Sometimes ghosts from my past come to visit. Ghosts: spectral remnants of pain, disappointments, traumas, fears, grief. And those ghosts can be big and scary and overwhelming. It’s as if I’m trying to sail a boat and all of a sudden those ghosts appear on deck and work to scare me more depending on which direction I need to steer my boat. But through therapy I have come to know how to recognize the ghosts and when they make their return. And through therapy and my self study journey I have come to understand that those ghosts can’t hurt me anymore especially if I choose to not allow them to hurt me. They are past feelings that have no basis in what is before me…what’s in my “present”.
My mind and body are exquisitely designed to keep me from harm. And my mind and body are exquisitely designed to learn from experienced harm so that I am protected from being harmed again. This is a trait we all share and has helped humans evolve over millions of years into the exquisite organisms we’ve become. But with PTSD my mind and body have been supercharged into hypervigilance. Genetics? Maybe. The age at which trauma occurs? Evidence is mounting. But some traumas and harms past a certain threshold throw certain people into the cascade we now know as PTSD. And once there those PTSD ghosts can lay dormant without our having any knowledge of their existence as our minds and bodies are exquisitely designed to completely block traumatic experiences from our consciousness. It’s the ghosts that appear for no apparent reason and from nowhere that exert the enduring legacy of our traumas. And the feelings those ghosts create are very uncomfortable and disconcerting. We’re left feeling like we’re losing our minds or going crazy. Substance abuse and/or suicide seem like the only way out (and I absolutely mourn for all our brave soldiers who daily live with this Hell…a terrible thank you gift from politicians who send our children to fight in foreign lands in the name of democracy and freedom and world peace…peace through more violence…state sanctioned violence and killing…bullshit!!!).
I consider myself lucky as therapy has allowed me to know I have ghosts. And therapy has even given me the power to see the faces of my ghosts. I know my ghosts. Are there more ghosts I don’t know about? Likely. But I know some really big ones. I recognize them. Do they creep in and visit without my knowing it? Yes. But it’s the feelings they evoke that let me know they’re visiting again. The feelings lead me to their faces. And their faces let me know what to do about their presence. Will they ever disappear completely from my unconscious mind? Likely not. But their occasional return allows me to learn from them. The ghosts can continue to be lessons. They may be scary lessons but they can’t hurt me. They appear, I let them run their course, I let them dissipate, and then I gain insights. But what was then isn’t now. What happened in the past is not happening now and likely will never happen again. It was a point in time. And my “now” can never be “then” all over again. It’s as if PTSD can be my superpower if I deem it so. PTSD can also be my undoing if I allow that direction to prevail. PTSD as a superpower? Yes, absolutely, as PTSD can bring me knowledge and insights that few will ever know (thankfully) and those insights can benefit both me and society as a whole if shared carefully and properly.
Two years ago I suffered a devastating mental health crisis which led me (back) to therapy. At the time (and obviously to this day) I used my blog to journal my healing journey and I was astounded by the number of student dentists who shared with me their struggles with mental health issues. And I vociferously encouraged and empowered those students struggling with mental health issues to seek help. And then the world turned upside down due to COVID-19. So many students living in isolation (some not in the best and/or safest conditions) and we had a crisis. And that crisis didn’t end when we returned to some semblance of an in-person educational experience.
Through it all I wanted to be and do more for my struggling student dentists. So in the summer of 2020 I earned a certificate in Psychological First Aid from Johns Hopkins University. At the same time there were murmurings of a student run mental health and wellness committee forming which needed a faculty adviser. And soon after that a key student in the nascent mental health and wellness committee approached me and solicited my opinion regarding the potential structure of a mental health and wellness committee. The following is what I proposed to that student and published within my blog on October 17th, 2020:
* I believe we need to empower and maintain a student run mental health and wellness committee that can be in constant communication with their student dentist colleagues.
* I believe we constantly need to nurture a community-wide belief within our dental schools that suffering with mental health issues is OK and NOT a sign of weakness.
* I believe we constantly need to educate/re-educate student dentists regarding the signs and symptoms of mental illness.
* I believe we need to empower student dentists to recognize mental health issues within themselves AND/OR within their student colleagues.
* I believe we need to constantly provide student dentists with up-to-date mental health information/resources. This can include but not be limited to: web addresses that provide relevant and pertinent information and help; phone numbers that student dentists can call for help; utilization of on-campus organizations that work to promote mental health (such as Active Minds); utilization of on-campus counseling centers; pamphlets; flyers; etc.
