Caring for the Caregiver

It’s been a little over 5 years since my husband was first diagnosed with PTSD.

In those 5 years, I’ve seen, done and felt far too many things that a normal person should never have to see, do or feel in the context of marriage.

I’ve seen my husband on the verge of  committing suicide. I’ve seen his physically violent outbursts where he randomly punches the wall, hurl objects at the wall and occasionally comes charging at me with hatred in his eyes.

I’ve spent many years trying to block these images from flashing in my mind every now and then. Many nights I’ve lain awake beside him in fear of what else is to come. Some days I worry about my capacity to be emotionally strong for him when he needs an emotional anchor to get him through his worst times.

In the course of all these years, much as I try to remember to take care of myself, I forget to.

A couple of months ago I visited my therapist again. Her perspective states that the only thing I have to do is take time to take care of myself.

The best advice I ever got was talking not to my therapist… but to my husband’s therapist instead.

He has the benefit of perspective and knowledge about my husband’s condition and progress. He is familiar with the symptoms and specific manifestations of my husband’s condition. He is aware of what elements or events will trigger another attack. And he knows how I should deal with it when the time comes.

—

The therapist says my husband is definitely getting much better. The irony is that at this point in time, the lines between his condition and his true personality are starting to blur.

His insecurities about himself is a function of both his condition, his upbringing and in part because of his own personality.

His outbursts are manifestations of his personality, sadly just magnified by his condition.

His neediness and being clingy are manifestations of his insecurity.

He advises me on several things that had I known from the start, it would’ve helped me a great deal.

—

First. He needs to learn to stand on his own without me always there beside him.

I don’t always have to be there when he has his attacks or his flashbacks. He needs to learn to manage his own fears and his own attacks. Me being always there is not helping either of us.

Second. If I can’t handle it anymore, it’s better for me to stay away than be there and exacerbate his flashbacks or his latest uncontrollable emotional outbursts. 

It’s counterproductive for both of us if I’m around but not in the condition to help him emotionally. So if I find myself in the middle of a situation where I’m tired and drained and unable to take what he’s dishing out — just leave the situation for awhile.

Third. It’s not about making all the emotions he feels disappear. It’s about learning to deal with them when they come.

The thing about PTSD is that it will always be there. There is no permanent cure. It will come, and it will go. The emotions and memories will always be a part of him… and therefore by default, will always somehow be a part of our marriage. The best thing at this point is to accept this fact, and together find a way to deal with it so it doesn’t get in the way of our marriage.

Fourth. Take time to be alone. As regularly as possible.

Both therapists actually advise me to take a few hours off every week just to take care of myself. Work doesn’t count. A few hours a week with no guilt to do whatever it takes to make me feel better and remind myself that I too matter, I too, have a life.

Fifth. Learn to disassociate.

The therapist also says: it is possible to deal with his outbursts and emotions without my own emotions getting in the way. However this happens, I have yet to learn it.

—

It continues to be a journey and a struggle today.  There are good days, and there are bad days.

I have to admit. In the recent past, the thought of leaving him has entered my mind so many times. Somehow and some way though, I’m still around. I often wonder how much more of this I can take. I worry every time there’s a new attack, or a new episode if the next time around will be the last.

I don’t know what strength is in me that makes me keep enduring and championing on. I can’t deny how much I love him. But I also know love is not enough. And yet I’m still around. The foolish optimist in me keeps hoping that there will come a day that it will all be much better someday.

Caregiver Burnout

Over the last year, I started a private blog which I ended up using as an outlet for whenever my husband would lash at me, sink into one of his episodes or flashbacks, or simply when I felt too tired and abandoned and just needed to vent to something.

When I started this blog, I noticed that I also stopped seeing my own friends and started isolating myself from people who knew me, knew what we were going through with my husband’s condition, and people whom I used to derive comfort from.

I think I stopped confiding in my friends when one day, I started feeling guilty that the only time I ever spoke to them was when something was going on at home again.

This evening, I ran across an article that describes this thing called Caregiver Burnout. Perhaps not too different from other terms I had already come across, but this article lists down every single thing I feel (well, almost…) right now.

—

(from healmyptsd.com. Original article here)

You might be experiencing compassion fatigue if you hear yourself say (or think):

• “You know what, they just don’t want to get better. I’m tired of helping someone who doesn’t want help!”
• “Why do they keep lashing out at me? What have I ever done but try to help?”
• “I can’t even bring myself to ask them how they’re doing, I know it is just going to be the same old answer.”
• “I know exactly what they should do, but they won’t do it. Forget it.”

