Mental Health Diary: PTSD

woman journaling on table with coffee

Talkspace’s Mental Health Diary series provides an intimate, anonymous week-long look inside the lives of those struggling with mental illness. Our first diary entry is from a Digital Content Producer and Journalist coping with the lingering effects of sexual abuse. Female // 30s // Los Angeles.

Diagnosis: PTSD; Secondary: borderline personality disorder, OCD, depression
Occupation: Digital Content Producer; Journalist
Location: Los Angeles
Medication: Luvox, Abilify, (Prozac); Xanax as needed
Therapy: Two 90-minute in-person therapy sessions a week; Talkspace therapist; Bi-weekly trauma group therapy; Weekly DBT skills group
Health Insurance: Cigna; (Blue Shield)

DAY 1

7:45 a.m.
I get out of bed on the fifth alarm and throw on clothing to get out the door in 10 minutes or less to make it to work on time. Basic self-care stuff baffles me, so I do the best I can in jeans and some rumpled shirt that really should be washed.

9 a.m.
I’m at my full-time job and writing to my Talkspace therapist about not going to the grocery store because I have no idea how to feed myself and the whole thing is overwhelming. I’ve already checked on my cats via security camera twice — no catastrophes yet. I check on them at least every hour, making sure they’re safe, that my apartment didn’t burn down.

3 p.m.
I wake up from a lunchtime nap. I don’t really remember what I was working on before lunch. It’s all a blur. Things have a way of blurring together and I don’t remember what I was doing.

5 p.m.
My in-person therapist texts me and I get a jolt of panic. She is rescheduling my appointment from tonight to tomorrow. I am always afraid she is going to cancel my appointments and will abandon me.

8 p.m.
I have been home from work a few hours and I read Roxane Gay’s Hunger, which touches on trauma and the way it forever impacts the body, mind, and soul. It’s nice to know I am not alone, and I find this book powerful, vulnerable, and all too relatable.

10 p.m.
I’ve cleaned the litter box and taken my meds, but I can’t fall asleep despite the guided sleep meditation, which hilariously starts with a warning not to listen while operating heavy machinery.

2:13 a.m.
Wake up and go back to sleep.

DAY 2

6:40 a.m.
Wake up and go back to sleep.

7:35 a.m.
My first alarm goes off but I ignore it and the next one. At 7:45 I get ready for work, tired. I can’t forget to pay my rent, bring my recorder, or notebook. Rent, notebook, recorder. Rent, notebook, recorder, I repeat as I wash my face. I plug in the security camera, get down on my hands and knees to check on the cat under the bed. Fine. I throw on my sneakers and grab my bag and pet the other cat goodbye. I close and lock the apartment door, saying my mantra, “Please keep the cats safe, Lord.” I’m not religious. And then I am off, driving to work.

10:30 a.m.
I bite my nails and try to catch up on the news. I scroll through headlines, check my email, start a project, check my email, check on the cats, check Facebook, write interview questions. I’m all over the place and uncomfortable.

1 p.m.
I eat my food truck grilled cheese and fries, which I get so often the food truck people know my name. It comforts me and I am focused on work. Once I am absorbed in a task the anxiety falls away.

5:30 p.m.
I leave work 30 minutes early for therapy, an 1.5 hour drive across the city in traffic.

7:30 p.m.
Therapy. We talk about my fear of the grocery store and needing proper nutrients — or to be honest, any nutrients. We make a healthy shopping list for the store together. I struggle with the self-care — somehow high-level work tasks are easy, but simple things like brushing my teeth are difficult.

My psychiatrist missed my phone appointment earlier, so my therapist gets him on speakerphone while I list my symptoms from a list, my therapist filling in the gaps: trouble sleeping, flashbacks/weird dreams, panic/overwhelm, difficulty with self-care, isolation, avoidance, helplessness, dissociation, derealization, depersonalization, thought-blocking, slow cognitive processing, depression, racing thoughts, rage, lack of motivation/interest, agoraphobia, intrusive memories.

He adds Prozac to the Luvox and Abilify I am already taking. I close in on myself a little, feeling exposed and like a failure. I don’t like listing my symptoms because I am trying so hard to pretend everything is normal, that mental illness doesn’t impact my life. It does.

10 p.m.
I am home from therapy. My cats chase each other while I agonize over what to do. I decide to tackle some work. I’m too wired for sleep right now anyway. Plus I didn’t eat dinner. I should do that, right?

11 p.m.
Bedtime. My mind races. I want to keep working, panicked now. Work is how I avoid dealing with the harder thoughts and memories — I can drown them out with sheer willpower. I know I need to sleep though. I turn on the guided sleep meditation.

