I feel as if, sometimes, the impression I give off is that I’m “better” or “recovered.” In a way, this is true. I have the best hold over myself that I ever have. I slip up on occasion, but my command of my illnesses is unmatched by any other period of my life. I’ve been through a lot and, in many ways, come out of the other side.
I’m afraid, though, that this gives off the impression that there is such a thing as totally recovered. This false paradigm, recovered versus sick, is just that; it’s a trap, meant to shame folks who are doing well because they can’t quite kick certain symptoms. This stickiness is, in fact, extremely common. Some mental illnesses are chronic, or lifelong by nature. Just because someone still suffers from a chronic illness, it does not mean that they aren’t the best that they can be.
I recently started on with a new psychiatrist. He’s a pleasant fellow and we got along just fine. He has the habit of giving out sheets with a checklist of the DSM-5 disorders that the patient has, to the patient. After my first session with him, I glanced down at the sheet. I knew what I had, but seeing it in DSM form was different. The thing that stood out to me the most was the type of PTSD I was written up for.
Generalized anxiety? Check. Depression, recurring, moderate? Check. OCD? Check. Anorexia Nervosa? Tepid check, for me. My eyes settled on the check next to Post Traumatic Stress Disorder. After the name was, enclosed in parentheses, a wee (Chronic) designation, nestled under (Acute).
I didn’t know what to make of it, and interpreted it in one of two ways. My first, gut reaction was “great, I’m never getting rid of this? What am I even doing therapy for?” My secondary and permanent reaction was more along the lines of relief. I wasn’t expected to be making huge leaps and bounds. It’s okay that I’m inching along, it makes sense.
I have diagnosed PTSD from two occasions. The first is from a sexually abusive relationship that I survived. The second is from being under the long-term (a handful of months) impression that someone I loved was in serious danger. Both are diagnosable sources of PTSD.
One can collect PTSD from any of four sources: direct exposure, witnessing the event, learning that a relative or close friend was exposed to trauma, and indirect exposure via professional experience (law enforcement, medical professionals, etc). I’ve italicized the two sources of mine.
PTSD is characterized by a long list of symptoms. Mine include, or have included, nightmares, emotional distress, physical reactivity, avoidance, isolation, exaggerated self blame, outwardly directed blame of perpetrators, inability to recollect key events, irritability, difficulty sleeping, and hyper-vigilance.
Yeah, I know. It’s quite the list. And given that I have chronic PTSD, this list will peter away over time. Generally, PTSD is diagnosed after symptoms have been displayed for one month or more. For me, symptoms began immediately, and they did not stop. The sexual abuse happened around two years ago, though it was for an extended period of time. The trauma by proxy happened this summer. My nightmares are infrequent and I’m less hypervigilant. That’s about it in terms of “recovery.”
And that’s perfectly okay. I’m doing everything right. I’m engaging in targeted trauma therapy. Sometimes I relapse into bad trauma related patterns, but I always catch myself and digest it all with my therapist. I’m doing all that I can to move on. In a way, that’s what recovery is. I’m fully invested in doing better and am doing all the right things. Nothing else can be asked of me. This may be chronic, but I’m kicking its ass when it’s not kicking mine.
Addictions are also often characterized intentionally as chronic illnesses. The idea goes that since the addict has a historic predisposition to getting hooked to something, they can never again engage with that something because they’ve proven themselves unable to handle it. There’s some dissent among the rehabilitation community, but this is the general consensus. If we view Anorexia and other eating disorders as addictions, as is also common, then it stands to reason that these diagnoses are life long, too.
I’m never going to be able to go on a diet. I know this about myself; I will collapse and restrict for the wrong reasons. Not only is the type of exercise I can do limited to non-impact activities, but I must exercise in intentional, delicate moderation. I can’t be vegetarian, vegan, pescatarian, or what have you. I must eat three meals a day. If I don’t do this, I will slip.
I am tempted every day. Right now, I’m in a phase where I eat three meals a day, but in my head I’m balancing each day out with the load of the day before in order to not gain weight. I’ve accepted that I can’t lose weight, which is a significant part of the battle. But I’m terrified of gaining a single pound. This may continue on for a while, though I’m working on it with my treatment team. As long as I’m performing the correct actions, I’m doing okay. Even better, I’m engaging meaningfully with my disordered thoughts. Within a chronic illness, that’s all that can be asked.
Next, I’m going to talk about how exactly PTSD by proxy (someone you love’s trauma creating yours) feels and works. In the meantime, take a moment to reflect on the specific incidents of extreme pain that others have described to you. Try to treat those pained memories gently and kindly. It’s a matter of brain chemistry. Pain that endures long, long after trauma is very human.
If you’ve done that already, go watch Us in theaters, preferably the fabulous and sparkly theater that I work at! Hint: the main character can relate…