* I believe we need to train several student dentists to be able to intervene in a mental health crisis (Johns Hopkins University offers a certification in Psychological First Aid which allows practitioners to help triage and stabilize patients who are in the grips of a psychological crisis).
* I believe we need to empower faculty and staff to recognize mental health issues within our student dentists.
* I believe we need to train several faculty and staff to be able to intervene in a mental health crisis (Johns Hopkins University’s Psychological First Aid).
* I believe we need to train and empower student dentists to contact designated, trained, and trusted student colleagues, staff, or faculty during a mental health crisis.
* I believe student dentists need a safe forum to gather to discuss mental health issues especially with fellow student colleagues. This forum should empower students to believe that they are not alone, that they are not suffering in silence, and that others are suffering alongside them. This forum should be a community where suffering students can learn to share and trust each other and work together to overcome the challenges of mental illness. This forum can also include outside-of-school activities that nurture mental health such as group nature hikes, outings, etc.
Fast forward to the present, a community/group effort, empowered by highly motivated students, staff, and faculty, has produced a functioning and thriving mental health and wellness committee: MUSOD’S Mental Health and Wellness Committee. And monthly we have speakers giving mental health and wellness presentations to the entire dental school. And those presentations have been very successful.
So why the hell am I saying all this? Cuz I implore any and all who are suffering from anxiety, depression, panic, or trauma to reach out for help. Please don’t suffer alone in silence and isolation. Anxiety, depression, panic, and trauma are insidious foes. They make you feel defeated and this is only heightened in over-achievers also known as student dentists. REACH OUT FOR HELP! Mental illness is an illness like any other illness that knocks us away from living life to its fullest. I go to my MD get my asthma treated when it knocks me on my ass. And now I have the strength to go to my MD and my therapist to have my panic attacks/PTSD treated when they knock me on my ass. I should not be and am not afraid/embarrassed to admit that I am suffering from a mental illness. And I wish that folks would not feel stigmatized by our society’s views regarding mental health. I am Danish and Denmark is empirically the happiest country on the planet. Denmark’s happiness comes from many different sources but Denmark doesn’t stigmatize mental illness: Denmark embraces mental illness and treats it effectively and its people are empowered to live wonderful stigma free lives. We Danish Americans are arguably one of the smallest ethnic minorities in the USA because ya gotta be nutz to leave Denmark.
So, we all got shit going on. Sometimes we can handle it. Sometimes we can’t handle it (and that’s OK). Sometimes things happen that tip the scales toward not being able to handle it (and that’s OK too). Sometimes our actions toward others can take someone’s precarious situation and turn things in a bad direction. Maybe we just need to remember to be nice to people. Or maybe we just need to be respectful toward others. We don’t know the burdens that people carry. And our actions can make or break someone’s day. Kind words and a smile are healing gestures (or are at least comforting). Even our body language can make or break someone’s day.
It’s OK to have shit going on. And it’s OK if the shit overwhelms us. There are really good people out there who can help us when the shit gets too deep. Reach out for help. Life is worth living well and we all can work together to achieve a life lived well. I can’t say it enough: I encourage anyone who’s suffering from anxiety, depression, panic, or trauma to seek help. I know how stressful dental school (and life) can be. And I have had to live through losing student dentists and colleagues to suicide. There’s a lot of life worth living. And it’s good and right to seek help and live to see beautiful todays and tomorrows.
WAGA and WAHEO: We All Get Along and We All Help Each Other. Namaste.
I am so very blessed to finally be on this PTSD healing journey. So many things aligned for me to be able to finally heal (and there’s a good chance that I will never get another chance to heal like this). Unexpected? Absolutely! But the Good Lord usually just laughs at any “plans” I develop. Nope, I am not in charge of my journey on this crazy spaceship we call Earth. And usually the BEST things in my life have arisen from the unplanned detours. I’m ridin’ that wave and whatever that wave does is any mortal’s guess.
That said, this is no easy journey. I am having to descend into the depths of Hell so I can heal my broken parts (under the guidance of a gifted psychologist…wow, sometimes she’s like a dragon slayer or a witcher the way she goes after the demons in my mind…more on that a different day). And those broken parts in me aren’t much interested in being fixed. In so many ways my spinal fusion and double carpal-tunnel surgery was SO much easier because all I had to do was lean back and let my body drive. Not so with this mental stuff. This is some of the hardest work I’ve ever done (but if I can survive and persevere through the forking Hell known as dental school then there is a good chance I’ll survive this PTSD healing journey).
