PTSD – Hers and Mine

Posted on March 6, 2011. Filed under: addiction, Addiction Resources/Support, AlAnon, Parent of an Addict, Treatment Centers, Uncategorized | Tags: , , , , , , , |

My daughter has been in recovery from heroin addiction for ten months now. Within the last two months, she has acquired her driver’s license, bought a car, begun working full time, and moved out of her sober living house and into an apartment with two other women in recovery. Did I mention that she has a ‘boyfriend’ that’s ten years younger?  (Does that make her a ‘cougar’?)  “Rob” is in recovery, himself, and is a personal trainer at her gym. He seems crazy about her – and she feels the same way about him. They both quit smoking, together, over a month ago.

When I spoke with Hayley a few days ago, she mentioned that she’s been having ‘using’ dreams.  She assured me that this is ‘normal’ for someone in recovery, approaching his/her’s one-year sobriety ‘birthday’.  Yet, these dreams are disturbing – both to her, and to me.  I could tell that in her voice – and  in her next breath, that she was working very hard at trying to reassure me – and, most likely herself, that these were typical of the dreams recovering addicts have.

Yet, I’m skeptical of anything my daughter calls normal. It’s all relative, isn’t it? It hasn’t been that long since she explained to me how ‘normal’ it was for heroin addicts to get abscesses.  And now, I’m wondering if dreaming about shooting up is a preliminary step towards her actually using again – and, of course, the BIG ‘R’ relapse.

Please don’t tell me that ‘relapse is a part of recovery’.  I’ve heard that adage many times, especially at Al-Anon/AA meetings. When an alcoholic relapses, the consequences don’t seem quite as dire as when a heroin addict relapses. The immediate addictive nature of heroin, illicit activity and connections to acquire the drug, paraphernalia required, exposure to chronic, life-threatening disease with just one needle poke, and threat of arrest, all accumulate into making heroin relapse a very different beast from alcohol relapse, in my opinion, although the end result can be just as devastating.  Yeah – I know – here I go again, escalating from a dream to the nightmare of reality.  It’s my “M-O”

Why did Hayley feel it was necessary to tell me about her dreams?  Was she just being transparent, and honestly answering my question of “How are you”?  Was she needing reassurance and support, or something more?  Is she not really working her program? Should she be talking to her sponsor about such dreams? How serious is this?

I’ve been wondering, lately, if I’m suffering from Post Traumatic Stress Syndrome (PTSD).  I can easily travel from 0 to 60 within milliseconds, ramping up my anxiety, fear, and sense of doom when I encounter certain ‘triggers’. I still get a cold chill down my spine when I hear a siren’s wail.  When I open up our local newspaper, I still expect to see my daughter’s mug shot there, in the Crime Stoppers box that posts names and photos of individuals wanted for arrest.  When I drive past certain streets, parking lots, houses, hotels/motels, restaurants, I look carefully, half expecting to get a glimpse of Hayley or one of her drug dealers.  I have flashes of very disturbing images of my daughter injecting herself and the depraved, sordid living conditions of the crack houses where she lived for a year and a half.  I can see her abscesses and track marks on her arms, legs, feet, and breasts, and scenes of her physical and sexual abuse – all throbbing in my head – and get almost sick to my stomach.  Will I ever be free of these disturbing images?

Although support groups, like Al-Anon, help family members of alcoholics and drug addicts recover from the effects of the disease, it’s really not enough for me.  I feel emotionally scarred.  I don’t think I’ll ever be able to look at my daughter again, the way I did prior to her life in the drug world.

Post-traumatic stress disorder is a type of anxiety disorder. It can occur after you’ve seen or experienced a traumatic event that involved the threat of injury or death. People with PTSD often internalize the event and re-experience the trauma again and again in at least one of several ways. They may have frightening dreams and memories of the event, feel as though they are going through the experience again (flashbacks), or become upset during anniversaries of the event.  In effect, they are not only traumatized during the “activating” event, but every time something triggers a memory of the event. A traumatic event is an experience that causes physical, emotional, psychological distress, or harm and is perceived and experienced as a threat to one’s safety or to the stability of one’s world.