Other signs of burnout:

• Feeling of dread when approaching time to encounter your loved one
• Blaming yourself because they aren’t getting better
• Physical fatigue
• Gastrointestinal problems
• Feeling depressed
• Feelings of hopelessness
• Poor hygiene
• Poor eating habits
• Apathy, feeling numb
• Difficulty concentrating
• Isolating yourself or avoiding others
• Compulsive behaviors
• Substance Abuse

… and more.

—

These past few months, I’ve found myself:

1. Wanting to work late nights to avoid going home early to spend time with him.
2. Looking for a glass or two of wine before I go home from work.
3. Rapidly sinking into despair and depression randomly.
4. Bracing myself for the worst when he shows any slight indication of a shift in mood from good to bad.
5. Feeling an unshakable feeling of restlessness and hopelessness that I’m stuck in this rut forever.
6. Wanting a cigarette every five minutes, if it means I can shorten my life and sever myself from having to suffer this life any further.

I’m not always like this.

But the episodes are increasing in frequency, and the feelings of despair are escalating in intensity.

The irony of it all is as I was looking back on all I had written in this blog since 2010, and from the prognosis of his psychotherapist — he is doing well. He is going through the healing stages of PTSD… though painfully and sadly for me — the caregiver — this stage is no easier to deal with than it was when he was first diagnosed.

How ironic is it that as he gets better, I get worse.

Every memory he recalls and brings to light, I shudder deeper and harder.

Every night that he ponders and allows himself to feel the hurt and pain without losing himself, I find myself getting more and more fed up about having to put up with this.

Every day I come home from work to find him feeling morose and sad for the memories he has put down on paper, I find myself wishing I had never come home.

Every night that he wants to talk past midnight to process his feelings rationally, my feelings of resentment get more intense.

Every Friday night, I sink into an abyss of fear about what this weekend of being with him will bring. Will there be another night where he needs my loving and patient support, and I won’t be emotionally equipped at that time to bring him comfort? Will he lose it again because I’m not responding the way he wants (or needs) me to? Will he resent me again for falling asleep in exhaustion when he isn’t finished baring his heart and soul again, for the Nth time? Will he think me unsupportive again when for the Nth time, he asks me the same questions he’s asked for the last 5 years, night after night after night — and me giving different versions of the same answer night after night after night?

The hardest part is knowing that all these things he’s doing is a significant step in his healing process. Being able to talk about his memories without losing himself in the process (for the most part). Being able to dredge up painful memories, mourn them and find a way to deal with them without medication.

He needs this. In the process, he needs me.

But as time goes by, I’m the one sinking deeper and deeper into my own trauma. And I don’t see a way out.

I don’t even see how I can take care of myself for a change, prioritize myself for a change — without him spending a single night without me by his side just in case he needs me. 

—

I’ve made an appointment this weekend to see my therapist again. After three years, this is the first time I found myself in a place where I no longer know what to do.

I think I know what she has to say. It’s the same things that’s been nagging me for the past few months. It’s the simple words that say I also deserve to take care of myself. Taking care of myself isn’t abandoning him. It’s allowing me to care for him better, by first taking care of myself.

But maybe I need to hear it from someone else first.

Compassion Fatigue

Wikipedia defines this as “a condition characterised by a gradual lessening of compassion over time. It is common among trauma victims and individuals that work directly with trauma victims. It was first diagnosed in nurses in the 1950s. Sufferers can exhibit several symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetency and self doubt.”

A website that specializes in giving support to victims of secondary trauma says that the following steps are the best way to get over the condition:

• Be kind to yourself.
• Enhance your awareness with education.
• Accept where you are on your path at all times.
• Understand that those close to you may not be there when you need them most.
• Exchange information and feelings with people can validate you.
• Listen to others who are suffering.
• Clarify your personal boundaries.
• Express your needs verbally.
• Take positive action to change your environment.

For the most part, these tips are helpful for professional workers who can change their environment and everything they’re surrounded with — if they want to bad enough.

What of us who live with it in the home day by day? Those of us who live and breathe it? Whose everyday routines are dictated by how someone you care for feels for that day?

It’s not quite as easy.

