View source for PTSD symptoms

There are a lot of good resources including books that describe [[Trauma]], PTSD and its symptoms. However, the effects are so devastating, that they do require repeated and multiple explanations for people who have not experienced it to at least get some understanding of it. To read further go to [[Trauma related resources]].

I keep a short list of tools that I found helpful coping with some symptoms at [[Daily functioning tips]].

== Misunderstanding of symptoms ==
For the first 4 years sometimes it was frustrating when I was explaining how I feel. I was telling to GP, psychologist or other people who could help or asked how I am, that I am constantly in state of fear as if something life threatening is happening right now or will happen any moment now. In reply I would be told that there are antidepressants and it will increase my mood and therefore will solve my problem. I would try to correct that I am not feeling depressed the problem is persistent fear, that I felt when I got hit by a car. That after 40 min of sleep I wake up terrified. I would get suggested that I should move on, not to think about it ever, just block these feelings or thoughts and do not ever mention them and everything will be fine. I wanted to tell them what about I hit you very hard with some hard object. Then I will give you an apple and you will no longer fell hungry anymore and you will be fine as nothing has happened.

Of course I never hit anyone, but the mismatch what I was saying and what I what people wanted to think about was huge. After being admitted to PTSD treatment research program by [http://www.traumaticstressclinic.com/ Traumatic Stress Clinic] I was surprised how well I was understood. Finally understanding what it is and how it works I wanted to write about my experience, so other people can avoid similar situations. However, dealing with QBE created additional stress and writing become very difficult.

Few years latter I started reading book [[Trauma related resources#Information about PTSD | The Body Keeps The Score]]. He describe many of the symptoms I experience much better than I ever could. For a time I was thinking I do not need to write about it, just reference this book. However, there were many symptoms and not all apply to everyone. Some of the symptoms are complex enough that it took me long time to understand them or that they may be related to PTSD. However, when I mentioned to specialist I was told that it is part of know PTSD symptoms and explained its affects. After feeling of being stupid has passed I realized - I still need to write about it.

== Life on hold ==
Trauma and consequent PTSD affects all aspects of my life. The best way to summarise it that my life was put on hold in suspended agony. Most of the time I operate in a shut down or autopilot mode. In this mode everything is subdued, including cognitive abilities, emotions, memory, goals, control and even self awareness. It is like a large part of yourself gets disabled. It feels more like a nightmare than real life. I spent way longer in this mode than being aware of what is happening or in control of my life. It significantly impairs my life.

=== Loss of not living your life ===
You may spend few days in bed not being able to anything if you get very sick with something like a flu. You still feel like few days lost, but it is fine. You can deal with it. Now imagine losing 10 years like this. Years that were going to be the best years of your life now become the horror.

This is very big and painful subject I will come back at it later. However, I can not just put it aside, the pain of loss is bombarding me all the time. Everything I see keeps me reminding it. The only path I see right now it to keep reminding me" "[[Daily functioning tips#It has already happened | it has already happened]]. I have learned what I can, but there is nothing else I can do about it now. I need to focus on what I can do now."

=== Incapacity to act ===
One of very devastating changes after the trauma is incapacity to act. The trauma and PTSD dramatically changes you capacity to function. There were many things that you could do to help yourself, but you cannot. It is documented in many studies about PTSD, but it is very hard to grasp. Even why being affected by it for more than 9 years I cannot believe it. It is just not me. It is out of my character. It is the same for not doing the things you want and need to do and doing the things you do not wand and should not do. There were many reasons for this:
* learned helplessness
* overwhelming fear
* cognitive decline
* exhaustion
* risk avoidance
* and so on.
I wrote about this many times before, so in time I will include this information. This is very big topic, not discussed often.

==== US troops leaving Afghanistan ====
My level of feeling of helplessness can be explained by example. If you have seen US troops leaving Afghanistan in 2021 and afghans clinging outside of the plain. I can identify with them. You can ask why they do not put an effort to protect themselves, better die fighting for your rights. They have been given a chance. But they do not see that option, they see clinging on the plain as the only option of survival. This is what trauma does to you. It makes you blind. I do find myself being blind same way. I may not see some path now too.

