Trauma and Your Body

One of my favorite books post transplant is The Body Keeps The Score: Brain, Mind, and Body in the Healing of Trauma. If you have been through a traumatic experience – car accident, miscarriage, violence, surgery, death, military service, fire, any kind of innumerable experiences – your body, including your brain will never forget.

As humans, we have a strong drive for survival.. The brain’s alarm system is turned on and we either fight, flight, or freeze. During 9/11, thousands of people ran from the danger. They knew to get out of harm’s way. When driving, we make decisions to keep ourselves and passengers safe. If we are going to be in an accident, we make a split second decision to avoid as much harm as possible. If our normal response is blocked by being physically trapped (hospital bed or trapped in a car), the brain’s electrical circuits continue to fire in vain. Even long after we are safe from danger, our brain might keep sending signals to our body to get out of or fight again danger.

Dr. Bessel Van Der Kolk explains “The Brain From Top to Bottom,” in Chapter Four, Running for Your Life:The Anatomy of Survival. The brain’s most important job is to make sure we survive. He describes the 5 steps the brain needs to do that:

1. Generate internal signals what our bodies need to survive (food, water, rest, shelter).

2. Create a map of the world to point us where to go to satisfy those needs.

3. Generate the necessary energy and actions to get there.

4. Warn us of dangers & opportunities along the way.

5. Adjust our actions based on the requirements of the moment.

Basic bodily functions we usually don’t think about when we are not experiencing trauma are easily affected when we are thrown out of equilibrium. How much does trauma and recovery affect our sleep, appetite, and mood?

When we keep acting like the trauma is ongoing, the threat is very real to us, the result can be PTSD.

If you have persistent memories or feel that you are still feeling in danger or won’t survive, seek out help with a counselor, psychologist or psychiatrist.

Cognitive Distortions, Part 2

Last post, I mentioned five cognitive distortions my first therapist shared with me. Our thought patterns influence our behavior and actions. The next five cognitive distortions also helped me and my hope is to help others.

6. Magnification or minimization. This is the habit of blowing out of proportion the negative things or mistakes and shrinking from positive facts.

You tripped over a cord and wonder why you’ve been a klutz all of your life. Or…

You receive a compliment on your hairstyle and come back with, “well, I’m really just trying to grow it out,” instead of “thanks!”

7. Emotional Reasoning. “I feel angry, therefore you have obviously done something wrong.” The tendency to believe that negative emotions affect reality.

8. Should Statements. Here you tend to motivate yourself via shoulds/shouldnn’ts . This attempt at motivation is usually attempted before the necessary skills are available or before you are ready. Result? Guilt.

Problem? Should’ve, would’ve, could’ve doesn’t help anyone.

9. Labeling and mis-labeling. Extreme overgeneralization. The attaching of a label because of some negative event. This happened, I surely am a loser.

Mislabeling involves describing an event with language that is emotionally loaded.

10. Personalization. This is the tendency for a person to see himself as the cause of this event is against reality.

Cognitive Distortions (Incorrect Thinking Patterns) Part 1

I started seeing a therapist around 2009 when I had two small children at home and feeling overwhelmed. I had developed some negative thought patterns that were running my life. My therapist gave me a list common thought patterns that take place and our viewpoint changes about life stinks.

Proverbs 4:23 says, “Keep your heart with all vigilance, for from it flows the springs of life.” Our hearts are the source of our thoughts, beliefs, and actions.

Some common cognitive distortions are below.

1. All-or-nothing thinking. This is using what is known as dichotomous thought. In other words you tend to see life around you as either all black or all white. The grays in life are lost. If for example you had terrible business lunch or your child threw a tantrum in public, your day is bad. Our days can have bad and good events and interactions in the same day.

2. Overgeneralization. Occurring when you take one single event and build it into a never ending patterns of defeat.

3. Mental Filter. This occurs when an individual identifies some negative detail (about themselves, others, or situations) and dwells on it. You have heard of rose colored glasses. This is the opposite, where brown lenses have been substituted. The outcome is a crappy view of life. For example, you don’t like the music or seats at church, so you find another church to attend.

