Catatonic Kid

You know one of the funny things about combining depression with PTSD is that you can manage to appear to have a lot of energy even when you don’t. My body holds down the accelerator while my mind puts on the handbrake. Oh, the car still runs, sure but it’s not good. You can’t keep going forever like that. It’s called ’stress’ but it’s not ordinary, run of the mill stress. It’s not the low-cost generic kind, and everyday things go on running this way the price goes up a little.

If it were just money we’re talking about here maybe I could tell myself it’s not such a big deal. But it isn’t just money. I pay for it in time and emotion and physical health. The list of ailments stress is thought to be a culprit in is virtually endless, and the more stress you have the more likely it is you’ll be able to spot a few things you recognise on that list.

So take your foot off the damn pedal, you say just as my neat little analogy packs it in and goes home too. Yes, the problem is I’m not actually a car. You can’t calculate stress like that, “wear and tear” cannot be accounted for in miles run or liters of engine lubricant consumed.

The issue is running through my veins right now - it’s in every tiny bit of extra adrenaline I’m exposed to and every hormone level that remains just that little bit off. Somewhere I’m exposed but nobody can tell me precisely where. Somewhere in my mind, too, there are the wrong kinds of chemicals - not enough here, too many there. And the tools we have to fix it are, to quote someone smarter than me, “like doing neurosurgery with an axe.”

A pill is not enough, sometimes a handful of them isn’t enough. A lot of things could be wrong. My body meets my mind walking down a busy street and they hold hands well enough but as with any couple they fight. My body and mind fight more than most, and that’s what makes these illnesses dynamic issues. It’s not just in your head, it’s not just changing one or the other. It’s about compromise, and writing the rules for a system that’s more than the sum of either part. It’s balancing you with me, and coming up with something that satisfies us both but doesn’t threaten that which we know of ourselves.

I still want to be myself once you fix the problem, see. So go ahead, tune my gears, shrink my head but don’t be surprised if I still don’t purr like a happy engine at the end of it all. It just doesn’t work that way. You still won’t be able to pull my foot off the pedal or loosen the brake but maybe you can curb the damage done. And that’s not such a bad start.

I’ve put together this crib sheet for Post-Traumatic Stress Disorder. Hopefully it’s useful, and it’s sure cheaper than the books. A summary never really hurts but let’s all be kind and remember that CK is not a health professional so she does not claim this is a definitive or complete guide to PTSD.

The Basics of Post Traumatic Stress Disorder (PTSD)

PTSD is an anxiety disorder with a wide range of severity.

PTSD is not a form of psychosis, though some people who experience severe PTSD may experience psychotic symptoms at times.

Having PTSD doesn’t mean you’re more likely to be violent, offensive or out of control than anybody else.

PTSD does not make you weak, lesser than anybody else or a burden (I’m just saying).

It is an illness that just about anyone can develop given the ‘right’ environmental circumstances though it is more likely in certain genetically predisposed individuals.

There is technically no cure but people with PTSD typically do have long periods of total, or near total remission of symptoms.

Equally, people with PTSD can have periods in which symptoms re-occur, particularly after further exposure to trauma, increased stress or following major life changes such as the birth of a child, marriage/divorce or the death of a loved one.

PTSD occurs after exposure to extreme psychological trauma, which can take many forms. This brings about an equally extreme and ongoing emotional reaction in the individual. So whilst people who have PTSD often have been exposed to physical trauma as well that in itself is not the cause.

It is possible to develop PTSD well after the psychological trauma occurred, sometimes even years later.

PTSD does cause specific biochemical changes in the brain and body. These are not yet all that well understood.

PTSD runs in families but genetic studies are complicated because there is always a very strong enviromental factor implicated in the development of the disorder.

PTSD is commonly treated with a combination of psychotherapy and medications.

Medications commonly used to treat PTSD include:

Antidepressants: Typically SSRI’s, SNRI’s or NaSSS’s.

