Pro Tips Link Copied 08.21.24

Triggered? Here’s How to Deal

911, what’s your emergency? BySam Brodsky

In the year 2024, the internet has had its way with the term triggered. It’s well-traveled territory for mental health TikTok and has been memed to the point of losing all meaning. Alas!

But this term is one mental health pros and the psychological community at large (including the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5-TR) have used to describe people, places, or situations that remind you of traumatic moments you’d rather forget and/or spark all kinds of mental health symptoms.

Whether you were already well-versed in all of that or not, here we asked therapists for more intel on what triggers are and what to do when they arrive.

What are triggers?

Generally speaking, a trigger is a “stimulus that elicits a reaction,” according to the American Psychological Association (APA). Like we said, these can be people, places, things, or situations that set off unhappy memories or emotional responses. 

Sometimes the call is coming from inside the house, meaning those triggers are internal thoughts, emotions, or physical sensations. For example, your heart pounding during a workout could bring you back to a time when you were scared for your life, says trauma psychologist Ayli Carrero Pinedo, PhD. 

Other times, things in your environment—a song, a smell, or the way someone looks—can be external triggers, reminding you of a traumatic event and/or causing an emotional reaction, like anxiety, panic, and depression, says clinical and forensic psychologist Dawn Hughes, PhD. Same goes for holidays or anniversaries, adds Dr. Carrero Pinedo.

Whether the trigger’s within you or around you, sometimes you can’t identify it in the moment, says Dr. Hughes. All you know is that you feel out of control.  

When we’re triggered, we feel intense and overwhelming emotions, memories, or physical feelings or we react impulsively, says clinical psychologist Abigail Percifield, PsyD. Though you might name-drop it casually with something like, “This botched salad order is triggering my trust issues,” that’s not quite right. “I see the term triggered being misused to describe when somebody is feeling bothered or uncomfortable,” Dr. Carrero Pinedo explains. But if you don’t feel overwhelmingly bad or out of control, it’s not the same as being triggered, she adds. 

That said, pretty much anyone can be triggered. You don’t need to experience trauma or have a mental health condition to be set off by something inside of or around you. Your neighbors loudly fighting can make you feel overwhelmingly anxious for no apparent reason. The weeks leading up to Father’s Day could make you feel depressed. A scene in a book could flood you with memories that make it hard to concentrate.

Still, if you have a mental health condition or survived something traumatic, you might be more likely to face triggers, says Dr. Percifield. For instance, someone dealing with a substance use disorder might feel triggered at a stressful family reunion and crave a drink, she says. Someone with obsessive-compulsive disorder (OCD) might be triggered by an intrusive thought about germs in their apartment and feel the uncontrollable need to wash their hands, says Dr. Carrero Pinedo. And people with post-traumatic stress disorder could feel triggered when something reminds them of a traumatic moment, says Dr. Hughes.

How to deal when you’re triggered.

No matter your situation, here’s what to do when those triggers infiltrate your life so you can feel better and move on faster. 

1. Acknowledge that your feelings aren’t facts.

When you’re triggered, you can feel like you’re in danger just sitting in your living room. Triggers are fun like that. So telling yourself that you’re being triggered but you’re still safe can disarm whatever’s freaking you out, says Dr. Hughes. 

You’re basically telling the panicked part of yourself that things are actually OK; you’re just going through a tough moment right now, and it will pass soon. That might even help those feelings resolve. You’re also gaining a sense of control when you feel very out of  control. 

2. Ground yourself. 

Once you’ve consciously established that the situation you’re in isn’t as dire as it feels, you can start to turn your attention to the present moment. “When you’re focusing on something else besides the trigger, you’re decreasing the initial overwhelming response that you had,” Dr. Carrero Pinedo explains. That reinforces the idea that you’re gonna be fine, even if you’re panicked (or whatever you’re feeling) right now.

To get more present amidst a freakout, turn to anything that feels soothing. You could quietly repeat, “I am safe,” to yourself; name the current day of the week or year; or put on some hand cream that smells good, suggests Dr. Hughes.  

There’s also the trusty 5-4-3-2-1 method, where you name five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. Mindfulness exercises like this put the spotlight on your senses, which helps you shift out of your head, says Dr. Carrero Pinedo. 

3. Move around. 

If you find that being triggered makes you feel physically frozen or stuck, doing the opposite can remind you that it’s safe, says Dr. Hughes. By rebelling against what your triggered brain wants, you might be able to shake off that response. You’re sending the message that you’re in control; your fears are not.

It could be as simple as wiggling your toes and fingers or walking to the bathroom, Dr. Hughes says. Do whatever feels easiest and build from there to snap out of it. 

4. Detach from your thoughts.

Sometimes when you’re triggered, you get stuck in your thoughts, says Dr. Percifield. You might catastrophize about all the things that could go wrong in the future or get caught up in a traumatic memory. 

When that happens, the first step is to ask yourself, “Are these thoughts telling me anything useful or important right now?” says Dr. Percifield. The answer is often no. That little step starts to create some distance between you and the mental chatter that’s upsetting you. That takes the power away from those ideas, making you feel less bothered by them.

Of course, that’s not the only way to get some space from the stuff bubbling up in your head. Here are some other strategies that can help you detach from your unhelpful thoughts, according Dr. Percifield:

• Imagine your thoughts passing by as leaves on a stream, words on a news screen, drifting clouds, or floats in a parade 
• Describe the thought, like, “I’m having the thought that I’m not good enough”
• Sing your internal dialogue
• Write the ideas on paper and re-read them as an objective outsider
• Visualize putting your thoughts into a container

A quick aside: If you’re finding it hard to separate yourself from your thoughts like this, it might just mean you’re too overwhelmed and grounding techniques (like some of the ones above) might work better in the moment, Dr. Percifield notes.

5. Hold yourself accountable. 

Because being triggered is overwhelming (and we’re only human), we can react in ways that we might regret later. Maybe you snap at your coworker, throw your phone across the room, or make a scene at Starbucks. That can lead to feeling ashamed, which sets off a cycle of more negative emotions, says Dr. Percifield. And that’s not ideal when you’re already feeling a lot of uncomfortable stuff.

But, if you take accountability for what you did when you were triggered, you might be able to move forward faster and use new coping skills down the line. “It also fosters a sense of personal agency, acknowledging that, even when we’re triggered, we still have the power to make choices about how we respond,” Dr. Percifield explains. 

So, if you acted out, apologize, Dr. Percifield suggests. If you relapse, call someone who’s supporting your sobriety, she adds. Whatever you gotta do to repair the harm done and grow from the experience is fair game, she says.

6. Work with a therapist. 

It might be obvious, but being triggered can impact how you function in your daily life. Maybe you can’t concentrate at work, you’re sleeping like shit, your reactions are harmful to yourself or others, or your mental health has been tanking for a long time. Any of that can really mess with your day-to-day. If you can relate, that’s a sign you’d benefit from working with a mental health professional, says Dr. Carrero Pinedo. 

