When PTSD and TBI Intersect, Hide, and Exacerbate Each Other

I’m not much in the mood to post, these days. I’m still fried from my last 4 days of being assailed… seeking shelter… being displaced… being at the mercy of the elements… and knowing that the winter is just starting. But I haven’t posted in about a week, and this PTSD+TBI business is actually something I need to write about.

This isn’t the first time I’ve written about this, and it won’t be the last. One of my first posts here, as I recall, had to do with how post-traumatic stress/PTSD and TBI can be interrelated, and TBI is often misdiagnosed as PTSD (which delays treating the TBI symptoms).

What I’d like to talk about is how I’ve been seeing a whole lot of interaction between post-traumatic stress and TBI in my own life, lately. A couple of weeks ago, I overheard a very heated conversation about someone’s trouble with neighbors. There was some problem with boundary issues and noise problems at all hours, and one of the guys I heard talking was just going off about this neighbor of his who was overstepping his boundaries. It was really getting heated, and the more he talked about it, the angrier he got, and the less clear he got in his reasoning. Then, I heard him say that when he was a kid, he had his nose broken a bunch of times by someone who used to beat him up — badly.

I got to thinking… this guy really got the crap kicked out of him, and the only way you can break someone’s nose is if you hit them in the face — that is, in the head. Plus, the fact that he got the crap beaten out of him repeatedly tells me that he probably has some level of post-traumatic issues going on, too. I’m no doctor, but listening to him was like listening to myself on a really bad day. Reasoning (or lack thereof) all over the place… getting set off by character traits of the problem individual (who may have reminded him of the person who’d beaten him when he was younger)… getting really worked up… going on and on about the same stuff over and over… and just not holding back. No impulse control. Hostility. Anger. Threats. Frustration. Hurt… the works.

Some of the stuff the neighbor was doing was on the fine line between agitating and infuriating — the operative factor was this guy’s capacity to deal with it… which was close to nill. I could totally see how even a little bit of PTSD and TBI could concoct a really volatile situation.

I just hope he doesn’t/didn’t act on any of his threats. It was not good.

And then we had the ice storms last weekend…

I was in an area that was pretty hard-hit (though not as hard as others) by the intense ice storms last weekend. And the house where I was staying was in the middle of the woods. All night, last Thursday night, I lay awake in bed, listening to trees and limbs crack and crash and fall and splinter not far from the room where I was supposed to be sleeping. Every 15-20 minutes, something else would break or fall, and I’d be listening hard to tell how close it was to the house… if it was coming my way… if it was coming through the window or the wall or the roof… listening to stuff hit the roof, hit the ground around the house, hit the ground in the woods not 20 feet from the bed where I was huddled. It was no war zone, it was no combat situation, but I swear, several times an hour, I wondered if I was going to make it through the night in one piece.

The adrenaline rush was intense. Just wave after wave of overwhelming fight-or-flight pouring through me like one flash flood after another. I’d hear a slow cracking off in the distance that got louder and sounded like it was coming closer, and the adrenaline would shoot through me, waking up every cell in my body, all my senses on high-alert, the blood pumping, sweat pouring off me, holding as still as I could, till whatever was falling would fall… then I’d listen to see if there was anything more, and I’d peek my head over the window sill to look out, but couldn’t see anything from the rain and the fog… that full moon eerily brilliant behind the clouds overhead… I’d grab my flashlight and call to others in the house to see if everyone was okay, and I’d check around the sides of the house to see if anything had fallen close or had come through a window or a wall. I couldn’t see much of anything, with all the rain and fog and my flashlight not being bright enough. Then, after satisfying myself that there was no damage, I’d head back to bed, thinking things were okay… and I needed to get some sleep.

Back to bed I went… for another 15 minutes, till the next tree or limb went down… Ice cracking and crashing… tops being taken off trees.. branches giving way… stuff just falling and crashing at every turn… There were times I seriously thought I was done for. I was in the middle of the woods, surrounded by 80-100+ -foot trees, in a monster of an ice storm. For all I knew, the end was near.

It wasn’t, now I realize. But it sure felt that way, at the time. And the lack of sleep didn’t help matters. Plus, when it comes to human experience and the effect it has on the body and mind, sometimes a threat doesn’t even need to be that intense or severe, to do serious damage. All that’s required is you think it is — and your body reacts to it as though It is real. At least, this is how I understand things.

