This Coronavirus crisis has been quite a stress-producing event for all of us, hasn’t it? Not only does it include the fear of catching the virus and getting sick, wondering if there will be the equipment available we need to get well, but also the loss of jobs, dealing with home working environments, not being able to purchase supplies you need, and the list goes on and on. It all adds to the stress level those of us with PTSD deal with every day. It’s no walk in the woods.
Let me suggest you take stock now of what you need and don’t have, or want and can’t get, so the next time an emergency arises you are better prepared. That being said, dealing with this added stress is something we need to think about and develop a plan to handle.
Of course, you know the VA has many resources for coping. The VA COACH ON-LINE is one, with many suggestions for ways to handle your stress. Meditation, physical exercise, relaxation techniques, journaling, talk therapy, anger management techniques, and many other ideas are listed along with guided exercises to teach you how to use them most effectively.
The thing is, each one of us finds our own way of coping, and when times become increasingly rough, we may need to add additional items to our usual ways of coping. We often find that no single mechanism will keep us in the healthy zone, so we have to resort to a mixture of different coping techniques.
Take some time today to think about what’s adding to your stress levels, and come up with a plan that will help bring your anxiety to a manageable level. When you have PTSD, you tend to want to isolate, but don’t fall into that trap! Call a friend and talk about what’s happening. Old adages such as “a burden shared is a burden halved” exist for a reason…they are true! Use your music, try diversion, write down a plan for what you’ll do as soon as the shelter-in-place order is lifted and follow through on it. Don’t let depression, stress, anger, or anxiety win – make a plan today!
While all of us shelter-in-place in an effort to prevent the spread of the Coronavirus, many businesses and organizations are working to find ways to continue providing services. Most non-essential appointments have been cancelled, as well as most scheduled surgeries that can wait.
As a Veteran, you may find your appointment at the VA Med Center has also been cancelled. That can be a frightening prospect if you were seeking changes in your current treatment plan, or were expecting to have your prescriptions renewed. All is not lose, however. If you would like to try a teleconference or a video conference instead of a face-to-face meeting, you can contact the VA to arrange one by going to: https://www.va.gov/coronavirus/.
If you are looking for accurate information on what Veterans need to know about COVID-19, you can access the VA’s website for the answers by going to the Frequently Asked Questions page. And, if the pressure becomes unbearable, and you are having suicidal thoughts, please call the Crisis Line at 1-800-273-8255 and Press 1 for assistance. You may also access the Crisis Line at: www.veteranscrisisline.net.
You certainly don’t have to have PTSD to be anxious over all the implications of COVID-19, the Coronavirus that is currently making its’ rounds throughout the United States and the world. If you turn on the television or your computer, you are flooded with reports of how people are being affected by the virus. Most of the news consists of projections for how serious the outbreak can be. For those who are already anxious, this additional stress can be almost as overwhelming as having the virus itself!
While it is understandable to be concerned about the Coronavirus, immersing yourself in a constant barrage by watching the news all day long only makes things more problematic. The Centers for Disease Control and Prevention (CDC) is the utmost authority in the U.S. about preventing and controlling pandemic outbreaks. Follow their advice and you will reduce your risk considerably. 8
- Wash hands frequently with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer.
- Cover your mouth and nose with a tissue when you cough or sneeze.
- Properly dispose of used tissues.
- Cough or sneeze into your upper sleeve, arm, or elbow if you don’t have a tissue.
- Clean your hands after coughing or sneezing.
- Stay at home if you are sick.
- Avoid contact with those who are sick.
- Clean and disinfect objects or surfaces that may have come into contact with germs.
- Make plans for what will happen if someone in the home becomes ill or if quarantine or shelter-in-place measures are ordered.
While it is wise to keep abreast of what is developing with the Coronavirus, do not watch television or follow it on your computer all day long. Remember, most people who get the virus will get through it just fine. Even if you are elderly or your immune system is compromised, it is not a guarantee that you can’t survive the virus. Do not give up hope! Do not give in to fear. We will get through this and we’ll be stronger for it.