There are lots of different ways a therapist can help you manage your symptoms and develop coping skills to get by when stuff goes down, but that will depend on what you’re dealing with. 

For example, if you have OCD, exposure and response prevention (a kind of exposure therapy) triggers your compulsions with the guidance of a mental health pro. Then, they’ll help you find new ways to manage those urges, explains Dr. Carrero Pinedo. This can help you slowly get used to your triggers and respond differently. 

If you’re experiencing triggers related to something traumatic, trauma therapy, like EMDR or narrative therapy, might be useful, says Dr. Hughes. These modalities can heal your trauma, ultimately eliminating triggers over time, notes Dr. Percifield. 

At the end of the day, “you are worthy of a nervous system that is calm and that is going to allow you to thrive,” assures Dr. Carrero Pinedo.

The post Triggered? Here’s How to Deal appeared first on Wondermind.

Explainer Link Copied 06.28.24

Do I Need Trauma Therapy?

Let’s get healed. BySam Brodsky

If you recently heard about trauma therapy, that makes sense. Over the last few years, for better or for worse, your friends, your fam, and the internet at large have become a lot more acquainted with trauma and how to heal it.

Trauma is any disturbing event that scares you, makes you feel helpless, leaves you confused, or stirs up other hard emotions that are so intense that they negatively impact your “attitudes, behavior, and other aspects of functioning” going forward, according to the American Psychological Association (APA). 

Whether you grew up in an unsafe environment, witnessed a tragic accident, survived one, or experienced something else traumatic, circumstances like these can scare the shit out of us and shift how we feel and function in everyday life. 

But the effects of trauma are as wide-ranging as the things that can traumatize us. On the more intense end of the trauma symptom spectrum, some can have flashbacks, avoid specific people and places, or experience depression, says clinical and forensic psychologist Demara Bennett, PsyD, who specializes in trauma. Some might also develop a trauma- and stressor-related disorder, like post-traumatic stress disorder (PTSD), she says. 

If you can relate (or know someone who can) and you’re interested in learning more about how to treat those symptoms with trauma therapy, we got you. Below, we spoke to mental health pros about what trauma therapy is, how it works, and how to find someone to help you work through your struggles. 

What is trauma therapy? 

Turns out, there’s no official authority that regulates what trauma therapy is, how it’s defined, and who gets to practice it. That makes this question a little tricky to answer. But, on a basic level, trauma therapy is therapy that’s meant to help you heal from thoughts and feelings caused by trauma, says Dr. Bennett. 

Yes, any therapist can help you manage mental health struggles stemming from past events or traumas. But a trauma therapist is a mental health professional who specializes in treating trauma- and stressor-related disorders as well as debilitating symptoms of trauma, says clinical psychologist Jessica Punzo, PsyD, president-elect of the APA’s trauma psychology division.

Even though trauma therapists aren’t regulated, they typically seek extra training, like internships and certification programs, to learn how to treat those conditions and challenges, says Dr. Punzo. That makes them better equipped to work with clients whose trauma symptoms are dramatically interfering with their lives. 

The therapeutic modalities used in trauma therapy are ones that’ve been shown to improve severe symptoms of trauma or were developed to do so (even if there’s not quite enough evidence yet to prove they work). 

Honestly, there are a lot of types of trauma therapy out there, including eye movement desensitization and reprocessing (EMDR) and prolonged exposure, and your trauma therapist will help you figure out which seems most suited for you, says clinical psychologist Abigail Percifield, PsyD, vice president of the International Society for the Study of Trauma and Dissociation. 

How long trauma therapy takes to work depends on many factors, but it could be as little as six weeks, says Dr. Bennett. Of course, sometimes people need years of treatment, especially if they have the type of long-lasting trauma that usually happens in childhood, aka complex PTSD (C-PTSD), says Dr. Percifield. 

How to know if trauma therapy is right for you 

If you’ve been dealing with severe trauma symptoms, you’d definitely benefit from finding a trauma therapist. And that’s true even if you’re not sure what brought them on in the first place, says Dr. Punzo. “Trauma is subjective,” she explains. “Therapists are not detectives; they’re not here to prove that you had a traumatic experience.” Instead, they’re here to help you deal with the aftermath in a way that feels safe and holds space for whatever you went through.

If you’re in therapy already, you might be wondering if it’s worth finding a trauma  therapist to address your symptoms. Ultimately, it’s up to you. If you feel like your therapist is helping you cope with whatever you’ve been through, that’s great! If you’re looking for more trauma-focused treatment from someone with experience treating severe trauma symptoms, it could be worth making the switch. That said, if your therapist suspects you’d benefit from services they can’t provide, it’s best practice for them to refer you to someone who can help, notes trauma psychologist Ayli Carrero Pinedo, PhD. So maybe ask them what they think. 

Types of trauma therapy

Like we said, there are lots of different approaches to treating trauma. Some of them have scientific evidence backing up their trauma-healing efficacy, and others don’t. While there’s some debate about the best standard of treatment for severe trauma, below we explain a few trauma therapies mental health pros generally agree are most helpful. 

Prolonged exposure (PE)

This is a kind of exposure therapy where you gradually face the fears associated with your trauma. PE teaches you that these memories and situations aren’t actually dangerous, according to the APA.  

With your therapist, you’ll describe the trauma as if it’s happening in present tense and record yourself, says Dr. Carrero Pinedo. Replaying this outside of the sessions (homework!) enables you to confront and process emotions that you may have been avoiding, she says. 

You’ll also gradually put yourself in real-life situations that trigger your fear associated with the trauma. For example, if crowds really scare you, you might go to the grocery store and just park outside. The next time, you might go to the door and, the time after that, walk in one aisle, Dr. Carrero Pinedo notes. (You get the point!)

Cognitive processing therapy (CPT)

CPT helps you challenge unhelpful beliefs that stem from your trauma, according to the APA. Some of those beliefs might sound like, “I was weak,” or, “I should have done something differently,” or, “If I open up to people, I’ll get hurt.” Whether you’re aware of it or not, these mindsets can keep you stuck, says Dr. Bennett. Over a series of sessions, your therapist can help shift your perspective by prompting you for evidence for or against these thoughts and eventually help you modify your own beliefs around the traumatic event, explains Dr. Carrero Pinedo. 

Eye movement desensitization and reprocessing (EMDR)

During an EMDR session, a therapist asks you questions about a traumatic memory while you follow their finger or something else from left to right with your eyes, says Dr. Percifield. Other times a therapist may have you hold a device that vibrates in one hand and then the other, or listen to a sound playing in one ear and then the other with headphones, while asking you questions, she explains. These alternating sensations, sounds, or visuals are examples of bilateral stimulation, which may help make your traumatic memories less vivid and emotional, according to the APA.

It’s not 100% clear why EMDR works, but one theory suggests that doing two things at once—the eye movement or other sensory activity, plus recalling the traumatic memory—disrupts your working memory, and this helps make what you’re remembering less emotional and vivid, according to a systematic review. Paying attention to these two things at once also somehow allows you to access more adaptive information about your environment and yourself—aka info you’ve learned from non-traumatic experiences, like looking at situations realistically, Dr. Percifield explains.