Doing anything related to the injury feels like I am going to cut my wrists. My body reacts as if I might not survive it. It is an enormous amount of fear and the body tries to protect from it by causing panic attacks or blocking anything related to the injury.

When I seen that story on the news it worked as some form of wakeup call. I saw my self in these people who were holding to fake hope and heading for certain death.

== Intrusive thoughts, flashbacks ==
The bombardment of memories of trauma and events related to it never stops. There can be visual memories, sensations, or just a feeling. Thoughts usually come after this. Most common thought is disbelieve "''How could this happen?''". There might not be even particular memory associated with it, just sudden memory of deadly danger, that feels real and valid. Often these memories and thoughts are called flashbacks.

== Insomnia ==
Insomnia is a major issue after trauma. I had no restful sleep a single night since the injury.

I wrote about it so many times before, that I do hesitate to write again. I will need to find and upload this information. However, it is in bits and pieces in many places, so it will take a long time. I also do not have any good solution.

=== Nightmares ===
It feels that nightmares are form of intrusive thoughts that come at night and significantly disrupt sleep. Now I have two types of nightmares. They are very different, but the emotional disturbance is at the same level:
# '''Deadly threat'''. I used to have reacquiring the same nightmare of me be hit by a car. After few years it started changing to some different types of danger, but it always remain deadly threat. Most of the cases I do die in my dream.
# '''Great loss'''. Most of the time it is loss of time. More common scenario is that I dream of my life before the injury and I am happy. This is the only time I experience happiness these days. Then something happens and I lose all of it together with many years of my life, or sometimes I just have a feeling of incoming loss.

No matter what scenario it is the effect is the same. I feel overwhelmed with fear or grief. Just writing this bit brought my heart rate to 127 and it stayed high for a while. To get a glimpse of the effect try to remember the most frighting experience or biggest loss you had. Something like when your life was in danger, or you got injured, or someone close to you died, or something more simple like break up, especially early in life. Now try to remember that feeling and how you functioned then. Then imagine reliving it every night with the same intensity. You do not want to go to sleep after that.

== Cognitive decline ==
This is probably the most annoying symptom - you can not act if you can not think.

=== Permanent decline ===
My cognitive decline after the injury was very drastic. I was able to act in autopilot mode, but when I needed to think, to plan, or to learn something new then I would hit brick wall. Event at the best estimates I felt that I am functioning at 5% of previous capacity while many areas become impossible at all. Yet, from outside, it might not seemed so bad as I still could do trivial things on autopilot and memories from past were still accessible.

In time it got a bit better, but my productivity even at best times is below 10% what it used to be. The main problem is that even average complexity problems were too complex for me now.

=== When stressed ===
When stressed my head can completely shutdown. Even if it does not shut down it becomes very hard to function. It is very easy to manipulate me as I become very suggestive.

==== English language deterioration ====
One of the interesting and noticeable impacts is how significantly my knowledge of English language drops if I am stressed. That was especially difficult when I needed to read legal documents related to my injury. Few complex sentences and I am no longer able to understand anything even if the rest of the document is in relatively simple English.

In some cases it helps if I ask for someone to read what I wrote. Well actually since the injury I have to do it with almost all text I write, including this site. So, after updating few pages I asked one support worker to read it. He told that he was able to understand my story, but asked maybe one of the parts he just read was written long time ago. That was actually the newest part and I thought I wrote it well. I was feeling only moderately stressed compared to my usual (which is highly stressed compared to normal) and I took long time to write and checked few times before asking to read. I asked why he thought so. He pointed to many errors, and there were many.

However, I have to write. Just need to keep asking to read it. I think if you look at my productivity it would be negative as I need more resources to help me, than I actually produce something useful. However, this is sad reality.

==== Making decisions that are not good for you ====
There is very common saying in psychology, that you make the best decision based on information that you have at that time. However, it is not true for PTSD. There were few ways how to make wrong decision and I do not have tools how to overcome these problems:
# If you are in fawn response, you will make decision that is best to please someone whom you perceive as a threat or partial threat. So, when your solicitor will give you an advice that goes against your wishes, your goals and logic, you will agree with it. You will find his arguments logical no matter how absurd and incorrect they were. It might take years to understand what actually has happened. Emotional processing and coming in terms with it will take even longer.