Truly, when your brain is releasing all those biochemical reactions to perceived threats — the adrenaline, the cortisol, the glucose, the various hormones and secretions that help us run from charging elephants/bulls/creditors and live to see another day — whether that threat is “real” or not isn’t the issue. It’s how real your brain thinks it is, and how extreme your body’s reaction to it is. If your body is freaking out because of an apparent threat, the power of psychological rationalization tends to decline. And the body has an interesting way of escalating… and escalating… and escalating… so that cycles of shock and surprise and fright and terror diminish the ability to think rationally about a situation, further compounding the effects of shock and surprise and fright and terror… so that with each subsequent wave of trauma, even if each wave is quantitatively “less”, it seems like more — it’s qualitatively more. And the experiences you have — even if they become milder — can take on an inflated nature that defies reason.

So that every little thing makes you jump. And the more intense your reaction — and the less threat there logically is — the harder it is for you to get your mind around it. To the point where you think you’re losing your mind, and you can’t figure out why you’re such a wuss.

That’s the trickiest part of post-traumatic stress for me. The fact that my body can be so fried by my brain’s constant cascades of chemicals, so exhausted from the sudden shocks and ups and downs… yet the reasons I’m jumpy don’t seem like that big of a deal. So, trees were falling in the woods around me? So what? It wasn’t like I was under fire in Falujah. So, I spent the night listening to limbs snap off, wondering if one was going to come through the window. It wasn’t like I was in Bosnia in the 1990’s, for heavensake. My body is indeed exhausted by its own experience, but my mind can’t seem to wrap itself around the fact that I’m entitled to be a bit jumpy, after four days of drama, being low on sleep, rushing around, trying to keep my life going… helping to tend fires to keep the house warm and the animals inside alive… helping so split wood and haul water and take care of sick folks who were wondering if they should go to the hospital to be safe… No, I wasn’t holed up in Afghanistan, but my body and brain took a beating this past weekend, I was in fact traumatized by a constant fear of imminent harm… even death, and it’s going to take a while to recover.

I think one of the hardest things about dealing with post-traumatic stress, when TBI after-effects are involved, is being able to get things straight in my mind about what I “should” and “should not” be thinking/feeling/doing. My brain gets fuzzy and one-track, when I’m under extreme stress, and I process things slower. Given that my processing time is slower than I’d like it to be, this adds more stress to already stressful situations, in that I’m mortally afraid that my reactions aren’t going to be quick enough, that I’m not going to be able to respond adequately, and I’m not going to keep up as I should. My brain gets scrambled, and I get agitated, jumpy, angry, hostile… to the people I need to be on good terms with… which adds to my existential crisis, because not only do I not know immediately what I need or what’s going on around me, but I also don’t know how to communicate well — or sustain good relations — with the people who can help me.

It’s a terrible, terrible thing, to be standing across the road from someone with the experience and resources (and power tools) to help you get through a crisis, but not be able to figure out A) what to ask them for/about, and B) how to ask them for what you need. To be that alone and clueless, just an arm’s length away from help, is a terrible feeling. And to be so fuzzy and turned around and fatigued and churned up, that you are only dimly aware that something is terribly wrong, but you can’t figure out what it is, just adds gasoline to the raging fires of anxiety and panic.

This winter is going to be an interesting one, I can feel it. It’s going to be time to tell people I know about my injuries and ask them for help. It’s going to be time to own up to being somewhat impaired and far less independent than I want to be. It’s going to be time to batten down the hatches, simplify my life, and find out who my real friends are. It’s going to be time to make changes — especially with people close to me, who get the brunt of my crushing anxiety when it’s at its worst — and we’re not at our best. I have a feeling it’s going to be time have large helpings of humble pie, suck it up, and forget all about my pride, in the process of just getting things done.

And it’s going to be time to take a long, hard look at my trauma fallout and understand how it intersects with and compounds my tbi symptoms. It’s going to be time to talk to my parents, to tell my family about my situation, and see if/where/how/when they can help me get by.

I hate this. I hate it all with every fiber of my being. But if I don’t learn how to ask for help quick, heaven only knows how long and how well I’m going to be able to make it through.

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Author: brokenbrilliant

I am a long-term multiple (mild) Traumatic Brain Injury (mTBI or TBI) survivor who experienced assaults, falls, car accidents, sports-related injuries in the 1960s, '70s, '80s, and '90s. My last mild TBI was in 2004, but it was definitely the worst of the lot. I never received medical treatment for my injuries, some of which were sports injuries (and you have to get back in the game!), but I have been living very successfully with cognitive/behavioral (social, emotional, functional) symptoms and complications since I was a young kid. I’ve done it so well, in fact, that virtually nobody knows that I sustained those injuries… and the folks who do know, haven’t fully realized just how it’s impacted my life. It has impacted my life, however. In serious and debilitating ways. I’m coming out from behind the shields I’ve put up, in hopes of successfully addressing my own (invisible) challenges and helping others to see that sustaining a TBI is not the end of the world, and they can, in fact, live happy, fulfilled, productive lives in spite of it all.

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