FYI, EMDR can potentially stir up traumatic memories you didn’t know you had, so experiencing them in therapy can feel like a lot, Dr. Percifield says. Maybe that’s not something you’re ready for. But EMDR can be a good option for people who don’t want to do in-person exposures or don’t have time for homework.

Trauma-focused cognitive behavioral therapy (TF-CBT)

This one is typically utilized by trauma therapists treating kids and adolescents and their parents or caregivers. It involves exposure work and learning coping skills for dealing with the effects of trauma, per the APA. 

The child would also create what Dr. Bennett calls a trauma narrative, where they’d think about the trauma and write about it, paint it, or express it in other ways. “It’s not just a retelling; it’s your opportunity to have more power over the experience,” she says. 

Narrative therapy

This kind of therapy is meant to rewrite your life story with “true but more life-enhancing narratives or stories,” per the APA. The theory is that by deconstructing the events of your life, including your trauma and the problems it’s caused, you can put it back together in a more helpful way.

This could be especially helpful when dealing with intergenerational trauma, or racial trauma, says Dr. Carrero Pinedo. “It can really emphasize the resistance of your ancestors, the strength of their survival, and the wisdom that they have carried throughout the years, rather than just focusing solely on the trauma experienced,” she explains. 

FWIW, if you suspect you have intergenerational trauma, consider researching traditional healing practices from your cultural or community background, says Dr. Percifield. “[Trauma treatment] doesn’t always have to be [from] a Western lens; we can have music and movement and dance. All those things are also ways of healing,” adds Dr. Carrero Pinedo. 

How to find a trauma therapist

Ultimately, a person who calls themself a trauma therapist should have the training to back it up, which might look like certifications in some of the trauma therapies we talked about above. There’s no one certification that a trauma therapist needs  to get in order to call themself a specialist in trauma, says Dr. Punzo. And even mental health pros without certifications can have training from reputable trauma orgs and years and years of experience treating trauma, so it’s best to look at a therapist’s full skillset and background, notes Dr. Percifield. You can also check out these directories to up your chances of finding a therapist who specializes and is trained in trauma therapy:

• International Society for the Study of Trauma and Dissociation
• EMDR International Association 
• Trauma-Focused Cognitive Behavioral Therapy National Therapist Certification Program
• Cognitive Processing Therapy For PTSD  
• International Society for Traumatic Stress Studies

Once you find someone, hop on the phone or email them to ask what treatments they’re certified in and the kinds of clients they see (they should say that most of their clients are dealing with severe trauma symptoms, complex PTSD, or trauma- and stressor-related disorders).

As you get started with a trauma therapist, check in to ask yourself  how you feel during your sessions, suggests Dr. Percifield. Is this type of therapy meeting your needs? Does it feel right for you? Do you feel like you can communicate with your therapist? If so, that’s great! If not, maybe keep looking.

Heads up: It might not feel amazing from the get-go. Being nervous about delving into everything  is totally valid, says Dr. Bennett. After all, we tend to avoid things that are emotionally distressing, she notes, and trauma is one of them.

The post Do I Need Trauma Therapy? appeared first on Wondermind.

Explainer Link Copied 03.07.24

What Counts As Trauma?

Let me, a trauma expert, break it down for you. ByKobe Campbell, LCMHC-QS

If you’ve been on the internet at all or have talked to anyone who’s into wellness and unpacking their ish, you’ve probably come across the concept of trauma many a time. Whether it’s through comments about trauma dumping, trauma stored in the hips, or trauma as the origin story of why they act like that, the term gets thrown around a lot. But you’re forgiven if you don’t fully understand what it all means, if trauma is an actual diagnosis, or if any awful moments from your past mean you’re clinically scarred for life. 

As a licensed mental health counselor who wrote a whole book about the topic, let me give you a crash course on trauma, how to know if you’ve experienced it, and how to start working through your past.

What counts as trauma? 

What causes trauma and how it presents itself can look and feel different for everyone. I always like to start by reminding people that these wounds are deeply personal and contextual; two people can survive the same thing and have wildly different psychological experiences and outcomes. Trauma is less about specific incidents that you experience or witness and more about how your mind and body respond to them. 

It’s possible you’ve heard colloquial terms like “Big T trauma” and “little t trauma,” implying that some traumas should be taken more seriously than others, but that’s not quite it. Really, trauma is trauma. If you’re hurt, you’re hurt and it doesn’t matter if the thing that hurt you was “big” or “small.” 

In fact, being exposed to any distressing conditions that exceed our ability to cope can have emotional repercussions. I often view trauma as getting “too much, too soon” (like surviving a jarring car accident) or “too little, too late” (like being neglected as a kid). If you want an official definition, the Substance Abuse and Mental Health Services Administration says, “Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being.” 

Trauma also helps explain how your past wounds color how you show up and perceive life today. That can look like experiencing heightened anxiety or fear, having flashbacks, struggling to connect with others, displaying anger and aggression, or feeling disconnected from your thoughts, feelings, identity, and/or memory. 

That experience can be true whether we know what caused the trauma or not. While we need more research to explain the phenomena, it’s also widely accepted that trauma can be passed down through generations and tear through communities—a concept known as intergenerational trauma. For instance, if your parents or ancestors endured something horrific (like slavery or genocide) and developed unhealthy coping mechanisms, like substance misuse or living in survival mode, that can impact how they raise you and how you live your life. So, yeah, healing from these emotional burdens can help you and so many other people too. 

Can trauma be diagnosed? 

While there’s no specific diagnostic criteria for “trauma” in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5-TR), there’s an entire section dedicated to “trauma- and stressor-related disorders,” which are conditions that require trauma or a stressful situation to be present to meet a diagnosis. One of the most well-known diagnoses in that group is, of course, post-traumatic stress disorder (PTSD), in which someone over six years old has been exposed to death, threatened death, serious injury, or actual or threatened sexual violence. Among other criteria, this diagnosis also requires you to continually re-experience the traumatic event in at least one way, via things like upsetting memories, nightmares, or flashbacks. 

Another diagnosis stemming from trauma is complex post-traumatic stress disorder (C-PTSD). Though it’s not recognized in the DSM-5-TR, it is recognized in the International Classification of Diseases (ICD). Basically, that condition stems from trauma that goes on for a long time and feels inescapable, like living in a dangerous neighborhood. For people with C-PTSD, they can deal with things like low self-worth, trouble managing their emotions, and feeling defeated. 

There are plenty of others—again, the DSM-5-TR has a whole section full of them—but the thing they all have in common is that traumatic experiences from the past impact the way people function in their current day-to-day lives. 

Do I have trauma, and how do I get help? 

If you’re currently wondering if your pain counts as trauma, I’d invite you to mull over these questions: 

• Is there any past moment (or moments) that might still negatively affect me? 
• Does it impair my ability to connect with others or do daily tasks? 
• Does it impact how I see myself? 

If you answered “yes” to any of those, you might have some unresolved pain and could benefit from speaking to a mental health professional. 