4. Disqualifying the Positive. Rejecting positive experiences, maintaining that they don’t really count. This behavior allows you to maintain an inaccurate belief in the face of contradictory evidence. You get a raise, but the cost of living is going up, so it doesn’t really help or count.

5. Jumping to conclusions: This refers to the habit of blowing out of proportion the negative things and shrinking positive facts (your own desirable qualities). A new family moved in the house beside you and they have a dog. You just know they will be loud all the time and the dog will poop on your yard.

Weight Lifting Can Help Depression

An article was suggested by my Sensei that I thought would be helpful here. There are advertisements & I haven’t seen the TV show referenced.

Physical exercise is proven to help depression’s physiological signs. Weightlifting is on of those exercises.

Is Depression Or Anxiety a Sin?

That question may surprise some, that question may offend some, and yet, my hope is that you think deeply about your answer. I’ve been told by Bible teachers, acquaintances , and even my son’s friends told him that because I have depression, I must be sinning.

From a Medical or Psychiatric Viewpoint

The Diagnostic and Statistical Manuel (DSM) created in 1952, is currently on it’s 5th edition. Depressive Disorders are characterized by feelings of intense sadness, guilt, fatigue, and irritability. During a depressive period, people with bipolar disorder may lose interest in activities that they previously enjoyed, experience sleeping difficulties, and even have thoughts of suicide.

There are depression disorder tests include questions about appetite, sleep quality, ability to experience joy, ability to participate in everyday activities, etc. They are open ended questions with time for the clinician to ask more questions.

Anxiety can go with or without depression. Anxiety disorders are those that are characterized by excessive and persistent fear, worry, anxiety and related behavioral disturbances. Fear involves an emotional response to a threat, whether that threat is real or perceived. These symptoms can be measured physically by pulse, blood pressure, an FMRI machine, depression tests measured by a clinician.

Transition to a Spiritual Viewpoint

We can all experience sadness and worry, and legitimately. Many situations come up and our responses are possible worry or sadness and we wouldn’t say that person has a mental disorder. If we run late and we really wanted to be on time, yeah, we can become anxious. When my dog, Barney died of cancer, I cried on and off for weeks. When I argue with a family member, afterwards I experience sadness and regret. When we have an event, i get anxious that we don’t forget things, don’t have to stop for gas, etc.

We have dozens of Bible verses to address trusting in the LORD or to not worry because the Lord will provide. We see His provision in the Bible, history, and I see it in my life. He has the entire world in His hand. He performs miracles daily.

Some Scripture verses…

Say to those who have an anxious heart, “Be strong; fear not! Behold, your God will come with vengeance, with the recompense of God. He will come and save you.” – Isaiah 35:4

“Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing?

Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they? – Matthew 6:25-2

“Therefore do not be anxious about tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble. – Matthew 6:34

So when does sadness turn into depression and worry tun into anxiety?

Generally, when the symptoms last for more than 2-4 weeks, according to most therapists and psychiatrists. A trauma can make theses symptoms last years.

We are warned not to worry, fear not, be joyful in the Lord. Yet, the Bible doesn’t have specific verses about continued sadness, OCD, bipolar disorder, borderline personality, hormonal disorders or thyroid disorders, etc. I’m a big proponent of feelings being real, but not truth.

We do see Christ healing by word ( raising Lazarus from the dead by having a tombstone rolled away and calling Lazarus’s name) ; healing by touch (healing a blind man by spitting in dirt and rubbing it on the blind man’s eyes, he touched Peter’s mother in law by the hand and she was well). Jesus showed that we are physical, emotional, and spiritual beings. He healed different ways based on the individual and situation.

To get back to the original point? Is depression or anxiety sin?

Most Christian denominations that believe in God as a Trinity (God the Father, God the Holy Spirit, and God the Son (Jesus) believe that the Son of God was Jesus and He lived a perfect life without any sin, so that we could trust in Him, to be able to have eternal life. Jesus never sinned. This is my firm belief.

Before Jesus Christ’s crucifixion, Jesus, as the perfect form of man and perfect form of God, went into a garden to pray. He prayed intensely. So intensely that the Bible says he prayed great sweat drops of blood.

