PTSD: Mental Illness or Nervous System Disorder?

I’m not a doctor or a psychologist, I just have cPTSD and MS (I like to overachieve). Trying to cope with and recover as best I can from both, I’ve started to wonder if PTSD is more a nervous system disorder than the mental illness it’s considered.

Hear me out on this…

Folks who don’t have PTSD tend to have a bunch of ideas about what it is, some of which aren’t the case for me. I’ve had intrusive memories, but I’ve never ‘been transported back’ to a traumatic incident and thought I was reliving it. Thank goodness! I always know where I am and when I am, but I’m easily triggered into remembering sights, sounds, and feelings that I’d rather not.

I have some habits that developed out of trauma that I don’t plan to ever give up. Every building I go into, I know where all the exits are shortly after I enter. I usually have a few escape routes planned. In restaurants, I sit with my back to a wall so I can see everything around me. I lock my car doors as soon as my backside touches the driver’s seat. I have a (legal) weapon in my bedroom, an alarm system, and a lot of dogs. Getting rid of these habits won’t serve me, I don’t think. The world is not a safe place, and no amount of therapy is going to convince me that it is. The people who think the world is mostly safe, as long as you don’t go wandering down a dark alley at night? They’re very lucky, and I’m envious.

I’m certainly not weak, or lacking in emotional intelligence. It’s not that I can’t handle life. I’m cognitively aware that the bad things are over, I’m not in danger at home or in danger from my husband. Logically, rationally, I know all of this.

My nervous system doesn’t believe it.

In the opinion of my nervous system, danger lurks around every corner.

This is why I wonder if PTSD is more a nervous system disorder than a mental illness. And I’m not shaming mental illness or saying there’s not a huge mental health component. But if I know that I’m fine and safe and the bad things are over and the bad people are gone…

Why doesn’t my nervous system understand?

When my PTSD is triggered, I don’t collapse into a puddle of hyperventilating tears. I’m not rocking back and forth in a corner, despite what many people think of when they hear “PTSD.” (I blame TV but that’s a whole other topic.)

“All” that happens is my sympathetic nervous system, or my flight-or-flight response, kicks into high gear instantaneously and physically hijacks me.

It’s not in my head. It’s in my body.

Cognitively, I’m completely aware that everything is fine and I’m not in danger. My nervous system is sure I’m going to die if I don’t flight or fight immediately.

My heart rate spikes, my breathing gets shallower, and I can feel adrenaline race through my system. I get a weird, hot pain in my back first. Then this hot, tingly feeling spreads everywhere. I feel anxiety in my belly, just below my rib cage. I don’t panic, but I get really irritable.

I’m very aware that what was done to me is over, I’m safe now, and it’s in the past. Unfortunately, my nervous system can’t make that distinction for some reason.

My nervous system is always on high alert and on a hair trigger. I’m super reactive to stimuli. An unexpected sound, seeing violence on the news or even in a movie, an unexpected change of events (don’t ever show up at my house unannounced, I don’t care who you are), a smell, or someone saying something to me innocently that contains a certain phrase or a certain tone…

My triggers aren’t few, I admit.

If I consider PTSD as a nervous system disorder, it makes more sense in some ways.

I don’t have symptoms; I have adaptations.

Our sympathetic nervous system is designed to keep us alive. I’m alive. My nervous system isn’t the enemy for just doing its job. I’m trying to be compassionate that it’s overzealous. It means well.

I think the problem is, the first almost 3o years of my existence, my fight-or-flight activated frequently. It’s not just the times when I felt my life was in danger. There’s only been a few times when my life was truly threatened. The times I knew I was in danger of being injured? Those are numerous.

I remember the exact incident that finally broke my psyche and Sparta-kicked me into the pit of PTSD. It was the night someone high on drugs and irrationally angry broke into my house. The most terror I ever felt was when I knew in my core that the person standing in front of me, this person who had no business in my home, was going to hurt me. When you know that someone has decided to hurt you, you just don’t know how bad…there’s a feeling you get in the pit of your stomach that I wouldn’t wish on anyone. That was the day I really understood how deep the pit of my stomach is. When you know bad things are going to happen to you at the hands of another, your focus shifts to just surviving.

I only felt that once in my life, and I hope I never feel it again.

Emotionally, I ‘shut off’ after that rush of terror. I reached acceptance very quickly and then completely detached from the situation. I felt nothing. It was like, because I knew what was going to happen, I didn’t need my internal alarm system screaming at me for the duration. My alarm system got very quiet. In fact, everything in me became very quiet and very still while I tried to figure out a way to get us to safety. My daughter was sleeping in her room, and I would do anything to make sure she kept sleeping and never knew there was a crazy man high on drugs in our house. It was the most numb I’ve ever felt, even to this day.

My therapist called it disassociation. I called it, doing what I needed to protect my daughter.

Even when I had to fight, because he went for my sleeping daughter, there wasn’t any emotion. There wasn’t any rage when I ran at him like an offensive tackle, or when I slammed into him and basically threw him down a hallway. (I’m big for a woman and he wasn’t that big of a guy.) There wasn’t even any emotion when my singular focus was killing him because he was now a threat to my child. No anger, no panic, just the calm objective of neutralizing a threat.

I had switched off early in our encounter. But when he muttered something threatening and went into my daughter’s room, she woke up terrified and then a different switch got flipped.

I calmly, numbly beat the hell out of him.

It was he who got to a phone first (he’d hidden my cordless phone after he gained entry to my house and took my cell phone soon after) and called 911. On me.