Still not sure about an experience’s effect on you? That’s more than understandable, so here are some signs you may be dealing with trauma and hints that you should reach out to a mental health pro for more help:

• Recurring nightmares related to the event(s)
• Unsettling memories of situations you previously forgot about
• Constantly feeling on guard and on the lookout
• Sudden withdrawal from friends and family
• Persistent irritability
• Constant sadness, anger, or anxiety
• Trouble remembering things or having or gaps in your memory 
• Fixation on past painful memories
• Self-destructive behaviors, like substance misuse, risky sexual behavior, and self-harm
• Exaggerated reflexes when startled 
• A steady stream of negative thoughts about yourself

You could also take the adverse childhood experiences assessment, which poses questions like, “Did anyone in your household ever commit a serious crime?” and “Did you ever run away from home for more than one day?” Reading through this can give you a sense of what types of events might’ve led to your trauma, but it’s not a sub for a therapist. An expert who specializes in trauma-informed care can give you an assessment, and, if necessary, a treatment plan and tools to help you identify, process, and heal from trauma’s effect on you. 

In addition to trauma-informed talk therapy, there are plenty of therapeutic approaches that can help you unpack and learn to cope with whatever happened to you. Eye movement desensitization and reprocessing (EMDR), for instance, is a type of trauma therapy where an expert has a client move their eyes in a certain way to help them deal with unpleasant memories and confront unhelpful thought patterns. Brainspotting is another option, helping you tap into your long-term memory and process negative incidents. 

Other methods that you can try with a therapist include neurofeedback (using brain wave measurements to help you cope with triggers), psychodrama (acting out past events to reflect on your feelings and help you feel more empowered today), and experiential modalities (think: activity-based therapy, like art therapy or animal care, that helps you increase your daily functioning and ability to deal with unpleasant memories). 

Ultimately, so many of us have experienced trauma, and it can be difficult to know how it impacts you. But when you do the work to dig into your mental health and, ideally, speak with a professional that you can lean on, you can find the healing you deserve.

The post What Counts As Trauma? appeared first on Wondermind.

Explainer Link Copied 09.29.23

Why Are So Many People Talking About Complex PTSD?

It’s…complex. ByKobe Campbell, LCMHC-QS

If you’re one of the many, many TikTok viewers intrigued by trauma, you’ve probably come across something called complex trauma and complex post-traumatic stress disorder (CPTSD). And, honestly, you’re totally forgiven if you don’t really know what these terms actually mean. Like, isn’t PTSD already complex enough? What makes complex PTSD special enough to get an extra adjective? 

As a licensed mental health counselor who focuses on trauma and helping women of color (peep my book, Why Am I Like This? How to Break Cycles, Heal from Trauma, and Restore Your Faith), allow me to explain.

What is complex PTSD, and what causes it?

Worth noting from the jump: CPTSD is not actually in The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). That said, it’s in the World Health Organization’s International Classification of Diseases (ICD-11) manual as of 2018, and many mental health experts (including me) treat it as a legit condition. While PTSD refers to surviving a traumatic event (or multiple events) and the psychological distress that can follow, CPTSD is used to describe the unique effects of exposure to trauma that is often prolonged (lasting months or years at a time), repetitive, and difficult or impossible to escape. 

So experiencing stuff like living with an alcoholic parent, growing up in a dangerous neighborhood, facing endless microaggressions, or even surviving human trafficking could lead to CPTSD. 

For the most part, complex trauma (like those events or situations above) usually happens when you’re a kid or adolescent and—in my professional experience—it might even feel normal when you’re going through it. That’s partly because it’s inescapable and constant or because the complex trauma wasn’t one distinct and obvious event. And that’s the biggest differentiator between CPTSD and PTSD: trauma related to a specific moment, like a severe car accident, a physical attack, or moments like undergoing treatment for a life-threatening disease, is associated with PTSD, whereas complex trauma can often be more subtle or ongoing. 

In case this makes more sense visually, think of trauma like a boulder (stay with me!). A boulder is clearly visible and undeniable. Anyone standing in front of it can see exactly what it is, and there wouldn’t be much debate on whether or not it exists. Complex trauma is like a pebble. It’s there, but it’s not necessarily obvious. But if every step you took was on a pebble, you’d start to feel continual pain that would shape the way you walk and live. Both of these diagnoses can impact you, but the way we see them differs. 

What are complex PTSD symptoms? 

CPTSD comes with a unique set of symptoms in addition to what people with PTSD experience. In case you need a refresher, PTSD symptoms include re-experiencing the trauma (through flashbacks, nightmares, intrusive thoughts, etc.), actively avoiding thoughts and memories associated with the event(s), and feeling like there’s often a threat lurking (and experiencing all of that for at least several weeks). With CPTSD, you can also expect significant issues related to your self-worth, your relationships, and your ability to regulate your emotions. You’d also often feel defeated, worthless, ashamed, guilty, or like a failure, and you’d struggle in basically every area of your life for weeks at a time, the ICD-11 states. 

Basically, with CPTSD, there’s an emphasis on an overall vibe shift in your personality. That could look like having trouble connecting with people, struggling to maintain relationships, showing chronic aggression, and experiencing frequent feelings of abandonment, anger, confusion, or hopelessness. There could also be persistent suicidal thoughts, hypervigilance (like repeatedly checking your surroundings), memory loss, and sometimes nightmares thrown into that mix as well. And these symptoms tend to be more persistent than the symptoms of traditional PTSD. 

Honestly, we need a lot more research to explain the mechanism behind chronic trauma and CPTSD symptoms. But, some studies cite a correlation between changes in the parts of the brain that deal with memory and emotions and CPTSD. Another more recent study (though small and imperfect) found that child and young adult CPTSD survivors showed “more variable” heart rate responses to emotional words (think: swearing or threatening) than the PTSD group, which could point to those brain differences. There’s also the possibility that genetics or someone’s social support system (or lack thereof) plays a role in whether someone develops CPTSD, suggests a 2020 article from the peer-reviewed British Journal of Psychiatry. 

Side note: When experts or clients talk about complex PTSD, borderline personality disorder is often referenced because the symptoms (like hopelessness, low self-esteem, fear of abandonment, and trouble managing emotions) can overlap, and the conditions can be mistaken for each other. But, from what I’ve observed over the years, there are a couple big differences between the two. For starters, trauma isn’t always the cause of borderline personality disorder, but it’s always present in CPTSD cases. And people with complex PTSD often seem to normalize or hide their intense, difficult emotions, while people with borderline personality disorder may become overwhelmed and seemingly controlled by their intense emotions.

How do I know if I have complex PTSD? 

Speaking to a professional is always the best option. Without any official DSM-5-TR CPTSD diagnostic criteria, therapists typically base their professional opinions on the ICD-11 criteria and your responses to several questions about things like your support system, confidence, and general well-being. Therapists also use methods like the International Trauma Questionnaire, which asks questions like, “In the past month, have you felt jumpy or easily startled?” and  “Recently, have you had upsetting dreams related to your trauma?” Another expert resource, the Adverse Childhood Experience questionnaire, asks questions like, “Did a parent or adult in your home ever swear at you, insult you, or put you down?” and “Were your parents ever separated or divorced?” to get a better idea of your background. 