If antidepressants don’t do the trick medications such as Atypical Antipsychotics, Anticonvulsants, Beta Blockers and/or Benzodiazepines are trialled. Their success varies pretty widely.

Individuals who suffer from PTSD alternate between periods of re-experiencing the trauma (in the form of flashbacks or nightmares) and periods of numbing/dissociation. This often makes treatment complicated, and is why psychotherapy sometimes takes longer than people expect.

People with PTSD cannot just “get over” the trauma. In individuals with PTSD the traumatic event still needs to be fully processed by the fear centers of the brain, and until that happens the trauma is repeatedly re-experienced in its full intensity in response to current environmental cues that are associated with it.

PTSD interferes with a person’s ability to sleep, may make them more prone to anger/irritability and makes them almost constantly alert for danger (hypervigilant).

One of the hallmarks of PTSD is an unusually strong startle response - for example, to loud or unexpected noises.

Anything in the current environment which is reminiscent of the emotional reaction experienced by the individual at the time of the original trauma can act as a ‘trigger’. That is, things in the here and now can put someone with PTSD back into the memory of the trauma but it is not experienced with the normal distance of an ordinary memory.

Someone with PTSD may see, hear, feel, taste or smell parts or all of the memory of the traumatic event as if it was happening again, including the same sense of fear/helplessness and terror that occurred at the time. However, the person’s reality testing capacity essentially remains intact so that they do know that the event is not really happening in the present - it ‘just’ feels like it is.

PTSD is more common in people who suffer from chronic migraine headaches.

Recent research suggests that individuals with PTSD are at higher risk for coronary heart disease.

In most cases the symptoms of PTSD will dissipate in time, though that depends on a number of variables, including:-

• Initial severity of the condition;
• Intensity of the original trauma;
• Whether the individual received appropriate treatment within an adequate time frame;
• Response to medication and/or psychotherapy;
• Incidence of co-morbid mental illness or substance abuse issues;
• Number of traumatic events experienced;
• Age at which the trauma took place;
• Whether the sufferer has a reliable support system;
• Whether the trauma was repeated and/or how long it lasted; and
• Individual predisposition to a more acute stress reaction.

You don’t just fall into happily ever after. That ending is spun of cotton candy fantasy and if it ever came it would be without force or finality. So much the better for our fears to grow, you see. A ready bed in which to draw the curtains in, around all I’ll never know. I can’t end this story before it has really begun. So don’t tell my happily ever after, just plunge me into your sweet nothings, your blissful retreat from the well-plotted book. I want a story not yet sung, to take a hand and go somewhere the world may not always follow.

Between the sheets is a whole new force -

I named it Wednesday because it’s hauntingly beautiful but hard to get over. You probably call it Love. What was that about roses and names again?

It’s up to you, of course because nothing smells so sweet to me these days but I like to name things thrice. One for you, and one for me, and one to keep under the Christmas tree. The third is secret like kisses stolen under mistletoe. The third is power - the hand that slips across your mouth in the middle of the night.

Your story isn’t begun with once upon a time in a land far, far away. But I’m far, far away even when my vision is clear. All locked in some turret with a dragon or two down below and a garden of ruby red roses thick with the scent of betrayal.

For the longest time I’ve held sovereignty over a heart that I didn’t own. I’ve crashed full force against a Berlin Wall I built with my two left feet. I exiled those feet a long time gone so now I’m falling through a starry night, through the wishes I made on those bright days I don’t remember when. I think sometimes, though I may not know the moment, I do know still. It was when I knew I could fly away and it would always be the first time I’d made the trip. When the closing of doors didn’t flood my mind with dread threaded to an ever shorter fuse. When I thought that I could trust my voice to bridge the gap between what I saw and what I lacked.

There are some decisions made you can’t undo, piper’s paid and meals made. So many dreams to dream but I’m stumbling through my life again because I see them in daylight too. So the days unfold, and time goes on like they told me it would but I try to remember that it’s in the opening of each day that the glory lies.

