PTSD – An Update on Me

This post is re-blogged from my main blog, AboutTeaching. It was originally published June 6, 2015

Quite a few people have been asking, so I guess it’s time to post an update on me.

As I wrote here, about a month ago I fell apart. I was in so much distress that I needed to take time off work.

The initial diagnosis was anxiety and depression, and there are elements of those, but according to my therapist, the main thing going on with me is post traumatic stress disorder – which feeds both of the other conditions.

I haven’t want to acknowledge it, but there were multiple traumatic events in my past. I’d just pushed them all down, buried them and kept on going. But, a couple of months ago the memory of one of those events was triggered, and brought back with it all the pain and emotion of the original experience. This seemed to have a cascade effect, and one after another, more painful memories of the past started emerging. It was like being forced to re-experience all the sad and traumatic experiences of a lifetime in rapid succession.

Things are definitely improving. Now that I understand what is going on, it’s less distressing. There is a rational explanation for the anxiety. I’ve even had days where I’ve felt completely normal. But I’m also frequently finding myself triggered. Everyday things will suddenly stir up a memory and I’m back there, re-experiencing trauma all over again. At times it is just painful, at others, terrifying.

The unpredictability of this has made it difficult to work. It’s hard to know from one moment to the next if I’m okay, and on bad days I have great difficulty managing the anxiety, concentrating or responding to stress.

Plus, I’ve had so much to process – counselling is forcing me to confront things I’d tried to bury. I’ve needed time away to provide the head space for me to do that.

I feel fortunate to have the ability to take some extended sick leave and to work with people who support that choice.

I also feel fortunate to have such a supportive online educator network. Since publishing those posts, I’ve received messages of support almost daily, and online friends, some of whom I’ve never met in person, regularly check in on me. It has helped me more than they know.

I’ve also been contacted by several teachers going through similar struggles. Sadly, not all of them have felt able to be open about it with their work, their friends or family, and are suffering in silence. It’s a sad reality that even though we work in a profession that cares so much about wellbeing, the stigma around mental health issues in adults still remains. There can be real consequences for speaking up,

I’m not sure how much of this I would have admitted if it had been work related. I’ve been be able to redefine my role over the past few years and get my hours down to a more manageable amount. I’m not finding work stressful. I enjoy it, I and I miss it. But if the stress of work was feeding my situation, I would have been less willing to share it. I’d worry that I would be judged as not quite up to the task. Who knows, perhaps that will happen anyway. I do wonder how damaged my credibility will be as a result of being open about what’s happening, and taking the time that I need to heal.

We would never question the need to look after a broken leg, or have treatment for a physical illness, but we do when it comes to mental health. It’s often seen as a weakness or a character flaw. The stigma around mental health issues needs to end.

In Pieces

This post is re-blogged from my main blog, AboutTeaching. It was originally published May 14, 2015

I broke into pieces last week (see my post on depression). Since then, part of me wants to laugh hysterically when I’m asked to do things. I mean its ridiculous. I’m completely broken. Sure, I’ll help you with that, just let me screw my arms on first. Wait, where are my legs again?

I realise it isn’t visible. While its obvious to me, there’s no reason that others wouldn’t assume I’m just fine.

That, I confess, is another reason I wrote my post last Sunday. I needed people to see that I’m not whole at the moment. I’m in pieces and I need time to put myself back together.

I took Monday off work. I was in distress and I needed to recover. But, when I tried to return to work on Tuesday, I hit some difficulties.

It took 3 attempts to leave the house. I kept bursting into tears, washing my face, and reapplying my makeup. On the way to school, I nearly had to pull over as I was so nervous. I was having a panic attack.

I was worrying about  falling apart and people seeing that. I also knew it was likely some had read my post, and while I’m not ashamed of what I wrote, I was apprehensive about their reactions.

People look at you strangely when you say you’re depressed.  I’d not only done that, I’d just publicly admitted to a history of self harm.