Living with a loved one suffering from PTSD means to some degree making way for the sufferer to go through the condition — whatever that entails, and however bad it may get from time to time — in the hopes that it just means he’s on his path to recovery already.

For me, moments that become unbearable can only be bearable if I hold on to that tiny flicker of hope that he is recovering, and that some day it will be okay.

What I’ve found helps a lot is finding a person close to you who understands what the condition is, and moreover what it also entails for the caregiver. I’ve found such a friend. She knows me so well that whenever an attack strikes and I feel a compelling urge to just walk away, she anchors me back to myself and reminds me that I’m stronger than this. That what makes me different from others who’ve gone through something similar – is that I don’t and won’t walk away. That there’s a bigger reason why I’m staying and doing everything it takes to get better.

That’s the best piece of advice I can give anyone who may be going through what I am.

If there’s no such person in your life yet who can just take that time to remind of what it’s all for — drop me a note, maybe I can be your sponge for a while.

Hanging by a Thread

How long do you think I can keep putting up with this?

I’ve barely recovered from the last episode we had that lasted for almost a full week. I sat on this same couch for days on end, feeling that painful, heavy weight in my heart that refused to go away. I barely ate, I just smoked all day, I wanted to scream at the world for everything that was happening, and still it took almost a full week for you to recover.

That time I understood why you were angry, and why you felt cheated and abandoned. I chose my work, I chose myself over you. Not that that was even wrong, I don’t do it often at all. But last night takes the cake.

I knew you were feeling miserable from the stupid things your co-workers put you through. I hate it myself, I told you that. I was upset about it… and told you that — maybe we should just try to enjoy the New Year first, what little we can to enjoy it before you get another phone call.

And then sometime during the wee hours of the morning, I made the big ghastly unforgivable mistake of falling asleep while we were watching TV. And that set you off again.

I was tired. I hadn’t slept for the past 3 days taking care of things for you. Or don’t you remember? The day before I was subjected to multiple invasive medical exams and I was physically still recovering from the pain. It was almost 2 in the morning. Naturally I would get sleepy and tired.

If you had needed me to stay awake with you, you should’ve just said so. You even painfully implied last night when I committed the unforgivable act of falling asleep that you’re used to it. Used to me abandoning you to sleep.

You go to sleep at 4-5 in the morning, and that’s okay. You have the luxury of getting up at noon. You’re a freelancer. On days when you don’t feel like working you can just choose not to.

I’m employed. I have a job where I have to get up early everyday and trudge to work. Don’t you remember? We need my income. My steady salary. Because you’re always scared to death about not having enough for the future.

Maybe what you need isn’t a wife. Maybe you need a robot, a machine who doesn’t need sleep, who has no feelings, who doesn’t go through anything, who just exists to do for you what you need it to do for you.

And this morning you opted to sleep on this couch. I saw you when I woke up at 8 in the morning from a painfully restless sleep. You were snoring soundly. And then 2 hours later, you get up and move to the bed where I was…. and you took the time to look at me with such accusation and disdain in your eyes before lying down on the bed and turning your back on me.

And it’s New Year’s Day.

In your sober, lucid moments you always tell me how you can’t live without me, and how I’m the only one who makes you happy.

But if you keep doing this to me, one day I’ll just get tired of all this and walk away.

The last time this happened, you have no idea how close I was to just walking away.

It’s not that I don’t love you. God, if all I’ve chosen to live with, put up with and sacrifice for isn’t enough indication, I don’t know what else is. My ability to keep quiet, hold in my emotions and feelings to make way for yours to be processed — you have no idea how hard it is for me. Maybe you don’t want to know.

Maybe it’s not fair that I feel this way knowing your condition.

But maybe it’s also not fair anymore to me because for months I’ve been living in silent agony wondering if this is all my life will ever be. My everyday is dictated by how you feel for that day. If you’re sad, depressed, angry, anxious, antsy or whatever other negative emotions you feel for that day is — I’m on my toes. On those days, I go to work with only half my head and half my heart where it’s supposed to be. I isolate myself from friends and family so I can stay with you. I sacrifice things that can be sacrificed to be with you and help you through it. I”m turning 35 this year, and seeing a baby breaks my heart every time. I’ve wanted a baby for the last 3 years but chose to swallow what I wanted because I knew you weren’t ready and didn’t want one. Never mind that even my doctor is telling me that beyond 35, getting pregnant would already be too difficult… or if it did happen, the risks for me and the baby would be compounded already. So never mind, turn my back on my deepest desire because you need me.