DAY 3

5:55 a.m.
I have a dream I slept through all eight of my alarms and it’s now 9 a.m. instead of 6 a.m. I’m confused, and it takes me a couple minutes to reorient myself to the actual day and time.

7:30 a.m.
I am afraid of the shower — it’s a trigger because of past experiences with my abuser — so I wash my hair and face leaning over the tub. I am ahead of schedule so I message my Talkspace therapist and pet the cats.

1 p.m.
I don’t know where the time’s gone since I got to work. I dissociate and lose small amounts of time regularly. I guess I’ve been writing and editing. I feel self-conscious in my shirt — it’s too revealing with its short sleeves and V-neck. I feel safer completely covered in baggy clothing.

3:45 p.m.
I’m feeling a lot of anxiety. I use the STOP skill — stop, take a step back, observe, proceed mindfully — and focus on breathing. I don’t know what’s wrong, but things feel wrong. I check on the cats just in case.

5:25 p.m.
The pharmacy can’t fill my new prescription without my new insurance information. When I try to log in to register online for a temporary ID card, it says the site is down for maintenance. I hate switching insurance. I’m privileged to have health insurance, and lucky I can work. Between my salary, insurance, and support from my parents, I can afford a lot of therapy, all of which I need to keep me stable. Everybody deserves this level of care. I just got lucky.

8:30 p.m.
I’m home, my head on my desk, cat curled up in my arms, my computer open. I sorted out my prescription and am facing a pile of freelance work. I hear this internal screaming and I feel the need to self-injure, but I urge surf, the technique of letting an urge build until it crests and recedes, without acting on my desire. I hear the screaming in my head, feel the distress. My foot jiggles under my desk, channeling the excess energy. I try to work a little.

9:34 p.m.
Bedtime, meditation app in hands. I don’t know if I took my meds or not. I’m having a hard time calming down.

9:43 p.m.
I move to the couch and pull my weighted blanket over myself, which helps calm down the nervous system, turning down the fight-or-flight response.

10:17 p.m.
Move back to bed. My thoughts are racing and I still can’t sleep.

3:40 a.m.
Wake up, go back to sleep.

DAY 4

6:05 a.m.
Wake up, start freelance work with my cat curled up on the desk.

8:50 a.m.
I’m at my job and writing two articles peacefully, the absorption leaving me anxiety-free for the moment.

12 p.m.
I decide I should cancel the meditation class I signed up for tonight so I have more time to work. I’m really anxious, again. I take some Xanax to slow down because I am feeling out of control.

4 p.m.
The Xanax makes me sleepy, so I sleep for 30 minutes during a late lunch.

DAY 5

6:00 a.m.
I lost an entire night because the Xanax knocked me out. I don’t remember much about getting home yesterday and I fell asleep fully clothed on the couch with the light on. I finally wake up when my alarm goes off. I am still tired, so I hit snooze.

7:15 a.m.
I have off from my full-time job today, a bonus company summer holiday, but I am still up early to work.

9:15 a.m.
I’m waiting on an apartment inspection and very anxious since I have to leave for therapy soon. I can’t leave until the inspection happens because I can’t risk the cats escaping because some strangers leave my apartment door open. My cats are my lifelines, and I pathologically obsess over their safety.

10:20 a.m.
The quick apartment inspection is over and I am still on time. I feel pretty good right now.

11:30 a.m.
I have my second 90-min therapy session of the week. We talk about how I can make a life worth living by doing activities other than work and therapy. I’ve been avoiding anything with people and prefer to stay in my apartment with the cats as much as possible where it’s safe. Apparently this isn’t what life is supposed to be like. The more ideas we brainstorm, the more overwhelmed I feel. My therapist says fun things will help me feel better about life. I know she’s right, but I am afraid.

1:15 p.m.
I stop at McDonald’s on the way to the doctor’s appointment I scheduled about losing weight. Oops?

2:30 p.m.
At the doctor’s office, I hand my doctor the medical excuse form for jury duty first. I testified against my sexual abuser in several court hearings, and jury duty is a huge trigger I can’t handle right now. Just going to the court to get the medical excuse brought on panic attacks and flooded emotions and memories last week. I can’t do it. She signs my form.

Then we talk about the weight issue. I’ve heard most of it before, about plant-based eating and shopping around the edges of the store, and tracking what I eat. My doctor is kind, helpful, and not shaming, so I appreciate this.

4:30 p.m.
Having a successful day so far, I decide to keep the momentum going — laundry. I haul the mini washing machine out of the closet, so I don’t have to go to the laundromat where there are people. I put the first load in the tiny washer, set it for 9 minutes and poke around the apartment, waiting. I hope to stuff all my laundry into just three loads. (The washing machine can only handle 11 pounds at a time.) Laundry overwhelms me and I just want to get it over with.

