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Help for Helpers

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Episode 54 -- October 19, 2020

The Trauma of Now: Helping Ourselves and Each Other

Our loved ones are under great stress and strain these days--and so are we. Many of us are front line workers, essential people that keep much of our society going. Some of us are first responders or health care providers who face incredible circumstances on a daily basis. Then, there are those of us who live with those essential workers, first responders, and health care providers. How do we manage this? How do we help them? How do we manage ourselves? In Shock Waves: A Practical Guide to Living with a Loved One's PTSD, Cynthia Orange helps us sort through all of this. And it starts with self-love. We need to give ourselves love by noticing the signs and symptoms of stress, managing our stress, and identifying depression when we need more help.

This excerpt is from Shock Waves by Cynthia Orange and has been edited for brevity.

Loving Yourself

We can give love to our traumatized loved one, our friends, our family, and ourselves all at the same time. We befriend and care for ourselves best when we recognize we have the basic right to

  • Be ourselves
  • Be treated with respect, as capable, competent, and imperfect adults
  • Set limits and establish appropriate boundaries
  • Refuse requests without feeling guilty or selfish
  • Feel and express our own emotions
  • Ask for affection and help
  • Change our minds, make mistakes, and admit when we don't know, don't agree, or don't understand
  • Decide when we are responsible, what we are responsible for, and how we choose to accept responsibility
  • Protect ourselves, and
  • Grow and learn

If you have difficulty remembering or believing your personal rights, copy this list, add any more you can think of, and carry it in your purse or billfold to remind you that you are a worthwhile and deserving person.

Signs and Symptom of Stress.

I have a cartoon on my office wall of a zebra gazing back at his rear end with alarm because his stripes are coming off, unraveling like a ribbon. The caption, "I think I'm having stress!" makes me smile and serves as a reminder that unless I take care of myself, stress can creep in, threaten my health, and possibly lead to depression.

We know from the volumes that have been written on stress management that we all need to get enough sleep, eat nutritiously, and exercise. Yet naps, vegetables, and yoga are probably the last things on your mind as you try to keep your household running smoothly in the aftermath of a loved one's trauma. You may have growing financial concerns if your loved one is unable to work. Your own job performance may suffer because your home environment is chaotic. Your loved one's insomnia or nightmares might be disrupting your sleep, and you find yourself exhausted during the day. You might be angry or frustrated because your loved one refuses to get treatment for post-traumatic symptoms. Or--if they are getting treatment-- trauma issues could seem to loom even larger as they devote necessary time and energy to therapy and you are left to deal with day-to-day family matters.

Here is an example:

We worried constantly about my sister when her young son was diagnosed with terminal cancer. My brother-in-law went to pieces and couldn't work, so in addition to the emotional turmoil she was having, she had to worry about how she was going to pay the bills, keep her job, care for her son and her other two kids, and keep her marriage together. The family tried to help her, but we all live across the country, so it all fell on her.

Left untended, long-term stress can lead to serious health problems. Among other things, stress can raise blood pressure, suppress the immune system, increase the risk of heart attack and stroke, give you headaches and stomach problems, disrupt your sleep, or lead to eating disorders and depression.

Review the following list of common warning signs and symptoms of stress to see how close you are to stress overload:

Cognitive Symptoms of Stress are:

  • Memory problems
  • Inability to concentrate
  • Lapses in judgment
  • Pessimism
  • Anxiousness, and
  • Constant worry

Physical Symptoms of Stress are:

  • Aches and pains
  • Diarrhea or constipation
  • Nausea, dizziness
  • Chest pain, rapid heartbeat, and
  • Frequent colds

Emotional Symptoms of Stress are:

  • Moodiness
  • Irritability or short temper
  • Agitation, inability to relax
  • Feelings of being overwhelmed
  • Sense of loneliness and isolation, and
  • General unhappiness

Behavioral Symptoms of Stress are:

  • Eating too much or too little
  • Sleeping too much or too little
  • Isolating yourself from others
  • Using alcohol, cigarettes, or other drugs to relax, and
  • Acting out nervous habits, such as nail biting

It's important to see a doctor for a full medical evaluation if you are experiencing a number of these symptoms. The longer you ignore them, the more serious they can become.

Think of stress as the tension on a violin string. If there is too much tension, the string snaps. If the string is too loose, the sound is listless and hollow. Again, it comes back to balance. A little stress can energize us and keep us sharp; too much stress can break us. When we tune into our bodies and our minds, slow down a little, and take care of ourselves, we strike a balance. We realize that we can compose the music of our own lives.

Stress Management

We can't eliminate stress completely, but we can learn to identify it and reduce it using some simple tools of self-care. Just as parents give their children a timeout when they get overstimulated, we can give ourselves a timeout when a stressful situation arises by counting to ten, breathing evenly and deeply, or perhaps changing the subject-- all strategies that can release and shift the tension of the moment. Adding something beautiful to our lives like music or flowers, and taking time to breathe in and focus on the beauty, can also create an emotional shift.

