• Nicole Dake

Mental Health Awareness: Post-Traumatic Stress (PTSD)

Updated: Jun 3

Trigger Warning: Contains descriptions of childhood trauma & Domestic Violence.


I looked like I had it all together, but inside I was sad and broken.


After a lifetime of alternating between trying to be perfect enough to get people to love me, and rebelling against their impossible expectations, I felt hollow inside.


I learned to smile through the pain, and pretend my feelings were unimportant, that all that mattered was what I accomplished.


By the time I was 25, I had a daughter, husband, college degree, and my own business. On the face of things, I was succeeding at life.



What is Post-Traumatic Stress(PTSD)?


Most people think of PTSD as something that happens to veterans coming back from war, and that is an accurate description, as far as it goes.


Often, when soldiers are returning from war, they have seen terrible things that they don't know how to process. They have lived on the battle front, where danger is a constant, and they develop hyper-vigilance to threat.


When our bodies have stayed in a constant hyper-vigilant state, the fight or flight response becomes activated more easily. This is an evolutionary response to very real danger.


There are other events that can trigger PTSD however, besides being in a war-front. It can be caused by other types of traumatic events, including sexual assault, child abuse, domestic violence, chronic illness or injury, chronic poverty, and many others.


The factor that is the same in all of these situations is the chronic stress response, as well as re-experiencing of the trauma as though it was actually happening.


Diagnostic Criteria


According to the DSM-5 (Diagnostic and Statistical Manual) Post-Traumatic Stress is characterized by:


You were exposed to one or more event(s) that involved death or threatened death, actual or threatened serious injury, or threatened sexual violation. In addition, these events were experienced in one or more of the following ways:

  • Directly experiencing the event

  • Witnessing the event as it occurred to someone else

  • You learned about an event where a close relative or friend experienced an actual or threatened violent or accidental death

  • Experiencing repeated exposure to distressing details of an event, such as a police officer repeatedly hearing details about child sexual abuse


You experience at least one of the following intrusive symptoms associated with the traumatic event:


  • Unexpected or expected reoccurring, involuntary, and intrusive upsetting memories of the traumatic event

  • Repeated upsetting dreams where the content of the dreams is related to the traumatic event

  • The experience of some type of dissociation (for example, flashbacks) where you feel as though the traumatic event is happening again2

  • Strong and persistent distress upon exposure to cues that are either inside or outside of your body that is connected to your traumatic event

  • Strong bodily reactions (for example, increased heart rate) upon exposure to a reminder of the traumatic event


Frequent avoidance of reminders associated with the traumatic event, as demonstrated by one of the following:


Avoidance of thoughts, feelings, or physical sensations that bring up memories of the traumatic event1

  • Avoidance of people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event

  • How to Anticipate and Manage PTSD Intrusive Thoughts


At least two of the following negative changes in thoughts and mood that occurred or worsened following the experience of the traumatic event:

  • Inability to remember an important aspect of the traumatic event

  • Persistent and elevated negative evaluations about yourself, others, or the world (for example, "I am unlovable," or "The world is an evil place")

  • Elevated self-blame or blame of others about the cause or consequence of a traumatic event3

  • A negative emotional state (for example, shame, anger, or fear) that is pervasive

  • Loss of interest in activities that you used to enjoy

  • Feeling detached from others

  • Persistent inability to experience positive emotions (for example, happiness, love, joy)


At least two of the following changes in arousal that started or worsened following the experience of a traumatic event:


  • Difficulty concentrating

  • Feeling constantly "on guard" or like danger is lurking around every corner (or hypervigilance)

  • Heightened startle response

  • Impulsive or self-destructive behavior4

  • Irritability or aggressive behavior

  • Problems sleeping

  • Hypervigilance as a Symptom of PTSD

  • Criterion F

  • The above symptoms last for more than one month.


The symptoms bring about considerable distress and/or interfere greatly with a number of different areas of your life.


The symptoms are not due to a medical condition or some form of substance use. (DSM-5 PTSD Diagnostic Criteria (verywellmind.com))


If you think you may be experiencing PTSD, please consult your healthcare provider for a formal diagnosis.


Mental Health as a Mom


As moms, we always strive to put our children first. That is what I did when I got pregnant with my daughter Atlantis when I was 19 years old. I pulled my life together, and went to college so that I could get a good job to support my daughter.


On the weekends, I made sure to always have some kind of fun activity planned for her, so that she would enjoy all of the best in life. I put her in gymnastics and swimming lessons as a toddler, I took her to the library, and taught her how to write letters on her etch-a-sketch.


When I cried about all the things going wrong in my life, I did it alone at night, after she had gone to bed.


All my daughter's physical needs were met. I gave her enrichment opportunities. I made sure she had time to play with her friends. I took her on vacations that were kid-centered.


Unfortunately, I didn't always focus on her as much as I should have, because I was also trying to parent her dad, who was always emotionally needy, and financially demanding. I tried to make him happy, and give him the life that he dreamed of, wishing that he would love me and fill in my empty holes. But for whatever reason, he couldn't do that.


When Things Break


After 6 years of marriage, my husband hit me for the first time. It was an outward manifestation of all of the psychological and financial abuse I had endured up to that time.


With two black eyes, I went to the hospital because I was having a panic attack. The doctor gave me a xanax and sent me home. It wasn't enough.


I didn't have support from family or friends to leave. Everyone liked my husband more than they liked me, because they only saw his charismatic side. They all told me I should stay, and faulted my mental illness - I had coped with depression as a teen - as the cause of the problems.


Domestic violence is often isolating, because victim blaming is easier than helping someone suffering.


There were many times that I reached out for help, but all my attempts were met with the suggestion that I should get counseling.