I’m running out of excuses for you. The last time this happened, I fought with my brother over you. He said you were selfish. I defended you with everything I had. He said at some point you need to fight back to get out of this rut… or choose to live in the rut forever. I tuned him out, and turned him away. You never asked me to do that, but I did anyway.

I’ve made so many excuses for you to other people and to myself. The times past when we’ve had bad fights where you hit me, shoved me or did whatever to me – I chose to live with it and accept it for what it was.

You’ve stopped hitting me for awhile now… but now you’ve chosen another way to punish me whenever you’re mad at me about something. Silent treatment. Looks of spiteful disdain. And then behind closed doors, you’d do something to hurt yourself.

I’m running out of excuses even to myself.

I’m tired. I’m too tired to even cry.

Relapses

Bystanders, observers and loved ones of PTSD sufferers, I believe, often wonder if a time will ever come when none of the sufferer’s symptoms ever return.

I wonder this myself.

I’ve been lucky, blissfully enjoying the past few weeks with minimal symptoms disturbing the peace and quiet in our home.

But I think it’s safe to say that the worry and fear that  extreme bad days would return —  was always just lodged at the back of my head, stilled and silenced in the hopes that it could stay buried there… and eventually just fade into non-existence. But that’s not the way it works.

—

It’s been four days since our current battle with my husband’s condition has returned with a vengeance. Because of a wrong decision I made on Friday night (to attend an office function I really wanted to attend — instead of going home immediately to take care of my husband, who at the time was feeling ill from flu symptoms), it set into motion a series of painful events over the next few days that leave me emotionally, mentally and physically drained. And it ain’t over yet.

—

On Friday night, although not directly asking me to go home, he was irritated while sending me clear messages that he wasn’t in a good mood; subtly hinting that he wanted attention; and eventually getting really angry when I chose to do something for myself that night, for a change. I figured I was gonna go home eventually, in just a matter of a few hours. It wasn’t for the whole night, it was just once a year. When I arrived home, it was like the Cold War had erupted in our humble abode.

I spent more than half that night trying to get a good night’s sleep on our tiny living room couch.

—

On Saturday, the Cold War continues. But it gets worse. He refuses to get out of bed, refuses to go through the normal grind of daily existence — doesn’t even wash his face, take a bath, nothing. He smokes like a chimney, plunks himself in front of the television set the whole day.

Meanwhile, I had opted to forego lunch with my own family. My brother and I fight, because it’s not the first time I ditch them because of a domestic situation. My brother gets upset in my behalf when he hears about what’s going on. He actually tells me I have a selfish husband who only thinks about himself, and refuses to ever consider — my own happiness. I defend my husband to the death. All the things I say, I believe. He’s not selfish, he’s just having a difficult time. And as my family, I ask only for patience, understanding, love and support — and to stop making it worse for me than it already is.

I try to apologize to my husband some time during the evening. He turns his back on me, then eventually slams the door in my face.

I step out to grab dinner on my own (and a glass of wine to steady the nerves), I get him dinner too, bring it home, but he ignores it. Eventually he demands to know where I’ve been, and asks suspiciously whom I met up with. When I say I was alone, he acts as though everything I was saying is a lie.

I’m surprised a few minutes later when he steps out of the room, and meekly apologizes to me. I wonder what he apologizes for, but I need ask. He apologizes for causing trouble for me, and for being selfish. For denying me the time to do what I have to do, or want to do.

He says he doesn’t wanna talk about what happened anymore.

I think then that things will be okay in the morning.

—

I wake up Sunday morning, started getting to work on something I promised him I’d help him with.

He eventually wakes up, sees me working, and says nothing. Eventually I approach him and ask him to eat something. I tell him there’s some food I had stored the night before that I can reheat. He says nothing.

I heat it anyway. Serve it to him anyway. But he still doesn’t eat.

So I think to myself — maybe if I also don’t eat until he eats, then maybe he’ll decide to eat something.

Some would call it manipulation. I think it qualifies as such. But I only wanted him to eat something to regain his strength.

When he finds out my intention, he gets wild again. Starts punching the wall.

And so I eat lunch.

