PTSD and fear: why we never get off the couch

            I'm beginning to evolve out of a 2 year cycle with PTSD.  The trauma was long-standing but was triggered by marital abandonment, which sent me down a sad road that I couldn't overcome.

 

            I'm glad there's so much more therapeutic help available now…I have been sustained by 2x a week talk therapy, hugely aided by the new research in psychotherapy-assisted psychedelics.  Particularly ketamine, and I'm now beginning a psilocybin microdosing campaign to (hopefully) lock in the benefits of KAP.  More on that later.

 

            The assisted ketamine accelerated recovery by "dusting off", testing, and demonstrating untold neural pathways that had fallen into abject disuse as the manic rabbit hole of PTSD took control.  Among the characteristics I experienced under the sway of mania are:

 

• Loss of focus—I stopped reading, streaming movies, going to theater, going to parties.
• Anxiety around others—it felt as if my normal behaviors were producing unanticipated and often negative responses, so I stopped socializing in large groups, and blocked the majority of my community.
• Loss of ability to make decisions—I couldn't get any balls rolling, so I stopped.
• Inertia—it's a cliché that PTSD victims can't get off the couch.  Until you've been on the couch for a year or two, please, accept this description as truth.  For sufferers like me, I could not stand, roll off, crawl, or drag myself to my knees.    
• Anxiety—which triggers so many IFS parts that I've lost track, but the main ones are anger…and fear.

 I've read a lot about the role of the dopamine cycle particularly in regards PTSD.  As I understand what research is showing, dopamine is countered by cortisol, and after enough damage, a deficit is created.  The major activity trauma-induced dopamine deficit ruins is movement. You can't get off the couch.  You can't dance.  Often you can't reach for health or food or love.  

Fear is what I want to focus on in this post.  Fear of…what, exactly?  As I learned I found that fear was the part that showed up.  I spent two days trying to call a realtor to set up a meeting…and could not do it.  Fear is why I could not leave the PTSD couch.  If I moved, the last ties I had with my past would be gone.  Forever.  I would not exist.  Pull the blanket up around my chin and breath…that's the only option available to someone like me.

 

For two years, in the end, and I still struggle.

 

I appreciate the fear that I now see in books about depression---PTSD's fear stops everything else, and the result is depression.

 

Why?  Here's what I think happens in the manic cycle.  If I moved, I would fail.  I could not allow this.  So I didn't move.  I stalled.  And, compared to my previous active happy life, that made more fear.  More failure.  The well of depression has no bottom that I've discovered yet, but it's easy to swim further down into the depths.

 

If I act, I will die.  Now.  That's what PTSD believes. 

 

Fear manifested as "if I sell my home, I'll die."  It refused to negotiate and I could see that it was the driving force.

 

The simplest (and entirely impossible) way to overcome fear is to stand up.  Make a phone call.  Go for a walk.  Go out to dinner by yourself. And find joy when, after months or years unable to do so, you discover that you're actually touching the phone…welcome back, prisoner.  You have been missed, at least by the true, good, healthy you.