Getting Free


After 3 years of enduring abuse, I started to fall apart. I started drinking more. I was angry and sad, and grasping at straws.


Finally, the 8th time I left my ex, I found someone to stay with who would help me. A close girlfriend let me stay with her, and she did the one thing that finally let me get free.


She took my phone.


When my husband couldn't call and alternately harass and guilt-trip me to come back, I finally had space inside my head to separate myself from him. It's not only physical separation from a whirlwind of a relationship like that which is needed, it is mental separation as well.


Whenever I had left in the past, my husband would blow up my phone so much that I never had a chance to call anyone else for help. He put himself constantly in the forefront of my thoughts, because I couldn't get away from his calls.


A few days of quiet, peace, and friendship helped me find the strength to leave for good.


You can't get well in the same environment that you got sick.


Therapy for Trauma


Over the years, I endured multiple traumas, not just with my ex-husband, but with my own family of origin as well.


It has been 10 years now since I got out of that relationship, and I am finally getting therapy that is specific to PTSD. In addition to doing talk therapy, I am doing EMDR.


"Eye Movement Desensitization and Reprocessing (EMDR) therapy is an extensively researched, effective psychotherapy method proven to help people recover from trauma and other distressing life experiences, including PTSD, anxiety, depression, and panic disorders. (About EMDR Therapy | EMDR International Association (emdria.org))


Our brains have a natural way to recover from traumatic memories and events. This process involves communication between the amygdala (the alarm signal for stressful events), the hippocampus (which assists with learning, including memories about safety and danger), and the prefrontal cortex (which analyzes and controls behavior and emotion). While many times traumatic experiences can be managed and resolved spontaneously, they may not be processed without help.


Stress responses are part of our natural fight, flight, or freeze instincts. When distress from a disturbing event remains, the upsetting images, thoughts, and emotions may create feelings of overwhelm, of being back in that moment, or of being “frozen in time.” EMDR therapy helps the brain process these memories, and allows normal healing to resume. The experience is still remembered, but the fight, flight, or freeze response from the original event is resolved."


Now that I have been doing EMDR for about 6 months, I am finally starting to feel better, and not like I am stuck in my trauma anymore.


I think one of the things that most people don't understand about PTSD is that we aren't just triggered to think about disturbing memories over and over. When someone with PTSD thinks about their trauma, it is like we are reexperiencing it over and over.


When a trauma occurred in childhood, someone with PTSD is continuously reexperiencing the trauma as if they were still a child.


By reexperiencing memories this way, we can't connect our adult brain or coping skills to the past. We are stuck knowing only what we knew as a little child. That makes it hard to move on.


With EMDR, I have been able to reprocess the traumas, and to be able to see those experiences as an adult for the first time. It has been incredibly healing.


Trauma Triggers as a Mom


When my partner Gary and I had our daughter, River, four and a half years ago, we decided on an Attachment Parenting approach. This is something that is important to me, because I know from taking child psychology courses during college, that early attachment to a care giver is crucial for a child's success early in life.


During River's infancy, Gary was a stay at home dad with her. He held her during her naps, because she wouldn't nap otherwise until she was about 11 months.


One day while I was at work, my mom came over to check on Gary and River. He was holding her while she slept. My mom didn't think that was the right approach. She told him, "Sometimes you just have to let kids cry so you can do something."


When he recounted this to me after I got home from work, a chill went down my spine. I realized in that moment that I had been neglected as a child.


In the months to come, I started thinking about my own childhood, and how I have never felt a close connection with my mother. I started reading books about Childhood Emotional Neglect and Narcissistic Parents.


Since I had spent years married to a man I believe was a narcissist, I was quickly able to recognize red flags between his behavior and my mom's behavior.


Breaking the Cycle


When we bring our unconscious patterns into conscious awareness, through therapy and other practices such as yoga and mindfulness, we are able to break those patterns.


By creating healthier self-talk and behaviors in ourselves, we are able to better parent our children in a more intentional way.


Doing therapy, and learning to be aware of my trauma triggers, has helped me learn to be a better mom. I work hard to use coping skills in my daily life and to teach them to my kids as well.


Simple coping skills like deep breathing, and naming our emotions, can help us teach kids emotional self-regulation. This is something I never learned as a child. I just learned that my feelings were bad, a burden to my parents, and I shouldn't have them. Not a lesson I want to teach my kids.


Feelings are always real and valid, it is what we do with those feelings that matter.


Conclusion


Many women who have PTSD as a result of domestic violence never break the cycle. This is because we often don't realize the beliefs about ourselves that cause us to get into those relationships in the first place.


Trauma can often be generational, because when we are in a place of trauma, we don't parent our children the best that we could.


Healing is difficult. We have to work to rewire our brains, and to create new healthier thoughts and behaviors to replace the self-destructive patterns that we learned in childhood. This is difficult because when we see violence and invalidation as children, we think these are the normal ways that people behave.


We don't look for a better life, or for better relationships, because we don't know that they exist.


Since it is Mental Health Awareness Month, I am sharing my story to help anyone else who is suffering to break the cycle. If you, or anyone else you know, is considering suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255. There is someone available for you 24/7.


Additional Information about Mental Health Awareness Month, including how to find suicide in your area, can be found at: Mental Health Month | NAMI: National Alliance on Mental Illness


Please know, help is out there! You don't have to be alone, or suffer in silence.



For more information on what I do for my mental health, check out these related blog posts:

Be Kind to Yourself (millenialmom.net)

Re-Thinking Selfcare (millenialmom.net)

Setting Boundaries and Standing Up to Bullies (millenialmom.net)

Feeling Unmotivated? (millenialmom.net)


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