Before dinner, while he insists we’re already okay, I start getting antsty. Panicky. Depressed. So I start sobbing uncontrollably in the bedroom. He comes to me, speaks to me coldly. Says that he already apologized so stop crying…. and what the hell do I want anyway? I say that I just want my husband back. He says something to the extent of — you can’t expect to do something to hurt me and not expect any consequences on your actions.

It breaks my heart, it makes me sob even more. But he doesn’t break.

I eventually leave the room, running to the privacy of my bathroom to try to stop crying, mop my tears.

I hear from the bathroom that he decides to turn on his game console, and starts playing games.

That night, I downed 2 glasses of wine straight just to numb the pain.

Decide that I can’t afford to go to work the following day. My entire face was swollen from crying. I was too exhausted. Had a major migraine.

But that night, he finally starts to eat some food. Little bites here and there.

—

Monday morning, he wakes up and asks why I’m not at work. I explain that I wasn’t feeling well.

He has work to do today. Since I’m around, he decides to ask for my help. Our conversations have improved a little bit today. Still distant, but at least civil and courteous.

He finally eats a full meal at lunch.

Towards the evening, the events that transpired for the work he was doing unfolded badly. By nightfall, he was angry again. Punching the wall. Making snappy comments to me on things not even related to his work.

But he eats a full meal again at dinner.

He still hasn’t taken a bath. It’s been 3 days since his last bath. For a guy who prizes cleanliness and hygiene, I start getting antsy again but decide to just let him be. He won’t die from bad hygiene for just a week.

Before bed time, he asks me for strong medicine to help him sleep. I give the him the one drug that’s always a guarantee to knock him out.

This medication Quetiapine Seroquel is usually prescribed for severely depressed patients, or patients with epilepsy. In my husband’s case, he was given Seroquel as a strong sleeping medication.

This medicine has a unique effect on my husband. It knocks him out completely for at least 12 hours, but not immediately. Within the first 2 hours of taking the drug, he gets extremely drowsy and sleepy. But as he falls asleep, he starts thrashing madly and getting intense spasms.

His psychiatrist has told me in his case, spasms and thrashing is a manifestation of all the aggression he’s trying to contain. Seroquel lets him release his aggression in this way… until he eventually knocks out for the night, and next 12 or so hours.

—

Today is Tuesday, and I have had to go back to work already. So when I left the house this morning, he was asleep.

I haven’t heard from him, and it’s a little after lunch… which probably means he’s still asleep.

Out of fear and anxiety, it’s almost as if I don’t even want to know how he’s doing today. If he has finally snapped out of the stupor he’s been in the past 4 days. If he finally has decided to rejoin the land of living. If I finally have my funny, sweet, loving and thoughtful (albeit clingy and needs sometimes) husband back.

Or if he’s still angry. Moping. Retreating from the world and from me. Pushing me away and choosing to live with the “friends” he has made on the virtual game console.

I continue to hope (as I always force myself to hope) that the Universe and God gives me my husband back to me today. That my heart won’t be broken again. That tonight I can have a real good night’s sleep without worries about my husband and my own life – nagging me as I try to force them out of my mind.

I have a hard time concentrating on work today. I’m sleepy, drowsy and groggy too from all the ordeal of the past few days. I have a million things to do that require my full concentration, but I can’t even get down to it yet. I feel a little bit bad that my one day of absence made me feel obsolete in the meeting I had to attend this morning. But all these can’t be helped.

Work has to go on. Life has to go on. And the hardest part is to continue being my normal happy, bubbly, aggressive self to avoid receiving questions you can’t answer truthfully anyway.

When the Going Gets Tough

Disclaimer: I write this as someone in a state of semi-drunkenness. On a Friday night after a long tough week, and the night before struggling to make sense of what’s gonna happen in my life — I’m not quite sure how cohesive or articulate this post will be. But let me try nonetheless.

—

The struggles of a caregiver for a PTSD sufferer can sometimes be harsh.

I lost my father recently to lung cancer. Yesterday was the 40th day since his death.

Since my husband suffers from PTSD as a result of the abuse he encountered with his family as a child, I thought that limiting his interaction with my own surviving family members would be more than enough to limit the triggers to his bad memories.

I was mistaken. Now it seems, I can’t even spend time with my own family (even without him) for it just reminds him of the very things he hopes to forget.

But let me backtrack a bit.