Here’s a quick definition of Post-traumatic Stress Disorder from Wikipedia:

Post-traumatic stress disorder or PTSD is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma.[1][2][3] This event may involve the threat of death to oneself or to someone else, or to one’s own or someone else’s physical, sexual, or psychological integrity,[1] overwhelming the individual’s ability to cope. As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress response. Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal – such as difficulty falling or staying asleep, anger, and hypervigilance. Formal diagnostic criteria (both DSM-IV-TR and ICD-10) require that the symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning.[1]

And, a more comprehensive review of the disorder and a more credible resource, can be found at the government’s National Institute of Health (NIH) website.

The irony of PTSD, as I’m applying it to an addict in recovery – and to family members who suffer from the effects of the addiction, is that alcohol abuse, depression, anxiety, and drug abuse, are all side-effects, symptoms, and complications from the disorder.  Yes – a drug addict in recovery can suffer from PTSD and be triggered to use drugs again!  The proverbial dog chasing its tail.

Here are the typical symptoms, treatment, and complications of PTSD, from the NIH:

Symptoms of PTSD fall into three main categories:

1. Repeated “reliving” of the event, which disturbs day-to-day activity

  • Flashback episodes, where the event seems to be happening again and again
  • Recurrent distressing memories of the event
  • Repeated dreams of the event
  • Physical reactions to situations that remind you of the traumatic event

2. Avoidance

  • Emotional “numbing,” or feeling as though you don’t care about anything
  • Feelings of detachment
  • Inability to remember important aspects of the trauma
  • Lack of interest in normal activities
  • Less expression of moods
  • Staying away from places, people, or objects that remind you of the event
  • Sense of having no future

3. Arousal

  • Difficulty concentrating
  • Exaggerated response to things that startle you
  • Excess awareness (hypervigilance)
  • Irritability or outbursts of anger
  • Sleeping difficulties

You also might feel a sense of guilt about the event (including “survivor guilt”), and the following symptoms, which are typical of anxiety, stress, and tension:

  • Agitation, or excitability
  • Dizziness
  • Fainting
  • Feeling your heart beat in your chest (palpitations)
  • Fever
  • Headache
  • Paleness

Signs and Tests:

There are no tests that can be done to diagnose PTSD. The diagnosis is made based on a certain set of symptoms that continue after you’ve had extreme trauma. Your doctor will do psychiatric and physical exams to rule out other illnesses.

Treatment:

Treatment aims to reduce symptoms by encouraging you to recall the event, express your feelings, and gain some sense of control over the experience. In some cases, expressing grief helps to complete the necessary mourning process. Support groups, where people who have had similar experiences can share their feelings, are helpful.

People with PTSD may need to treat depression, alcohol or substance abuse, or related medical conditions before addressing symptoms of PTSD. Behavioral therapy is used to treat avoidance symptoms. This can include being exposed to the object that triggers your symptoms until you become used to it and no longer avoid it (called graded exposure and flooding).

Medicines that act on the nervous system can help reduce anxiety and other symptoms of PTSD. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), can be effective in treating PTSD.

A number of other medicines used for mental health disorders may be prescribed. A doctor should monitor you if you take these drugs, because they can have side effects. Sedatives can help with sleep disturbance. Anti-anxiety medicines may be useful, but some types, such as benzodiazepines, can be addictive.

Support Groups

You can find more information about post-traumatic stress disorder and coping with a national tragedy from the American Psychiatric Association — www.psych.org.

Expectations (prognosis):

The best outcome, or prognosis, depends on how soon the symptoms develop after the trauma, and on how quickly you get diagnosed and treated.

Complications:

The most well known cases of PTSD are seen in war veterans. However, PTSD is not only caused by war. Any significant traumatic event or a series of traumas over time can lead to symptoms of PTSD. Some common causes are:

  • Child or domestic abuse
  • Living in a war zone or extremely dangerous neighborhood
  • Sexual Assault
  • Violent Attack
  • Sudden death of a loved one
  • Witnessing a violent death such as a homicide

When I Googled “PTSD in Drug Addiction”, it directed me to this website and a treatment option offered at some drug addiction treatment centers:  Eye Movement Desensitization and Reprocessing (EMDR). (NOTE: This site was informative, but I think it is sponsored by the Promises treatment centers that offer EMDR – just be aware that this is NOT an unbiased, clinically researched site.)  I seem to remember that EMDR was listed as a treatment option at Hayley’s treatment center, Safe Harbor, but she never received it.  However, I think that NOW, with Hayley well in to recovery, perhaps she could benefit from such specific treatment for PTSD.  Dunno.  I’m going to do more research.