==== Stressing over appointments ====
Appointment cause particularly large amount of stress. There is one example:

I have some tartar build-up and need professional teeth cleaning. They are very busy this time of the year and you need to make appointment at least a weak ahead. I liked the last one, so I looked for her contacts. It took me at least few hours as I could not remember when and where I was and was looking in wrong places, but found it. Made an appointment week ahead. On Sunday, day before the appointment I double checked the time and was surprised to find that I wrote different date: in my mind it was on Monday, but I had Tuesday written. After some thinking I decided to go on Tuesday. I changed an alarm to wake up just before 8:00. Made a call in the morning to make sure that I have dates right. It was correct. I set up alarm at 7:00 in the evening. I need about 40 minutes to get there. I slept especially bad during the night and maybe from 5:00 was just resting n bed and waiting for the alarm to ring. I was interrupted by my sister asking why I have not left. It was 7:35. I rushed as much as I could. On the way I called to inform that I might be 10 or 15 minutes late, but was told to turn around as there will be not enough time to do the procedure. I spent so much time and experienced so much stress and all for nothing. It it a small thing, but it is reaped over and over again and it accumulates to reasonable problems.

==== Overlapping appointments ====
Stressing over appointments, especially medical ones, maybe started from the first time when paramedics arrived after the injury. I was in shock, disoriented, had amnesia and could not understand why I was so scared. Then I felt even worse in the emergency department. I got overwhelmed and ended up with a severe panic attack on my first visit to the GP, when she asked what parts of my body got hit. The appointments got worse after I have seen QBE appointed doctors for assessment. I learned that doctors can be verbally abusive.

One of the bizarre problems is booking overlapping appointments. I do not have that many appointments, but when I am asked when I can meet, the first thing I think of is the time I am busy. Then something glitches in my mind and I forget why I thought of that time and tell it as a free time.

I tried to keep track of appointments for the last 2 weeks. I get it wrong about 50% of the time. This includes regular appointments and events, that are the majority of scheduled activities.

=== Memory and thought blocking ===
Surprising amount and importance memories and thought can be blocked (suppressed) without you ever realising. This is why it is so difficult to deal with it. How can you remember something that you do not know that you forgot? It is very different to forgetting name or date. As you do remember that you should know this, but just cannot remember what it is. The link (association) is missing. However, when memories get blocked there is no entry point left for it. There is nothing left to indicate that some memory is missing. There were two ways how I lean that something is missing:
# When memory is triggered from outside. Then it is hard to understand how I could have forgotten it in first place.
# When memory comes back on its own. Sometimes, in unusual and inconvenient time. I think it is still coming back because by of being triggered by something I just not notice what was the trigger.
I think all these memories are being blocked because of the stress. Just sometimes it is not so apparent.

==== I did not think I will survive, but why? ====
I have started seeing psychologist for EMDR treatment about 4 months ago after [[PIC Assessment Conference 2023-06-28]] (tribunal). That was exceptionally difficult time for me. One of the things I told he was that I was feeling that I am not going to survive. Now few months passed and my efforts to cope with situation started paying off. About month ago, during one of the sessions my psychologist asked me do I still feel that I am not going to survive (that was during session when we were discussing some particular memory). I said no. I remember having the feeling that I am going to die, but I cannot remember how I was going to die.

For few weeks now I started looking back at tribunal, something I had to postpone at that time because I was [[When you cannot cope | not able to physically cope]] with it. However, I cannot delay it any longer and need to deal with it. I managed to solve some other issues and I think I have better support around me. Despite this I struggle to revisit memories of tribunal and its determination or even more to take some action. Sleep quality dropped and feeling of constant danger intensified. Last week of support workers at Safe Haven asked how it is comparing to the time few months ago, when I was not able to sleep at all and did the feeling that I am about to die come back. It is bad, but lucky it is not as bad as it was before. However, I still could not remember how I was going to die. Despite increased time spent for relaxation and medication to slow down my heart rate now it stays very high. I think this is main contributor to my heart pain. Tho nights ago, I woke up with the feeling that my heart is going to burst. Constant pain was back with the sharp increases radiating to my shoulders (especially towards left side). Now I know that most likely it is not going to give up and the pain is not as bad as it was before. So, I remember - I was going to die because my heart was going to burst. I spend more than 2 months with only concern how to survive till next day and I forgot it. But now I remember.

