What Induces Fear?

[Nika]

i'm curious. how does 25mg of zoloft help severe ptsd? how often would you say that you experience flashbacks while on zoloft compared to the times you weren't? the reason i ask is because i'm taking fluoxetine for the depression aspect of my bipolar, but my psychiatrist said that it can also help my ptsd (in addition to the topamax i take). i have several flashbacks a day, but am hoping to cut that down to 2 or 3 a week.

25mg/day was plenty for me for 6 months because my body is extremely sensitive to everything I put in it. An advil knocks me out. I was given Percocet when I got my wisdom teeth out--didn't dare touch the stuff. This is the first time in my life I'm taking medication of any kind.

Pre-Zoloft: I had a few times during the school day, usually in two classes that were full of triggers. At school they would last usually only a few minutes. I would have them at home when I was in my house because some of my traumas were in my house. At night, I usually had them about two hours before falling asleep and two hours before waking up, on a good night. On a bad night, I would get about an hour's sleep and have flashbacks the rest of the night or be awake in terror. Of course the whole time I was very depressed. Over the summer, my depression got deeper. I was having a hard time getting out of bed both because my flashbacks would take longer to "finish" since I didn't have to be up in the morning, and I was often too depressed to get out of bed. I would dissociate so far that I wouldn't notice that I hadn't eaten all day or I would forget I existed. At the beginning of the summer when I started to lose my sight, I was too dissociated to notice. I had an emotional breakdown where I cried for about a week solid. This is when my parents caved. (My parents were vehemently anti-prescription-drugs up until this point.)

Post-Zoloft: I still have flashbacks during the day, but they are very brief and it's only a few times a day. The only time my flashbacks get unbearable is if I need to be in a social situation or there is a lot of noise in my environment. At night, my flashbacks are also very brief (about 20 minutes--compared to the hours they were before) and I am generally sleeping the rest of the time. Now I still dissociate but I am still aware of my physical body. I don't dissociate as far as I use to, meaning I can't "leave my body" like I used to. I am also aware of when I am hungry, which is good (except that lately I haven't had any appetite at all because of nausea.)

 

[Hear Again]

nika,

how are you able to determine how long your flashbacks occur? when i have a flashback, i lose all track of time and have no idea how long i was "out."

 

[Nika]

I can feel when one is coming on and have gotten in the habit of checking the time. And then when I come back to my senses, I check the time again. My flashbacks feel like they go on forever even if they only last a few minutes, too.

 

[Hear Again]

nika,

one other question. how is one able to have a flashback before waking up? do you mean that you experience a flashback in your dreams 2 hours before you wake?

 

[Nika]

(Sorry that is for the nighttime flashbacks. For the day time ones I can gauge the amount of time because when I had them in class, the teacher would usually still be on the same topic.)

 

[Hear Again]

I can feel when one is coming on and have gotten in the habit of checking the time. And then when I come back to my senses, I check the time again. My flashbacks feel like they go on forever even if they only last a few minutes, too.

i have no idea how long my flashbacks occur, but they also feel like they take place forever and a day.

 

[Hear Again]

(Sorry that is for the nighttime flashbacks. For the day time ones I can gauge the amount of time because when I had them in class, the teacher would usually still be on the same topic.)

do you mean that you would check the time with your watch when your flashbacks occurred in class during the daytime?

 

[Hear Again]

nika,

i can't feel when a flashback is coming on because it happens too suddenly. one second i'm a part of my environment and the next i'm not.

 

[Hear Again]

i hope people don't mind reading my questions to nika. if anyone thinks they are off-topic, let me know and i will continue to discuss this with nika via pm.

 

[Nika]

nika,

one other question. how is one able to have a flashback before waking up? do you mean that you experience a flashback in your dreams 2 hours before you wake?

The bulk of my flashbacks are during my sleep hours (most likely because some of my traumas were while I was waking up/falling asleep and some others were in my current bedroom.)

It's hard to describe. All I can say is that during sleep I get a mix of flashbacks, nightmares, and anxiety attacks. It's hard to sort them out, but I have a habit of waking up every hour on the hour, unless I'm in flashback. Upon falling "asleep," I would fall into flashback. I would come out of the flashback a few times and then usually fall back into it, back and forth. I had to be up for school at 7am, and I remember waking up at 5am, and then when I would fall back "asleep" I would fall into flashback, and I'd wake up again, lucid sleep, wake up, fall back into flashback, etc. Sometimes I would "oversleep" because my flashback would run over. I hated getting to school late knowing that the reason was completely beyond my control and not something I could explain. I used to arrive at school early to prevent that from happening, but by this point I was so sleep deprived I decided it wasn't worth losing forty minutes every night "just in case."

My daytime flashbacks are very different. When I have them I am completely frozen and I have no idea what's going on around me. If someone calls my name or something, I don't respond. This landed me in a lot of trouble in school, obviously. My teachers accused me of spacing out. Of course I would come out of it feeling like I was just traumatized again, and then I would have to fight back tears. My Junior year and especially my Senior year were both extremely difficult for this reason.

 

[Nika]

do you mean that you would check the time with your watch when your flashbacks occurred in class during the daytime?

That or I would gauge the time based on where I was before the flashback happened. I can't feel my flashbacks coming on during the day, but at night I can.

