Life has been pretty eventful, lately. I’ve been very active at work, which has become even dicier than usual, because upper management has told everyone that the company needs to slash expenses by tens of millions of dollars. Not tens of thousands… tens of millions.
I guess that’s one of the hazards of working for a huge company — all the numbers get so big, and even if they are proportionately not that big — representing maybe 1/100th of 1% of the total budget — it still sounds like a lot. And people get scared.
Getting scared is understandable, but the big problem with having that happen is that the adrenaline and the cortisol can impair your thinking, which makes an already challenging situation even worse. A sympathetic nervous system on constant alert just wears you down, and if your parasympathetic nervous system never gets a chance to kick in, because you can never get a chance to rest long enough to let it come back online and do its job to repair the damage of all that stress, it wreaks all sorts of havoc with the whole system — physical, emotional, neurological, mental, spiritual.
If you never get a chance to chill and get your body back to some sort of stasis, you’re basically screwed.
And you can end up with a nasty case of PTSD, even if you’ve never been to a battlefield. Constant threats of anihilation (losing your job, your home, your marriage, your kids, your very identity)… living in the shadow of perpetual, unarticulated threat from upper management which is not communicating what it’s planning to do with the budget in the course of the next year… not to mention dealing with others who are under considerable stress, thanks to the conditions, and are falling back into defensive postures and looking for a way — any way — to protect themselves, and the devil take anyone who gets in their way… Even if you’ve never been in a humvee that’s driven over an IED near Basra, the post-traumatic stress can build up.
And Houston, you’ve got a problem.
I’ve been thinking a lot about PTSD, lately. In particular, the connection between the over-active sympathetic nervous system (which puts us into fight-flight-freeze-fake-it-or-fun mode) and TBI. I know a lot of vets are returning from Iraq and Afghanistan with both TBI and PTSD. And their families are facing their troubles along with them. The VA may be doing a bit about it, but by all reports, they’re not doing nearly as much — nearly as well — as the vets and their families (indeed, our entire country) needs them to.
I, myself, have been noticing more and more how PTSD has colored my life. There are a million little things that have set me off, over the course of the years, that strike me as being directly related to my TBIs. Yet my neuropsych assures me that the issues I have “should not” be causing me as much trouble as I’ve been experiencing. I look at my life prior to my most recent TBI — my behavior, my performance, how I lived my life — and I look at my life after my mild traumatic brain injury in 2004, and there is a marked difference.
Yet, the actual neurological issues I have as a result of the injury — compared to what others have experienced — are relatively mild and “should not” be impairing me to the extent that I have been impaired.
So, what’s the deal?
I’ve been thinking really long and really hard about this, trying to take an objective point of view and not jump to any premature conclusions. And I actually think there are a couple of significant factors that come into play that my neuropsych cannot measure or is not oriented to.
First, there’s the physical issues I’ve got. The constant headaches. The pain. The insomnia/sleep disturbances. There’s the fatigue. These things, alone, would make an average person a bit nuts. But all together, on a regular (but somewhat unpredictable) basis, serve to push me closer to the edge than I care to go.
Second, there’s the agitation/anxiety. This actually ties in with the physical issues. When I’m tired, I get more agitated and anxious. And when I’m more anxious, I get more fatigued because it’s harder for me to sleep. The agitation sets my spouse off, because I start to “rev” and they know what that means… I’m headed for the deep end, yet again, and who knows whether I’ll go off or manage to keep my cool? The anxiety sets me on edge and gives my temper a sharp, sharp point and a much lower flashpoint, which also messes with my spouse’s head.
Third, there’s the post-traumatic stress which results from all this that tends to really disrupt my life. The jumpiness, the flashbacks on traumatic situations (even seemingly little ones can set me off), the automatic avoidance of circumstances that are similar to formerly traumatic situations, emotional numbing, and a persistent belief that my life is going to be a lot less positive and productive than others’.
There are more factors that come into play, of course, but these are the Big Three — the physical issues, the anxiety, and the PTS — that combine to make my life more “interesting” than I’d like it to be.
So, what to do? Like I said, I’ve been giving these things a whole lot of thought, lately, and I’ve been specifically thinking about them in terms of what to do to fix it all.
Because I do believe they can be fixed. Granted, the headaches may stay with me for the rest of my born days, as may the pain. But the human system is wonderfully maleable and able to adjust and change. If I can’t fix the pain stuff, I may at least be able to manage it and find ways to mitigate the effects — like the agitation and anxiety.
After all, it’s the agitation and anxiety and post-traumatic stress that affect those around me and my relationship with the rest of the world. My own personal aches and pains are my own — my main objective, nowadays, is to keep them from spilling over into the lives of others and making their lives more difficult than need be.
That being said, I’ve been working with an approach that seems to offer me some solutions. It’s simple, and it’s basic, but it’s been working well for me. Essentially, I’ve been directing a lot of my time, energy, and attention into one thing:
I do it with breathing — counting my breaths and making sure that I’m not hyperventilating. Hyperventilation makes your heart beat faster, and it gets your system revved. And when my system gets revved, the vigilant part of me does its self-protective job and I instinctively think that it means I’m in danger Warning Will Robinson! Danger! Danger!, so my system gets even more revved and charged up, and I start to get even more agitated than I was to begin with.
It’s wild how that works. It’s like there’s this well-trained part of me that is constantly scanning my body for clues about what’s going on in the world around me, and when my body seems to be telling me that I’m in danger — by my heart rate increasing and my breathing going faster — part of my brain kicks in to tell me there is trouble happening NOW and you’d better brace for impact.
Meanwhile, I might be in absolutely no danger, whatsoever. I’m just breathing too fast, and my system is reacting to that — not to any danger that’s around. And my reactions to situations and events and people around me (especially family members) gets all blown out of proportion.