Now I’ve been extremely stressed (anxious) that I’ve cause myself to have a migraine, my pulse to go to 140, BP super high, but I’ve never been so stressed to have great sweat drops of blood.

By all medical accounts, Jesus was anxious. But never sinned.

My opinion is that medically standard anxiety or depression are not sins. If Christ had the raised heartbeat, blood pressure and sweating blood – all physical manifestations of stress and He never sinned, anxiety and depression are not sinful medical diagnoses.

I know some extreme conservatives will disagree. I’ve had one extremely conservative psychologist tell me to my face I wasn’t depressed and didn’t experience PTSD, and ignored any medical proof I gave.

I’m asking you to clearly think and weigh physical, emotional, and spiritually evidence to make a well informed decision. I’m asking that if you disagree with me, to be wise about how you teach and word these issues to your children.

The Importance of Sleep, Part Two

After reading Why We Sleep Unlocking the Power of Sleep and Dreams by Matthew Walker, Ph.D., I found his summary of “Twelve Tips of Healthy Sleep” to be beneficial. If you never read the book, following is the most important information to improve your sleep and keep you healthy.

1. Stick to a sleep schedule, Go to sleep and wake up at the same time each day [even on the weekends].

2. Exercise, but not too late in the day. Exercise each day, but not after two to three hours before you sleep.

3. Avoid caffeine and nicotine. Coffee, most sodas and tees, and chocolate all contain the stimulant caffeine. Caffeine can take up to eight hours to wear off.

4. Avoid alcohol before you sleep. Having a nightcap or one alcoholic beverage may help you relax, but heavy drinking robs you of deep sleep and keeps you in the lighter stages of sleep.

5. Avoid large meals and beverages late at night. Heavy foods can cause indigestion and drinking too many beverages can cause interruptions to urinate during the night.

6. If possible, avoid medicines that delay of disrupt your sleep.

7. Don’t take naps after 3 p.m. Naps can help disrupted sleep, but too late in the day can make it harder to fall asleep.

8. Relax before bed and don’t over schedule your day [easier said than done!].

9. Take a hot bath before bed. The drop in body temperature after the bath can help you feel sleepy.

10. Dark , cool, gadget free bedroom. Get rid of that thing in the thing in the bedroom that can distract you.

11. Have the right exposure to sunlight. Scientists suggest sunlight in the morning or first half of the day to regulate sleep patterns. Too much exposure late in the day can keep you up.

12. Don’t lie in bed awake. If you can’t get to sleep in 20 minutes, get up to do some light activity, reading, light housework, but not watching TV or searching on the internet.

The Importance of Sleep, Part One

My current reading is the book, Why We Sleep , Unlocking the Power of Sleep and Dreams by Matthew Walker, PhD. He shares the importance of sleep. It’s an extensive explanation on sleeping patterns (from in utero until old age); who needs to sleep how long; how it affects the body; what diseases adequate sleep can prevent (or decrease the chances of contracting); stages of sleep and what happens in each stage; when we dream, what it may mean, & how science can interpret a limited meaning of dreams.

Chapters 1 & 2 introduce the need for sleep routine, the negative and dangerous effects of sleep deprivation, who sleeps how much, caffeine, jet lag, melatonin and circadian rhythm. Adults need a standard of eight hours of sleep each night. The shorter hours you sleep, the shorter your life will be. While we sleep, every single major organ in the body and brain, are enhanced during sleep (or harmed if we don’t sleep enough). If we adapt to the old saying, “I’ll sleep when I’m dead”, that death may be a lot sooner than we think.

How does our body know when to sleep? Why does a cup of coffee keep us awake when we “need”it? Everyone has a circadian rhythm, the internal twenty four hour clock our brain helps to keep us awake and asleep when we need to. Our innate biological clock is technically 24 hours and 15 minutes – about the amount of time the Earth rotates around the sun. Our body adapts to the light and darkness as the most reliable source of keeping a circadian rhythm. (Does your body get off track when we change our clocks twice a year? Takes a little getting used to?)

