Complex PTSD

The first half of this post is my own observations of experiencing what is essentially iatrogenic PTSD. The second half is a brilliant article on PTSD in general. 

My neuropsych doctor confirmed what was in this post about my own iatrogenic experience in another post.

Granted I have other more bodily related issues too, but the below article (cut and pasted) is a large part of what I am dealing with…“garden variety” complicated PTSD.

I sent the below to my neuropsych doctor and a couple of other people to get their feedback. I figured that I’d share it on the blog too, as I often do.

This is what it’s like to be me…severe PTSD…no doubt…the thing is the trauma was CAUSED by the actual psychiatric drug withdrawal nightmare…now it feels stuck…granted I had trauma earlier in my life but the serious damage was caused by the withdrawal…it’s freaky and I don’t trust anyone will actually understand how severe it is…the reason (my husband) lives downstairs is because of my startle response…this article explains it.

It’s compounded by the fact that there is physical damage caused to GABA receptors by the benzos, physical brain damage, iatrogenisis…so it’s not JUST trauma from the experience but also IATROGENIC trauma…truly ugly shit.

Yes, my spouse has been living on a separate floor from me because my startle response is grave and severe. If there is noise anywhere in the house *my body* responds in terror. Much like I feel as if  I’m in a war zone. It’s insane to *watch* myself respond the way I do, because, my mind is clear and it’s like my reptilian brain makes my body do stuff while I watch. And in my mind’s eye, I look like a terrified trapped animal. In my mind’s eye, there is a calmness while I watch my body do all this crazy shit. It’s very hard to explain and it’s horrible.

Anyway there is still much that is going on in my body too, this is only part of the picture. But it’s a large part.

Of significance is the fact that anxiety was never a primary issue for me.
I didn’t have anxiety problems before drugs. Not significant ones. This is drug damage that then in turn caused trauma. Now who knows what is what.

Many people who speak of this sort of thing on the benzo withdrawal boards don’t have a psychiatric history either. Some people get what resonates like PTSD and they were prescribed benzos for a muscle pain or some other non-psychiatric issue.

I shared this with my husband too his brief response was this:

I spent some time looking at benzo boards where people were talking about their experience of protracted withdrawal as a form of ptsd. There was nothing specific that stood out — beyond the fact that this seems to be far from uncommon.

I’m more interested in the question of treatment because this seems to be an issue (PTSD) that has received a lot of attention — obviously mostly for people who got ptsd for different reasons — and thus something that could be quite treatable. Indeed, it seems possible that you might be at a point where more of what you are experiencing is ptsd related than withdrawal related.

I would agree that that which is most disabling for me is PTSD now. I’m still in pain often but often enough if the PTSD wasn’t in full gear I’d be able to do more. My body is still rehabbing in many ways so it’s not like I’d be all better without the PTSD, far from it, but it sure as hell makes things much much worse than they’d otherwise be.

And so yes, there has been lots of study of complicated PTSD and while no one understands withdrawal per se, they do understand PTSD and there are some good treatments available and the good ones do not use drugs. How much would translate over to this particular manifestation of PTSD remains to be seen. I can hardly read, talk or write still these days, and that is not all PTSD related. I have real cognitive issues related to generalized brain damage of some kind too…but slowly I will continue to find answers that I might continue rehabbing and leave my damn house again.

The article was found here at a website dedicated to helping people with PTSD. PTSD Forum. I’m sharing it as an educational article as that is the spirit of the website it’s taken from.

Trauma’s Interaction With The Brain

The amygdala is the brain’s alarm, contained deep within our brain. The amygdala is the core of our issues with PTSD, and where we need to start so you can interpret your own image on how your reactions are forced upon you, instead of the rational decision that often comes a second or later, though often too late for the hurtful and spiteful things we say first, from a very misinterpreted and confused amygdala to our output.

The above image represents your amygdala. The normal place for the alarm (amygdala) is over to the left, being the safe place. Now, if something very extreme happens, being your traumatic event, the needle is now moved over to the right side, being the war zone. This is now where your needle rests normally. Now conceptualising the above image, your needle is already in alarm mode, so the slightest event will now trigger your internal alarm to react or respond to the most trivial things. It is like your neighbour having a cheap alarm fitted, whilst it detects a burglar, it also detects a passing truck, birds or a football hitting the house. So realistically, we could call your neighbour’s alarm faulty. Another model to explain this alarm reaction is the PTSD cup explanation.

With PTSD, you have developed a similar faulty alarm within your mind, being your amygdala. Unfortunately, each time the alarm goes off, you take it seriously. You may get angry with yourself for allowing your alarm to go off in the first place, though this only makes matters worse. You can no more stop your alarm going off than I could keep from blinking if I attempt to stick my finger in my eye. Very slowly you can coax your alarm system to move from the extreme right (war zone) backwards towards the Belfast position (being stable, but could explode anytime), then further back to your safe place once again, where a person without PTSD often resides.

Achieving this is not merely an intellectual thing, but a combination of mental thought and exposing yourself to things you avoid. It is like learning to swim. You may know with your head that you will float because of Archimedes’ Principle, but you only know it at an experiential level when you let go of the side wall in the pool. Inevitably getting the alarm back to the correct position is two steps forward and one back. If for example, you hear in the media of a trauma just like yours, the alarm will move over a notch towards the right, or as you expose yourself to self-interpreted fears, and real fears surrounding your trauma.

The drama of trauma is written by the hippocampal system involving the hippocampus and probably the pre-frontal cortex. This system is aware of what’s going on at the amygdala level and can send a message about how seriously the alarm should be taken. The only opposition to this is that if a particular traumatic aspect was so traumatic, it may have actually bypassed the hippocampus and burnt itself directly into the amygdala instead. This has an impact on memory recovery.

At this point, talking and writing about the trauma, each incident and its effects, are a critical aspect in the recovery of lost memories. If you try and block memories when they arise, you will find yourself attempting to think of other things – though the more you try and block the memories, the more you think about them, thus the more symptomatic response. This is only a brief point on this part, as exposure therapy is covered in more detail within the trauma diary forums.

The Bubble and Emotional Numbness

Those who experience severe trauma can become very concerned about their numbness or emotional flatness, which tends to make you feel like a bottle of soda without the fizz. Whilst the fizz will not return on its own, it will return gradually and often unexpectedly if you engage in increasing doses of activity. Unfortunately, you will feel as though you reside within a bubble.

You will feel as though you cannot connect to others, because of the differing settings of your alarms that they cannot possibly understand if they have not been through the severity of trauma you have. Heroic behaviour means gradually acting opposite to the feeling of flatness and disconnection. To begin with you will feel like a robot going through the motions, but you are pressing into the service part of the brain’s command / demand system (the anterior cingulate and dorsolateral frontal cortex) that can override fearful messages from the hippocampal / amygdala system, so that over time and with daily practice, the fear may still be there, but it becomes a fear that you are no longer afraid of, more accept it for what it is, a memory.

It takes a lot of energy initially in small, controlled doses to burst the bubble you feel that you reside within, and reconnect to people once again. You must not blame yourself for the flatness of fizz or being within your bubble, because you are not responsible for the problem – only for working on the solution.

My neuropsych doctor confirmed what was in this post in another post.

About Monica Cassani

Author/Editor Beyond Meds: Everything Matters