So, I focus on my breathing. A lot. I have to consciously think about it, because I instinctively go to the fast-breathing thing, without realizing it. And I’m unconsciously stressing myself out for no good reason, other than a bad habit. This slowed breathing thing is literally a new kind of training I’m doing — I have to teach myself to do this, and I have to do it regularly, like you would practice any other kind of physical or occupational skill. If you want to get good at something, you need to do it a lot. And if you want to become an expert, you have to do it for at least 10,000 hours. That’s a lot of time. I’m not sure I’m going to get to 10,000 hours of regular slowed breathing practice anytime soon, but it gives me something to work towards.
Fortunately, the benefits of slowed breathing are apparent immediately. I don’t have to wait for 10 years, till they kick in. When I slow my breathing to, say, 5-7 full breaths per minute (5 breaths per minute, or 12 seconds per breath is optimal, but I’m not quite there yet), I can feel my system start to release and relax. The tension that has me all clamped up starts to loosen, and I can feel myself start to chill and calm down. Even when I’m in a very tense situation with someone, if I can manage to consciously slow down my breathing, I get more clarity and more calm. And that helps them, too.
I really need to do it for myself, though. Because getting all riled and worked up over whatever is in front of me, is NOT going to help me deal with it in an effective and satisfactory way. And in the end, my main goal is to deal with crap — preferably in a way that will keep it from coming back on me again.
I can slow my breathing down — sometimes even slower than 5 breaths a minute, because I have to get my parasympathetic nervous system to kick in
Source: Coherence: The New Science of Breath
I have to get my PNS to get the upper hand, because things are spinning wildly out of control and if I don’t get a handle on myself, I am SO going to be sorry later(!). So, I slow my breathing and breathe really deeply.
But if I’m in a situation with someone who is, themself, on the edge (and they are unaware of the importance of breathing and ratcheting down the intensity), my own modulation doesn’t always do the trick to diffuse the tension.
Sometimes my controlled breathing alone doesn’t do it. So, I have to think of something else. I have to use everything. I have to be able to think clearly, myself, and step back from the situation… step back and observe what’s going on, without getting pulled into the midst of it all. I have to use all my resources — including presenting as being very “on” so others will take me seriously… talking people through all the options and alternatives we have… using humor… or sometimes just removing myself from the situation.
It can get pretty challenging in some situations, as I have no control over what others do and say, and I may react to some unconscious signal they send and do/say something that’s not helpful — or downright harmful to the situation. But I have to do it. I have to stay calm. I have to start with my breath, focus on it, and not let anything get hold of me without my say-so. I need to be the one calling the shots in my life — not some jerk across the conference room table or some a-hole who just cut me off in traffic. I have to be the one who decides how I feel, how I act, how I react, in any given situation — rather than letting outside circumstances dictate to me what I think, feel, or do.
See, that’s the most debilitating thing about PTSD for me — how it takes away your autonomy and your ability to decide for yourself how you will think, act, react. It strips me of my independence and makes me a victim of outside circumstances — all due to things I do not/cannot see, and forces that are set in motion deep within the hidden recesses of my brain and my central nervous system.
Does this relate to my history of TBIs? You’d better believe it. As a result of all those injuries, I’ve been presented with countless challenges I didn’t understand at the time, and I’ve been immersed in chaos and confusion that set my autonomic nervous system into high gear — over and over and over again. As far as I’m concerned, PTSD is what makes TBI a long-term challenge. Even if the majority of neurological issues resolve, to all appearances, there’s the subtle and corrosive effect of one minor (or major) disaster after another, one inexplicable catastrophe after another, that kicks your body into action, often without you understanding just how much action is needed, or how extreme (or subtle) a response is required.
The result of one problem after another, one logistical surprise after another, one unanticipated screw-up after another… and the considerable challenge of dealing with a world that doesn’t much care for our screw-ups… it all adds up to stress. Post-traumatic stress. No matter how “small” the traumas may seem on the outside, no matter how “minor” the problems may look on the outside, inside a scrambled brain — one that’s driven by intense emotional lability and extreme reactions that are hard to modulate — you’ve got a potent environment to create mountains out of molehills and experience relatively minor traumas as life-shattering events.
How it “really” is on the outside makes no difference. Inside your brain – and your body – the experience is extreme. And the cascade of biochemical Alert! can be just as intense as if you’re in a serious car accident or you’re holding your buddy in your arms as he dies.
That’s the wacked-out thing about TBI — it can totally screw with your perceptions of relative importance. And it can create internal conditions that are very similar to extreme danger, when on the outside, in “reality” the situation is not that huge of a deal.
So, knowing this, and thinking about all the situations I’m presently in that I have a tendency to make into Huge Deals, I’m doing everything in my power to keep calm. Control my breathing. Consciously relax. Remind myself that things may not be nearly as bad as I think they are. Remind myself that others often have a very different interpretation of what’s going on, than I do — and they may be more right than I am. I exercise each morning to get my heart rate up and move the lymph through my system, so I don’t get sick. I make a point of getting to bed at a decent hour each night, and I make sure I stretch before I go to sleep, so I can make it through the night without cramping up and waking up from the pain of my tight muscles. I keep myself on a decent eating plan and I steer clear of a lot of processed sugar, because that spikes me and gets me all jazzed — and then I crash afterwards, which makes me crave more. I steer clear of “cheap” carbs that get me jazzed up, too. Keep my junk food consumption down, and remember to have my apple each day, so my digestive system stays regular and I don’t get all “stopped up”.
There are a hundred different tricks I use to keep calm. And some days I have to use them all. But it’s worth it. I like having a life, and if I can’t stay calm, what I have becomes a lot less like life and a lot more like just surviving.