For instance, Gardening is very powerful for me--digging and connecting physically with the earth to participate in the creation of something beautiful or nourishing is very healing. It is like trauma had the power to take away the ground beneath me. Feeling and actively living with that ground brings some core strength within me "back home."

If possible, try to get outside at least once a day for a short walk or a quiet moment. Wear comfortable and loose clothing whenever possible. Try to eat nutritious and regular meals, and avoid abusing alcohol or drinking too much caffeine. Try to get enough sleep. Find a safe place to feel, express, and embrace your feelings. Consider a warm bath or getting a pedicure. Watch a light-hearted movie, and laugh. Laugh often.

Another stress-busting technique is contained in the two-letter word "no." It's perfectly okay to decline an invitation occasionally, to tell the PTA president you aren't able to chair this year's fun fair but you would be happy to bake some bars or help in some other way.

When my husband was recovering, the old tapes of "you have to be nice to people and be a good hostess" got replayed and I never considered I had the right or choice to say I wanted to be alone. There was a solid stream of people at the hospital, but they pressed against the wall, afraid to come close. I guess they just needed to see him alive.

It's all right to ask friends and relatives not to call during dinner, and it's all right to tell someone you will call them back if it's not a convenient time. It's fine to ask people not to stop by without notice. It's even permissible to say no to your children when they beg for an unnecessary toy or pair of designer jeans. And when you're dog-tired and overwhelmed, it's okay to say no to household chores once in a while, and yes to a long soak in the tub or a few more hours of sleep.

Stress's Cousin: Depression.

Too much stress for too long a time can make us more vulnerable to depression--a common yet serious medical illness that can affect all aspects of life if left untreated. Symptoms of depression, which mirror the symptoms of stress, last for more than a few weeks and can make it difficult to function in daily life. Depressed individuals might feel hopeless, disinterested in things that used to be pleasurable, or even suicidal. When we are depressed, it is also common to be plagued with cognitive distortions--what those in Twelve Step recovery groups often call "stinking thinking."

The idea that our feelings result from the messages we give ourselves is at the heart of cognitive therapy. In Feeling Good: The New Mood Therapy, Dr. David D. Burns explains how our thoughts or perceptions (our "cognitions") can direct our feelings. Until I got help with my depression, I didn't realize how distorted my thinking was. I made sense to me.

When we slip into distorted thinking, we have a tendency to see the world as black and white--we live in an always or never world. Burns writes that distorted thinkers are often convinced others are looking down on them, and jump to negative conclusions. (If a friend doesn't call or if someone isn't paying close enough attention to you, they must hate you.) Distorted thinkers think at the extremes. They might magnify their faults out of proportion while they play down any strengths they have. They may also confuse their emotions for facts. It's an "I feel therefore it is" approach to life. (If I'm angry, you must have done something contrary.) Burns maintains people in despair also tend to beat themselves up for what they think they should and shouldn't do, ultimately creating self-loathing, shame, and guilt because they feel they are constantly falling short of their expectations. Distorted thinkers also label themselves based on their failures (I should have done a better job) and take responsibility for any negative (If my traumatized loved one withdraws, I must have done something wrong).

Distorted thinkers don't only blame themselves. To feel better about themselves, they often blame others for their unhappiness. (The clerk at the store put me in a bad mood, my friend made me miss exercise class, my boss made me look stupid, the mechanic hates women, God is punishing me.) They avoid taking responsibility by holding others responsible. But they gradually feel worse as their list of scapegoats gets longer, their trust level plummets, and their sadness intensifies. When my therapist suggested I read Burns' book, I felt like a curtain had been lifted. There wasn't a wizard behind it, only a mirror, only me pulling the levers, controlling the thoughts. I was both elated and terrified to realize how powerful my thoughts were, and how negative or distorted thoughts could paralyze me. It was so much easier to blame Michael or PTSD for all my problems than to accept responsibility for my own thoughts, feelings, actions, and reactions.

The good news is that depression is a very treatable condition. The Web site www.depression-screening.org offers a confidential screening for depression that can help you determine if you should seek professional help. As with any other illness, you should see your doctor if you think you might be depressed. Mental Health America (www.nmha.org) also provides free information on depression, its treatment, and local screening sites.

For more about PTSD and how to best help both you and your loved ones, read Shock Waves by Cynthia Orange.

About the Author:
The facilitator of a caregivers' support group, Cynthia--along with her husband, a Vietnam combat veteran--often speaks to audiences about the effects of trauma. She has published hundreds of articles about addiction, recovery, parenting, post-traumatic stress disorder (PTSD), and caregiving in various publications, and several essays and poems in literary journals. Cynthia is the author of two Nautilus Award--winning books with Hazelden Publishing, Take Good Care: Finding Your Joy in Compassionate Caregiving, and Shock Waves: A Practical Guide to Living with a Loved One's PTSD.

© 2010 by Cynthia Orange
All rights reserved