Our brain is a marvelous organ that, in normal circumstances, does amazing things. We take in information, process it, make decisions about it, and act on what we know. But when we have PTSD the chemistry in our brain changes.
In normal circumstances, the different regions in our brain communicate back and forth. The prefrontal cortex allows us to think, plan and make decisions. The amygdala is the center where emotions are processed. The hippocampus is where information about your experiences are processed and stored in long term memory. The cerebellum is responsible for regulating motor control over your muscles. Usually these parts of the brain send messages back and forth constantly and with no problem. However, when we have PTSD, the communication between regions is compromised.
Chemical changes occur when your brain goes into the “flight or fight” survival mode, and with PTSD, it remains in this state. The part of your brain that thinks logically cannot send the message to the amygdala that the danger is past and you are okay. The hippocampus is unable to store information as long-term memory (that’s why you seem to forget everything), and that is also why memories of the trauma stay with you and you feel as if you are in still in danger. Research has revealed that Veterans who have PTSD may have smaller hippocampal volume compared to Veterans who do not have PTSD.
The good news is that research has also shown cognitive behavioral therapy can increase hippocampal volume. We cannot forget that PTSD is founded in chemical changes in the brain. We must not forget that we can reverse those changes with treatment!
When we experience long-term stress, our brain functioning is affected. This is due to the chemical changes our body goes through when we are in a continually aroused state. When we are in “flight or fight” mode for an extended period of time, the body continues to secrete chemicals to keep us ready to either rumble or run. Unfortunately, we weren’t meant to remain in this constant state of arousal.
With PTSD, we are in this chemically imbalanced state to start with. Adding more stress is like pouring gasoline on a fire. We just keep escalating until we are so burdened, we can barely function. Is it any wonder then that what we want most to do is just hide out until the danger blows over?
Taking care of ourselves is the first step in coping with excessive stress. We need to focus on eating well, sleeping soundly, and not adding to our problem by ignoring our own basic needs. It’s a time to put into practice all those ways we’ve learned to cope: meditation, deep breathing exercises, prayer, music, art, etc. Whatever it is that works for you, now is the time to use it.
Taking care of yourself is only one step though. If things are really bad, you may want to consider getting some counseling, not because you can’t cope on your own, but to help you relieve some of the stress so you can cope longer and better.
Talking the situation over with someone you trust can be very helpful! Sometimes just putting things into words helps you get a handle on the emotions that are involved. Getting a second opinion about what’s happening can reassure you that this isn’t your imagination running away with you.
Stress can cause even the healthiest person to become exhausted. For those of us with PTSD, added stress can be the straw that breaks the camel’s back. Watch out for long-term stress, and have some ways of defusing it in your tool box. Be kind to yourself!
There has been a lot of attention given to opioid use in the tabloids lately as they are so often abused. Like most other pain medications, opioids can be dangerous if misused.
Opioids are often found in prescription medications and in illegal drugs such as heroin. If taken incorrectly, the can negatively impact your respiratory system. Taking too high a dose of an opioid can cause you to stop breathing.
Opioid use can also be addicting, or you may develop a tolerance if you use them on a daily basis. Tolerance causes you to require larger and larger doses to achieve the same amount of pain control. You should always check with your doctor before increasing or decreasing your dosage. Do not take someone else’s medications, including opioids, and don’t share your drugs with others. Someone else who takes your meds might not be tolerant.
With opioids, as with all other medications you are taking, know what it is you are taking. If the medication looks different from what you’ve been taking and there is no notice to that effect on the medication bottle, ask your pharmacist before proceeding. Take your medication exactly as prescribed and directed. Do not mix medications with alcohol or other drugs.
Opioids, like other medications, can be wonderful for controlling pain, but if misused, they can cause you much grief. Use caution when taking your medications. They are prescribed to help you, not harm you.
I once had to write a paper for my psych class about what it was like having PTSD. Not just the clinical part, but the impacts it has on us on an everyday basis. I wrote about the symptoms and the hardships of having PTSD, then I struggled for how I could put how it makes me feel into words. I finally said:
“Having PTSD is like waiting for the other shoe to fall.”