When I was a child, I was also physically, mentally and emotionally abused as a child. I can’t say for sure if my husband had it worse than I did. But in my case, I ran away from home when I graduated in College. It’s not much… but all this time I just knew I could do better and create a better life for myself living on my own than with my family.

I don’t think I have… nor will have PTSD. I’ve been lucky that it’s been relatively easy for me to forgive, bounce back and move on from tribulations and despair.

I never expected that spending time with my surviving family to commemorate my father’s 40th day death anniversary would trigger an attack so bad… that my husband asked me last night to reconsider my being married to him. Nowadays, me spending time with my own family reminds him of his own family and triggers a bad attack.

This evening I bared part of my heart to some friends.

While it didn’t make me feel better about my situation, here’s something I realized: baring your heart and soul reveals many things about the people around you whom you think have picture perfect lives. Today, i realized that the people I had looked upon as people who seemingly have “no emotional problems to deal with”, actually do, and actually have it just as bad (if not worse) than I do.

At the end of it all, the only thing it tells me is this.

People around us exist to give us hope, and to remind us that in this life, we all suffer our own painful fate. But we all get through it somehow, we all find happiness at the end of the pain.

The Neglected Caregiver

I’ve found it strange that upon my husband’s diagnosis, his psychiatrist did not exert any effort to speak with the ones who would be caring for him and living with him on a day to day basis, i.e. me.

When all the shockers exploded on my husband’s symptoms, I was caught unprepared. I didn’t know how to handle it; I didn’t know how to help him; I didn’t know what to do.

Even when I had gone to the doctor’s clinic to pick up the medicine prescriptions and the doctor was handing them over to me, there was no effort to explain anything to me. If I hadn’t asked, he wouldn’t even have told me that all he was going through was normal and could be expected. And if I hadn’t asked too, he wouldn’t have given me the number of a therapist I could see on the side.

And to think that all the sites that talk about PTSD all say that a sufferer’s recovery can be helped greatly by massive support from family and friends.

It’s so easy for doctors to fall prey to non-information.

Is it easy because when they step out of their offices and get into their own homes, they don’t deal with the painful day-to-day of living with a PTSD sufferer? I may be out of line in saying that it’s easy to give lip service and conduct therapy with patients, and mouth off facts like an encyclopedia or Wikipedia all the symptoms, causes, treatment, recovery of the condition.

But they don’t experience what it’s really like. Nor do they see and feel the worst of anything.

What wonders it would’ve done for me if someone had taken the time to explain my husband’s condition to me, and guided me through what to expect.

Having information helps a great deal. Knowing what to expect, and understanding the source and deeper meaning behind every word, action or reaction just somehow puts things into better perspective. It doesn’t make it easier. But it explains a lot of things. Maybe in some way, it helps the caregiver objectify every episode and try to find some distance from the painful things that could be said and done.

I’ve seen it many times on various websites. PTSD does not affect only the sufferer but the entire family and household. So why aren’t there enough support systems to equip the family members with what they need to combat this illness?

Maybe, it medical practitioners had a little bit more of human empathy in them, then maybe thousands of caregivers like me wouldn’t have felt so lost, alone and forlorn.

Secondary Trauma

While creating this blog, I came upon this new term “secondary trauma”.

About Trauma uses these words to describe the condition:

Known by various names — compassion fatigue, secondary or vicarious traumatization, and “burn out”, the symptoms here are usually less severe than PTSD-like symptoms experienced by direct victims in a disaster. But they can affect the livelihoods and careers of those with considerable training and experience working with disaster and trauma survivors.

…the risk increases when traumatic exposures are unexpected, or among those without adequate preparation.

Expect this, if you work with or are exposed to the stories of many disaster/trauma victims, and take steps to protect yourself at the first sign of trouble. Basically, there are three risk factors for secondary traumatization: 1) exposure to the stories (or images) of multiple disaster victims, 2) your empathic sensitivity to their suffering, and 3) any unresolved emotional issues that relate (affectively or symbolically) to the suffering seen.

The site basically also says that the secondary trauma sufferer must be able to find ways to deal with his/her own stress, seek counseling if necessary.

—

After my husband’s first major bout with depression when he stayed in bed for four days straight, didn’t eat and inflicted injuries on himself — I found myself making an appointment with an associate of my husband’s therapist.

Perhaps I just wanted to make sense of what was happening to him, articulate how it made me feel and all the doubts that surfaced in my head about whether I could hack this or not.