Lastly, everyone’s rhythms differ from each other. Are you a night owl or a morning person? Our society revolves around the 30% morning people and causes the 70% of night owls to struggle with sleep deprivation. School, business hours, the bank, etc. favor the early morning person, 0700 – 1700 (7 a.m. to 7 p.m.).

Caffeine is the second most traded commodity in the world, second only to oil. It is the most widely used psychoactive stimulant in the world. Caffeine blocks what they call adenosine receptors in the brain and inactivate these receptors. Caffeine tricks the brain by blocking the sleepiness feeling and make us feel alert and awake. What’s the problem?

Caffeine shelf life is 8 hours. If you have coffee around 3 p.m., that caffeine isn’t out of your system until 11 p.m. (if you metabolize it in an eight hour average). Coffee after dinner? Not getting to sleep until 2 a.m. Drink decaf? Decaf still has up to half of caffeine in the coffee. Not drinking coffee? Caffeine is still found in some teas, sodas, energy drinks, dark chocolate, ice cream, some pain relievers, and some weight loss pills. There will be a caffeine crash to deal with. Energy level can plummet quickly.

Dr. Walker also advises against the widespread use of sleeping medications because eventually they will wear off.

Since I have been challenging myself to get more sleep, I feel better, even healthier. I have a weakened immune system from my transplants and sleep helps to strengthen my immune system. I feel happier when I have 8 hours of sleep.

January Depression and Social Interactions

January is a time I always experience depression. I’ve been injured or ill most Januarys in my adult life. I’m more sedentary, getting less Vitamin D, melatonin, and less social interactions with neighbors or the general public. And let’s not forget the fabulous weather we have. (I live in the upper region if South Carolina where we have cold, rainy Januarys).

Besides using my Emotional Journal, I need some time outside, whatever exercise I can do, and a daily interaction with a friend. Talking, praying, to getting together at Starbucks are a few of my favorite fun and deeper ways of interacting.

Generally the more depressive state reports more negative social interactions. Research had shown that the more depressive symptoms who experience both a high number of positive AND negative interactions showed a state of well being. (N.B. Allen & P.B. Badcock, 2003). When we experience more social interactions, both negative and positive, we are more sensitized to the people of every day life. We face both social rejection and social acceptance.

Humans were created to have the need for connections and to gain acceptance into social groups. We have bonding ideas, beliefs, activities, or experiences and we work hard to keep these bonds strong. We need the connections emotionally and spiritually, as it plays into our mental health, and can cause negative physical health symptoms.

Even if I can’t meet face to face with a friend, a phone call or at least a text to say hi helps to lift my spirit. Instead of going through a drive through to eat, do laundry or banking, try getting out of your car and comfort zone and walk in to talk to a live person. If you are in a line for checkout, do you automatically get on your phone to avoid people, or make small talk, smile, ask how someone’s day is going – and listen to their answer. Try to be positive, even if they are not.

Right now, I’m headed to the dog groomer to pick up my spaniel and are walking into the business and try to talk to the groomer.

How are you? Hmmmm….

So how are you? An easy question…or not.

I really never know exactly how to answer this question. How much should I tell? Getting transplants and living with chronic illnesses isn’t like healing a sprained ankle or lowering my cholesterol.

Do they want the truth? Would they understand? Is it just a courtesy to ask how I’m doing? Do I say good, fine, I’m getting along – just to avoid being awkward or to keep from opening up and crying?

Do I tell them the 8 additional diagnoses resulting from receiving three transplants? If I do, they might think I’m not thankful enough & I didn’t deserve the organs since I’ve experienced depression, don’t have a great quality of health, have sleeping problems, brain damage, get sick easily, have audio sensitivity, daily headaches, vomit 2-3 days a week, my kids are preoccupied with my health…

My answer depends on a few factors…

How well do I know this person?

How much energy do I have to spend on this conversation?

Are they the type of Pollyanna that tells me ‘it could be worse.” I know it can, and that kind of response shows me that they haven’t listened or can validate when anyone tells them that the world isn’t all kinds of sunshine and rainbows.

Do they really care, or is it a check off that they have “ministered to someone’ or shown “kindness”?