That said, going through extremely tough times or having a sucky childhood doesn’t automatically mean you have CPTSD, as the ICD-11 states. It’s possible to survive bad experiences and not meet the diagnostic criteria, which is why it’s important to consider if you meet all the required symptoms of CPTSD too. Taken together, all your responses can help an expert piece together your story and how your past experiences are impacting you today.  

Without a professional’s help, it’s hard to accurately see your experiences for what they are, but one way to try is by asking yourself: “What events, big or little, have influenced how I show up today? Are there any areas of my life that I feel are significantly and negatively impacted? Do my experiences line up with those PTSD and CPTSD symptoms mentioned above?” Just remember that not all symptoms happen at the same time, so it’s OK if you feel different each time you revisit that list.  

How is complex PTSD treated? 

Because trauma is deeply personal and, yup, complex, one person’s treatment will look different from the next person’s. So talking to a trusted pro who can create a long-term plan is best. For anyone worried about having to relive every single bad memory, you can happily unclench your jaw because not all therapies make you detail everything. But, if you want to feel better, you will have to talk about some things. Those topics will become clear to you and your provider when the time’s right. 

Because CPTSD research is limited, most experts look to popular PTSD treatments. Some people prefer trauma-informed talk therapy, which is an established method for treating PTSD and looks promising for anyone with CPTSD, suggests a 2019 systemic review and meta analysis. In my practice, we’re fans of eye movement desensitization and reprocessing (EMDR), which is another tried and true PTSD treatment. This type of trauma therapy involves moving your eyes in a certain way that might help you process unpleasant memories. Ultimately, the goal is for you to face the distorted beliefs that you have about yourself.

You might even respond to somatic (body-focused) therapies, which help you identify and release physical tension associated with painful memories. More treatments include brainspotting (using your visual field to tap into your long-term memory), cognitive processing therapy (learning how to question and change unhelpful beliefs about your trauma), and neurofeedback (measuring brain waves and teaching you to control how you respond to triggers). 

There’s also something called psychodrama, which is tapping into your inner thespian and acting out moments from your past as a way to revisit and retell the stories that have shaped your life. Of course, you and your expert buddy can move slowly and take breaks along the way when emotions start to swell. Through this engaging exercise, you can work through your feelings, regain your sense of self, autonomy, and strength in the process. 

When you have a better idea of your history, diving into a book on trauma might also make you feel better. Some of my favorite resources are Try Softer and Strong Like Water by therapist Audi Kobler, LPC; Why Am I Like This? by me; Trauma & Addiction by psychologist Tiyan Dayton, PhD; and The Boy Who Was Raised As a Dog by children’s mental health researcher and clinician Bruce Perry, MD, PhD.

In the end, complex PTSD has its name for a reason. Trying to heal it without professional assistance is like trying to perform surgery on yourself. Not only will it likely not work, but it can also cause more pain than necessary. And who wants that? The best gift you can give yourself as someone who might have symptoms of CPTSD is to be honest about your story and let someone else hold your hand through the healing journey. 

The post Why Are So Many People Talking About Complex PTSD? appeared first on Wondermind.

Q&A Link Copied 06.15.23

Best-Selling Author V.E. Schwab Is No Stranger to Rejection

“Accepting that rejection is the cost of participation is essential.” ByMarilyn La Jeunesse

Despite having over a dozen best-selling books to her name, V.E. Schwab says they still get rejected at least once a month. “Rejection and waiting and the instability and the insecurity is all part of the process. It’s so easy in creative fields for worth and work to become inextricable,” Schwab tells Wondermind.

As a self-described anxious creative, Schwab decided early on in their career to be transparent about their own mental health so others going through the same publishing hurdles would feel less alone. “If you feel like it’s only you, it feels like an indictment of your own ability instead of the fact that things are hard.”

Whether it’s writing her own complicated emotions into the characters in her novels or using her platform to advocate for other authors living with mental illness, Schwab has built her career on authenticity and honesty. Below, Schwab opens up about their mental health journey, learning to cope with rejection, and the terrifying thoughts keeping them up at night.

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WM: What’s something you do to take care of your mental health every day? 

VES: Rain or shine, cold or warm, I take my dog for a walk on the beach every morning. Something about starting my day with the vastness of nature and feeling really small … it’s one of the most grounding things I can think of. It’s the very first thing I do before I’ve even had a pot of tea or any breakfast and it’s just really my favorite way to start the day. 

WM: Why is destigmatizing mental illness important to you?

VES: I made it a point to talk about my creative health, and mental health went hand-in-hand with it. It would’ve been disingenuous to talk about one thing and not the other. Mental health is also a really big component in my writing. It’s a theme. People think it’s easy for me [to talk about mental health]. It’s not; it’s terrifying. But enough people come up to me and say, “Thank you for talking about this thing,” or “I felt less alone,” and really, that’s the whole point of it. If I can make one other person—especially another creative person—feel less alone in their struggle from my point in my career, I think that can be heartening. It makes it worth it—as uncomfortable as it is for me. If I have a platform and I don’t use it, what’s the point? 

WM: How do you deal with failure or negative feedback from readers?

VES: The one thing that gets easier, the more books you have, is that you engage with people for whom your work is essential. Reading is entirely subjective, and sometimes we find the right content at the wrong time or it’s simply the wrong content. It is not our job to write a story for everyone. That is a one-directional route to mediocrity. There’s no such thing. So what you try and do is write for an audience of one. For yourself. And then it becomes an incredible boon when somebody does connect with it, when somebody has this passionate association. And when it doesn’t land for someone in that way, it’s a lot easier to shrug off. 

Every other aspect of writing has gotten harder for me. The more books I have out, my own mental happiness treadmill kicks in and I’m constantly resetting the markers. I struggle a lot with down talk. I struggle a lot with getting into negative head spirals. This week’s head spiral is the metric system of social media and like, Why are my view counts on my stories down this week? and, What is it saying about me? and, Is it that my people don’t like me anymore or should I be putting more energy into creating content, but then I have a finite amount of energy that needs to go towards my books, but then what does it matter if nobody is reading my books because I’m not generating enough? I was lying awake yesterday morning at 6 a.m. thinking about this, and [that] doesn’t lead to any form of fulfillment. It’s so hard, and I don’t ever wanna pretend like you become immune to it. 

Accepting that rejection is the cost of participation is essential. Understand that the only way to avoid rejection is to not participate. And that is your choice, but that’s also the only way to guarantee you don’t get what you want. I mean, I can say that, and yet, in the last 48 hours, I have spent a solid four to five hours obsessing over things outside my control. … At the end of the day, the only thing in my control are the words on the page. That’s what I need to come back to whenever I feel myself spiraling: What do I have control over?

WM: Can you tell me about when you first realized you had OCD and panic disorder?