Some people retreat. They feel awkward and uncomfortable. Other people will be beautifully compassionate, and when things are close to the surface, compassion reduces me to tears.

Some would be shocked I wrote about self harm on my blog. Some would find themselves confronted and repulsed.  And publishing my pain for the world to see is breaking all sorts of taboos.

But in the morning, people were normal. A number told me they hoped I was feeling better and chatted about how much sickness and flu was going around. I tried to deflect the conversations.

I stand by my belief that in hiding mental health issues just contributes to stigmatising and isolating those who suffer. As a school leader, I want to lead by example.

But it’s one thing to believe, and another thing to act. It’s hard to casually say to a crowded room, “Oh no, I don’t have the flu, I have depression”. So I retreated to my office, and tried to focus on my timetable, and the lessons I needed to run that day.

Shortly before classes were due to start, I dropped into the principal’s office. I was there to talk business, but as soon as she saw me, she stood up and asked if she could give me a hug. ‘Why?’ I asked. She gestured towards her computer, and there was my post, open on her screen.

One of my colleagues had been in a few minutes earlier and told her to read it.

If you’re a school principal, and one of your staff reveals they have depression, or any other mental illness, you would do well to follow my principal’s example.

The way she responded was perfect. She’d already read my blog so I didn’t need to explain anything, instead she said, “I know you, I know you know how to manage this and you’ll be okay. Just let me know what I can do to support you.”

See, there was no judgement, no freak out, no questioning. There was no patronising advice and no assumption, that just because I’m struggling with mental illness, I’m not capable of managing. Instead, what I received was respect: “I know you know how to manage this…how can I support you?”

I thought for a moment, and the one word that came to mind was “acceptance”. That’s really all the support I need. And by that I mean to accept the truth of it, and to allow me to do what I need to do to manage it without judgement. Just as she had when I injured my shoulder, or took 3 weeks off with a severe bout of flu.

By recess, the anxiety that made it hard to leave my house had grown into a monster. I knew that at least some people on staff had read my blog, but I didn’t know who. The person who shared my blog with the principal, never usually reads it, so it must have been passed around at least a little. I felt so exposed and I couldn’t look anyone in the eye.

I was over thinking everything. If someone smiled, were they being friendly, or were they feeling sorry for me? What about that teacher who was too busy to say anything when we passed in the corridor. Was she in a rush, or was she avoiding me, because reading my post  has made her uncomfortable?

The anxiety was so bad, that I started to have panic attacks. I couldn’t leave my office. I was shaking, hyperventilating and trying to keep calm. I closed the door, but that wasn’t enough, I had to shut the blinds as well. And all the time I was hungry, but too panicked to go into the staffroom and get my food out of the fridge.  I calmed myself down a couple of times and attempted to leave, but as I got to the door, I’d start panicking again. So I just stayed in there, trying to calm down and resisting the instinct to hide in the cupboard.

The panic itself fed further anxiety. I’m an assistant principal. I’m meant to be strong and together. A supportive and reassuring presence. Not an emotional wreck who wants to hide in a cupboard. I mean, who does that, and how can anyone respect me? How can I respect myself?

I decided to stay in my office until the next period, when I’d be teaching Year 6. They make me laugh, and as I said in my earlier post, teaching is so immersive. It demands all of my attention and there’s no space for depression in those moments when I’m working with students.

But when the bell went, as soon as I neared the door, I’d weep, shake, and hyperventillate. After 10 minutes of trying, I gave up. I needed to be home.

I found the principal, told her I had to leave, and that was it. Again, there was no judgement from her just acceptance. She trusted my ability to determine if I was fit for work. Trust and respect, that’s the support I need.

I know in my earlier post, I wrote that I had strategies to manage this. Well, sometimes its harder to use them than others. And sometimes they don’t work. Once mental health impedes my ability to work, or lead a normal life, then I know its time to seek help. I’ve seen my GP and have a follow-up appointment tomorrow. And I’ve a medical certificate that covers me for the week off work.