7:45 p.m.
I survive a trip to the grocery store! I get almost everything on the list my therapist and I made. I may not care about my body — to be overweight is to be invisible and that means creepy dudes leave me alone — but all the sugar I usually eat ramps up my PTSD. My therapist didn’t mince words. I can’t get better if I don’t eat better.

10 p.m.
The grocery store knocked me out and I haven’t gotten any work done. I read, take my new meds, now six pills in all, and go to sleep.

DAY 6

6 a.m.
The alarm goes off. I dream my abuser is allowed to come back to school and teach like nothing happened, like he didn’t abuse a student, and nobody believes me when I say he’s dangerous. The dream makes me tired and disoriented, so I reset my alarm for later.

6:30 a.m.
Alarm goes off. I reset it for later.

8 a.m.
Alarm goes off. I thought it was supposed to go off earlier. I am confused and a little panicked I can’t remember why the earlier alarm didn’t go off. Even when I lose time and forget something mundane, it’s still disconcerting. What else have I missed? I get up and shower.

8:27 a.m.
The work I am supposed to be doing isn’t due until midnight, so I give up, too tired to do anything now.

9 a.m.
I call in to my Dialectical Behavioral Therapy skills group, which teaches mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance skills for people like me who self-injure or otherwise struggle to manage emotions. When it’s my turn to share, I talk about working on the PLEASE skill — treat physical illness, eat, avoid mood-altering substances, sleep, and exercise — with my new healthy eating mission.

12 p.m.
Today marks three months exactly without self-injury. To celebrate I am getting a new tattoo, a color madala my brother designed. My tattoo artist works on my arm, covering cigarette burn scars in the process. It looks amazing when it’s done.

3 p.m.
I am back home and hungry. I eat a salad but I really want sugar. I don’t feel like doing any work, so I listen to an audiobook, Carrie Fisher’s The Princess Diarist, while playing a Frozen game on my phone. It’s my favorite combination of distraction skills to keep me calm.

7 p.m.
My parents call from the east coast and tell me about their dinner party. I tell them about my tattoo. They are proud of my 90 days without self-injury. So am I. We talk for over an hour.

10 p.m.
I can’t really remember what I had been doing, but I am tired. I roll over on the couch and fall asleep, still dressed with the light on.

12 a.m.
I wake up, think I should move to my bed or at least turn the light off but I turn over and immediately fall back asleep.

3:26 a.m.
I wake up again and this time get off the couch, feed the cats, put on pajamas, and turn out the light. It crosses my mind I have forgotten to take my meds (this happens at least twice a week) but I am too tired to care. I fall back asleep.

DAY 7

6:31 a.m.
Wake up again, fall back asleep.

7:40 a.m.
Wake up again, fall back asleep.

8:31 a.m.
Wake up again, check my email, fall back asleep.

9:30 a.m.
Decide I should stay awake to work. I will tackle my article first. I don’t know how to write the intro. I’m worried it will be terrible and I have no idea what I am doing, but I can’t avoid it forever, the deadline technically already past. I’m hungry, but I hate all the healthy food in my apartment, so I choose not to eat.

1 p.m.
I’ve squeaked out a draft of the article, though it took forever and it’s way too long. I realize part of the reason writing this article is so hard is because I’m writing about dating. Any mention of dating or sex brings up unwanted memories and past fears — intimacy means unwanted sexual advances and abuse. It always triggers me.

2 p.m.
I go to an individual meditation session. I tell my teacher how I’m trying to calm down my overactive fight-or-flight response while also trying to open up and express my emotions. We talk about skills that can help and decide it’s time to start a daily meditation practice. We’ll see how that goes.

4:15 p.m.
I stand in line at Starbucks to get my coveted midnight mint mocha frappuccino. It’s not on the healthy eating plan, but since I skipped lunch, there is plenty of room on the calorie scale.

4:30 p.m.
I Skype with my brother, sister-in-law, and young nephew. I don’t really know what to say — my life is so small and boring, so it’s a short conversation. I can’t very well talk about all my therapy or how the grocery store overwhelms me. I love seeing them though. I hope I get better at connecting and talking one of these days because I want them in my life.

7:45 p.m.
I realize I should shower. I can’t muster up the courage or the energy for that, so I wash my hair and face instead. I check my email before settling in on the couch to listen to a new audiobook, Jennifer Traig’s Devil In The Details, and play Frozen.

9 p.m.
I deem work finished for the day and I don’t have energy for anything else. I message my Talkspace therapist one last time, feed and water the cats, take my meds, and hop into bed.

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