PTSD and Depression. The Big One (Part 2)

Some time ago I wrote about the build up to my big illness.

I said that I would write about the main illness itself. This has taken me longer than I hoped to get around to it but here goes.

In February 2010 everything came to a head in very quick succession. I was increasingly getting flashbacks and nightmares relating to the PTSD along with frequent intrusive thoughts and a very exaggerated startle response. My level of anxiety shot through the roof. Anxiety understates it. A lot of the time it was very real fear or terror. At the same time my mood slumped and I experienced depression to a degree I never have before. I started to cut myself. I’m not going to go into details on the reasons as I have covered that previously. But at this time I cut myself particularly severely on my calf. The details are quite gorey but I ended up in hospital having stitches. The following weekend I was nagged and dragged reluctantly to see my GP. Reluctantly because I was still trying to kid myself I was in control! My GP was superb at all times through my illness and at this point prescribed drugs to deal with the acute situation. It happened that,before I was due on duty at work again, I had a routine medical at occupational health. The timing of this could not have been more fortuitous. We are drug tested as part of our routine medicals. I know I would test positive for a lot of things as beside the drugs my GP had recently given me I was also taking fairly strong painkillers for a chronic back problem. And of course I did test positive. This is not a problem per se. The samples are sent for analysis to check that it is the prescription drugs you have declared. But you are suspended whilst these tests take place. But I also flagged a concern because of the cuts on my calf and arm as the worst one meant I couldn’t carry out the fitness test. Because of these concerns the nurse referred me to see the consultant physician that day. I was, still, deluding myself that I was carrying things off and disguising how ill I was. In retrospect I know I wasn’t. Apart from anything else I have seen photos of myself from this time and I really do look ill. But I wasn’t functioning in any normal way and my nerves were all over the place. The doctor saw this straight away and immediately told me I was going sick whether I wanted to or not. This was probably the best thing that could have happened. I was a few days away from a total emotional collapse. That happened anyway but if it had happened at work it would not have been pretty.

But within a few days I had what people would mostly describe as a nervous breakdown. If I thought this was the low point I was, unfortunately, very, very wrong. The initial estimation of the time I would be sick was six weeks. It turned out to be much longer than that and it was pretty much a year to the day before I was declared fit enough to return to work. It was a long year!

As I have said before there are parts of it I don’t recall at all. Some memories have been prompted by people talking about it and reminding me or a diary I was encouraged to keep. But some things I have been told that happened I have absolutely no memory of. I do remember the overwhelming feelings associated with PTSD and the deep depression. I find it hard to accurately describe this to people who haven’t had these things which is very frustrating. But I certainly remember a totally consuming feeling of sadness and hopelessness. I thought I knew what depression felt like and as I have mentioned before I had bouts of depression previously. But they were nothing compared to this. There was also quite a lot of self loathing. My self-esteem was non existent. You really do believe that whenever anybody has treated you badly it is simply because you are a worthless person. It is for that reason that I needed to speak to some of those people as I tried to get better. I think it is actually more than just a lack of self-esteem. There are times when you positively hate yourself. Shit happens to you because you are a shit person; or so you think. Then there were the PTSD symptoms. The flashbacks, the nightmares, the insomnia, the massively heightened startle response and bouts of anger. There was also gut-wrenching anxiety and fear. This was fear, that at times amounted to terror; but for no definable reason. Some times I felt completely empty and hollow but, conversely, some times I felt so full I was going to burst.

I also remember crying a whole load of the time. From gentle weeping to uncontrollable, body-wracking sobbing. Often the tears would come with absolutely no warning. Sometimes I would have no idea I was crying until I had been for some time. Frequently I would be sitting having a meal with my family and I would just have to get up and leave because I had started crying and knew I could not stop. I remember one occasion going to meet my OH for lunch. I had had a particularly difficult morning for a variety of reasons. I was walking across Hungerford Bridge which links the South Bank to Charing Cross. And I was sobbing uncontrollably. I was also in a blind panic and had a desperate need to get to my OH as soon as possible. I was vaguely aware of other people staring at me but I just could not stop. This or similar happened on several occasions.

