Exploring Secondary Trauma and the Impact of PTSD Recovery on Your Relationship

I have a million things I want to say, so many that when I put my fingers on the keyboard, it all falls away, and I can’t think what would be the best thing to share. Plus, I’m not a writer like Aaron is. So, I guess I’ll just start with what is staring me in the face today.

• What is PTSD?

Before I talk about my own experiences with “secondary trauma,” I want to relay that whatever I write here in following entries, please know that Aaron is my twin flame, my lover, my brother, my best friend and my soulmate.  I have never felt so close to another human in my life. Also know I am not an expert about trauma and post-traumatic stress disorder (PTSD) — nobody can understand it unless they have it. But somehow I get it because I feel so close to Aaron. I know the real Aaron. I know who he truly is so when he is in a PTSD bubble, I understand there is no lack of fortitude in this man.

The journey through PTSD is a non-cohesive one. A trauma-informed professional told us early on in Aaron’s diagnosis that this would take a long time to heal. The person who gave the original diagnosis, our first and much-loved therapist Richard Cohen, described PTSD recovery like a ginormous ship at sea. At a certain point, you realize with a bit of hindsight mixed with a tiny bit of objectivity, that it is actually changing course. I feel our ship has turned several times. Most recently this last week.

Thank God Aaron had the notion to call out for help last week. To walk himself to the emergency room and knowingly ask for extra help took a lot of something. I say he had the “notion” because to call it “courage” might be perceived as an assumption that others who have indeed died by suicide did not have courage. Whatever instinct Aaron had — an inner knowing that something was terribly wrong and different from a regular PTSD bubble (our term for when he’s experiencing a PTSD episode) — I’m forever grateful for and it feels wonderful to have him sitting by my side and back at work today.

The last couple of days have been spent relinquishing shame, guilt and secrecy, which in turn have come out of learning that while an antidepressant was the medication that helped the PTSD so much, it was the cause of this breakdown. I’ll never forget the improvement in Aaron when his dose was increased from 10 to 20 mg. It was astounding. Within 24 hours it was like he got his old self back — the self I met in the fall of 2016 when he rented my spare bedroom via Airbnb (two months before we realized we were madly in love with each other).

But now we see the big picture of what transpired over this last year: suicidal ideation and a sudden gambling problem. The whole PTSD thing was taken to another level for Aaron and for us both. Nobody in the psychiatric space mentioned when they met with him to watch out for any side effects such as compulsive behavior or suicidal tendencies. We both just went with what was taking place at face value — as though a new level of his trauma were surfacing finally as a part of his healing journey. But in fact, while the PTSD episodes grew farther and farther apart, the medication was taking his mind and spirit deeper and deeper into a new kind of despair.

Four days ago at the behavioral health hospital (can I just call it the fucking psych ward?), they took Aaron off the antidepressant and adjusted it to a different antidepressant immediately. At first it scared me that Aaron’s medication had been changed overnight. So we Googled the old and new meds, and discovered antidepressants can cause compulsive behavior like gambling or binge shopping, and that antidepressant specifically can cause suicidal ideation.

Let me take a moment to be very clear: we are not anti-medication and we are not making any recommendations about any treatments for someone else’s recovery from PTSD, alcoholism or other difficulties. We are simply sharing our journey. Antidepressants can work incredibly well for millions of people. But two people can have very different reactions to the same medication. I’ll add here that as a person who was diagnosed with secondary trauma, I started taking an antidepressant last summer and found myself feeling great — no heart palpitations, no waking up in the middle of the night, just feeling like myself for the first time in a long time. And yet I began compulsively eating for the first time in my life. The effects of medication can be life-saving and life-threatening at the same time.

I’ll get back to my main point: the events that transpired last year, the feelings Aaron experienced that led him to a psychiatric ward under a 72-hour hold (a.k.a. 5150), may have been caused by the drug that helped the PTSD so much. We took way too much for granted to not get a doctor knowledgable with prescription medication to be consistently involved. This, by the way, is a by-product of the MediCal system and the difficult nature of even getting in to see someone who can refill your prescription without a four to nine hour wait. Ugh. Don’t get me started. I’m sure Aaron will write about that.

Recovering from PTSD is a full-time gig. It’s exhausting for the person with PTSD and for their loved ones who just want to get through it. You can’t believe our recovery protocol, things we know we’re supposed to do that help. I’m lumping in Aaron’s with mine: AA meetings (in my opinion, trauma is often connected to addiction), Al-Anon meetings for me, yoga, exercise, eating well, seeing trauma specialists, therapists, finding and attending a male survivor group, GA and Gamanon meetings.

Then there’s working the 12 steps in these programs and meeting with our sponsors, reading personal growth books to get educated, having a spiritual life, trying to have some fun along the way, maintaining relationships with friends and family — who for some may not understand what’s happening, or may worry that you are in some sort of a domestic violence situation or that maybe you should consider not being with this person at all. We are both forever grateful to have families who love us and have showed great compassion even when the reports were not great.

When he’s in a PTSD bubble, there’s another list of things to do (our “trigger protocol,” which we will share with you in a subsequent entry). During these difficult bubbles, life stands still and it’s all about helping Aaron come out of it safely, alive and hopefully not having damaged my car, our home, trashing another iPhone (he’s been through four phones this year), or hurting himself or me by accident.

When he’s finally emerged out of the bubble, which can be anywhere from hours to days, he’s busy bouncing back to normalcy, and then I fall apart with exhaustion. I’ve been holding it all together so he knows he’s safe and loved, and that I’m not leaving him (me leaving the room, the house or the city is one of his major fears stemming from his PTSD and provide the triggers that cause an episode. If you’ve read, “Inciting Incident, 1976,” you know that during the traumatic event, Aaron perceived he was left behind by his best friend, Roman, and truly alone with the abuser).

This last year Aaron had very little contact with a psychiatrist — other than to get refills or to up the dosage. We now realize that not seeing anyone consistently was a huge misstep, and we know now you must keep your support system going and informed with complete honesty.  But again, it’s hard to stay on top of all you need to do to try and stay ahead of the PTSD.  Sometimes, when the episodes become more infrequent, you’re so grateful to have a break that the routine can slip.

So here we are today, 100 mg of a new antidepressant, and he’s sleeping a lot. My greatest concern is he was prescribed this medication to deal with the effects of the other medication.  So… what does Aaron really need? What are the chances of being drug-free and being able to live with PTSD?  Even if Aaron is not really a person who feels suicidal or a person who is addicted to gambling, the side effects of drugs are real because they have real health consequences and real behavioral consequences. These things happened. But they are not really Aaron’s true self.

I’m learning that I need to maintain my own balance and get in touch with my feelings while quieting my worsts fears. I will continue to be his true advocate, and I am getting better at allowing him the dignity to recover, but not without the fear of losing him. People who support trauma survivors are not trying to control their behavior and choices and yet, that’s exactly what we are doing when we are constantly worrying about what we say and do: making sure their brain doesn’t misinterpret a normal detail of life, like a text or an email, a career letdown or a business trip or a night out with a friend. Avoiding triggers like landmines is how we can lose sight of ourselves, our own feelings and develop our own sets of triggers. This is how “secondary trauma” is born.

PTSD is a mental illness. The brain has been re-formatted at the moment the trauma occurs. The goal is to help the brain process the trauma by creating new neural pathways, which you can do, but it takes time. We’re planning to look into other healing modalities that reportedly work faster and where the difficult task of reliving the trauma during treatment is absent (neurofeedback and rapid response therapy to name a few). We’ll see what we can employ and quite frankly, what we can afford, but that’s a topic for another entry.