Compass - Blogs - Love and the Invisible Injury

Caring for Yourself

8/29/2010 9:59:32 PM

One of the worst things I ever did was to devote myself fully and completely to meeting every need he had. And it’s the most cliche thing in the world, too, isn’t it? If you don’t take care of yourself, you can’t take care of anyone else... blah blah, I kept hearing sayings like that. But what did those people know? I had to do this. His needs came first. His needs were more important than my needs. If I didn’t take care of him, everything fell apart. He had something really bad happen to him, he deserved my care. Oh, there were so many reasons why I prioritized him over me.

I did it too, for years. It didn’t matter if I had to drop everything because he was having a bad day, I could just wake up early and get my work done before breakfast. This was back when his memory was really bad; I had these incredible lists of things that were going on in my life, things for my work, and things I had to remember for him. Which was everything he ever had to do. I remember the first time I forgot to remind him of something he needed to do for work; I was upset about it for days because I felt like if I wasn’t perfect than I was letting him down, and after everything he’d been through he deserved a competent caretaker. If I wanted to do something and he was having a bad day... well, I’d stay home and make it all better for him.

While I was doing that, I could not see how this was harmful. Looking back, I can’t even figure out how I was so blind to what I was doing to myself or how I wasn’t being the best wife I could be because I wasn’t taking care of myself. It never once crossed my mind that maybe I should have eased up on myself.

I learned this lesson the day he got his diagnosis. (Which should really be a whole blog topic on itself, come to think of it.) We went to the doctor, they told him he had PTSD, they told us what would happen now, we went home, and I promptly collapsed on the couch for three days. It was as if now that I knew that someone else was going to take care of him, my body and mind could finally take the break that it had so desperately needed.

This revelation didn’t come immediately or anything like that, but I did come to realize that I could not shoulder the burden of anticipating his every need and devoting myself completely to caring for him. I started to leave him to go out and do things that I wanted to do. I started slowly releasing responsibility to him for taking care of many of his own needs. I started saying “No.”

“No” was a big change in our relationship. It took some time to find a balance for that. At first he felt like I was rejecting him, then he felt like if I said no to [insert whatever need here] that he shouldn’t ask me for anything else. And I certainly felt really guilty about it at first, I think I may have even taken it back a few times. We are still working at it, but we’ve got it down to a pretty good system where he’ll communicate his needs to me openly, but I’m going to prioritize myself and sometimes I’ll say no.

This doesn’t happen often, maybe only once every few months. But it’s got a big effect. Doing things that I don’t want to do has a lasting impact and makes me unhappy and resentful. When I do things as I am willing and able, I can do them with a happier heart. It means that everything I do is better.

And I take care of myself, even if it comes at his expense sometimes. If he doesn’t want to go out and would be happier if I stayed with him... well, sometimes I’m going to still go out. If he needs something and I have work that has to be done by tomorrow, then that’s what I’m going to do.

After I reread what I just wrote, I thought to myself, “I’m making myself sound self-centered and selfish.” But if nothing else, I want you to understand that it is so much better for him now that I’ve done this. I’m a happier person, which I’m sure makes me nicer to be around. Most importantly, everything I do for him is being done better. I think when I was running myself into the ground I was constantly operating at 85%. Now, even though I may not do everything all of the time, when I’m being a caretaker I’m going at 100%, and that more than makes up for anything I choose not to do.

I can tell you my story, and I can dispense advice, and I can try and convince you to take care of yourself. But unfortunately, I think this might be one of those lessons that everyone has to learn the hard way. I’ve yet to meet a wife who says, “Oh, yes, it was easy for me to find the perfect balance of caretaking and me time; I’m so glad that everything has worked out so well.” What about you? Is this a lesson you have learned, or is it is one that you are still learning? How do you and your spouse deal with it when you need to prioritize your own needs?

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"But he looks fine!"

8/15/2010 9:09:50 AM

The very nature of the “invisible injury” makes it very hard for some family and friends to understand. Had he come home with an injured limb, I have no doubt that the people we know would have been kind and patient with his limitations. But because there is nothing visibly wrong with him.... well, they just don’t get it.