VES: I’ve honestly figured out a lot of my mental health through the act of creating and assigning things to characters that I’m not always ready to handle with myself. I remember writing August Flynn who’s in This Savage Song and has this cyclical thinking where he spirals in his own mind. It was a lot easier for me to explore that part of myself through him. It was really hard to write a character like Henry Strauss in The Invisible Life of Addie LaRue, who is so directly me.

I had a lot of stuff in my childhood which contributed to my ability to handle mental health now. Like I had—and still have—a very severe God complex because I grew up with an ill parent. When you have a sick parent, it’s easy to become obsessed with this idea of, If I just am vigilant enough, if I just pay enough attention, I can keep this person safe or keep this person alive. Unfortunately, that did translate into a lot of my OCD tendencies because it’s verified. The worst thing that can happen for mental health is when you have a fear or a phobia and it’s rewarded. Because I was hypervigilant, I did prevent several really close calls with a parent and then that incentivizes mental illness, because your brain is saying, What if, what if, what if? And then you’re proving your brain right. It’s something I still struggle with. 

I would say my anxiety and panic disorder really reached a fever pitch when I started publishing. … I would go on tour and I would have panic attacks, and I would white knuckle it through the event and the moment the event was over I would just implode. I would have a night-long panic attack. Because I spent so much time pretending to everyone around me that I was OK, it would elevate my panic. One of the best things I ever did was speaking about it publicly and letting my team know and letting readers know this is a thing I’m struggling with and like, “Here’s what I need, and here’s what we’re gonna do.” It’s one of the reasons I don’t do signings anymore. I sign everything beforehand because I know I essentially have about a four-hour ticking clock from the moment an event starts, and if I go past a certain amount of time, my anxiety has just been keying up and it’s gonna crack. 

WM: Would you be open to sharing your journey with medication?

VES: Going on medication is one of the best things that ever happened to me. It does not solve everything, [it] simply elevates my baseline. It’s not that I never have panic attacks, not that I never feel things building, but it takes a considerable amount more to set me off. Before, one bad hour could trigger a panic attack. I’ve been on SSRIs now for almost a decade. And it honestly saved my life in a lot of ways. I don’t like talking about it as a catch-all because it’s not. There’s a huge amount of things I do in my daily life which also help. For me, exercise and physical movement is a luxury I have but is also deeply important to maintaining mental health and burning off anxious energy and recentering myself. I was really loath to go on medication for a really long time because I thought, What if it interrupts my creativity? What if it changes my brain? And it did change my brain, but that change was to help balance a level of chemical nervousness, a level of chemical inability to process anxiety. I am operating at such a high vibration all the time and all it does is make it a little easier to handle.

WM: Your new book deals with PTSD and chronic pain, how does this reflect your own experience with these struggles?

VES: PTSD has really related a lot to my own upbringing and being in a hypervigilant environment and how it’s really hard to kind of disengage from these tendencies. Because I write fantasy, I found a way to put this into my characters. There are two brothers in this Shades of Magic series and now in Threads of Power who are tied together in a way where one brother is literally keeping the other one alive. But, because of that, there is also this pain shared between them where when one suffers, the other one suffers. And it creates a very complex dynamic. Oftentimes, mental health and the psychological struggles and the aftermath of trauma gets explained in really reductive or minimalist ways in stories. And the fact is it is a complex web of experience and action and reaction.

I get frustrated when stories show trauma but then, as the stories continue, there’s no aftermath. … So that is a thing I am really deeply interested in investigating because I think it helps my characters feel more human. The fact is, when we move through complex circumstances in life, yes, it’s incredible that we come through them, but the expectation that we come through them unscathed is so unrealistic it feels like it’s not actually doing a service. It’s lionizing characters in a way we can’t lionize humans and simplifying characters in a way we can’t simplify humans.

My interest in everything I do is simply to make my characters feel as real as possible. Part of that reality is when they go through really difficult things, those things sink their teeth into them and they kind of drag behind them like a shadow. It’s one of the ways to not only carry a story forward from book to book, but to make sure my characters grow in realistic ways. ‘Cause it’s not about showing strength as the entire shaking off of trauma. Strength is the ability to live through it and to deal and to cope and to face these traumas in time.

WM: How did your journey discovering your own sexuality impact your mental health?

VES: I don’t wanna claim that journey is complete. That is a journey I am still on. I do not feel realized in any way. One of the scariest parts for me of being a public figure is this expectation that when I make any form of declaration about myself, it’s permanent. And it’s really a huge amount of pressure for somebody who is very much still figuring it out. … I don’t like labels for that reason. It’s one of the reasons I’ll use queer or gay, but I don’t really use lesbian very often because I’m still trying to figure out my relationship to everything. 

What I know is I don’t believe in a binary. I don’t ever believe in the simplicity of here or there. I think it’s all such an extraordinary spectrum. I’m just trying to be honest about the fact that that journey is an ongoing thing. Sometimes there’s an immense amount of pressure to step out of the closet and know exactly who you are and who you’ve always been. That’s one version. And another version is the person who’s still going room to room trying to find where they fit or trying to think if they wanna be in the house at all.

WM: As a best-selling author, how do you cope with the pressure of constantly living up to the expectations of your previous novels?

VES: I’ll be very honest with you, I’m 22 books in [and] my greatest fear professionally is somebody saying “Her last book was better.” What I try to do is not make it qualitative in that way. I always say I never want my books to be apples to apples. I want it to be an apple, an orange, a pineapple, a pear. I want each of my books to be mine. 

I don’t like the phrase better or worse because I think that leads to creative paralysis. Do you judge it based on the number of book sales? Do you judge it based on the number of people who have tattoos based on that series? Do you judge it on the people for whom a book saved their life? Do you judge it upon which book made someone a reader? How do you decide which book has the most merit? I try really hard to set a different creative challenge for myself every time to try and prevent that level of comparison. Does the fear live inside me every day? Of course. But I try to make sure the thing I wanna achieve in each book is deeply personal to me in a way that readers probably won’t know. 

The more work you have to choose from, the more people will disagree, so you have to just accept that and let the book be the best version of itself and be the most intentional version of itself and let go of the arbitrary metrics of popularity.

WM: What’s one piece of advice you’d give to your younger self?

VES: Not to be in such a hurry. Because I started [my career] as a teenager, I was so impatient to be taken seriously. You—as a creator, as a writer—have to take yourself seriously before anyone else will. But I was in such a hurry and patience is a thing I have always really struggled with. 

One of the first tattoos I ever got, I got when I was 19. And I was really impatient ’cause I was a swimmer and there was this very limited window I had before I needed to get back in the pool, and a tattoo needs like three weeks to heal. I was so impatient that I went and I got this tattoo and it has a typo. The thing is, it’s a very easy-to-fix typo. It’s a Latin U that should be an A. It’s in a gothic script. Very easy to fix. I will not let myself fix it. I will not let myself get this typo corrected because I still, at 35, need the reminder to slow down, take a breath, and not be so impatient. 