But seeing the therapist didn’t really make me feel any better.

Beyond just telling me that I needed to find ways to take care of myself better (since I can’t expect hubby to be the one to take care of me while he’s dealing with this), there wasn’t anything new I learned during those sessions.

I didn’t know what I was expecting, to be completely honest.

But on hindsight, maybe all I wanted was someone who would, for a change, put my needs first and foremost.

After dealing with days of his continuous depression, and the weeks immediately following those days — I found myself teetering on the brink of despair and panic. It’s not easy watching the one you love the most in this world hurt himself and confront a point in his life when he didn’t want to go on living anymore. It hurts like hell.

The panic I felt when I thought he really would kill himself is a panic unlike other I’ve ever known. It was plain, abject fear – as black as night and as dreadful as the worst terminal illness.

For several weeks, I struggled against the flashbacks in my head of those horrible days — and the flashbacks wouldn’t go away. I spent many nights lying awake beside him wondering if I could live for the rest of my life like this, and if I had the strength the endure what I would have to endure for God knows how long.

When I finally spoke with my therapist, the only thing she could tell me though was that — yes, it’s gonna go on for a long, long time. You have to understand what he’s going through but take care of yourself too.

How exactly do you that?

Looking back, I think what I just wanted was to stop hearing how hard it was for him. I already knew that.

I just wanted someone who could acknowledge how hard it was (and is) for me too. And maybe reassure me that although this is happening now, this too, like all things, shall pass. And that someday, the husband I fell in love with and chose to spend the rest of my life with – will come back to me.

Years later, I find myself doing the reassuring to myself. It’s a little strange, but maybe in some weird way it’s the only way I can keep my sanity and retain some semblance of happiness and joy.

And truth be told, my husband is getting a little bit better in little baby steps as the days go by. It’s a slow, long and painful journey but I remain hopeful that the day I’m waiting for will come, one way or another.

So I’m here to tell you, if you’re experiencing secondary trauma like I am too, that someday things will be okay. Just take it one day at a time. As long as you have some strength still left in you, keep fighting, keep holding on, and keep believing that someday this will all be okay.

Til then, I’m here to listen and let you know — you’re not alone.

Recovery Stages for PTSD

Much as in traumatic events we experience, there are also stages of recovery for PTSD. Most sufferers would alternate between these stages randomly. Nonetheless, you can observe general patterns of behaviour that’s true for the most part to distinguish which stage the sufferer is already in.

Stage 1: Emergency/ Outcry Stage. The onset of a major anxiety attack that manifests in intense physical reactions (hyperventilation, rapid breathing and pulse and elevated blood pressure). At this stage, the victim finds himself/ herself in a situation that triggers the “fight or flight” response and makes the victim feel extremely helpless. Fear overtakes them almost completely.. such that when they’ve finally emerged from this situation, they often feel confused about what just happened.

Stage 2: Emotional Numbing and Denial Stage. The classic case of “sweeping under the rug”, pretending they never happened to avoid any emotional responses. There are many who don’t actually move on from this stage. Hence, it’s crucial for caregivers and/or loved ones to pick up on these symptoms to help the sufferer seek help.

Stage 3: “Intrusive-Repetitive” Stage. Flashbacks, major mood swings, irrational behavior are what characterize this stage. At this point in time, the sufferer begins to confront the trauma that started it all. Victims are more prone to being easily startled. Many manifest antisocial behavior, fearing that contact with the outside world would either trigger another repressed memory; or feel that they’re too vulnerable to have normal interaction with the outside world.

Stage 4: “Reflective-Transition” Stage. The survivor by this time has reached a point where they are able to slightly distance themselves from the situation and see it from a bigger perspective. At this point, he/she has begun to move forward with a more positive and constructive frame of mind, with the full intent of moving on. Many refer to this as the healing process where they are finally able to confront the trauma and deal with it.

Stage 5: Integration Stage. At this point, the survivor has finally recovered from the trauma, and has successfully reintegrated into society. He/she has overcome the trauma, and can now deal with it without causing intense feelings of fear, anxiety and despair. He/she can finally find peace within himself/ herself and move on to have a happy, full life.

—

My husband alternates between all stages — depending on the time of day, week and circumstance.