I am no expert on mental illness/wellness but I’m trying to make sense of things within me the best I can. For my PTSD (I wager this is the same for many suffering from PTSD) it seems like there was an initial trauma event that triggered emotions. You might not even realize that that particular incident did or meant anything (I didn’t). Maybe our brains downplay the event or even block it from consciousness (my brain totally blocked the event!!!). But that damn event is always there lurking behind a veil within our unconscious mind (case in point: ME!!!). And that damn event can wreak havoc without our even knowing it as the emotion/s from that event can rear its ugly head in so many different and potentially damaging ways.
I am going to use fishing as an analogy for my PTSD because I feel like my initial trauma event (and its emotions) was like a fish hook or a fishing lure. Often times when fishing I use several fishing rods at once and I feel like my initial event/hook was something I casted out into the lake (unconsciously) and that hook just sat in the water quietly doing nothing and eventually just became forgotten. Over time I casted out lines from several other fishing rods and those lines were definitely within my conscious world and were even productive (I think of this as my ability to live my life and build a semblance of success). But that one forgotten line just sat there doing nothing but waiting for its moment.
As time moved on I had a few more trauma events after that initial event and I think of those events as weeds and/or snags on the bottom of the lake. They grew and multiplied but they were never really a problem. I just kept fishing and catching fish with my productive (conscious) fishing rods. In other words, I was living my life with some semblance of success.
Then the storm: the big trigger event that activated my PTSD. And now that quiet and forgotten hook went berserk. It was like an unconscious out-of-control reeling in of that forgotten hook followed by an unconscious wild/out-of-control cast of that hook with no particular aim. And then that crazy hook dove deep. And as that hook dove deeper it grabbed onto and dislodged multiple weeds/snags which led to even more furious reeling. Finally that weed and snag filled hook lodged in an immovable snag (like a submerged tree branch). And then that hook was STUCK!!! In other words, my PTSD had now come into full consciousness and it was not going to release without HELP!!!
And now I am receiving help. My psychologist is helping me to get that hook dislodged from that submerged tree branch. My psychologist is helping me to clean all those weeds and snags from my hook. And my psychologist is helping me to learn ways to safely cast that hook again. It’s ridiculous for me to think that that hook will go away for good. Far from it. That hook will likely be with me forever. But with care and training and retraining my hope is that I will never get that hook snagged into anything ever again. But even that may be ridiculous. So should that hook become snagged again (likely it will) my psychologist is teaching me ways to dislodge that hook effectively.
I am a work in progress. I am a glorious mess. But I’m doing the work. And I will continue to do the work. Stay tuned…
I have PTSD/Anxiety Disorder (the Americans with Disabilities Act classifies PTSD as an Anxiety Disorder). And how do I know this? After a really big/acute exacerbating event in the not-so-distant past I finally sought help and received a mental health diagnosis (but only after YEARS of chronic suffering). In that moment I finally admitted that something was not right and I wanted/needed to feel better. I first reached out to my MD who prescribed a medication. Then I went to a gifted therapist who really helped me to do the TOUGH work of healing. And it’s tough work. And it can be painful work. And it is sometimes endless work. And, for as much as I HATED dental school I might be tempted to redo dental school before facing my inner demons (umm, no, just kidding, because dental school probably exacerbated my symptoms HORRIBLY). But you might get the point: overcoming mental illness can be hard work. To make things even harder our American society has a hard time accepting mental illness. We who are suffering are labeled as weak, pansy-asses, freaks, dangerous, unworthy of respect, unworthy of trust, unworthy of responsibility, etc. I would argue that to risk healing is WORTH THE REWARD!!! To feel a semblance of life and wholeness again is so worth it. And I would argue that people working through mental illness are some of the strongest people on the planet due to all the issues we must juggle at every moment of every day. Sadly, though, many people are unable to start the journey toward healing and that is a horrible reflection on the state of our American society.
So how did I develop mental illness? Probably many factors led to and/or predisposed me to its development. Was it my multiple head concussions coupled with a traumatic brain injury where I lost all feeling on the whole left side of my body (akin to a stroke) that gave me a susceptible brain? Maybe (and the research jury is still out on that one). Too much gluten before I knew it was poison for my body? Gluten is known to cause tremendous anxiety issues. Family history of anxiety and depression? Another big maybe. But through therapy I was led to a buried life event: I was wrongly accused of causing a medical mishap that led to the death of a patient (that news was delivered to me by a powerful person within an office with the door closed…). Kinda tough for a young person to handle. And only now, decades later, do I remember how HORRIBLE that was. But I totally blocked it out and mental illness has a NASTY habit of being caused by a repressed memory/emotion. And so I bumped along through life and certain events would trigger a response within me (such as when a colleague pulled me into my office and threatened me with bodily harm…yep, blocked that one out of my mind for MANY years and started having flashbacks about it this morning and, sadly, I have FREAKED OUT for so many years at just the thought of being alone in an office with someone…especially someone of power). And I’d wonder what the hell was wrong with me, suffer with it, and keep telling myself to man up! Well, I believe all those exacerbations only led me to bigger and darker paths. And unfortunately that tends to be the trend for so many people with mental illness.
