Does the PTSD of Illness & Pain Ever Go Away?

I developed tendonitis in my right wrist -- probably from using an external mouse on my computer. I saw a doctor. Got a removable splint to wear and was told not to strain my wrist. No big deal, and no PTSD (post traumatic stress disorder).

A few day later, I sliced open two fingers on a sharp metallic edge of a tray I did not notice was so sharp. Blood gushed. I could see the fat layer of my fingers. I used the voice (you know the one. We all have it in serious situations where obedience is required and no questions are to be asked) to tell Richard - I need you to drive me to the emergency room, now.

I was fine during the waiting and the stitching. I joked with the doctor, got to know her life story, gave her recommendations for local restaurants.

Then, over the next few days, I was either hyper or low-per -- unable to sit for more than two minutes or unable to get out from under the fleece blanket and off the couch. I either felt feathery, as if gravity were not strong enough to hold me down; or I felt compressed & dense, as if I were the center of a cosmic black hole.

I was hypervigilant about the wound -- checking it a few times an hour to see if there were any signs of infection or to see if a stitch had come loose. I held my fingers under a fluorescent light. I examined them with a magnifying glass.

Within the course of a ten day period, I made two visits to the surgical physician's assistant and two more to after hours care. I was sure something had gone wrong.

As I was experiencing all this, I also had the awareness to ask myself if my excessive scrutiny might not be a leftover from the terrible fear of things going wrong that chronic pain can infuse into one's very cells. The answer was - Yes. I knew my behavior reeked of PTSD; but I couldn't stop it. I needed repeated confirmation that everything was OK.

In fact, one doctor I saw told me there were no signs of infection. But a few days later, the surgical physician's assistant I saw confirmed that I did have an infection, still in its early stages. I was relieved she caught it. But the misdiagnosis only reinforced my watchfulness.

Now, about three weeks after the finger slicing, I am calming down. I trust it's healing, as it was meant to do.

But when will the PTSD of living with pain finally heal?

Coping with the PTSD of Illness

In a recent post, I wrote about Post Traumatic Stress Disorder and illness. Some people who experience severe stress - war, natural disaster, abuse - continue to suffer even after the trauma has stopped. They may experience PTSD symptoms -- intrusive memories, flashbacks of the events, nightmares, and sleeping difficulties. They may be hyper-alert and startle easily.

I believe serious illness can also result in a PTSD-like responses in both the ill person and the partner. Memories or flashbacks of particularly difficult, frightening, or painful moments can intrude. Both partners can be overly vigilant about the slightest symptoms and fearful of a relapse, even if the illness is in remission or the chronic symptoms are well managed.

What can a couple do to manage these PTSD-like symptoms?

1. Talk about it with each other. Tell each other that you are worried and watchful. Talking about it won't cause a relapse to happen. If anything, it can reduce stress.
   
2. Remind each other that -"That was then, and this is now." Use this phrase almost like a mantra to repeatedly remind each other that the past is past and there is no need to respond in the current situation as if the past were about to resurrect.
3. Get some sleep. Tiredness puts us more on edge.
4. Distract each other. When one partner starts to become fearful or worried, turn on the TV, read a book aloud to each other, go for a walk, talk about the kids or the neighbors, even pick a fight about something petty.
   
5. Speak to a therapist. If you need extra help, get it. There is no need to suffer if help is available.
   

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.