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.

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 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 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.

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:

1. 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.

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:

1. When memory is triggered from outside. Then it is hard to understand how I could have forgotten it in first place.
2. 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 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 and 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 threat response.

Reduction in body sensations

The greatest reduction was when I regained sensuousness. 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 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 - 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. Durig 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 the most helpful. 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

1. PTSD does reduce internal body sensations and it can be to very significant level.
2. 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.
3. 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.
4. 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.
5. 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.

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.

1. Other people can see that you are sweating a lot.
2. It leaves traces, that you have been sweating a lot leaving all your clothes or blankets and mattress drenched in sweat.
3. 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 consequences. The last example was last night. I hardly slept 40 minutes during whole night. After 4:00 I made a call to lifeline and after during conversation I started feeling hungry. After first few bites I learned that I am so hungry, that I must been very hungry for few hours already but did not feel it.

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.

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

Fawn

https://psychcentral.com/health/fawn-response

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 injury and PIC assessment conference (read also surrounding entries).