When the cops arrived, I was sitting calmly several feet away from where he was literally crying on the floor, ready to hit him again if he moved. I think the fight knocked the drugs out of his system. Or maybe I’d knocked the drugs out of his system. Either way, he was less high by the time the police arrived.

I think, after that godawful night, the only thing that kept me from ending up in the loony-bin was that I’d been forced to fight and I’d won. I didn’t feel it at the time, but I think that helped me feel a semblance of control. In the end, I ended up with all the power. I won the fight, I protected my daughter, the cops took him away, and I survived. I think eventually that helped me in immeasurable ways.

Even after that incident was over, I stayed emotionally offline to a large extent.

I was angry all the time and on a hair trigger. Every sound, every movement made me jump. I felt disconnected from everyone in my life, even my daughter, who I’d been willing to lay down and die for. Or kill for, if it became necessary. I couldn’t feel happiness, or joy, or empathy or compassion, or any kind of human connection or positive feeling.

We started therapy immediately. I was initially worried my daughter was traumatized, but the therapist was confident after several sessions that she remembered nothing. It was me he was ultimately more concerned about. I saw him very regularly and so did my daughter just in case she had things to process.

It was the next year that I was diagnosed with PTSD, and a few months after that I was also diagnosed with MS. I went through a lot of therapy and did a lot of hard work to be able to feel things other than anxiety and impending danger. I was doing well for a long time, I thought.

But I guess it never really goes away.

Even now, many many years later, just remembering that night as I type this…I’m safe at home with an alarm system and a 100 lb dog and a 180 lb husband four feet away. But even though I’m safe and I know I’m safe, my body feels exactly like it did back then before I switched off. Same sick feeling in my stomach, same adrenaline coursing through my body, same weird feeling in my chest, same headache, same elevated heart rate, same anxiety, same dread.

Excuse me while I spend a few minutes deep breathing to calm my nervous system.

When flight or fight occurs, it comes with a whole cascade of brain and body chemicals and neurotransmitters and I think all of that trained my fight-or-flight response to be on, all the time. Our brains and bodies are highly adaptable so maybe my brain and nervous system adapted to feeling threatened regularly?

My sympathetic nervous system is very good at its job. I’ve re-framed my adaptation of ‘hair trigger alert’. It’s not really a bad thing that I’m triggered to potential danger quickly and easily. I can just as quickly decide, “False alarm, there’s no threat.” But physically?

The physical effects take much longer to calm down, and that’s where the problem lies. After a fight or flight response occurs, it’s supposed to end. Mine doesn’t.

But if I view my PTSD as a nervous system adaptation, can I unadapt?

It seems logical to me that if my nervous system can adapt to always being ‘on’ to protect me from danger, I should be able to retrain it to calm down. That’s my hope anyway.

I’m trying to set aside times every day to just relax and breathe deeply. Well, I exhale. Apparently it’s long exhalations that activate your parasympathetic nervous system, which is the ‘brake’ that calms the sympathetic system down. (Also known as the ‘feed and breed’ response, which counters fight or flight.) I’m still doing yoga every morning, which is supposedly good for nervous system regulation. It sure has me doing a lot of prolonged exhaling.

I’m so over ‘toughing’ it out. Like I have anything to prove to anybody anymore. I don’t even have to prove anything to myself. I’m tough as nails. I’m resilient. I’ve got more grit than a bikini bottom sitting on the beach. So now when I feel my nervous system trigger an alarm, I make sure there’s actually no threat and then I start deep breathing and slowly exhaling until my system feels normal again. I’ve finally given myself permission to medicate when necessary because it’s not a sign of weakness.

It takes awhile to physically relax sometimes, but I’ve got nothing but time these days.

If my fight-or-flight system stays on, it’s stress. Stress triggers my immune system. My immune system is destroying my central nervous system. Stress is literally eating my brain stem and spinal cord.

It gives new meaning to the phrase, “I’m my own worst enemy.”

Just re-framing my reactivity into something positive has helped, instead of fighting against it or being upset about it. So now I think, ‘Thanks, Amygdala. I’ve checked it out and everything’s fine.” And then I commence the breathing with constant reminders to myself that everything’s fine, until I feel back to baseline.

I’ve also been reducing stimulation if I can. I can’t stop the aggravating traffic noise outside but I don’t have to turn the TV on as soon as I get out of bed in the morning. I’m learning to embrace the quiet when I can. I used to have the TV on all the time for background noise but now I leave it off all day. My poor brain has enough to contend with, just trying to stay calm and relaxed without beeping phone notifications, the TV blaring, sirens going by the house, one of the dogs chasing a cat through the kitchen, etc. I’m learning to be okay with quiet stillness.

I figure I have nothing to lose by switching my focus from working through my PTSD feelings to calming my sympathetic nervous system. The least I can do is try to give my poor amygdala a vacation after all the work it’s been doing for decades.

Fun update:

I started this post over a week ago. I had to stop several times, remembering. I’ve gone back to reread and edit several times, and I’ve taken lots of time in between each reread because not only is that the typical recommendation when editing, but it’s also been emotionally difficult. Today I’m doing the final read-through and I don’t feel sick or anxious at all reading through what happened all those years ago.

It’s like I purged the feelings about it by letting them drain into this post. Every time I reread it for editing purposes, the physical feelings became less and less and now they’re barely there at all.

That’s splendid news!

The downside is, because it seems to help, now I’m going to write allllllll the things. 😉

Click here for a list of PTSD symptoms.