Then there were the suicidal feelings. It was something that was there most of the time, just much stronger at some times than others. At one point I got as far as writing letters to those close to me explaining why I felt I had to do it and how it was not their fault. I have dealt with the suicide thing on a previous post. I do remember on one occasion going for a walk for several hours; actually I spent most of it sitting on a bench in the rain, in a cemetery. I don’t really know why. But my OH was so sure I was at the point of suicide that she had phoned a crisis line and then the police. I got home to find her distraught and that several police officers had been looking for me. I think that and the cutting were incredibly difficult for those around me to cope with. I think people end up starting to think it is in some way their fault. But the illness makes it impossible to recognise the effect you are having on other people. I have said before that I refuse to be ashamed of the scars I now have. The cutting served a very real purpose that I have described elsewhere. But I do regret and I am disturbed by the effect that seeing me do that had on those around me. I tried to hide the fact I was doing it but ultimately that is impossible with those closest to you.

Another big feature was insomnia. I had trouble sleeping since the Baltic Exchange bomb but this was on a whole new level. I went through long periods where I literally did not sleep at all. Those nights I did manage to get to sleep it was never more than a couple of hours and I would wake from a nightmare. I think I understand the mechanics of this. One’s brain is so hyper-vigilant and prepared for an imminent disaster that it won’t let you sleep. That degree of sleep deprivation is horribly disorientating. It makes any sort of constructive thinking impossible. And that makes recovery incredibly difficult, if not impossible. It is confusing, draining etc. I used to crave sleep with a vengeance but it would not come. Depression makes decision making difficult. With the sleep deprivation it became impossible at times. If I had to make a decision I would become extremely stressed and distressed and would usually just swerve it somehow. Or suffer another “mini breakdown”. I found I couldn’t even speak cohherently. Often I would just not be able to recall basic words or half way through saying something I would forget what it was. Depression also brings with it a lack of motivation. Add exhaustion to that and most days I was pretty non-functional.  I think this added to the suicidal process as well. So long as death meant sleep. Again, I have covered that in a previous post. The psychiatrist I was seeing at the time was on a placement as part of her ongoing training. She wanted to give me a short course of sleeping tablets but her consultant (who had never met me) blocked this. I am not totally sure of the reason but I believe it was mainly to do with an unconnected situation that he had completely misinterpreted. I asked to see him in person and he was intransigent. He was horribly arrogant and seemed to have to “god-complex” that some consultants have and I felt that he was affronted that a patient was questioning him. Thankfully his attitude was very much a one off. Everybody else I saw about my illness was fantastic. My OH spoke with my GP. Thankfully she intervened and after talking to the consultant she over-ruled him to a degree and gave me some sleeping tablets. Looking back this was a life saver. I was not sleeping at all at this time and had I not got any sleep I feel sure I would have continued a rapid downward spiral.

At times I drank heavily. I would not say that I became alcoholic as I don’t think I became dependent on the alcohol per se. But there were certainly times when I needed the effect that a lot of alcohol can achieve. To drink so much that the pain and fear and self-loathing were dulled to a degree and to feel something like sleep. I think I got to the point where I might drink a bottle of vodka in one go. Not a very healthy thing to do!

At its worst,as I sank further into depression, I think I began to dwell on previous unhappy things in my life. Things like the death of friends, terminations that girlfriends had etc. Things that maybe I had not worked through fully before. But they took on a whole new lease of misery coupled with the deep depression I was already in. There are still a couple of things I would like to work through now as part of relapse prevention.

And so it went on for many months. There would be periods when it would lift slightly but still miserable and these were short-lived. And then I would slump again and each slump felt worse than the previous one.

But, I did get better. And that is largely the purpose of starting this blog. As I have said before; however awful it gets, it will get better. More about the recovery another time.

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6 responses to “PTSD and Depression. The Big One (Part 2)

  1. Thankyou so much for writing this!! I can’t say much more at min, but know you’ll understand why x

  2. Guy, thanks so much for sharing this. I have to say it is one of the best insights into PTSD that I have ever read. It really gives the reader a much better understanding of the illness and how it can impact the life of the sufferer and those around them.

    I found it particularly interesting how you admit that you initially told yourself that you were in control, and that your break down came when you were signed off work. It just goes to show how sometimes we do need others to intervene and say, “No more – you need time out!” I am so glad you had some great professionals behind you during this traumatic time.

  3. Hi your blog was very interesting. I have been to the black hole. Breakdown. 5 suicide attemps. Depression on going all since 2002. Phycotic episodes where I would scream and hit out. Drinking.

  4. Hi your blog was very interesting. I have been to the black hole. Breakdown. 5 suicide attemps. Depression on going all since 2002. Phycotic episodes where I would scream and hit out. Drinking.

  5. Samantha Ritchie

    I’ve been on the other side, watching someone I love go through that black hole, and I recognize so much of what you have shared. It takes some kind of courage, intelligence and sensitivity to share this; thank you.

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