Yes, I worry about Hayley suffering from PTSD and it becoming a trigger for relapse.  And, I wonder if I, too, am experiencing a version of PTSD and need to find a way to re-process and cope with the trauma of my beautiful daughter becoming a heroin addict.  Yeah – I know I do.

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13 Responses to “PTSD – Hers and Mine”

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Hi recovering Dad my name is Jacqueline I am a daughter who is also recovering from heroin addiction and I just wanted to reassure you that everything you both are feeling and experiencing is completley lets not say normal but it is exactly where you both are supposed to be I am 5 years clean and still have using dreams on occasion but what I really wanted to share was that my Mom had and still has anxiety and fear around my recovery and why wouldnt she I chose for a long time to do what I did and many times failed at help only to dash the hopes of those who loved me my mom got to the point where she was always waiting for the other shoe to drop. The first 3 and a half years I couldn’t share my struggles with my mom because it scared her and it took me acceptance to understand where she was coming from my point is that the key to us moving forward was expressing a what we wanted from one another and b what we could actually give so we stayed off certain topics and I relied on my recovery friends to support me on those subjects and no in the last year and a half things have really come full circle she is no longer scared of me relapsing she is no longer scared of what my addiction is capable of because she trusts in what I’m capable of and ya on days where everything is hopless and I’m in a mood I dont call my mom cause I know it freaks her out but I now can talk about using dreams, cravings and she knows its just part and parcel of my journey. Your daughter is practicing the principle of honesty in all her affairs which is awesome however she cant read your mind and if some things frighten you talk about it with her and have faith that her higher power is leading her exactly where she needs to go and truth is it isnt the dreams that will get her loaded it a choice and as long as she doesnt pick up then she wont get loaded! Good Luck and celebrate each moment your family is free from active addiction!

I simply want to mention I am just new to blogging and site-building and definitely savored you’re website. Likely I’m going to bookmark your site . You definitely have fabulous well written articles. Regards for revealing your blog.

This is a great post, Peggy and I really appreciate all the comments. In AA and Alanon we talk about addiction being a family disease and it is so true. As a parent, spouse or sibling of someone with the disease of addiction, how could we not be affected. But, the more important question is, what happens next? For me, alanon has been a true lifeline. Although my daughter is doing well, I still wonder and worry about her. I need to find ways for my love of her to be a positive force, not a negative one, for both of our sakes. So, I go to meetings, talk to friends, read Alanon literature and other insightful material, and try to take good care of myself physically and spiritually. Some days it works pretty well – some days not so good. Keep writing, Peg – you are honest, insightful and articulate. I appreciate you and your readers so much.

Hey Peg! I only have a minute here. So happy to hear about the 10 months!
Emily did EMDR. It did work.. I would like to try it myself..
But some people I am working with now, are highly recommending: http://www.clearyourmind.net
I may go to FL and a few sessions. I will be back .. have to run now.. but so happy for both of you! Hugs, kelly

Oh Peggy – I have been away for 6 weeks or so and am rejoicing reading about Hayley’s continued recovery. HUGE congratulations to her. To all of you for getting through this. You continue to be an inspiration to us all. As for the PTSD – I can well believe it. Hannah’s addiction has taken its toll on all of us. I mostly feel fine but at 33 have spots I never had as a teenager, have smoked more cigarettes than before (just quit) and have watched both my sister and my mother start a course of anti-depressants. Heroin is a family disease. There is no doubt about it. Love Nx