That was all I said about it, but it was enough. Not only did I get an “A” on the paper, but my instructor came to me and told me that one, simple statement blew him away because it captured the essence of the feeling completely. We know disaster has happened once. We expect it to happen again – we just don’t know when it’s coming.
When we’ve gone through a trauma that’s bad enough to cause PTSD, we end up fearful that another will soon follow. It’s that sense of waiting, fearing that something is coming, but never knowing exactly when, that makes it so difficult to handle. It’s hard living like that because you miss so much just waiting for whatever is coming next.
I’ve thought of that statement over the years and I still agree with it. I’ve heard the first shoe drop to the floor. I know there is another and it’s just a matter of time before it falls too. Until then, I’ll be hypervigilant waiting for it to happen. That’s the true essence of PTSD – knowing what can happen, and waiting for it to happen again.
With PTSD, it is necessary, at least for me, to find time each day to back away from all the stress and turmoil in my life, and find that sweet spot of peace where I can go. It is necessary because I need to replenish myself mentally and spiritually. Only in that way can I continue to cope with all the stress. I manage this by finding the little things that mean something special to me, and focusing on them.
I can find my place of peace in many different places: I may be engrossed in a good book, or take a walk in the woods. It is always surprising to me how much nature nurtures me!
I may listen to music that speaks to my soul, or spend some special, quiet time with my dogs. I may go take a walk in the mall or go to a movie.
Your way of connecting to your peaceful place may be far different from mine. I spend time working with crafts. You may like to go fishing. I call up a good friend and share my latest situation that made me laugh with her. You might rather spend hours cooking something special.
Whatever it is, and however you can get there, take the time to look for and connect with your peaceful place each day. You’ll be better off for doing it!
Dissociation means disconnecting. When we think of it in terms of PTSD, it is a method of self-defense. Dissociating allows us to escape. We just do it mentally rather than physically.
Dissociating is a term it took me a while to learn. When I finally understood it, I was relieved because I had what I thought of a “time blackouts.” For example, I remember entering a room once where I was forced to walk past my father.
Now, my father was a violent man, and I was terrified of him as a child. I stopped in the doorway and wondered if I had the courage to walk past him when I would be in a confined space and close enough for him to hurt me if he wanted. Then, all of a sudden, I was on the other side of the room, past him! I had no memory of having walked past him. It was as if I had been transported through time.
That experience, and others that were similar, were very frightening to me. I wondered if I had “blipped out” because of mental illness or some other strange mental defect. Years later, after much research, I ran across the term “dissociating,” and looked it up. I researched it thoroughly and realized that was what had happened.
I no longer think of myself as being defective for having lapses of memory. I think of myself as having some pretty cool build-in defense systems that protect me from things I could not otherwise deal with. Dissociating is just another way I coped with the horrors I was living with. It is another way I found to successfully survive.
Stress can have a severe impact on PTSD. After all, PTSD usually comes with a good dose of anxiety to begin with. Stirring in a load of stress with it just expounds the problems we’ve already been dealing with.
I’ve been under a lot of stress lately. I’ve had multiple appliances break down in the house (washing machine, hot water heater, furnace and television). Because most of them we cannot get along without for any lengthy period of time (especially the water heater and furnace!), I’ve had to scrounge to find the finances to cover replacements and repairs. That’s stressful.
At my house it is also “puppy time.” That means all of our female dogs have whelped. So, in addition to the water heater and furnace not working, all of a sudden I had 42 puppies to think about! How do I keep them warm enough? How do I get their bedding clean? Believe me that was stressful!
Over the years, I have learned that if I’m in one of those “heavy-stress” periods, then I need to stop and spend extra time taking care of myself. No one else is going to do it. It means that sometimes I have to leave the regular chores for another day. Or, that I am eating out more and cooking less. It also means I have to think about whether I’m getting enough sleep, and that my nutritional status is healthy so I can handle all this stress. I have to take extra good care of me!
Stress is a factor that is going to affect all our lives. Sometimes it will grow out of control and we’re going to have to hustle to withstand it. Taking care of ourselves is the best place to start! We all know how what we need to do; let’s just make sure we do it!