That was one of the reasons why I was not able to find new solicitor and appeal PIC decision in court. That would have been fatal defeat if I would have died trying to defend myself from QBE lies. I had to find a way to live another day before I could look what to do with these lies.

While writing I am lying down with my whole body relax, I do not need even to hold my head, it is being supported by pillows. I am moving only my fingers. Yet my heart monitor is screaming that I need to relax. My heart rate is as if I am doing heave load intense exercise, and I am posing my body close to failure.

I am back after break. My heart rate is at 73 now. A bit high, but this is as low as I can get. I am also aware that I no longer feel my body the way I used, but some tools actually can help a bit.

==== Not being able to get help ====
In 2021 I have seen US troops withdrawing from Afghanistan and there were people hanging on the plain and dropping to their death. I could not stop crying and it was not only because I have seen tragedy, but because I knew how they felt. You can ask why they do not put an effort to protect themselves, you better die fighting for your rights. You might think that they have been given a chance to change their country. But they do not see that option, they see clinging on the plain as the only option of survival. They been struggling on their own and they know that when the help leave they have no chance. So at the time when it seemed they got some help, they were not able to use it. 

Later psychologist give me an explanation that sounds reasonable: you stop seeking help if your experience is that every time you seek help you do not get result. To save your from exhausting on fruitless attempts your body starts blocking even any thought about it. This is my situation. I have no result to show. Just none. So, I do feel like these people who in face of danger hang on the plain to certain death. Now, I understand, how simply there is no other alternative. There would be an alternative if you are well, but when you are so ill there is no other way.

This is what trauma does to you. It makes you blind. I do find myself being blind same way. I may not see some path now too. There were two threat responses involved in this scenario [[#Freeze| freeze]] and [[#Fawn | fawn]].

==== Not wanting to be a burden ====
Because help was so difficult to find and I desperately needed, I started overvaluing the efforts someone needs to put to help me at the same time I started seeing less value in myself while I am ill. I was feeling that if I ask for more help than I am getting I am risking not getting any. So, I did not ask for it even when I desperately needed it. There is a good chance that I missed some potential help this way. Now I feel guild that I was not able to explore more options to find help. However, this is all is well explained by [[#Fawn | fawn]] threat response.

== Hypervigilance ==
[https://en.wikipedia.org/wiki/Hypervigilance Hypervigilance] is when I keep scanning environment for potential danger without even realizing. It consumes a lot energy and may keep me awake whole night. Hypervigilance especial goes up when there something related to traumatic experience. 

Example: I have been looking at my previous [[Moya de Luca-Leonard solicitor#Complaint to OLSC | complaint]] about Moya de Luca-Leonard. It is a terrible experience of betrayal. It brought me feelings of complete helplessness and injustice. I did not notice that I become hypervigilant. I jumped from sound of balcony door being opened one flour above with my heart racing as if I am faced with significant danger. However, this door opens loudly every time. I should have been used to it over last 10 years. But I jumped this time. One hour passed and I am still trembling. The reaction is subsiding, but now exhaustion is taking its place.

== Over reaction to bad news ==
When I get bad news I react as if my life is in physical danger again. My whole body goes into maximum readiness to fight for my life. So, next day I am already completely exhausted. For example I am so tired, that event having glasses is too much. It feels that glasses are so heavy and they are pressing skin on my nose so much that if I keep it any second longer it will break my skin. So, I am now typing without glasses. Lucky I used to be very good at typing without looking. All these typing lessons 30 years ago are paying off.

I had a plan to write to RLC in the morning, but instead I spend all morning lying in bed and resting. Any move any thought is painful.

Looking at sun light (just being outside) has unexpected effect. It removes last bits of alertness and allows exhaustion to take full control of my body. Now I am dosing off all the time.

== Reduction in body sensations ==
The greatest reduction was when I regained consciousness after the injury. The first feeling that come back was vision, then hearing, but then that was it. No pain, no cold or hot, no touch.