Oh yeah…. It takes it’s toll on us parents, for sure. Like Dawn, I have the blood pressure issues, NEVER did before. I am easily startled now, to the point that my daughters LAUGH at the situation, but also are beginning to make noise long before they pop around the corner into my office, because they don’t want to hear me gasp (possibly choke!) and jump out of my skin. I never used to be like that. Sirens make me cry. All sirens. Seeing the police cars on the side of the road and someone sitting on the curb in cuffs makes me cry. Misplacing something here in my home makes me have a complete internal panic attack – is she stealing from me again? Then when I find whatever I was looking for, the relief makes me cry. Phone calls while she is out start my heart pounding. The least little thing will make me emotional. I am tightly wound and vulnerable, for sure… You would think that the fact that she just celebrated 11 months clean would “fix” this for me. Not so. I am very very grateful, very happy, very proud of my daughter. I am scared shitless. Yep, I definitely think we parents get PTSD.
P.S. So, SO happy about Haley’s progress. My daughter talks about using dreams also. I try to encourage her to express it, get it out, own it and gain victory over it. And then when she leaves the room…. you guessed it…. I cry. I carry Kleenex everywhere now for convenience! 🙂

I can only add a little to what’s already been expressed in the comments so far…when my son came out of an 8 month long treatment facility he would tell me things like what Hayley told you about the dream. He was taught in treatment that relapse begins in your head with your thoughts and that he needed to tell someone whenever he had those kinds of thoughts or whatever and that by doing so it takes the power out of it. But, when you keep things to yourself is where they can grow and become dangerous. I think it’s good that Hayley is able to tell you about these things, it’s healthy for her to do so.

I’ve also done some poking around on the subject of PTSD as it relates to drug addicts. From what I’ve been able to gleen on EMDR, it’s a relatively new kind of therapy, but generally a well accepted form of treatment for PTSD….I’ve wondered about the possible benefits of this for my son as well. Hang in there…and good for Hayley!! She’s done really well…keeping the prayers going!
Kristi

Kristi – thanks for your comments. I think you’re right. Using dreams seem to be the ‘norm’ – and sharing them is probably healthy. I seem to need this reassurance – it’s helpful.

Lisa Najavits wrote a great book about trauma and addiction called Seeking Safety. You can find it at Amazon.com. It’s written as a manual for counselors, but it is very readable and has lots of handouts for clients that are helpful. You can also find lots of articles and resources at her site http://www.seekingsafety.org

I wanted to mention that some of the info you quoted from NIH website talks about treatments that ask you to recall the traumatic experience. I just want to clarify that in early recovery from addiction and in early recovery from PTSD the focus is on physical and emotional stabilization and learning to address symptoms. It is not a good idea to ask someone to recall the traumatic event in early recovery because this can be destabilizing and result in a relapse. Beware of counselors who don’t understand this.

I also wanted to make sure you know about the Recovery Moms 2011 survey Peggy. And to let your readers know that they can take the survey at http://www.recoveryhelpdesk.com (it’s only 5 questions and it’s anonymous).

So far 30 mothers have taken the survey (my goal is 50). The more who take the survey the more interesting the results!

Tom – I posted your request for participants in your moms’ survey on my blog.

Peggy, you need to work on your own recovery. Hayley will do, what she wants to, you can’t control it. If she is destined to relaps, then she will, nothing you can do about it. You can, however, work on your own codependency issues and try to stay focused on that. One day at a time.

well, let me see. my daughter started using not quite 12 years ago. my blood pressure, which until then had always been very low, around 85/50 suddenly shot up five years later to 275/195. I had two heart attacks (stress induced) and was diagnosed with severe anxiety disorder.

PTSD? Damn Skippy!! To this day, when I see her number on the caller I.D. I don’t want to answer.

I can be having a wonderful day, and contact with her puts me right back where I was years ago. Shaking, bowels rumbling, sick to my stomach, hot and cold flashes, on edge, ready to rip someone’s head off, temper wanting to flare but being held tightly in check.

Oh yeah. and they say it takes as long for it to go away as it did to get it. So, I figure IF I live long enough, I should be past the PTSD part in about 2018 or so.

Dawn – you’ve been in the trenches. Hope you can find ways to take care of yourself. Easy to say – – – but ultimately, it’s the only way we can recover from the devastating effects of addiction. Thanks for always laying things on the line. My journey will take the rest of my life.


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