Do I yet dream? In the opening itself a future blooms.

My future? In lifting the lid Pandora lives and Schrödinger’s atoms dance on the head of a pin.

In honour of Pope Week here in Sydney here’s a prayer with a distinctly Australian flavour:

Our Lager,
Which Art in Barrels,
Hallowed Be Thy Drink.

Thy Will Be Drunk.
(I Will Be Drunk),
At Home As In The Tavern.

Give Us This Day Our Foamy Head,
And Forgive Us Our Spillages,
As We Forgive Those Who Spill
Against Us.

And Lead Us Not Into Incarceration,
But Deliver Us From Hangovers.

For Thine Is The Beer,
The Bitter and The Lager,
For Ever And Ever,
Barmen.

~Anonymous.

I was talking to an Irish-Catholic waiter this week who told me how his ‘Da’ and all the other blokes of a certain, somewhat beleaguered age in his village would head to the pub for most of Sunday Mass. They’d have one of the kids check out which hymns were being played and as luck would have it the pub was next to the Church. So when the blokes heard the final hymn starting up there’d be a mass exodus out the pub door and in through the Church door! Talk about your opiates for the masses ‘eh

There’s a frenzy opening in my mind. A ripping, tearing kind of joyful destruction edged with a fine ribbon of schadenfreude that will spare nothing and no one as it penetrates completely. It spreads, thick and viscous as even my blood and loops itself around inside me, until there is no space left between myself and this state.

I have a bacchanal taking place in my heart tonight. I am the lightning of long forgotten gods, and the wine that tainted their lips. I know the strangest dreams, so full of furor and wanting. I hear the clashing of cymbals and the pounding of bass drums in my mind, and the world dances about me in a stream of colour, one melding with the next because I am only an echo in this place. I beg each restless fibre of my being to have a little charity. I’m running but I’m standing still, winning but losing -

“What?”

My watch, you know the time? I’ve forgotten that somewhere along this hurried line I drew with only a piece of a chalk. There’s no way back, now the tide is high and with that line went purpose and clarity, the things of every moment, the things of presence and sense and surety. The curve of a day, that graceful arc is gone.

Though, my song will slow and not cease, this I know, and this I dread. That even this will grow heavy, and leave me wanting.

There is an underlying anticipation to each bullet I fire from this gun.

It is only when she hits a target that she comes undone.

And later the apology, the dreadful apology that is coming down to rest in the sounds of silence. For then, looking up, you may perceive a fair day that shines like a pretty penny or two.

But they do not make you richer.

They don’t even compare.

Deep beneath my sorrow lies a time of stillness, of perfect unity fastened with a silver pin that was the gift of the graceful hand of death. She is a child, and I need but look into her restful brown eyes to see the adamant arrow she has aimed at my heart yet I am not at rest. My heart seizes, and with it my mind stirs a fire that has long been left unattended. She commands my attention but…

My glass has fallen, ever so slowly, casually slipped from the cup of my hand to shatter in the dirt and all I hold now is a phantom weight. She tells me to release this presence for it is not the glue which binds and it will not keep me anchored to this time and place. There are no anchors, only mastless ships in a diamond sea that come ashore when the wind is warm, and sticky with the taste of honeysuckle that tickles the back of your throat.

“You do not remember me,” she says, “but I remember you.”

“I know.”

“I know. “

Now, changeling child of each and every season past and yet to be, stand by my side and smile a little longer, even if it is only the glimmer of a smile, a happy ghost that will not be undone by the winter to come. I will have my own winters, and my own springs, you see. And even in the long and sleepless summers we will know that time is ripe, as the juice from a pomegranate plucked at first harvest on the night of a crescent moon.

Shapely young sorrow, you dance with me a jig. Why do you come to me so, dressed in all the finery of a painted Puck? I know that should I call this luck, you would laugh and play upon your pipes a grave and mournful tune yet you would not mourn. I would, though, and as my tears poured out like rain the desert floor would crack between my feet and I would be swept away in a flood of my own making.