It starts with the people who don’t believe his diagnosis because he doesn’t act how they imagine a PTSD veteran to act. They fail to understand how much preparation and recuperation goes into “seeming fine”. Meeting someone for lunch can take a day and a half of worrying and wanting to back out. The actual lunch itself requires a few hours of great mental discipline, ignoring physical pain, and at least one panic attack in the restroom. The aftermath includes two days of exhaustion. All of this work on his part just to see someone for lunch means that they’ve gotten everything he has to offer for the whole week; he’s not going to be of much use around the house or any fun with me.

Sometimes when he is talking about the PTSD-related things that are going on with him, he hears “Don’t worry, that’s no big deal, everyone does that.” What a dismissive thing to say. Yes, that’s true to an extent. Everyone forgets things sometimes, everyone has off days, everyone gets scared. But most people can still live a normal life with those problems. When he is talking about how he hasn’t left the house for a week, it doesn’t help to hear about how you didn’t feel like doing anything either and watched movies all weekend. He wants to go out but experiences a panic attack when he does. When he is talking about forgetting things, your story about losing your keys isn’t the same. You were late to work that day, he can’t hold a job because he can’t remember how to do one.

I think the people are trying to make him feel better, that his problems aren’t as bad as he thinks they are. But it doesn’t make him feel better, it makes him think that they believe that he is just a whiner for complaining about problems that everyone has, or that they look down on him for not being able to handle things better. I promise, his problems are not like “everyone’s.”

It is frustrating that some of our close friends and family members don’t believe us when we tell them his issues. Just because he works so that his symptoms are not on display doesn’t mean the diagnosis isn’t real. At no point did we think to ourselves, “Hey, wouldn’t it be fun to make up a medical history and share it with those closest to us in an effort to dupe them!”

We try to manage his problems the best we can. And most of the time it works, and he can hide it from the world. We aren’t asking for pity or special recognition; we just want others to not take it personally when he cancels on plans at the last minute and to refrain from making comments that minimize or deny his problems.

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Triggers

8/5/2010 8:47:58 PM

The day I realized something was wrong with my husband was because we got lost. It took about five years until someone told us that getting lost was one of his triggers.

A trigger is something that exacerbates PTSD symptoms.They share a common element with the traumatic event. When the event happened, the sensations the person experienced fragmented and got stuck in short term memory. So later, when the person has a similar sensory experience, it calls up the feelings associated with that memory immediately. The person might not even recognize that they are having that sensory experience - we often are not aware of every scent we smell or sound we hear. For that reason, triggers can be hard to figure out and don’t always seem logical.

Counsellors or therapists who work with PTSD patients can help identify and understand triggers by seeing broader patterns that the person might be too close to see. We had that experience in a doctor’s office once:

“And when did you get hit by that IED?”
“October.”
“And when did [insert traumatic event] happen?”
“October.”
“And you said you had a really hard time last year and weren’t able to leave the house... when was that?”
“October.”
“And you said you have been having trouble keeping it together over the last few weeks. What month is it now?”
“Oct.... oh.”

Other triggers can replicate an experience. Getting lost is a trigger for my husband because it evokes the same feelings that he felt when he was lost in Baghdad. Smell can have the deepest imprint; the scent of oil is another trigger for him.

Every trigger does not lead to the same reaction. October leads to depression, getting lost causes anger and panic, and oil makes him want to vomit.

Understanding your triggers gives you power over them. Sometimes you can avoid them. We are always going to pay someone else to change the car’s oil. He doesn’t go to crowded, busy places. But when you can’t avoid them, you can anticipate them and prepare for it, lessening the shock. Blood is another trigger for my husband; he’ll pass out if he’s surprised by it, but when I fell off my bike, I was able to go home and say, “I’m bleeding. You need to be prepared for that and help me.” Understanding and anticipation can make all the difference in the world when your goal is to just function normally in public. But first you have to identify what these triggers are. How long did it take you or your loved one to be able to understand and deal with their triggers?

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