Therapy Tuesday : Mental Health Awareness Week (C-PTSD)

I hate the word anxiety. To me, that implies being anxious about an exam or something. Let me tell you a story. 
*trigger warning*

A long time ago, longer now than it seems, a little girl was born into a family that would shape her view of the world for the rest of her life. This isn't unusual, indeed, it is the norm. What separates this little girl from the lucky ones, is that this family was not somewhere she should have been. 

She spent her life hiding in her 6ft by 8ft bedroom. Sometimes openly, sat on her bed reading a book to escape, but sometimes hiding underneath the divan bed or buried in your tiny wardrobe. Why? There was noise, and noise meant something absolutely terrible was about to happen. She didn't know what or why, but it was sudden, unpredictable and without explanation and she was always bracing herself for it. 

School was her safe haven. She began seeking out the love she wasn't getting at home from a select handful of teachers. It's a wonder they didn't read into this, but in the early 90s this wasn't the 'normal' protocol. 

She lived with her mother, father and younger twin brothers until the age of 12, when her parents separated. This turned her world upside down and inside out. While her father was the main source of terror, she had been brainwashed for many years by him. She was told that she was not wanted or loved by her mother, that she was more concerned with her brothers and he was the only one that would be there to love and protect her. As long as she didn't put a toe out of line.
No talking. No asking questions. No crying. Nothing. Silent, complete and blind obedience. The kitchen door was locked. No leaving the bedroom from 7pm. He would sit on the stairs, and wait. She learned the sound the steps made, and which floorboards creaked, so she could use the bathroom in safety.

Her father ruled with an iron fist and terrorised the children to keep them 'in control'. This little girl's brothers were autistic, but this wasn't recognised at the time. The little girl was essentially a dummy used to demonstrate punishments, because she had already learned how to disconnect and not feel any pain, unless he said so. However, what happened then was she would blindly shout and cry just to get it over with. 

When she reached 8 years old she began to notice arguments between her parents. They were aggressive and she had an innate urge to still protect her mother and seek out her love, knowing full well what would come later from her father. She didn't care. She still wanted her mother, despite the face she was never there for her.

During one night-time argument on the landing of the upstairs of the house, she came out from her bedroom and stood between her parents, screaming at them to stop. Her father picked her up and threw her 10/12 feet into her bedroom, hitting the wall and landing on her bed. Her mother did nothing. She automatically went limp, but remained conscious. A year earlier her brothers had pushed her down the stairs, which led to a hospital admission due to concussion. Her mother wasn't there then.
She had given up trying to get her mothers love. She had earned the nickname "leechy Louise" for the times she would seek out a cuddle and was always pushed away. Her brothers were more important. She was being physically attacked by them regularly by now and was of course being over-powered. If she was unwell, she was always told to "die quietly".
When August 1997 rolled around, shortly before her 10th birthday, and something incredible happened. A little West Highland White Terrier came into her life. This little puppy was her absolute everything. She felt love for the first time in her life, gave twice that and more back, fiercely protected her and ensured she was happy. Her bond with animals was born. 

Her teenage years were no better. Alone in a house with her mother and two brothers. But she had her Westie and that meant she was ok. High school was a living hell. She was bullied and constantly betrayed by so-called friends, and began to drink and abuse drugs to escape. She also began exhibiting signs of dissociation and was not eating. In 2001, she also began having incredibly painful migraine attacks. There was a massive campaign about parents who didn't send their children to school being prosecuted or even jailed, so she was forced to go to school more often than not.
At the age of 14 she was sexually assaulted.
She left school in 2003. She also left her mothers house to live with her father. She started working the day after her 16th birthday. She went to visit her grandparents that new year and was involved in a car crash with her grandmother. The car was hit from behind and sent flying across both sides of the dual-carriageway. They weren't seriously hurt. Her grandmother was miraculously unharmed but she acquired a nasty whiplash injury to her neck and back.
The car was a write-off. Seeing the damage, being surrounded by blue lights and the feeling of imminent death led to a very basic response. She wanted her mother. She called and called to no answer. Eventually she got a reply, to which she explained what had happened, only to be told to stop being so over-dramatic. 

She left her fathers flat a couple of months later, for her own safety. 

Back at her mothers house she was subjected to a campaign of emotional abuse which didn't stop until she was forced out of the house following a complete mental breakdown and suicide attempt in 2006. She was stuck in a bedroom smaller than her childhood room, with her abusive boyfriend. She had two options. Live on the streets or live with him. She did however, find the strength to finally stand up to her father. She had nothing left to lose. They never spoke again.

For the next 3 and a half years, she was emotionally, physically and sexually abused. She developed a serious eating disorder and alcohol dependency began to manifest itself. 

Following her escape, she was left with the aftermath. For the first time in her life she was on her own, and therefore safe. The worst was over for a while. Her Westie passed away in 2010. She still hasn't recovered from the trauma. 

The end. 

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I have a condition called generalised anxiety disorder. This means I 'worry' about anything and everything on a constant loop. It never stops. I'm perpetually scared. I plan for the worst. I'm a perfectionist. On the back of this, I have been diagnosed with PTSD. My psychiatrist described it as Complex Post Traumatic Stress Disorder due to my specific cluster of symptoms, but also explained that the latest DSM revision did not accept this as a unique condition, much to his - and many other doctors and patients - frustration!

