A Continuation From Yesterday- Anxiety and Public RestRooms

Okay, I thought I’d give another example of simple pervasive anxiety and how I have to walk myself through it.

Public Bathrooms.

That’s right- public bathrooms. Every time I go in I check the door, make sure it says ‘women,’ and then for some weird reason once I’m actually in the bathroom think I went in the wrong one.

Of course this is ridiculous, especially at work when the men’s bathroom is down the hallway about half a block. But the minute the door opens I think I entered the wrong one and will get in trouble.

So I have to think: Okay, you checked the door twice, yes? You hear the copier; the copier is outside the women’s room. This is the ladies room. There were no urinals when you entered- this means it’s not the men’s room. And if it was? So what? You are in a stall, they can’t see you; you can’t see them. Everyone goes to the bathroom.

These thoughts get worse at school, as the men’s and women’s room are right next to each other, but again, there are no urinals when I enter so why the thought that I entered the wrong room? And more importantly, what does it really matter?

It’s funny to me because in life I have purposely gone into the men’s room many times, such as at plays and in restaurants when the woman’s line is too long. Nothing happens. Once, one guy was a bit off –put but then laughed it off. (I do make sure the room is empty by asking a man who comes out, and a friend usually watches the door, or a manager). So what harm is there? Heck, I’ve even had to cover a friend once when both lines were so long she went around back to the bushes. Nothing bad happened (though I suppose that time what she was doing WAS illegal) so why the anxiety?

The simple answer in my mind is that when that stress or whatever hits it tries to find a way to completely undermine myself and take away my self-control. Depending upon how self-confident I am, I might worry until I see some feminine shoes walk by, though I’m stopping myself faster now as the CBT comes in – the main thing being, I already checked the sign twice, I know the area, and in the end if I’m in the wrong bathroom who really cares?

It just annoys me at times that these thoughts creep in and can be so pervasive about such stupid little things.

Picture taken by Stefan Kühn from http://commons.wikimedia.org

What Is Post Traumatic Stress Disorder?

Per the National Center for PTSD:

Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.

They go on to say that:

Many people who go through a traumatic event don't get PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include:

• How intense the trauma was
  
• If you lost a loved one or were hurt
  
• How close you were to the event
  
• How strong your reaction was
  
• How much you felt in control of events
  
• How much help and support you got after the event

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years.

What I think it leaves out in the bullets above is the duration of time spent in a situation. Would I have PTSD if say, I was taken away from my mother before I ended it myself in my twenties? If someone, any one had helped me, how would I be today? I had no control over my life, thoughts, or actions for so many years. In fact, for most of my life the only thing I could do was react, never act. I reacted to her moods, to her actions. It was pure torture for those 18 years I lived directly with her, and to think I didn’t cut ties until I was twenty-something!

No one knows for sure why some people get PTSD and others don’t. Is it brain chemistry? A hormone, a release of some chemical when trauma happens? There is a lot of controversy still about an experimental PTSD drug. I think it’s still in clinical trials. What it does is deaden the emotions during a traumatic event. Thus, if say something explodes like happened Wednesday, and you take the pill it won’t attach the fear to the memory so the theory is later in life if something like that happens again you won’t experience PTSD symptoms.

So what are PTSD symptoms? They vary a lot. The DSM-IV lists three different groups of symptoms, the first are intrusive:

• Distressing memories of the event
  
• Distressing dreams of the event
  
• Acting or feeling as if the traumatic event were recurring
  
• Intense psychological distress when reminded of the event
  
• Physiological reactivity (sweating, heart racing, etc.) when reminded of the event.

But leaves out the symptoms associated with each of these. For instance, when memories starting coming back that cause ‘distress’ or ‘anxiety’ one can feel dizzy, faint, light-headed, confused, start to shake, get chills, have stomach cramps or nausea, etc. I suppose some of this is listed under Physiological reactivity. I always thought the dizziness was from something else, but had a clean bill of health. Yet when I start to remember or something happens my mind swims. Like all things, symptoms differ with people.

Others are listed as ‘numbing’ symptoms:

• Efforts to avoid thoughts, feelings, or conversations associated with the trauma
  
• Efforts to avoid activities, places, or people which arouse recollections of the trauma
  
• Inability to recall an important aspect of the trauma
  
• Markedly diminished interest or participation in significant activities
  
• Feelings of detachment from others
  
• Restricted range of affect and emotional responsiveness
  
• Sense of a foreshortened future

Which really blew me out of the water. I thought my personality was gloom and doom, even though I remembered fighting against my mother to not watch COPS and other such programs about the worst in society all the time. My favorite color was yellow for a long time and then suddenly I wanted the world in black. I felt every one of those above so strongly, especially the last. I never thought I’d live past age 21 and when I did, didn’t know what the hell was going on. I still have problems with feelings of detachment, like I don’t belong anywhere and can’t connect with people. And of course the third on the list – inability to recall an aspect of the trauma – there are a lot of black holes in my memory. But considering what I do recall, it’s probably best they stay that way.

Lastly are the ‘hyperarousal’ symptoms:

• Difficulty falling or staying asleep
  
• Irritability or outbursts of anger
  
• Difficulty concentrating
  
• Hypervigilance for signs of danger
  
• Exaggerated startle response

I always know something is up when my sleep patterns change, because damn, I love to sleep.

There are many theories on treatment and I am doing what is called Cognitive Behavioural Therapy, or CBT. Per Wikipedia, “The particular therapeutic techniques vary according to the particular kind of client or issue, but commonly include keeping a diary of significant events and associated feelings, thoughts and behaviors; questioning and testing assumptions or habits of thoughts that might be unhelpful and unrealistic; gradually facing activities which may have been avoided; and trying out new ways of behaving and reacting. Relaxation and distraction techniques are also commonly included. CBT is widely accepted as an evidence-based, cost-effective psychotherapy for many disorders.”

So I have a checklist of symptoms that once a month we check. When a traumatic event happens, I go through and see my reactions. I do feel like a computer doing a system check, but since neither my body nor thoughts were ever really mine growing up, I’m just beginning to learn how I work. She goes through relaxation exercises with me and we talk about situations and how I feel during them. It may sound simplistic to some, but it is so hard for me to understand how I’m feeling at times and with everything, once it has a name, you can begin to control the beast.

I hope to post more information and get more links up soon. I’m new at this and still feeling my way around.

That great painting above is from http://www.refuter.com painted by Dmitriy Kedren