I have heard that after close to death experience people describe experience "out of body". What I did not know that there is significant reduction of sensations that are consequences of PTSD. Some are less dangerous like reduction in sensation of taste or loss of feeling of hunger, but there are some that are very dangerous like no longer being able to feel that you have fight or flight response, and your heart is beating at maximum rate, and you are sweating profusely.

=== No feeling of heart rate ===
I had heart check few years before the injury and it was in perfect condition. Before the injury I lived very healthy lifestyle and was not expecting to have any concerns about my heart till I reach way over 100 years. 

Few years after the injury I started feeling pain in my heart. There were few months when I had more stress. I was told by GP that it might be only stress related pain around my rib cage and that I should not worry about it. I still insisted on referral to cardiologist. Physical stress test revealed that I my heart endurance dropped significantly, but it was not yet at the level of concern. I tried to limit amount of stress doing things that are in my power even if main reason of stress - PTSD, was outside my control. Last quarter of 2022 was exceptionally stressful. Pain in my heart intensified despite the measures I took in the past. I again went to see GP about potential damage to my heart. Again, I was told that the pain is coming from my chest and not my heart and I should not worry about it. Strong pain continues for several months till [[PIC Assessment Conference 2023-06-28]]. That was re-traumatising experience and heart pain started getting significantly worse. Then I got unjust PIC determination based on fraudulent reasoning. It was followed by [[PIC Assessment Conference 2023-06-28#False promise to go to court | false promise by my solicitor to go to court]]. Losing a change to get justice had a terrible effect on me. I hardly could sleep haunted by flashbacks. My heart pain intensified to the level that it felt that it is going to burst at any time. I remember lying in bad and thinking that it will be an ultimate defeat if I simply die there of a heart attack.

I took the only option that I could find was a retreat, so that I can survive to fight back. I knew from the past that my body sensations go down a lot when there was something going on related to my injury: I would not be able to feel hunger properly, taste, time perception especially at night would be very wrong. I started suspecting that my heart is working overtime especially at night. I checked my heart rate one night at it was about 150 beats per minute. My first reaction was that it could not be. However, I checked it again and it was the same. It was a big shock for me. How it is possible that I am not able to even notice that my heart is beating at its maximum. This felt unreal. I did not know that it is even possible. Imagine yourself doing physical exercise that it is close to failure and not even noticing it. All my inside must be bringing, how I am not feeling it. The only feeling that got through was terrible pain in heart. However, this is already the last limit. I should have felt any rise of heart rate. I used to be able to count my heartbeat just by paying attention to it. Where are these sensations. 

Reasonably soon I bought a smart watch to keep track of heart rate. I head to check it several times as it was hard to believe the results. During the day my heart rate was fluctuating between 100 and 120 while at night it would go up to 150. No surprise I was having such a strong pain, that it felt like it is going to burst.

I have stepped back even further from anything related to the injury. Postponed everything that could have been postponed. Let them win, as it will be an ultimate victory for them if I am dead. I head only one goal - to survive. I focused on keeping my heart rate bellow 100. If it went above, I dropped everything and went to breathing exercises. They seemed to be helpful, but only to some extend and with modification. First I take deeper breath, so they were slower. However, I provide more oxygen to my body. Secondly, breath in take same time or slightly longer than breath out. Trying to force otherwise creates lack of oxygen and my heart rate goes up. Most of my day and even more so during the night was dedicated to slowing my heart rate. It took at least few months till I started slowly looking again at the things related to the injury.

Heart test results revealed cholesterol buildup in my heart arteries, despite me having low level of cholesterol. There is 25% blockage in two places. As my cardiologist said, it is not all bad news, I do not need heart surgery yet, I can live with 25% blockage without significant impact, but it is active. It is growing now, and I need to take action.

I am taking now medication to reduce heart rate. I know it is not a solutioning, but I need to do everything I can to reduce the damage on my heart. I also modified my diet significantly and taking medication to reduce cholesterol levels. I am also trying to regain some feeling on how my heart is doing even so for now I rely on device. It takes a lot of time and effort and could been avoided if not injury and consequent retraumatasing experience, but it is out of my control. I have to do what I can do as I want to live. 