I’m completely impatient as a human being. And I really wish I could have told myself, “Take a breath; it’s OK. Not everything has to happen right now.”

The post Best-Selling Author V.E. Schwab Is No Stranger to Rejection appeared first on Wondermind.

Explainer Link Copied 01.04.23

Everything to Know About Facing Your Fears in Exposure Therapy

This type of therapy can help with things like anxiety, PTSD, and OCD. BySam Brodsky

If you feel particularly triggered by a person, place, or thing, you might have heard that being around said person, place, or thing—though definitely not what you want  to be doing—actually can help in the long run. No, really! Even if it’s cringey or uncomfortable or, well, terrifying. That’s where exposure therapy comes in.

Therapists use exposure therapy to help you face your fears and do things that your trauma or anxiety naturally want you to avoid, says licensed psychologist Renee DeBoard-Lucas, PhD. Since fear can show up in mental health conditions like anxiety disorders, PTSD, and OCD, exposure therapy is often part of the treatment plan for those disorders, according to the American Psychological Association (APA). 

Exposure therapy is generally considered to be part of cognitive behavioral therapy (CBT), which is about the connection between your thoughts, behaviors, and feelings, says licensed clinical psychologist Tamara Jacobs Sussman, PhD, an assistant professor of clinical medical psychology in Columbia University’s Department of Psychiatry. With exposure therapy, you’re essentially changing how you behave in the face of fear to, in turn, shift how you think about and feel about that fear, she explains.

You confront fear—with the help of a therapist—inside and outside of the therapy space, and, based on what kind of work you’re doing, you may also learn coping skills (like breathing techniques) along the way. Exposure therapy can look a little different depending on the person and the therapist (and what your specific trigger is), but the overall goal is to teach you that you can handle tough situations.

Sure, it might seem intimidating. Super. Intimidating. But it’s a cool concept because you’re “gaining a sense of mastery over your fear,” says Dr. Sussman, “like there’s something that you can do about it.” Read more on how it works ahead.

Exposure therapy is often—but not always!—used for anxiety. 

A big area you’ll see exposure therapy come into play is with anxiety. That’s because anxiety tends to trick people into thinking certain things are more dangerous than they are or that negative outcomes are more likely, and it also makes people underestimate their power to cope, explains Dr. Sussman. With exposure therapy, you’re learning how to think about your anxiety in a new way and proving to yourself that you really can cope with that anxiety, she says. 

But you don’t have to have an anxiety disorder to benefit from doing exposures, says Dr. DeBoard-Lucas. “There can just be anxiety that is getting in the way of something you need or want to do,” she notes. 

Exposure therapy isn’t just about throwing you headfirst into your fears.

While there is one type of exposure therapy that actually starts with throwing people into a situation they find most scary (called “flooding”), that’s not what the experts we spoke with personally use. Also, most people wouldn’t realistically sign up for that. Typically, exposure therapy involves what therapist Brittney Chesworth, PhD, LCSW, calls an “exposure hierarchy” (and what the APA refers to as a “graded” pace). 

Step by step, you’d take on bigger and bigger challenges to confront your fear, starting from something that isn’t too hard to handle, Dr. Chesowrth says. For example, if you’re scared of needles—or have a diagnosed phobia of them—you might start by looking at a photo of a needle, then working your way toward finally getting your blood drawn. Though a therapist might have you do relaxation techniques when you’re facing your fear to calm down, the whole idea is to eventually get you to a place where you can go into uncomfortable situations without any support, Dr. Chesworth explains.

There are also steps in between to make the scariest situation on that hierarchy a little less scary. And once you do each exposure on your hierarchy, you’d reflect on how it went for you to wrap up the experience in a bow, says Dr. Sussman. How did it make you feel? Did you find anything surprising? What did you learn? (Hopefully that you can pull through!) 

Worth noting: “The goal of exposure therapy is for people to do the things they want and need to do, so I wouldn’t ask them to do something extreme and unnecessary,” Dr. Sussman explains. So, if you’re afraid of spiders, the last thing on your list doesn’t need to be sitting in a room with 100 of them, she says. And, FWIW, you’re not going to head into a therapy session and get forced to do an exposure that feels like it’s too much for you, adds Dr. DeBoard-Lucas.

The fears you face in exposure therapy can be tangible things or more nebulous concepts. 

While we tend to think of exposure therapy as a way to face our fear of something concrete—like needles or spiders or water—it’s actually often used to deal with the intangible things that cause us anxiety too. For instance, an exposure hierarchy can help you learn to tolerate uncertainty and fear of the unknown, which is a big, ominous, anxiety-inducing thing that’s top of mind for people with generalized anxiety disorder, Dr. Chesworth explains. 

Addressing an intangible fear like this works the same way, but you’d be putting steps on your exposure hierarchy to deal with uncertainty itself and relinquish your need for control, Dr. Chesworth says. For example, you might like leaving extremely early for appointments because you’re nervous about what parking looks like or if you’ll get stuck in traffic. One item on your list would be that you show up half an hour early instead of an hour early. 

Exposure therapy can even address fears around physical symptoms—like if you deal with panic disorder or health anxiety. A therapist might help you learn to tolerate symptoms that usually trigger your health anxiety or a panic attack (like a racing heart) using “interoceptive exposures,” explains Dr. Chesworth. For example, some of her clients might avoid working out because they’re afraid of a sudden heart attack, so she’d have them run stairs or in place to learn, over time, that increased heart rate from exercise won’t up their risk of a heart attack.

It’s the same with panic attacks. “You can tell someone all day long that panic symptoms aren’t dangerous. But they’re not going to believe it until they can learn to experience the symptoms and see for themselves that they’re not dangerous and stop avoiding the things that are bringing on those symptoms,” Dr. Chesworth adds.

Exposure therapy can also help with OCD, trauma, and PTSD.

A specific type of exposure therapy used in OCD treatment, called “exposure and response prevention” or “ERP,” exposes you to what makes you anxious or afraid, and then encourages you to not  do whatever compulsion you usually engage in to lessen your anxiety, Dr. Sussman explains. For instance, if you feel like you have to check the stove one, two, three, four times, this might look like leaving the house without checking at all. If you’re someone with relationship OCD, you might purposely read an article about signs your partner’s The One, then refrain from asking anyone (even them) for reassurance.

Treating PTSD also often involves exposure therapy.  Experts can help patients confront traumatic memories with a specific exposure therapy proven to help PTSD symptoms called “prolonged exposure” or “PE,” explains Dr. Sussman, who offers this type of trauma therapy. PE usually lasts for about three months, according to the APA. With PE, a therapist might have you repeatedly talk through a traumatic memory—what the APA calls “imaginal exposure”—and name thoughts and feelings that make you not want to relive it, such as, “If I had done things differently, this wouldn’t have happened,” Dr. Sussman says.

You’d then go over what Dr. Sussman calls “hotspots” of the traumatic memory that are the hardest to think about. You might slowly work your way up to going places or doing things that remind you of the trauma—stuff you tend to avoid—like walking at night, Dr. Sussman says. You’d do a lot of these situational exposures outside of therapy when you’re ready, she notes.