I try not to be negative, I really fight it.

I’ve had so many people from transplant recipients (who were out of the hospital in 10 days versus the better part of a year in the hospital), to church members asking me how I’m doing (while looking around the sanctuary at the same time and having to cut the conversation short because their family is hungry) to a close friend getting tired of me “being sick.”

I actually went to a dinner with friends and one guy was having a third glass of wine, saying that it was ok because that was what your liver and kidneys were for. This couple visited me in the hospital, brought meals and were our friends!

I never asked for this life, but it’s my “Option B,” ( read the book by Sheryl Sandburg & Adam Grant). My original marathon running, healthy mom, part time hairstylist life was taken away from me. Heart failure found about 5 years too late, followed by open heart surgery , then 2 years later with a heart, live, and kidney transplants with three hernias, brain damage, balance and audio problems, followed by much more was my second or “Option B” life. I don’t have the options opened to me before.

So…this year I’m not renewing my beauty license because I know I won’t go back to work, my job is taking care of myself, being a stay at home mom & wife I’m establishing a better sleep routine, improved nutrition – 18 days without soda- spending a lot of time with a pain and rehabilitation clinic in Greenville , reading and doing the exercise I can while working through neuropathy.

PTSD: Signs, Risk Factors, and Treatment

I still have hospital nightmares that have me being rolled onto hospital beds or transport, with me running away from a criminal, only to be trapped in ICU. Not joshing with you.

I have sudden thoughts and feelings when put into a specific circumstance that closely identifies with my hospital trauma, I feel like I am physically and mentally back in Emory University hospital the summer of 2012. IVs, tubes, Physical therapy, speech therapy, occupational therapy, labs 4 times a day,, new IVs every 2-3 days. You know I really think the hospital likes needles and tape.

The last time I felt PTSD extremely serious was Christmastime 2015 when our niece, MJ, was in ICU due to a horrible car accident. I had prayed and taken 1mg of Ativan (needed more), I felt the cold air (to keep the germs away, the sounds of the non stopping beeps, and the sound of her ventilator. A ventilator has a specific sound that I will never forget because I had been on them many times.

Post Traumatic Stress Disorder symptoms can include:

    Persistent re-experiencing of the trauma
    Reoccurring dreams or nightmares
    “Flashbacks” or “deja vu” (sensing that the traumatic trauma is happening in the present)
    Sleeping disturbances
    Increased avoidance of general social situations

These symptoms are certainly not all, but some of the most common symptoms to describe the official definition of the PTSD. They disturb the quality of life starting with lost sleep, decreased mental capacity to focus on the present , and declining having meaningful friendships.

Risk Factors can include:

People who have experienced a natural disaster, catastrophic illnesses, combat exposure, incest, rape, assault, losing a loved one.

Types Of PTSD – Clinical Presentation Acute (less than three months) and Chronic (More than 3 months in duration).

Psychological origins and consequences of severe trauma

Attachment and Repetition: Severe stress experienced in childhood and infancy is Attachment and Protection. They experienced in-utero, at birth, or sometime early childhood. These children or infants will seek out attachment, even to an abusing parent, developing into a lifetime of perusing attachments with abusing friends or spouses.

Hyperarousal : Inescapable shock, depression, and a depletion of norepinephrine. This leads to a receptor sensitivity in parts of the brain Their nervous systems may be permanently altered so people are unable to reduce the excessive emotional arousal.

Since PTSD often comes out of nowhere, at an instant, how should we get treatment?

Most professionals and most people would recommend psychotherapy, cognitive therapy, or Behavioral therapy.

Secondary, but much less recommended – medications to help certain aspects, but won’t completely heal.

If you don’t know where to get help and you’re in trouble, call 9-1-1.

Call the National Suicide Prevention Lifeline 1-800-273-8255.

Call a friend, call a pastor, counselor, priest, Rabbi, or someone you admire with spiritual leadership.

PTSD and any other mental illness doesn’t get bettor on its own. “Time Heal All Wounds” is not true.

Sources include : Handbook of Clinical PSchopharmacology for Therapist; Susan Tankersly Therapy; Greenville Psychology and personal experience.