So play me no tunes, dance no more, and let me not hear nor speak nor even think how close you might come to unraveling my self and reason with but a word or two:

You could tell me of all the sunrises I will not know, and set my heart so full with longing that it would burst in wonder. You might whisper to me of the love that the good, the studious, the settled will know when they have done their part. What’s mine to do seems done, and more than that I am not a real girl in this place, and so I fear I’d fade into the twilight, having eaten the last apple on the tree.

But oh, how there is will and power in this place of no sense, of riddles and rhymes and lesser crimes. I have a little of that will today, and perhaps tomorrow a little more? Maybe at the setting of the moon all these spells will be undone, and the golden ribbon about my throat will be unwound. I will turn my head as the sky above me fills with the first whisper of a cloud, and in that moment I will feel the chase begin in my heart.

As the high winds turn, so too shall I, and there will come a changing of the guards. I shall stand naked under a bright white eternity, near stupefied. All at once recalling the feeling of my skin singing with the breeze, of green visions so full of every living moment that has stood (a beasts with two backs) against time, of the taste of warm fires long since extinguished, and of the touch of a waking finger curling around my own.

All these things and more I will discover, and in such awakenings I will fear neither the unholy child nor the jester playing with my marbles. I will spread my legs, and plant each toe into the tender earth, saying softly:

I know. Now, I know.

Oh to labour still, under the weight of our delusions, to fight and feint as we follow the byways of daydreams and deceptions. Delirium takes over yet our eyes, wide open, look upon the world, running over with clarity. Faith, and the realisation of that faith is a spring that runs deep in the hearts of us all. It is ever the soft rumblings heard from afar that remind us of that which lies beneath all things.

There is an untapped wonder awaiting each of us, and I’m not speaking merely of the spiritual but faith in the very human, very present promise of our own emotions, thoughts and deeds. In the thick blanket of night I touch the purity of remembrance and hope, the oft neglected silence attuned to the beating of my heart.

There is a tremor holding me together, the crack which divides and unites as yin meets yang by a declaration of distinct opposition. I am made closer to a whole by division, and I come to value that which I do not see nor seek.

In the flux, in the rush of sensation that overloads my every sense I know there is great potential. I remember that these hours spent in darkness and uncertainty will open into something I had not expected nor asked for. I notice not the tricks my mind plays on me to steady my course but the rudder itself, and so the wind returns and fills my sails. And on I sail, into the great blue something wherein lies not destiny but the fruits of all my labours, and yours too.

Never forget that what’s mine is yours and yours is mine. The simplicity of that connection is as close to perfection as any of us may ever hope to come. This is no prophecy but fact, neither plain nor indistinct though surely it is somewhere close to madness. Perhaps it is a purgatory but if so it is one in which it is safe to play, and grow and to turn over and over in the palm of your hand. You can see into the nature of each moment with this kind of fulfilling, intimate forgetfulness: a snowglobe to be shaken but not stirred.

Land me, dear Captain, in the presence of this monument to memory, mind and the might of ages. I have mislaid the map you made me but still I know it like the back of this same outstretched hand. It is a blessing kept in the absence of any god because it comes only in the ebb and flow between us. We are creators, you and I, and this we must not forget.

Speaking of goals which feel impossible to make, let alone succeed at I failed miserably at mine today. I’m OK with that because I had an inkling it might happen like that but it still feels like giving a lecture with a mouthful of peanut butter. I need to find a new tax accountant. Really need to because the firm I’m with at the moment has the highest turnover of any company I’ve ever encountered that wasn’t also part of a fast food chain. I’ve had half a dozen different accountants in the past two years. No joke. And for the kicker a vague relation of mine runs the company I’m currently with.