==== Lessons ====
# PTSD does reduce internal body sensations and it can be to very significant level.
# The most dangerous reduction in sensations probably would be not feeling of pain. However, at least for me it happens only in very extreme situation and does not last long. Few hours max, even to be fair perception of time was also severely affected. However, some loss of sensation of pain till it reaches some threshold happens way more often, but I do not have good suggestion how to deal with it.
# Not feeling your heart rate even if it is running at the very maximum is second the most dangerous loss of sensation in my mind. However, there are few things that worked for me.
#* Get a device to measure heart rate. There are now plenty of reasonably cheap and accurate devices to track heart rate. Other functions may not be so accurate, but it seems heart rate most of them get right.
#* Set alarm at heart rate that is too high for you. At first, I had to set it to 120, because otherwise it was at alert mode way too often. However, now I have reduced it to 100.
#* Select and use calming methods that work for you. You can have a look what works for me at [[Daily functioning tips]]. The most common for me is stepping away, breathing exercises (double inhale) and meditation (body scan).
#* Introduce lifestyle changes to limit further damage to your heart. In this condition heart can be easily damaged by other risk factors that otherwise would not be a concern. Yes, it is unfair and difficult, but alternative is high risk of early death! I went to almost vegan diet and dedicating more time to breaks. I am already very unproductive and missing deadlines, but if I am dead, then deadlines will not matter.
#* Take medication. I am using medication to reduce heart rate. Yes, its effectiveness is very low, but you do all you can.
# Be aware of the danger. If you have or know someone with PTSD, take care to track heart rate properly. I wish someone told me about it long time ago. Instead, I was told not to worry "it is just a chest pain, not related to your heart". The problem is that it is hard to imagine that you may not be aware of such heavy load on your body. I do not know how common these symptoms were, but what I have read from research heart problems is one of the key reasons for early death for people with PTSD. So, I would recommend heart rate tracker for everyone with PTSD.
# Heart rate tracker does not have to be fancy, but it is useful to be able to keep track on your computer and to access data using other applications.

==== Heart rate variability ====
When I have panic attacks, or feeling overwhelmed I get an a

=== Net feeling how much you sweat ===
While sweating a lot is not as dangerous as heaving your heart beating at the rate close to failure it has advantage that it is easier to observe.
# Other people can see that you are sweating a lot.
# It leaves traces, that you have been sweating a lot leaving all your clothes or blankets and mattress drenched in sweat.
# One of the simple ways to see that you were dehydrated is the color of your pee.
Most significantly I do not notice how much I sweat at night. I can wake up dripping in sweat and not notice it. For example, few nights ago I was having trouble falling back to sleep and at one point I felt strong itch on my back. When I have reached to scratch, I realized that I am all dripping in sweat. I was so wet as if someone poured a backed over me. However, I have not noticed it till I touched my skin. 

The other example of entity of dehydration was few years ago. I went for ultra sound check for my bladder. I had not to drink any water that morning. Then they do one measurement, then I need to drink 2 or 3 cups of water and they do second measurement. The goal is to check it when it is empty and at least half full. After the injury I started getting stressed when I had doctors appointment. The assessments arranged by QBE made any appointments even more stressful. So, before harmless appointment for ultra sound I was stressing a lot even if I was not realising it. After first check I drank 3 cups of water waited 20 minutes and went for a check. My bladder was empty. My body was so dehydrated that it kept all water. I drunk another 3 cups and again same result. At the end after 12 cups of water I got re-hydrated just enough to start filling in my bladder. It was still less than half. The lesson: I can sweat so much that I will be severely dehydrated over one night and not notice it.

=== Not feeling hunger ===
I still get hungry, but do not feel it. It happens when I am severely stressed for a long time. Often it goes together with lack of sleep. It is different to loss of appetite as I still get hungry, I just do not feel it. Body feels at such high threat mode that does not forward feeling of hunger to consciousness. 

Typical example. I hardly slept 40 minutes during whole night. After 4:00 I made a call to lifeline and during conversation I started feeling hungry. After first few bites I learned that I am so hungry, that it was painful. I must been very hungry for few hours already but did not feel it.