What is anxiety? 

Anxiety is a biophysical response to fear provoking stimuli, courtesy of our friend we love to hate, adrenaline. Adrenaline primes the body for the 'fight-or-flight' response which lives right at the back of our brains and isn't something we can get rid of. It's there for a good reason. The trouble is, rationality doesn't factor in to this region of the brain. It's basic survival. Cavemen didn't have time to question whether or not there really was a lion outside his door.
I'm currently working on a much more in-depth anxiety post with material from the day hospital so this is a very basic run-down. 

So people with anxiety disorders, at it's worst, feels like you're living with a lion that's been starved and is foaming at the mouth while stalking you. 

The fight-or-flight response is physical and unbelievably scary if you experience it out of context. 

- Your heart rate increases and you may feel like it's about to burst out of your chest.
- You feel hot as all the blood rushes to the large muscles, preparing you to either kick the shit out of something or run the hell away.
- You may start breathing faster to accommodate your elevated pulse rate, possibly making you hyperventilate. This is where most people tip over into full-on panic attack.
- You might feel dizzy, sick or have an upset stomach. This is the body's way of basically clearing out ready for the danger. It doesn't have time for digestion so it just get's rid of it. Nice, eh?
- Your vision might go blurry. 
- You will be incredibly alert and aware of your environment. This is called hyper-vigilance and it's a nightmare to live with.
- Everyone will get the "ohmygodsomethingreallyshitisabouttohappen" feeling and feel compelled to either look for the danger or escape at light speed.

This isn't a complete list by any stretch but are the most common symptoms. I also shake uncontrollably and occasionally experience pseudo-hallucinations. Insomnia also factors in hugely in my anxiety; it's due to being in a hyper-vigilant state - looking for the lion outside my door. The reality is I am compelled to continually check my house for danger and make sure everything is locked and shut. If I don't do these checks I feel like I will explode and usually end up in full-on panic.

Being in an anxious state changes your thought patterns and behaviours drastically. You believe your automatic thoughts and take them as 'intuition'. No-one likes being 'anxious' so it's absolutely normal to stay well clear of the situation or environment that provokes this. I have only been able to function these past two years due to 'safety behaviours' that limit and control these anxiety symptoms. They're a psychological bandage, which I'm slowly letting go of.

The Vicious Cycle of Anxiety:
By it's very nature, being in an anxious state is paralyzing. In the context of PTSD, this is exacerbated.

The Vicious Cycle in PTSD
The Vicious Cycle of  PTSD
What really grinds my gears is when people tell me to 'calm down' or 'stop being so ridiculous'. Please understand, those with anxiety are trying to control the uncontrollable. It takes years of practice to even get to grips with the basics. I'm just as frustrated as you by being in this position, believe me. But if I start stressing out about that too, we'll never get anywhere and I'll just end up avoiding you too.

Think back to the last time you were worried or scared about something. Now imagine that on a constant basis that only ever escalates. This isn't just for a day. Imagine feeling like that for weeks, months or even years at a time.

That story I told you at the beginning? That's the root of my 'anxiety'. I've spent all but the past 5 years of my life living in psychological war-zones. Is it any wonder I see danger wherever I go? Is it any wonder I'm always bracing myself for the next attack from someone? My brain is stuck in survival mode. On an intellectual level I know I am in no danger, but the automatic thoughts tell me otherwise.

My brain developed a release valve for when the level of fear/anxiety is too much. Dissociation is an off-switch from conscious awareness. This protects it from further damage, essentially. Again, I will be talking about this is much greater depth in further blogs. 

So. If you have a friend or family member with anxiety, please just be kind to them. Don't force them into things they can't handle. Help them with their breathing exercises, listen to their fears and do not tell them they're ridiculous or stupid. Ask them what would make them feel better. If they want to be left alone, that's ok. Just check on them in a few minutes and stay within ear-shot. 

Finally, these are my five golden rules for getting through an anxiety or panic attack:

Golden Rule 1: Do not fight it. Accept that this is a surge of adrenaline going through your system, and within 20 minutes it will be over. No-one has ever died from a panic attack. This is a very primal response and our bodies are built to deal with it.... much like child-birth!
Golden Rule 2: Be kind to yourself. Be aware of your thoughts but don't argue with them. That will just prolong the whole thing or trap you in a cycle of panic attacks. 
Golden Rule 3: Become an absolute master of breathing exercises. My personal favourite is: breathe in for a count of 4, visualising blue, then breathe out for a count of 4, visualising red. I like to think of myself as setting fire to my anxiety attack and breathing it out like a dragon... ;)
Golden Rule 4: Write down what triggered your attack, what you felt and what thoughts you had. This is invaluable in working to get shot of the attacks for good. 
Golden Rule 5: STOPP! Stop and step back. Take a breath (or 20). Observe. Pull back for perspective. Practice what works (no, not drinking or getting high...)

Thank you so much for reading. If you have any questions, please fire away and I will do my absolute best to help! Also, feel free to share your experiences of anxiety and what helps you.

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