 

[Nika]

Whoops--sorry! If I am boring everyone else to death, let me know so Hear Again and I can switch to PM.

 

[Nika]

Sorry, Hear Again. To clarify: during the day my flashbacks occur much like yours. They come on way too suddenly for me to check the time. However I figure they must only be a few minutes long since my teacher will be talking about the same thing when I come back out of the flashback.

At night I can feel them coming on. My eyelids get heavy. I check the time, then I know if I close my eyes my flashback will occur. I used to try to keep them open, but that would only make me sink deeper. Now I just let them close and go through the flashback.

 

[Oceanbreeze]

Oceanbreeze,

I'm not just relying on the book. I've had several therapists tell me Zoloft was probably the best option for me.

My meds are working wonderfully for me. They've helped decrease both the frequency and severity of my symptoms.

Of course I can't say what works for me works for everyone. I can't say that a medication is side-effect proof. I'm just saying that based on what I've read and heard, Zoloft is one of the safer drugs. I don't mean it in an absolutist way--there's always an exception, all drugs have their side effects. I do recognize that. I guess I assume people understand that when I make that statement. I will try to be clearer in the future.

I just increased my Zoloft dosage because my depression is coming back, probably triggered by my winter "vacation." But now I'm on the minimum dosage, instead of half the minimum dosage. My body is very sensitive to anything that goes into it, so that's why 25mg/day worked beautifully for about 6 months despite pretty "severe" (according to my therapists) PTSD and MDD symptoms. (If you think I'm "awfully symptomatic" now you should have seen me this summer. In fact I was supposed to be hospitalized.)

I'm sorry, Nika, but I'm not buying anything you say. If your condition is as bad you say it is, you WOULD be hospitalized without question as a danger to yourself. Not only that, but you wouldn't just be on a low dose antidepressant, but a combination of meds at therapeutic doses. That dose you say you're on is the minimum dose for that med. Most people with severe ptsd are on, at least, 100mgs.

You're just not making any sense whatsoever.

 

[Nika]

I'm sorry, Nika, but I'm not buying anything you say. If your condition is as bad you say it is, you WOULD be hospitalized without question as a danger to yourself. Not only that, but you wouldn't just be on a low dose antidepressant, but a combination of meds at therapeutic doses. That dose you say you're on is the minimum dose for that med. Most people with severe ptsd are on, at least, 100mgs.

You're just not making any sense whatsoever.

I should have been hospitalized but wasn't. The reason I am on such a low dosage is because my body is extremely sensitive to any sort of medication. I don't mind if you don't buy it because I have had many doctors deny my cases and no longer let it get to me. I have had eye doctors deny my eye problems for 7 years only to realize maybe I wasn't malingering. So your denial doesn't phase me in the least. My current psychiatrist understands just how sensitive I am to meds of any kind, unlike other doctors who have tried to put me on more. In fact I did have one doctor put me on 600mg Advil (and she wouldn't let me leave the office till I took it) and I ended up passing out.

 

[Hear Again]

That or I would gauge the time based on where I was before the flashback happened. I can't feel my flashbacks coming on during the day, but at night I can.

how are you able to feel a flashback coming on at night, but not during the day? sorry if all of my questions sound like an interrogation. i don't mean for them to. i'm just trying to understand a little more about flashbacks.

 

[Hear Again]

I should have been hospitalized but wasn't. The reason I am on such a low dosage is because my body is extremely sensitive to any sort of medication. I don't mind if you don't buy it because I have had many doctors deny my cases and no longer let it get to me. I have had eye doctors deny my eye problems for 7 years only to realize maybe I wasn't malingering. So your denial doesn't phase me in the least. My current psychiatrist understands just how sensitive I am to meds of any kind, unlike other doctors who have tried to put me on more. In fact I did have one doctor put me on 600mg Advil (and she wouldn't let me leave the office till I took it) and I ended up passing out.

one of your doctors actually forced you to take a med in her office? wow. if that had happened to me, i would have started flying off the handle swearing up a storm and my doctor would have had to physically prevent me from leaving his/her office.

 

[typeingtornado19]

how are you able to feel a flashback coming on at night, but not during the day? sorry if all of my questions sound like an interrogation. i don't mean for them to. i'm just trying to understand a little more about flashbacks.

I have no idea why its one time, but not the other, but i can always feel them.

 

[Nika]

how are you able to feel a flashback coming on at night, but not during the day? sorry if all of my questions sound like an interrogation. i don't mean for them to. i'm just trying to understand a little more about flashbacks.

They are very different. I don't know how to explain it. At night it's as if my body says "oh you have all the time in the world to process your flashback material" whereas during the day it's more reflexive in nature. My nighttime flashbacks are often mixed in with nightmares and hallucinations.

 

[Nika]

one of your doctors actually forced you to take a med in her office? wow. if that had happened to me, i would have started flying off the handle swearing up a storm and my doctor would have had to physically prevent me from leaving his/her office.

I wish I had the gumption to do that. The thing is that those situations are so triggering for me that I usually end up freezing. That's why I constantly get into situations where authority is stepping all over me or doing things against my consent, cause it's literally like I lose my voice. But I am thinking those same things as you and wishing I had my voice!