Tuesday, February 17, 2009

Post Traumatic Stress Disorder and Illness

I recently received an email from a reader of this blog. The author nursed his wife back to health from cancer. Now that she is doing better, he suffers from "shell shock." Her every cough and pain sends him reeling back into the fear he lived with when he thought she might die.

PTSD - Post Traumatic Stress Disorder is a condition that trauma sufferers can experience. It can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD are usually considered to include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

People with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to. They may experience sleep problems, feel detached or numb, or be easily startled.

Why am I writing about PTSD in association with this man whose wife is a cancer survivor?

Surviving illness, recovering from a potentially terminal disease, finding relief from pain and suffering are all joys to be celebrated. So where does PTSD fit in?

I believe that just as war and violence serve as external threats that damage the body and warp the spirit, so too can debilitating illness serve as an internal threat that harms body and soul. The result of living with this protracted internal threat, illness, can also trigger PTSD, long after the illness has abated or been controlled.

Violence contaminates the lives of its victims. During the abuse or the disaster, there is no escape from either experiencing fear and pain or anticipating fear and pain. One's world shrinks to the size of a tiny circle charged with the terrible energy of violence. Even after the violence ends, its energy continues to saturate the life of its victims.

Life threatening illness, chronic pain, and debilitating health conditions are also violent traumas -- to the body, the mind, and the spirit. Even if the illness is cured or the symptoms relieved, the reverberations of the stress the illness caused can continue for a long time.

When my pain condition was unconrollable and at its worst for months on end, there were no walks around the pond, no movies, no tasty food, no socializing -- there were only degrees of pain. Psychologically, being tortured from the outside may have different meaning than being tortured from the inside, by your own body, but the ongoing stress, exhaustion, fear, and constriction are just as powerful.

And if you share your illness experience with a committed partner, that partner suffers his or her own trauma and also lives inside the circle of fear.

For months, even years after my pain was under control, I trembled at the slightest pain ripple and re-experienced myself curled up on the couch in a fetal ball of hurt and desperation -- a position I could often be found in during the bad old days.

For months, perhaps a year after pain was not the determining factor in our lives, Richard still watched me like a hawk. Scanning. Vigilant. Looking for the tiny clues that used to signal an impending pain attack. I could hiccough, burp, groan after watching a bad movie, or rub my belly after eating too much and Richard would bark, "What's the matter?" as if he were a watchdog on alert. His morning greeting remained, "How are you doing?" for a long time. When he finally switched to "Good morning" we both smiled.

Living with serious illness, suffering the invasiveness of medical tests and surgeries and drugs, waiting for results, living in a closed circle of fear, being unable to govern your own body, enduring pain and exhaustion -- all this is a persistent traumatic ordeal that can result in "shell shock," in PTSD.

In an upcoming post, I will write about what couples can do to address the PTSD of illness.


Maureen Hayes said...

Thanks for addressing this important, and often overlooked component, to illness and pain. I am still going through this with my mom. I was the one in pain, she the caregiver. Now that things are better, she is constantly on guard for the pain to return. I know she loves me, she went through hell and back with me, and it hurts to see the fear she has.

I look forward to your future post on the subject and thank you for discussing it with us.

Anonymous said...

I'm glad you wrote about this perspective. I hadn't thought about it this way, and it makes so much sense.

I have Major Depressive Disorder and Generalized Anxiety Disorder. Nine years ago, I went through a very severe depressive stage and my mother was my caregiver. Since then, I have had other, less severe depressive stages. But each time my mood goes below a certain level, we both are immediately on alert, hyper-vigilant and living in grave fear that I will return to that severely depressed state.

I really like the way that you have written this post. I will be bookmarking it to pass along to others. Thank you.

clusterfree said...

I survived a decade of cluster headaches, CPH to be precise. After having several attacks every single day for ten years just the feeling of a headache developing sent me into a panic. Looking back, I must have looked crazy. I now know that I suffered from PTSD for years after the Headaches subsided. I wish I would have talked to a professional about it and maybe saved myself from myself. Well, it's all in the past now. I no longer have panic attacks when I get a headache. And Im happy to say, I havent had a Cluster Attaack in several years.. I survived!

Anonymous said...

Thank you so much for this. Having survived my husbands sudden cardiac arrest during a routine procedure and the multiple open heart surgeries and months in ICU, being told 8 times to call in the family because he wasn't going to make it, I struggle daily with the side effects of this time.