So I’d like to move firms before the tax office pounds me for whatever these idjits have missed while they were twiddling their thumbs and staring into space. The latest one hasn’t even bothered to contact me to give me their name so it’s all a bit of whatever. I’m pissed but mostly because of the trouble it’s causing me to try and change firms.

I’d made a booking to go see a new accountant this afternoon. I canceled because I’m a giant chicken. I couldn’t face it today. I really just couldn’t. I think partly it’s that I have no idea what I’m doing. I mean, seriously, no clue. I’m not good at new social type things of any description but this I can’t even plan ahead for in my mind. I’ve never been in to see my regular accountants in person. We email. Now, I don’t know about you but I’m finding this really pretty funny because of all the stereotypes that abound about accountants. I mean, isn’t the accountant supposed to be the mildly socially inept one? But no, this is me we’re talking about so things are as they are - a little off balance, me with one foot on seriously rocky ground.

So now I’ve cancelled the appointment and I’m looking for a firm which will be able to manage to get the ball rolling via email/fax. I know, I’m strange - I’d rather trust some person I’ve never even met to handle this stuff than one I have to deal with face to face. But it’s the truth of it. I’m tired, and frankly the less I have to deal with the better. Perhaps I shouldn’t be quite so apathetic but I really just want to throw my tax files at someone and say take care of it. Maybe I’d care if I ever saw any money back from my taxes but due to complicated family crud I never do so it’s really just a whole lot of me signing endless reams of paper that add up to exactly nothing.

Thinking long term, and in theory, I will see that money again but seriously, I can barely plan a week in advance let alone decades away. I have to try and plan that far anyway so here’s hoping my new accountant might be marginally more useful than the morons I’m currently stuck with who haven’t given any signs of intelligent life in quite some time. Well, forget intelligent, just any sign of life at all would do me. I’m not shooting for Einstein here folks, just a couple of brain cells to rub together might be nice.

Everyone you’ll ever encounter is struggling against great odds - whether they’re a pauper or a king, an optimist or a pessimist, the queen of sanity or a fool. We, each of us, battle daily to conquer our fears and vulnerabilities, and to answer that which lies beyond us. There is nothing so sure in any of us than that we are unsure.

So do you ever think the goals we set each other are too high? I’m not saying we shouldn’t reach as far as we can but more that for those of us who struggle with life sometimes goal setting can be a project in itself. Have you ever tried to set yourself a realistic goal when you’re unwell? For those that don’t have a mood disorder or similar mental issues I can only describe it as something like filling your mouth with peanut butter then being told to give a lecture, now, immediately, in front of a crowded room.

You see, when you have a mental issue of some kind you end up in the oddest situations. You can be going along great guns then you’ll wake up in the morning and find yourself in some strange and barren place that looks nothing like where you left off the night before. When you’re a bit nuts then truly the dots don’t join up for you all the time, at least not in the obvious way. There is almost always a connection between emotion and reality, no matter how crazy you might be but finding it isn’t a simple thing.

Mind, I do think you can apply this line of thinking to your life even if you’re not a bit off balance to begin with. It never hurts to treat yourself, and those you encounter with greater care. Your reasons for doing so may be somewhat different but it’s the same deal, really. Is it not harder to bury your head in the sand than to face the fight we all fight with every ounce of reason we possess? If we do not face it, if we turn away then there is less of each one of us in the world, and so less firm ground upon which any one of us can stand and say: I am not afraid.

So when I speak I do not aim so much to be kind as to go gently in this world, taking a hand in mine where it is offered. I search, and I struggle and when I grow weary of the fight I want not so much love itself as to be filled with the knowledge of love, to be sure that relief will come in the solace found in company, to understand something of comfort when I look into someone’s eyes, less than to be understood in this instant.

Sitting where the waves meet the shore I think to myself that there is no worry so large that the tide cannot wash it away. That tide is built between us, in the rush of emotion that passes through each of us at the brink of day. There is nothing that it cannot soothe, nothing so unknown to any heart that it should forever be borne alone, no heaven or hell so distant to imagination that it cannot be made comprehensible.