So what is mental illness/wellness like for me? Everyday I feel like I’m putting on a bullet proof vest, a helmet, a rain suit, and putting up an umbrella (sounds extreme but I guess one just gets used to things). Daily I do my mental wellness exercises. I read a lot of psychology books. I try to be physically active and in-shape. Oh, and big reveal here…I consume almost no alcohol (oops, I guess I talk a big show) and I can sometimes go MANY months without an alcoholic beverage (and when I do drink it’s only a small amount). Sometimes I long for when I was “normal” (and that can be counterproductive). And I take my medication (fluoxetine) and regularly visit my therapist.
OK, so I’m doing the work, but what does it REALLY look like? Please take a look at the picture above. I love LEGOS. I’ve built LEGO models my whole life. LEGO models come in MANY pieces. And every LEGO model has an end point…it’s a whole and complete object. And sometimes I liken the LEGO endpoint to how I was when I was “normal” and I’m putting the LEGO pieces/pieces of my life back together. And sometimes I liken the LEGO endpoint to a new direction for my battered life where I am putting pieces together to build a whole new and beautiful life for myself. Now, every LEGO model has all of its pieces organized into individual bags. Each bag represents a new part of the build. And as the build progresses subsequent bags are opened and the new pieces are organized and utilized to build toward the endpoint. I liken this to how mental wellness treatment is always ongoing. We reach plateaus. We feel good for a while. But then the healing journey begins anew as more wounds are revealed and more building (or rebuilding) ensues.
Recently I suffered an acute exacerbation of my PTSD/Anxiety Disorder. Knowing my diagnosis has helped me to know more about myself. And knowing my diagnosis has helped me to identify my dark alleys and triggers. But I am still a work in progress. I may not know all my dark alleys and triggers. And no matter how hard I try I am sometimes acutely thrown into situations where I have NO control over how the situation unfolds. This recent exacerbation was one of those bad days for me. The bad days are few and far in between for me (I’m going on two years now). And these bad days are usually triggered by other people’s actions toward me. I don’t blame people for how they react to me or treat me. I am a unique person with unique needs and I don’t react to some things the way most folks do (and SO many people do not understand nor can detect mental illness). Sometimes people with confrontational styles can be very threatening to me. And in these situations people usually just end up getting more and more pissed at me because my defense against threatening people is to freeze up: I am unable to speak, I am unable to move, I am unable to do anything other than look the person in the eye (BTW, fight, flight, or freeze is very real). This can be very upsetting for many people (it can make people more angry which leads to greater threats hurled at me and all this makes me freeze up even more). But in a threatening situation would my adversary rather I freeze up or go into fight mode? Fighting accomplishes nothing and only makes things worse (I did manage to get a Master’s Degree in Dispute Resolution many years ago and we mediators try to practice what we preach when we can). And there is a good chance that all the stress I’ve been under lately only lowered my threshold for a bad moment (this is a very real thing for people with Anxiety Disorder). Big confusing life changes can also predispose me to a bad day (and there have been some big confusing changes in my life recently). I know I have some damage control to do but losing control and ending up in a full blown fight would require much more work.
So I’m having a tough weekend. I am working diligently through all of my mental wellness tools. But even with all that I am having to take a medical leave of absence. It’s a tough pill to swallow. But this is how our society deals with mental illness. I am grateful that I have many resources to help me through this tough time. I have great friends and I have a great medical team. And I have LEGOS (please see the pictures above). LEGOS can be therapeutic. Sorting and arranging the jumbled mess of LEGO pieces reminds me that I am a glorious mess who is a work in progress. All of those LEGO pieces represent the pieces of my mental wellness waiting for something good to happen. And soon I will be building those pieces into an object, a something, a something that’s new, a something that will be better, a something that is closer to being whole.
Please know that mental illness can be treated and transformed into mental wellness. Healing is awaiting. And on this World Mental Health Day (and everyday) I am committed to letting people know of my journey and my message that through a mental wellness healing journey ANYTHING good is possible.
Doc's Writing Refuge 