==== Tips ====
'''Drink water to check how hungry you are'''. Not feeling hunger also means that you don't feel how full you are. I try to eat based on time, but because of poor sleep my circadian rhythm is out of sync. I do end up feeling terribly hungry at night and it even impacts my sleep without me noticing it. Same way I may be hungry or actually still be full during the day when I would expect otherwise just based on the clock. The good way to test am I very hungry by drinking some water. If I am hungry and been hungry for some time I will feel sudden pain in my stomach. This is a good way to test as drinking a bit more water when you are very stressed is a good idea. You can test level of hunger by having a snack, but this way you may end up overeating and that is not a good idea.

'''Do not eat till you are feeling full'''. I used to eat till I feel that I am getting towards full, then I would stop. I believe it a healthy way to eat. Because of this I have a strong habit to add to my plate a little and then go for extra if I still feel hungry. However, now when I am stressed, the feeling of being full comes only when I am very full and can not eat anymore. This leads to overeating. So, now I have to change the way I eat. To somehow measure portion and stop without the feeling of fullness. Often I end up not eating enough. This is OK with one exception for supper as I may end up feeling hungry at night. However, I did not find good solution for that yet. I think I have to live with that problem till I manage to keep my stress level low most of the time, so that not being able to feel hunger properly will not be an issue anymore.

== Breaking stuff ==
It has been 9 years, and I still cannot control it. It happens more often when I am exhausted especially due to lack of sleep.

== Reduction in body control ==
I lose precision in my movements. It is even more challenging when it comes to fine motor skills. The first ones I noticed was early after the injury. I needed to sew something. Just putting a thread through the needle required enormous amount of energy. Then several movements with needle felt so exhausting that my body could not issue another command for my hands to move. As if my nerve system used all its resources.

One of the sad examples was when few years ago I took out fan from my laptop in order to clean and oil it. I was thinking that I may need to replace it, but it was not necessary. However, I was not able to assemble it back. No matter how hard I tried, how much rest I took before, how much coffee I drunk, nothing helped. I just could not connect everything right and laptop did not work. It stayed there for months. I was trying over and over again, till I finally gave up one day and put it away. It is still waiting for the day when I will feel better.

The most common example now is when I am not able to type. I start making errors. Often every second keystroke is wrong. Despite this I try to find ways to push on. [[Daily functioning tips#Working in bed | Working in bed]] is one of the tricks I use in attempts to reduce disruption it brings.

== Survival mode ==
Survival mode is when your body mobilizes all resources to survive perceived threat to survival. It does not really matter if threat is real of incorrectly perceived due to PTSD. The reaction is the same. The problem is that many people do not understand or chose not to understand how it affects you. PTSD makes the fear that you felt when your survival was in real danger to linger and your body to have same reaction in less dangerous situation. I like to use one of two examples to help to explain how it affects you.

'''Walking in tunnel'''. This is from diary. One day I thought I will write about how it feels to be in survival mode. Lets say for some reason you find your self walking in tunnel. It has very little light and seems to be empty. However, soon you realize that it was quiet only temporally. It is a busy motorway with cars and trucks going at speeds over 100 km/h. At any time any of them can hit you and kill you. You are nearly avoiding them and when you manage to call for help you get a response: try to do something else, maybe doing a puzzle while standing there while you know that you will get hit any second now. Doing a puzzle will relax you. Then after relaxing you can keep avoid them. It is physically impossible. It just not make sense. The cars will not wait. So, even if I am exhausted and dozing off all the time, all I can do is to attempt to do something useful, like writing this document. I can't even stop and think “is it useful?” The whole day passed and I wrote only a quarter of the page while I was putting all my energy into it. This sums up my day.

Another example: was about being robbed (mugged). More about it later.

There were the situations where you do not have control. You can not get out of danger by your self. The thing is while you are in survival mode you need help. The first thing is you need to remove threat. Ideally by someone else. If you can not find help that means that life becomes more dangerous and you need to start avoid many things to ensure your survival. Have a look at [[Daily functioning tips]], [[When you cannot cope]] and [[Ways to get help]] of my experience of navigating to recovery.