I’ve needed the time out. I had more panic attacks yesterday, and my ability to concentrate is shot to pieces. I’ve been over thinking everything and unable to make decisions about the most simple things:  A friend DM’d me yesterday to ask how my day had been. He’s been supporting me throughout this episode.  I started to panic: How should I answer. Should I tell him the truth? If I did, he’d probably feel obliged to keep supporting me, and I don’t want to be such a burden. Everyone has their issues, and I don’t want to burden them with mine. But, if I lie and say things are good, then he’ll think I’m fine and I’m not and the support has really been helping me. I worried over this, for around 20 minutes, before settling on replying with ‘better than yesterday’ or something along those lines.

Cameron, my TERpodcast colleague contacted me this morning about preparing the script for the episode we were due to record this evening, and I felt the anxiety rising within me again –  and disbelief. How on earth could anyone think I could do any of this when I’m in pieces?

But of course, how would anyone think otherwise? There are no visible injuries. He was understanding though. I warned him he might need a back up plan for this episode, so we pulled the plug on my contribution and he’s working on Plan B. I feel so fortunate to be able to step back from these things, and so grateful that my colleagues support me, when I know it creates an extra burden for them.

And so, it’s the first day I haven’t had to DO anything, no work, no doctors appointments, no other commitments. I haven’t had to leave the house, so there’s been less cause for anxiety. But my mood feels lighter too – For the first time in days I don’t feel like I’m IN distress, just drained, exhausted and melancholic from the experience of it. I think I’ll be better soon.

Why I Published that Post on Depression

This post is re-blogged from my main blog, AboutTeaching. It was originally published May 12, 2015

Trigger Warning: mentions of depression and suicide.

My last post in which I revealed my struggles with depression, came as a shock to some readers. This is a space normally reserved for issues of education, not issues of  mental health.

I was nervous about it, but I felt I had to publish.

Public blogging helps me sort through ideas and find clarity. In a private journal, I go in circles, ruminating. It’s unhelpful. Writing for an audience forces me to make sense of things and communicate in a more constructive manner. It brings a responsibility to find a positive or practical outcome.  It was when I started to write the more positive part of my last post that I recalled strategies to help me in my own struggle. So at a personal level, public blogging is a helpful process.

But an even more compelling reason was  this story, shared in my Twitter feed by George Couros and then on Facebook by Tina Photakis. My heart just broke for this suicide victim, who was trying so hard to maintain an image of normality when inside she was in so much pain. She perceived that the perfect lives everyone else presented on social media was real for them, and only she was faking it.  None of us have perfect lives, we all have flaws, we all struggle, but if we only present our best parts to the world, we risk isolating others who struggle, perpetuating the belief that they are alone and not normal. I don’t want to be complicit in that.

Since publishing, I’ve received messages of support from so many of you, I’m thankful for that, and I cannot tell you how much it makes a difference. I’m doing it tough at the moment, but the the messages of support, kind words, the acceptance and validation are helping carry me through.

If you think you are struggling with depression, or if this post has triggered some difficult thoughts and emotions in you and you need help, check out the Beyond Blue website. 

Living with the Shadow of Depression

This post is re-blogged from my main blog, AboutTeaching. It was originally published May 10, 2015

Kintsugi (金継ぎ?) (Japanese: golden joinery) or Kintsukuroi (金繕い?) (Japanese: golden repair) is the Japanese art of fixing broken pottery with lacquer dusted or mixed with powdered gold, silver, or platinum, a method similar to the maki-e technique.[1][2][3] As a philosophy it treats breakage and repair as part of the history of an object, rather than something to disguise. Source: Wikipedia

Trigger Warning for mentions of self harm and suicidal thoughts.

