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I am very close to finishing a course of psychotherapy, provided for me by my local Talking Therapies service. This therapy has come at the end of what has been a very challenging year, for reasons I never predicted.

I have blogged in the past about my struggles with depression and anxiety, my complex grief journey, and my determination – indeed my need – to normalise the topic of mental illness. These things have been perhaps predictable parts of the course of events since my brother Ian’s suicide in 2011.  But on hearing the term post-traumatic stress, thoughts are taken beyond the relative commonality of depression and anxiety to something more complicated. I am not suggesting for one second that depression and anxiety are straightforward, but they are – sadly – common.  Conversely, PTSD feels like something very far removed, needing to be born out of specific and – by its very nature – unusually traumatic events.  Most of us would not want to entertain that in our lifetime we might have to deal with such intensely traumatic events that we are made vulnerable to developing PTSD.  In many people, the condition might feel so removed from their world that the only context to link it to is service personnel who develop the disorder following the horrors of active service – something which most people would not expect to come near to experiencing unless the armed services was their career choice.  PTSD and suicide rates among ex-service men and women has recently been highlighted by a very prominent social media campaign, and quite rightly so. There is a long discussion to be had about how we as a society have let down these men and women who have experienced such trauma when serving their country.  However, PTSD can also be experienced by other people who have been subject to intense or prolonged trauma.  People like me.

My symptoms began about a year ago, with auditory hallucinations. A door knocking, a bell ringing, someone whistling or saying hello. This began in the weeks after the fourth anniversary of Ian’s suicide, and luckily I linked these two things. I assumed that my brain was just a bit overloaded and felt that I didn’t need to panic unduly. In fact, looking back I was surprisingly calm and accepting. I told a couple of people and their (very understandable) response was to question whether the noises were actually just external and I was mistaken. I can only say that the noises were definitely coming from inside my head. It was the most odd feeling; unlike any other sensation of hearing that I’ve ever experienced, before or since.  This went on for a couple of weeks before other symptoms appeared which I couldn’t feel so calm about; a feeling of intense fear with no cause – frequent, horrific and gratuitous nightmares – hypersensitivity to noises and sights – a constant feeling of vulnerability in my relationships – “flashbacks” and intrusive, persistent thoughts about events. Some of these events which I had flashbacks to, oddly, I had not even been present during or witnessed directly (but on analysis, I realise I have imagined with painful frequency over four years, and in intricate detail).  I began to feel exhausted and constantly on-edge with fear and worry.

I went to the doctor and she mentioned PTSD. I thought firstly that this was an unlikely diagnosis as, after all, I did not witness Ian’s suicide, I did not find his body and I did not even find out about his death until hours after his body had been taken, safe and cared for, to the mortuary in his local hospital. I didn’t feel I had been through anything which meant I should be traumatised in this way.

Through the process of therapy, and after a long year with some all-time lows, I have learnt that my trauma comes not just from Ian’s suicide, but from years of trying to keep him alive prior to him dying, when he was desperately ill at points. And ultimately from my failing to do this.

Through therapy I have been encouraged to think through the effect that this stress has placed on me and I have been encouraged to revisit the traumatic times in order to process them – visiting Ian in hospital every day for a month after he had attempted suicide in 2004, witnessing his self destruction through heavy drinking, taking repeated phone calls over the years from him in varying states of distress and feeling completely helpless and powerless. I have finally come face to face with the enormous weight of responsibility which I felt for many years, due to Ian’s secrecy about his illness.  I was in my early 20s when Ian’s illness began in significance – barely out of childhood really – and I have had to be honest about the knock on trauma which his wish for secrecy has caused me in the long term.

Through therapy I have realised that since Ian died, and particularly in the last year, I have felt constantly scared and fearful about both rational and irrational things, and this is what characterises the feeling of PTSD; a state of perpetual fear due to events which the brain has not properly processed.

I have been encouraged to look at my ultimate fear that someone I know may die by suicide again, and I have examined the consequence of this fear – that I have not always been able to put in place sensible and appropriate boundaries in friendships. My default feeling in friendships, and even with acquaintances, has been that of an enormous pressure to help people who are struggling.  I now understand that, while this in itself is not necessarily a dreadful thing, it is born out of fear which means that if I am not able to help someone then I feel a personal responsibility for this.  My task now is to work on changing these patterns of thoughts and feelings, and allowing myself to feel that I do not need to ‘save’ anyone.  It is not my job to save.

My purpose in writing this blog is to clarify my own thoughts and learning which have come from my therapy, and also to try and shed some light on PTSD, which is a scarcely understood condition and one which I think carries – like many other mental health problems – a huge amount of misunderstanding and incorrect assumption.  Basically, PTSD is about fear. Raw, unprocessed, intrusive fear which stems from unusually traumatic events.  I am grateful to have been given the opportunity to understand this – and myself – better.

That’s all for now.

Louise x