Understanding PTSD- Part 5, Mood changes

Something horrible happened to you, or someone you love, and, for some reason, you just feel or are acting differently.  This looks like any of the following:

1. Cannot remember important aspects of the traumatic event(s)

2. Negative and persistent beliefs about yourself ("I am bad"), others ("no one can be trusted"), or even the world ("the world is a completely dangerous place")

3. Persistent and distorted beleifs about the reason it happened or the outcome of the event ("It happened because I can't make good decisions" or "it is up to me to keep everyone safe").

4. Feelings of fear, horror, anger, guilt, or shame that will not go away

5. Not wanting to do things that you used to enjoy doing

6. Feeling just…different from others around you

7. Having a constant struggle with experiencing positive emotions such as joy, happiness, satisfaction, laughter, or even loving feelings.

BUT WHY IS THIS HAPPENING???

1. Difficulty remembering certain pieces of the trauma (#1)

   1. This is your brains way of protecting you from feeling overwhelmed. You went through something horrible. Your brain is trying to protect you from your stress response system (fight/flight/freeze part we talked about in the trauma brain blog) from being activated…so it keeps things kind of hidden. This could be long term, or, it could be until you are able to work through them as you feel safer to do so.

   2. Also, remember when I talked about trauma and the brain? During times of stress and trauma, signals are sent to the memory part of your brain that communicate that there is not enough energy to focus on memory…because it needs everything it has for survival. So, memory is impacted in times of trauma.

2. Changes in beleifs (#2) and distorted beliefs (#3)

   1. The whole purpose of this is to help you regain control of your life and your ability to predict things. Your brain is trying to make sense of what happened, so it identifies the cause of the trauma as being a specific category, so that rules can be made in order for the bad things to not happen again (Belief: no one can be trusted. Rule: Keep quiet and don’t connect to others. Hope: No one will hurt me again). The idea is that the rules you previously made did not exactly work, and so you were hurt. Therefore, if we create new rules, maybe the bad things will not happen again (or so we hope).

3. Persistent feelings of fear, horror, shame, guilt….(#4)

   1. Trauma taps into nearly every basic human fear. Trauma reminds us of our lack of control. It brings up fear of the unknown and death. It makes us feel isolated because we feel like no one understands, or we have to keep it to ourselves so that we don’t burden others. It brings up our fear of failure because in that moment we failed ourselves (we did not fight like we thought we would) or failed others (we could not keep them safe).

4. Not enjoying things you used to (#5), feeling different from others (#6), and difficulty experiencing positive emotions (#7)

   1. You are also experiencing what is called hypervigilance (which we will talk about next time but is pretty much just an increased awareness of everything). Your body is focusing all of it's energy on this continued effort to keep you safe, so it is conserving energy just in case there is another threat. Getting excited, being happy, laughing…those take resources that your body just does not have right now.

   2. It also makes sense because after you have been exposed to stress for long periods of time (think extended experience with violence or working on a trauma unit), your body releases so much cortisol that it can impair thyroid function, resulting in feelings of depression.

SO WHAT DO WE DO ABOUT IT?

1. Grieve the loss

   1. Sometimes there are tangible things we can grieve, such as loss of property or a job as a result of trauma. Other times, we need to grieve the loss of existential things such as our belief in the goodness of others or a world that is truly just.

2. Challenge the thought. Ask yourself:

   1. What the evidence is that the belief is true? What is the evidence that it is untrue or not completely true?

   2. For thoughts that may have been formed based on what others have said, is that source reliable? Did it come from a person you can trust?

   3. Does the belief seem true because you have said this to yourself so many times?

   4. Am I basing the belief on the whole picture, or just a small piece of the picture?

3. Talk to someone about it