Last week, I was in the principal’s office, discussing curriculum adjustments for students with disabilities. I kept my tone light, and my face professional. But behind it, I was preoccupied by a vision of blood – pouring from long slashes running from my wrists to my elbows,  gushing, like a broken dam from my stomach, cut open.

I returned to my office, sat down and stared at my hands for several minutes.  Just staring, on the verge of tears, when I finally thought “What the fuck am I doing?” and got on with the timetable I was working on.

I thought I was past all this, that I was cured, and that I had better coping strategies. It took me by surprise to have those thoughts again.

I was diagnosed as clinically depressed when I was 30, but I’ve lived with depression on and off since at least my teenage years. Some people describe it as a black dog. I think of it more as my shadow self. Its part of me. A friend, whose embrace I find it easy to fall into. It creeps up so softly, that at first I don’t realise it’s there. It can hang around for months before I realise I’m in its grip.

Years ago, I used to cut and burn myself.  When my depression was at its worse, I was numb. There was no pain, but there was no joy. I felt nothing. During those very dark days, I wanted to feel something, anything. Pain was good. Cutting or burning allowed me, just for an instant to feel something and  know I was alive.

But I mostly wanted to cut myself open because I didn’t know how to express the pain I was feeling. I still don’t. I was and am ashamed of it. I don’t have a right to feel this way, when so many people have greater problems, better reasons to suffer. Cutting and burning – they were physical manifestations of pain I had no right to feel and wouldn’t express any other way.

Random events have opened up old wounds for me: the murder of a teacher in NSW; encountering someone who attended the same  high school as I… suddenly I find myself assaulted by memories. Things that were buried are close to the surface now. The scars I thought had healed  are open and bleeding.

I remember the strategies the psychologist taught me. To monitor my thought patterns, challenge the negative ones and avoid catastrophising. I know I need to practise mindfulness and gratitude, to get out in the sunlight and to get some exercise. I’ll do all that,  I will — but for now, I’m letting myself bleed a little. I’m cutting myself open with my words this time – letting you peek behind the mask.

You see, I know I’m not alone in this. There are so many of us who struggle with mental health. Everyone acknowledges that it affects others, but we so rarely admit to it in ourselves. We carefully craft our public identity and our social media profiles to show that we are positive, competent, capable. It’s a risk to confess that we’re also flawed. But that’s why I’m confessing. Depression isn’t something that happens to a small group of weak-minded people Self harm isn’t a weird deviant practice. It’s common, but it happens in silence and shame.

Having lived with this on and off for years, I know I’m okay. At the moment, I’m experiencing symptoms of depression, but I don’t think I’m trapped there as I once was, and I can get myself out.

I’m using apps to monitor my mood several times daily. When I’m depressed, my tendency to catastrophise leads me to believe that I feel that way all the time, instead of it being just a part of my daily experience. I become quite anxious. I never want to return to the dark place I existed in years ago, when planning my death became a full-time obsession. My fear of returning to that compounds the problem. Mood monitoring helps me recognise that it’s not that bad – sometimes its just a mood, and there are times, each day, where I feel good. In fact, I experience moments of joy each day, and my outlook is still relatively optimistic. I can immerse myself in activities (like baking the raspberry macarons that are currently setting in the oven) and for a time, completely forget about these darker emotions.

And yesterday, I found an app called “Happify” which has activities and games to increase positive emotion. I was skeptical, but my initial experience has been good. Last night’s task was to simply identify 3 positive experiences that occurred during the day. Given that I’d had a migraine for most of it, and was feeling fairly melancholy for the rest, I doubted I could find any. But sure enough I found three. Immediately my mood lifted somewhat, I felt appreciative, and it helped me to remember that even while I’m fixating on the negative, good things are happening. I just need to pay attention.

There’s a stigma to depression, and its a risk, as a teacher, admitting to it publicly. As much as we want to promote mental health in our schools, we don’t like to admit to having problems with it ourselves. It’s can be seen as a failing, a sign of weakness. Its okay to admit I stayed in bed for half a day with a migraine yesterday, but a character flaw to confess that I stayed in bed for half a day with depression today.

