Saturday, April 20, 2013

PTSD: Mischief Managed

That's my mom. She's VERY supportive, as you can see.

As many of you know, I've been hearing this diagnosis for months now--maybe a year or more, even. I'm not sure, because I just put it right out of my mind every time, because that's ridiculous, right? Post-Traumatic Stress Disorder? That is something that soldiers get, from the chronic stress of being shot at night and day, or being in explosions, or seeing their friends killed. Not from being... well... me. It just felt presumptuous, or something. But my GP has been saying it the longest. "Belinda, you're dealing with a good deal of PTSD after everything you've been through." I should have listened to him, because he also treated Alex, and he's been in on EVERYTHING. And then there was the therapist who saw both Alex and myself, and the two of us jointly. "Belinda, it sounds like you have PTSD." Nah, I'll be fine--I'm doing so much better already, see? Watch me spin these plates!

Because I "overshare," but moreso because so often, things I've "overshared" here have helped others with similar problems, I want to talk about this. My overriding symptom is a tremendous anxiety/panic, that manifests in tachycardia, sudden and instant all-over sweating, flushed skin, nose and eyes dripping like faucets, lightheadedness, and that classic feeling of "impending doom," when there is ZERO emotional stimulus happening, and I don't, intellectually, feel panicked, anxious, or even upset about ANYTHING. It was always the worst upon waking, and I wasn't getting much sleep to begin with. I felt like I was having a heart attack, and of course, that fear made all the symptoms was misery.

At first, I would just wake up and immediately hit the treadmill, without even getting dressed or anything. It felt like I had adrenaline poisoning that HAD to be worked off. Sometimes it seemed to help. Sometimes. It felt better than doing nothing. Then over the course of a year or more I just took benzos. Xanax or Klonopin, low doses, 2-4 times a day. Xanax ER worked really well for me, but my insurance wouldn't cover it, and $200/month for one prescription just wasn't something I could sustain. Plus, I was just treating symptoms and not addressing the cause. Which I was NOT acknowledging as PTSD.  So my GP started running heart tests on me, "to rule things out." He knew there was nothing wrong with my heart, but he's not the kind of doctor to not listen to his patient's concerns. When those tests turned up nothing and I was still complaining about my heart, he referred me to a cardiac specialist and a neurologist.

Guess what they both said at our initial consults? "It sounds a lot like PTSD." The neurologist recommended Buspar to "reboot [my] neurophysical responses," did some tests, then told me to get finished with the cardiologist before seeing her again.  She wore jeans and cowboy boots, so I took her very seriously. My cardiologist looks like a more-handsome Don Cheadle, so I took him VERY seriously. He ran tons of tests, including a 24/7 heart monitor, which was the only thing that turned up anything out of the ordinary, that "anything" being exactly what I'd described--periods of sudden racing, pounding heartbeats for no apparent reason. I had more tests, which were normal. I have not yet had my followup with him, but I've gotten letters saying as much.

In the meantime, I had still been seeing my wonderfully patient and thorough GP, who is some kind of Norman Rockwell throwback to the "family doctor" of some ago time. He sits down and TALKS to you, refuses to see pharmaceutical reps during office hours, and won't have any drug-branded products in his offices. And he's a ginger. I love him. Anyway. Going at it from the anxiety angle, we'd tried a few of the antidepressants (starting with the neurologist-recommended Buspar) that are used for anxiety disorders, but without success. Just like all other anti-depressants, they had the unfortunate side effect, in me, of ...wait for it ...CAUSING PANIC ATTACKS.  Yeah. The anti-crazy drugs make me crazy. So I'd just kept taking the benzodiazepines, and they were getting less and less effective.

This brings us to a couple of weeks ago, when I was sitting in my GP's office, shaking and crying and begging for help. I had made an appointment with a psychiatrist, because I recognized that something was going on with my brain, but it was going to be weeks and weeks before I could get in. In the meantime, I was dying. Or at least that's how it felt. He said (I paraphrase, because I didn't take notes), "Belinda, you have lived for over a decade under constant fire. Maybe not from bullets, but it might as well have been. Your brain and your body are now conditioned to respond to every little bit of stress in a certain way, and absent a real-time crisis, you're just eating yourself up from the inside. We have to do something--you can't go on like this."

And that's when he pulled out (what was to me, anyway) the big guns: a class of drugs known as atypical antipsychotics. Which made me go, "NUH-UH," because while I might be a little crazy, I'm definitely not psychotic. ALEX took those drugs, and he was capital-C Crazy. But then I realized that he never had a psychotic episode in his life, and HE didn't balk at the label.  And intellectually, I knew that this class of drugs is seeing a LOT of off-label use. I still said no, because I'm smart like that. So Doc wrote me another prescription for Klonopin, and said to call him back in TWO WEEKS, no less, if I wasn't remarkably better. And off I tottered to the pharmacy... and when they brought me my prescription, it was two prescriptions: the one I'd been expecting, and the other that I'd refused. Tricky, tricky Doc! So after a lengthy discussion with the pharmacist, who assured me that it was a small dose, and that, as the doctor said, it would only be temporary, I went ahead and took it home, where I reflected upon it some more.

And then, as bloggers are wont to do, I took the issue and crowd-sourced it. Albeit more privately, with a select group that I knew had experience both with this drug and with anxiety disorders. For once in the history of the Internet, the response was entirely unanimous: TAKE THE MEDICINE. It's temporary, it will help you, and (paraphrased) you're being kind of stupid about this whole thing.

So I started that night. Two weeks later, the relief I'm getting is phenomenal, and I wish I'd done this an age ago. And if you are reading this and have lived the kind of stuff I've lived, know that it's impacting you. I held it together amazingly well for a number of years, but after all was said and done, it caught up with me, in spades. I WAS living under a hail of bullets and explosions, to the metaphorical point that every sudden or loud noise sent me crashing to the ground with my hands over my head. I'm still a bit twitchy, but I absolutely believe that I AM, in the words of Doc, restoring my brain to factory settings. And even though I know it's temporary, a this point, at this level of relief, I don't think I'd care if I were told to take this medicine for the rest of my life.

Heck, maybe I'll even get away from the house. Living with Alex, I really couldn't get away, nor could I have people over. Afterwards, that mindset was pretty much all I knew. Even when I DID begin a new relationship with a man, it was with someone who was "safe" in that he didn't live here, was a bit emotionally unavailable, and was of an age that made it pretty well a sure thing not to last. That wasn't an accident, I don't believe. My subconscious operates on a HIGHLY EFFICIENT LEVEL. Be afraid. But do come visit, or let's go out, shall we? I think I can safely promise not to cower underneath a table at any point unless an actual air-raid siren goes off.


  1. I am soooooo proud of you. I know how hard it is to start taking those pills. I am so happy that you are feeling a difference already. And that you aren't blacking out hourly. XOXO

  2. You deserve to be healthy and happy. You're an amazing woman.

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  9. Take care of yourself. I mean that. My meds may be anti-depressant, not anti-psychotic, but we both know that meds that help us face the world can do a world of good.
    As for that awful and impossibly long wait for psychiatric care - get with it, medical profession. People are dying here. Got it? Good.