There are a lot of resources about trauma, just a few that I found interesting:
* https://www.promises.com/addiction-blog/trauma-move-beyond-survival-mode/
* https://www.psychologytoday.com/us/blog/lifting-the-veil-trauma/202006/why-survival-mode-isnt-the-best-way-live
* https://beckinstitute.org/blog/ptsd-as-a-survival-mechanism/

== Threat responses ==
https://psychcentral.com/blog/fight-flight-freeze-stress-response

I sort responses based on their severity. This is the same order that I find in most of literature. Some symptoms overlap between different threat responses. I describe them in first occurrence and only mention in other responses.
=== Fight ===
==== Diarrhea ====
That is one of the sure signs that your body can not longer tolerate stress and you need to step back from what ever you are doing at this time. However, because I have such a time pressure I often push my self till the next more severe symptom.

=== Flight ===
=== Freeze ===
=== Fawn ===
https://psychcentral.com/health/fawn-response

== Psychosis ==
== Inadequate emotional state ==
=== Fear overriding all other emotions ===
=== Feeling worthless ===
=== Making enormous number of mistakes ===
=== Learned helplessness ===
=== No longer being able to take risks ===

== Guilt ==
The injury was not my fault. It was driver fault. Yet I am the only one who has to deal with consequences. The same is with so many re-traumatising experiences that followed. While there are some people who acknowledge that it was not your fault, especially from professionals providing mental health treatment, the legal system puts all responsibility on you. Even if by the rules and law it should not be the case. As the time passes and I was not able to reach result I becoming feeling more and more guilt for not being able to get better and not being able to get justice. Despite all my efforts to stay logical about it, I feel immense guild for not getting justice against the driver, the policeman, QBE representatives, scamming lawyers and corrupt PIC officials. It is their fault, but I have to pay for it.

== Seasonal changes ==
This is one of the symptoms that I would find hard to believe, but I experienced it. Body does remember the time of the year of the injury. To be more precise it remembers all details situation, feeling, smells, sounds, time of day and even time of the year. So, when same time of the year approaches hyper vigilance goes to extreme level. It is just amazing how well all this information is recorded and then triggered without any conscious input. I have now 2 events being reminded by anniversaries (described in diary) of [[Diary#2024-03-20 14:29 | injury]] and [[Diary#2024-06-26 20:05 | PIC assessment conference]] (read also surrounding entries).

== Mega jetlag ==
I remember that since the injury jetlag when I come back to Australia become very bad. I remember that it is very bad, I become completely unable to do anything, and it lasts about 2 weeks. However, I could not remember how it happens. I am going to write this time. I also cannot remember what I do besides usual recommendations about jetlag. Despite this, I hope that this time I have more ideas about support and will be able to complete at least few tasks that are very important.

This is what I have noticed so far:
# For the first few hours, I am still in travel mode. All thoughts about the trip, did I manage to come back and not to lose any of my stuff on the way.
# Then exhaustion hits hard and I start dosing off no matter what I do. I had very light and anxious sleep waking up all the time as if I am still travel. For about 40 minutes.
# Finally, I wake up with full blown panic attack. No thoughts, no particular reason, just pure fear. It feels like I come back to war zone. I am sure it is not true; I do not know how war zone feels, I have never been in one. But I believe it is way more terrible, I do not want to diminish the horror of war, I just do not have any better wards to describe how I feel now. 
# The pain in my heart is gone. However, I do not think it is gone, I think my pain tolerance is temporally increased. My gums do not hurt too. I injured it while biting two days ago. It was hurting and have not healed yet. But it is not hurting even when I poke it with my tongue. Yes, it is just increased pain tolerance. The pain will be back soon, most likely very soon.
# Next day. Complete exhaustion. All I can do is to lie in bed.

=== Tools to ease jetlag ===
This should go to page about tools, but later.
# Staying in bed. Helps with trembling, weakness, dizziness. After several hours of rest tried to get up. Not a chance, need to stay in bed.
# Thinking about new safe place - safe haven. Helps to focus enough to write. That was the place where I was able to write about my emotions. I cannot go there now, as I cannot leave bed, but I am putting myself mentally there. While writing I am imagining that I am having conversation with support worker surrounding myself with memories of as many details as I can, like images, smells, sounds, people, time of the day and so one.
# Fighting exhaustion. Coffee does not help. I found [[Daily functioning tips#Working in bed]] especially useful as it saves energy and gives a chance for short naps (just few minutes) that gives a way to progress to something that otherwise would be complete lack of energy.