life-threatening.
In the months before my diagnosis, I was completely unable to deal with or process any negative emotions. I’d burst into a flood of tears at something as innocuous as an episode of Frasier, and even a minor disagreement with my girlfriend would escalate into hysteria, and uncontrollable fits of despair and rage, causing me to smash things, or punch walls until my knuckles bled. Then the nightmares started, until I didn’t sleep for nearly 2 weeks, due to fear of the endless reel of horrors flooding through my head. I thought I had escaped those horrors by not sleeping, but they rapidly followed me into the waking world in the form of flashbacks.
If you think you understand flashbacks from seeing the scene of Rambo in the police station, you don’t. At this point, it didn’t require a trigger for me to be thrown into a waking nightmare, I was simply being bombarded by traumatic images, voices, even sensations on my skin, but mostly the emotional and physical reaction to traumatic events that were no longer in the past, but were there with me in that moment. This wasn’t simply reliving memories, but rather this was happening to me, now. Thrown from one nightmare scenario to another, sometimes in sharp detail, others in a disjointed, surrealist montage of sensory inputs.
Whenever I thought for a moment that it couldn’t get any worse, it did. Not just in the nightmares and flashbacks, but in the very real pain I began to experience during these attacks. Have you ever been so distraught, that the urge to cry is accompanied by a deep ache in your chest? That’s how it would start, but the pain would then escalate, until it became unbearable, continuing to grow until all I knew was the pain until I was afraid I might die. Even then the agony would keep intensifying until I wished it would kill me, just so the pain would end.
I still don’t know how I summoned the strength to contact the Brighton Therapy Centre, or how I dragged myself to the initial assessment. The mere thought of therapy terrified me more than anything I had experienced during my life. I was fortunate that the director of the therapy centre reacted the way he did to my call. I can only assume he heard something in my voice that told him, if he didn’t get me some help immediately, then it was very likely I wouldn’t be alive to receive it later.
When I was given the actual diagnosis, my first thought was that can’t be right. I wasn’t a soldier, I hadn’t been in a fire, a car crash, or a war zone. I hadn’t been raped or tortured, yet here I was being told I had PTSD, by a therapist who was a specialist in working with torture victims. Reading between the lines, my first thoughts were I didn’t deserve this diagnosis. Somehow it being given to me, was an insult to those who had genuinely suffered trauma.
This is a common reaction, that PTSD is something reserved for soldiers. I felt so ashamed, weak, and helpless that I had let my much less worthy life experiences, somehow belittle the genuine sacrifices and trauma of literal war heroes.
Perhaps this explains the most common response I get to my diagnosis. Usually accompanied by a somewhat confused glance, and head tilt.
But think about that for a moment. Because what that question is actually saying is;
“Really? Are you sure? So, you’ve had life experiences that are SO traumatic, that they quite literally broke you? Would you list and detail those traumatic experiences for me?”
I understand the natural human curiosity behind this. But as the person on the receiving end, perhaps there are better ways to react, as you’re talking to someone who is almost certainly struggling with the symptoms, the causes, the diagnosis itself, and everything those 4 letters embody in our collective misconceptions about psychological trauma.
Also, and I want to be really clear, I did not end up with this diagnosis due to a lack of mental toughness or psychological resilience, just as I didn’t survive these things and get through therapy, because I was somehow braver, or stronger than the many who sadly don’t make it.
I was lucky.I was lucky in having a daughter, who regardless of her youth, her autism, and her own struggles with mental health, stood by me, listened to my stories. She supported me every inch of the way through my treatment, even through the pain it caused her, and how my history and mental health had impacted her life.
I was lucky to have friends who stuck by me, even when I tried so hard to push them away.
I was extremely fortunate to reach out to the amazing people at Brighton Therapy Centre, and almost unbelievably lucky to be put together with the therapist who knew how to work with someone like me, and stuck with me no matter how difficult I made it for him.
However shouldn’t it be more than luck?
If the predictions come true, and that one of the long lasting impacts of this pandemic, is a tidal wave of mental health issues, and PTSD amongst our healthcare workers, then don’t we as a society have to find a way to be better at this? Because right now, from this end of the diagnosis, it feels like I lucked-out at Russian Roulette, only there were five bullets in the gun, not just one.
I was lucky to have the wherewithal to get help privately. The access to support through our NHS has to be improved. Whilst I respect the difficult job that GPs do, it makes no sense to have to go through a GP for a referral to a therapist, makes less sense for GPs to be prescribing antidepressants, without any accompanying therapy, and it should be to our national shame, that it can take many months to get an assessment, and even longer to get a therapist assigned.
We as a society, have to be better at having conversations about mental health, and making it easier for those who are struggling, to talk about it. Perhaps it would also be better if the most common response to someone telling you that they have PTSD, would be;
“Thank you for sharing that with me. Is there anything I can do to help you?”
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