In the unmasking of the troubles we face we can know one another a little better, and then the odds we battle are not so momentous, nor the goals we set so impossible because what has been glimpsed once can be seen again. Maybe not by the same eyes, and perhaps not in the same way but with the same potential if we share compassion, and consolation and peace.

Because I really am an uber geek…
_________________________________

Kerry: Now Mark, I think this ER’s great,
But…there are problems that can’t wait!
Now Benton’s fine, and Carter too,
But Ross and Susan just won’t do!
Now who do you think that we should hire,
Since both of them today I’ll fire?

Mark: Kerry, maybe we should wait and see…

Kerry: That’s great Mark! I knew you would agree…

Jerry: Dr. Weaver? Sorry to interrupt…
But the paramedics just pulled up.

Mark: Ok, I’m here. What have you got?

Shep: This little boy has just been shot!
His pulse is faint, his breath is weak.
We did all we could to stop the leak.

Riley: And this woman here, she has a broken hip…

Carol: How did she fall? How did she trip?

Shep: The kid’s mom was getting in my hair,
So I shoved her–lightly–down some stairs.

Mark: Benton, Kerry! Take the mom to three!
Doug and Susan! Come with me!

Riley: But wait, but wait! Oh don’t you see?
We’ve got some more; one, two, and three.

Kerry: You’ve got three more? How can this be?
Explain it, tell it all to me!

Riley: Well, Shep was driving. Really fast.
A light turned red. Shep hit the gas.
We hit a car, it hit two more.
Soon the total rose by four.
Another bang! Another crash!
But we couldn’t stay, we had to dash!
We grabbed these three but I am sure,
The injured totaled sixty score!

Carter: These people really are a mess!
Their injuries I cannot guess!
It makes me sick, my knees are weak,
A toilet I must soon go seek…

Benton: It’s ok Carter! Stay on your toes!
It doesn’t get worse than this you know!
To Trauma four let’s take these three.
You can do it, come with me!

Green: Ok, let’s get this boy on the table.
To save his life if we are able!

Haleh: Dr. Green! This boy is cyanotic!
I can’t find a pulse…oh, wait I’ve got it!
But it is weak! Oh, woe is us!

Doug: Give him saline! IV push!
CBC, chem 7, stat!
We will save him, bet on that!
Oh no, he’s showing poor perfusion!
Lydia, start a blood tranfusion!

Lydia: But Dr. Ross, I hate to say.
The blood bank didn’t come today!
We’re out of blood, I can’t believe!

Doug: Here, use mine! (rolls up his sleeve)

Kerry: We need some help! There’s been a crash!
Someone’s heart stopped with a flash!
But Dr. Benton saved the day,
And Carter’s going to be ok.

Susan: What can I do, where can I go?
I’m not incompetent you know!
I deserve a chance and with good reason,
I only killed one guy last season!

Chloe: Hey, Suze? Look! It’s me…
I doing great…oh, can’t you see?
I’m back on drugs and feeling woozy,
Can you take care of little Susie?

Susan: Not now Chloe! I’m in a panic!

Kerry: Get Susan out, she can’t handle it!

Mark: It’s fine! It’s done, the kid’s ok.
We’re sending him up on his way.
To surgery he’s off to go,
They must sew up that bullet hole.
But Dr. Ross, he’s out of sorts…
We had to take a dozen quarts.

Benton: Ok, we’re done. I did it all.
I used a double breasted suture saw.
I closed them up, I fixed their ills.
I patched their wounds, I gave them pills.
I have their livers in this sack.
I did it all, behind my back.
I need more patients, give me more!
I just cured three, now give me four!

Carter: What happened? Did I miss it all?
I saw some blood. I took a fall.
But it doesn’t matter, we saved the day!

Carol: Get ready! There’s more on the way!

Copyright © 1996 by Brent Fogel