But for the most part, he’s often at Stage 3 these days especially right before bedtime. For several months now, he deals with panic attacks at night alternating between unreasonable worry about the future, and having uncontrollable flashbacks about the most traumatic events in his life. Little events or occurrences throughout the day would trigger the night time flashbacks – whether it was a colleague who made him feel humiliated; or a minor illness that reminded him of childhood illnesses and how we was made to feel weak; or something else entirely.

I’ve seen the difference between then and now though. While he was under medication, the pain would be less. He would gloss over the past events and pretend that it never happened. He would refuse to talk. When he’d “go under”, he’d be virtually impossible to coax out of that world.

Nowadays, he would describe in minute detail whatever he was remembering. He would talk about how he felt then, and how he felt now as a result of it. He would link those events with what’s happening to his life now. He would liken the emotions he felt then to the emotions that bad experiences in the present would evoke.

But most of the time, he would do it without medication. If any, just a low dose tranquilizer to help him calm down.

Nowadays, a little time, patience, love and reaching out goes a long way.

—

It isn’t easy though. Not for him, and certainly not for me.

My father recently passed away. Along with that comes many changes in my life, and in his life. Without meaning it to, attending my father’s wake, cremation and inurnment, and spending continuous time with my family evoked intense reactions from him – which we continue to deal with now.

Related to this, as his one and only caregiver (and the only person on Earth with a personal relationship with him whom he trusts with his condition), it has taken a toll on me as well. It’s not easy to go through the grieving and mourning process; while still being strong for him.

I also have a full-time job that pays the bills (since he’s a freelance practitioner) – my job is a necessity, rather than a want.

And so this means that day after day, night after night – I need to find a way to keep myself strong, sane and healthy — while balancing a full-time day job; trying to be emotionally and physically present for my grieving mother and siblings (who now incites negative feelings in my husband); and being “there” for my husband day after day, night after night.

How do you do that exactly?

I have no answers yet… except to just take it all one day at a time, in the hopes that the day will soon come when my husband begins to truly heal.

The Beginning of this Blog

It’s been three years since my husband was diagnosed with PTSD. Three years since my eyes were opened to what it means to have your better half suffer from this condition. Three years since I understood what it meant to have PTSD taking up residence in your home.

My husband was emotionally, mentally and physically abused throughout his childhood, up until his early adulthood.

We’re of Asian descent, which means that in for this society at large, much importance and emphasis is placed on the so-called “family ties”. Traditionally, kids don’t leave their parents’ home until they get married, or reach their 30s. Here, abused kids stay with their abusive parents. Here, people turn a blind eye to bad things going on inside the home.

And so, if a child here were living in dire and abusive circumstances, he/she would be forced to live with it far longer than if it were in an American or European society.

My husband has lived with the pain, humiliation and despair for more than half his life now.

Everyday since three years ago, there’s always been a silent prayer in my heart that when I get old, I still have my husband with me – living, breathing, happy and healthy.

If you were in circumstances like mine, then you know what that last statement means.

You know too, like I do, that in a marriage, there are worst things a couple can deal with than betrayal and infidelity.

—

I created this blog because one night, after hours of trying to pacify one of my husband’s particularly bad anxiety attacks for almost three hours and finally having him fall asleep; I found myself just sitting on our couch staring off into space while feeling so tired, drained, alone and unappreciated.

I just needed to talk to someone or let out all the pain I was feeling.

But who can you call at 3 in the morning on a weeknight?

I went online, trying to find articles or blogs — not written by the PTSD sufferers, but written by one who was like me — the recipient of the PTSD manifestations just to find a voice who resembled my own; who knew what I was going through; and would help me through the everyday ordeal of living with this condition.

But I found none.

Truth is, sometimes, caring for someone with PTSD isn’t too far from caring for someone with a terminal illness. You know that when you’re taking care of someone dying (which I had already experienced as well), you always have to be strong. You cannot show a hint of weakness. You cannot show how afraid you are, how uncertain, and how much it hurts you as much as it hurts them – seeing them in so much pain while you — can only watch and do what little you can to make it better.

No matter how strong you are though, you can only take so much.

All the resources for PTSD say that caregivers must care for themselves first — before they can care for the sufferer.

So I created this blog for people like me. People whose spouses or loved ones are suffering from PTSD and just need someone to talk to, write to, vent to, or would just want to read about someone else’s experiences… and know that somehow, there is a way to live with this condition.