In fact, years ago,  after I admitted I had a history of depression the principal I worked for refused to allow me to take on any extra responsibilities or leadership. He thought it would make me vulnerable and took a paternalistic decision to protect me, by limiting my opportunities for leadership and career advancement.

But I’ve been living with depression for longer than I’ve been teaching. It’s accompanied me throughout my career. And yet, I’m an accomplished teacher and a school leader, who has earned the respect of my colleagues and community.  When I work with students, I’m completely immersed – in flow. Teaching brings me such joy, and demands my full attention. When I’m teaching there is no room for the darker moods. which can take hold in the quieter moments.

If you think you are struggling with depression, or if this post has triggered some difficult thoughts and emotions in you and you need help, check out the Beyond Blue website. 

When positive thinking doesn’t work

One of the hardest things to get my head around is that I am not in control.

I suppose we all realise that at some point in our lives. Serious illness or injury  forces us to confront the fact that our bodies are just going to do what they want at times. They’re vulnerable. We do what we can to prevent injury or illness, and when we suffer, we seek treatment and therapy, but we can’t really control the outcomes.

But when it’s a problem in my brain…that’s something I thought I could control. I know, or thought I knew what to do. Cognitive behaviour therapy has taught me how to challenge my unhelpful thinking and reframe my thoughts. There are a wealth of cognitive strategies that make a difference and help us to become resilient.

This belief that we are in control of our minds has become pervasive. Positive thinking quotes show up in my Twitter feed daily:

‘You can’t lead a positive life with a negative mind’

The idea that positive thinking strategies work is comforting. It gives us a sense that we’re not helpless, that each of us has the ability to change our lives and to create our own happiness.

But, it’s only part of the truth – we run much deeper than our thoughts.

I can’t begin to describe the shame I felt at having a breakdown that rendered me incapable of working for over 2 months.

I felt it was my fault, that if I had enough discipline I should have been able to re-frame my thinking.  I’d allowed myself to become broken. I had the wrong mindset. I’d done it to myself.

Only that wasn’t the case.

Traumatic experiences aren’t just stored as explicit memories. They are also stored as implicit memories, and according to my psychologist, while I may have processed the explicit memories of trauma, those implicit memories remain stuck, not fully processed, stored in my brain’s amygdala.

Innocuous things, like  a sound, a colour or a movement trigger associations with past trauma. Consciously, I know I’m safe, but the amygdala identifies it as a threat and takes over. It’s a survival response which floods my body with ‘stress’ hormones charging me up for fight or flight.

The amygdala shuts down my prefrontal cortex – which does all my reasoning. Again, this is a survival response, designed to allow humans to act quickly and instinctively in extreme danger, rather than thinking things out. But it also means that cognitive strategies aren’t going to work.

And, according to my psychologist,  its not a matter of using cognitive strategies in a preventative way. Those strategies work on the reasoning part of my brain, but they aren’t likely shift the physical and emotional memory stored in my amygdala.

What she has recommended is exposure therapy, where I am re-exposed to those trauma memories in a safe environment, and am helped to process them properly. This should mean they are no longer stuck, and no longer trigger a fear response. But, exposure therapy takes time, and to be honest I’m terrified. Our attempts so far have only had limited success. I become so distressed that I resist, and so we’ve spent our sessions circling around issues as I use every strategy I can to avoid confronting the past.

Since being triggered just over two months ago, I’ve been in an almost permanent state of high anxiety and distress. If full-blown panic attack is around a 10, I’ve been operating on around a 7 or 8. My body is so full of stress hormones that it doesn’t take much to push me back up to a 10, and every time that happens more stress hormones flood my system, making repeat panic attacks more likely.

I can’t prevent the trauma triggers, as they are unpredictable. 2 nights ago, for example, I had a nightmare induced panic attack. I couldn’t see that coming, I can’t prevent what I dream about. Sometimes I’m triggered by a sound, or a movement. The other day I was triggered by the prospect of doing a research masters.

Pretty much all I can do is focus on reducing the frequency and intensity of the anxiety.

To reduce the level of adrenaline, I have to move. When I was on leave, I walked for around an hour each day. Now that I’ve returned to work, I do a 40 minute walk to and from walk, as well as a twenty minute walk each lunch time. If I drive instead, I make sure I’m home early enough to go for a run. It relieves the pressure that constantly builds inside of me. Last week was raining however, and this limited what I could do. I could jump on the cross trainer at home, but I couldn’t ease the pressure by taking lunchtime walks.

I meditate daily. I’m learning to create a mental space between myself and the anxiety. Instead of thinking “I’m anxious”  I’m learning to just note and observe the feeling – “that’s anxiety”. Somehow this space seems to make it less overwhelming. It’s not a cure, however. Earlier this week, just 15 minutes into meditaton, the anxious knot in my stomach exploded without warning. In an instant, I was overwhelmed with an urgent desire to escape, gasping for breath, shaking, adrenaline coursing through my limbs. But the daily mindfulness practice does help me throughout the day. If I notice myself becoming stressed, I bring myself back into the moment, and focus on my breathing, the sounds and the sights around me. This doesn’t prevent a panic attack, as when triggered, they occur instantly and without thought. But it does help reduce the level of stress in my system and therefore the likelihood of an attack.

Medication is helping too. I’d naively hoped it would make the anxiety go away completely, but it doesn’t. It has however reduced its intensity – taken the edge off so to speak, and it is my and my psychologists hope that this might enable me to relax more in exposure therapy and give it a greater chance of working.

Finally, I’m trying to focus more on my impact on others than what’s going on inside of me. The saying ‘ people don’t remember what you say, but how you make them feel’ has resonated with me strongly recently. I’m trying to be conscious of this in my interactions. I want to listen, to support, to show interest and compassion. I may be feeling crap inside, but that doesn’t mean people can’t feel better for being around me. Being other person focused keeps my mind off my own pain.

Progress has been slow, but I’ve finally been able to return to work. Teaching children is a fascinating and joyful experience, full of meaning and demands my full attention. When I’m working with them, I’m completely immersed and I don’t notice the unease that sits inside of me. It’s the lunch breaks, the meetings and the admin times where I become aware. I’ve a growing knot of tension in my stomach, quite painful and nauseating at times. By the end of the school day, the pressure has become unbearable, and I leave as early as I can to walk or run it away. But I’m getting through each day, and making a positive difference. I have to be happy with that.

Immersion

People say it comes in waves. Depression and anxiety ebbs and flows like the tide. Gentle and so subtle you don’t realise what’s happening until you’re immersed. But sometimes its more like being caught in a storm, sudden, violent and painful. It comes on suddenly, a violent assault. It aches so much and there’s nothing I can do but endure and know that it will end.

Pain

Things were going well for a while. Every day there were increasing moments of normality, where the tremor of anxiety was almost stilled. There were even moments of almost carefree happiness, fun and joy.

Yesterday, however, I woke with a sense of great unease. It seemed to come from no where. I couldn’t identify a trigger.

It grew rapidly into a state of inexplicable distress and pain, tight across my chest, and heavy in my stomach. It felt unbearable. My thoughts became dark and self destructive.

I dug my fingernails deep into my palms. I made a fist punched my thigh.  Physical pain to block out the emotional pain.

I meditated – a few minutes of quiet relief.

When the rain stopped I went for a walk. There were brief moments where the winter landscape was able to distract me from the pain.

I went to dinner with my partner and for an hour or so felt calm again. But then the unease started to grow again, so rapidly it began to overwhelm me. I felt like I was suffocating and couldn’t wait to get home.

Home again I curled up on the couch and silently dug my nails into my palms as hard as I could.