If you think exposure therapy might be right for you, check in with a mental health professional.

If you’re interested in this type of treatment, look for a therapist who specializes in exposure therapy by tailoring your search online. Check resources like Psychology Today, where you can filter for mental health pros who offer ERP and PE. You can also look at the International OCD Foundation directory for therapists who might have experience with ERP. Try the Academy of Cognitive and Behavioral Therapies to narrow down mental health pros with exposure experience through their CBT training or with an exposure therapy speciality. 

Keep in mind that even though you have a therapist walking you through this process initially, you’re very much in the driver’s seat because doing exposures on your own is a big part of the process. In-session exposure once a week isn’t enough for progress’s sake, says Dr. DeBoard-Lucas. You’d practice making phone calls in a session, if that’s what you’re anxious about, and then continue doing those calls at home, she explains. You’d also have your therapist help you prepare before doing exposures away from them, assures Dr. Chesworth (it’s not completely DIY). 

This will give you the tools and confidence to cope without your therapist later on in life. “Learning how to approach the whole thing so that you can design an exposure for yourself can be powerful because you can teach yourself how to get past fears,” Dr. Sussman says.

The post Everything to Know About Facing Your Fears in Exposure Therapy appeared first on Wondermind.

Q&A Link Copied 12.28.22

Pro Skier Drew Petersen Is Grateful to Still Be Alive

Being diagnosed with bipolar II and PTSD made him feel like a science project, but it was also super validating. BySam Brodsky

Heads up: The following article discusses suicidal ideation.

Drew Petersen began his professional career as a backcountry skier when he was 19. He’s climbed and skied down enormous powder-covered mountains, getting filmed along the way. In 2017, doctors told Petersen that he was lucky to be relatively unscathed after a rock he describes as the size of a microwave landed on him while ascending Oregon’s Mount Hood. Though he physically recovered, the effects the accident had on him mentally were difficult to ignore and exacerbated struggles he dealt with since he was a kid.

Here, Petersen talks to Wondermind about overcoming PTSD post accident; navigating a bipolar II disorder diagnosis; finding strength in therapy; and embracing (yes!) the wonderfully complicated, sometimes scary, often beautiful human experience. He shares all this because, he says, “the people who are struggling and feeling the deepest, darkest pain need to know that they’re not alone.”

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WM: How are you doing lately?

Drew Petersen: Big picture, I’m doing really well. Big picture, I’m living the life that I want to be living. I’ve found a lot of meaning in what I’m doing, and I’ve found my purpose, my North Star, and my compass for being here on this planet. That compass is on shaping and changing the future and culture of mental health.

On a smaller scale, I’ve definitely kind of been in a little bit of a whirlwind. I’ve been traveling nonstop the past three months. This week I’m home, and I think I’m sleeping in my own bed for five nights in a row, which is the first time since the middle of August. So I’m very happy to be home. While, you know, it’s primarily good work that I enjoy, I’m definitely feeling it. And for me, having bipolar II disorder, I really need routine and consistency in my life, so that’s definitely been a bit of a struggle. I’m just trying to lean back onto that mental health toolkit that I’ve built  to avoid going into a depressive episode.

WM: And what’s in your mental health toolkit?

DP: Previously, my mental health toolkit was almost exclusively just outdoor athletic pursuits. And those are still really key to me. But my journey has been about building a much bigger toolkit. For me, it’s still skiing and running, but in addition to that, it’s making sure that I’m taking some alone time and continuing talk therapy. I just scheduled a couple appointments with my therapist yesterday. Also, getting consistent and quality sleep is just really key for keeping equilibrium in my brain. I have a daily meditation practice and a daily gratitude practice where I write down a list of 10 things I’m grateful for both on a macro and micro scale. Everything from a hot cup of tea to being on this planet. 

Another part of that mental health toolkit is leaning into working on creative projects and trying to center back to where I find meaning in what I’m doing. And then another part that I’m constantly trying to work on is building a stronger social life, which is still a challenge. A lot of my professional life is online, so as much as I love how many people I get to connect with digitally, in-person interaction is where it’s at. And it also means going from a social life that was primarily built on friendships based around skiing and drinking, to having real depth in my friendships and creating really solid connections.

I’m almost three years sober, so sobriety’s part of the toolkit too. 

WM: You said in your short film, Ups and Downs, that skiing gave you “emotional control” growing up. Can you elaborate on that?

DP: On a basic level, skiing releases a lot of positive chemicals in your brain by being outside, but also, for me, where I found a lot of emotional control was when I was taking risks and I was skiing really hard. If you’re skiing fast and jumping off cliffs, like I say in my film, that’s gonna be a rush of chemicals to your brain and that’s gonna feel really good. That actually speaks to a conversation with my neurologist the first day that I met him [in 2019]. … He was the first person to make me see that it was emotional control I was getting from skiing at a young age that I wasn’t able to get elsewhere. 

I also used skiing to distract from and avoid my emotions and some of my personal internal struggles. … As I got older, skiing became really the only source of stability or happiness in my life. I used it to, in many ways, keep going.

WM: Growing up, when was the first time you remember struggling mentally?

DP: The earliest memory that I have of suicidal thoughts is from when I was 9 or 10 years old. I was in the fourth or fifth grade, and the memory that I have is from being in my elementary school. And it took a lot of years of therapy for me to even remember the memories of struggling when I was a kid. It was just a survival instinct by my brain to tuck them away in a file cabinet and try to forget them. Honestly, those memories are something that I still struggle with and something that I’m still working through in therapy and trying to unpack. 

With a lot of the work I’ve put in, I’ve been able to heal over a lot of my wounds. A lot of ’em are still scars—some of ’em still pretty ugly scars—but the memories from when I was a kid…they’re still open wounds and I still feel a lot of pain from that.

As a kid, everything that I felt was at 110%, both good and bad, high and low, and happy and sad. I definitely had an all-or-nothing mentality. I always had to be the best with skiing or with school, but that runs out. When something would go wrong, I’d also freak out and get really angry, so in hindsight, that full spectrum at both ends made a lot of sense after I got that [bipolar II] diagnosis [in 2019]. 

WM: You also mention in the film that getting a PTSD diagnosis from your therapist in the fall of 2018 was validating. Why was that?

DP: When I was diagnosed with PTSD 15 months after a near-death accident, it validated what I was feeling in that I wasn’t making it up. It was really going on, and having a diagnosis meant that there was something we would do about it too. On a broader scale, I think diagnoses are like a double-edged sword sometimes. For me, especially when I was so deep in these struggles and so deep in my mental health journey, a diagnosis just made me feel like a science project. But then the flip side of that is exactly what I said: It’s validating. It means that what you’re experiencing is real, and it means that there’s something we can do about it.

WM: You said in your film that being a pro skier isn’t your whole identity and neither is being a person with bipolar disorder. Can you walk me through how you came to that mindset?

DP: A crisis of identity was a really big part of the overall struggle for me, especially my identity as a professional skier. I had been dreaming of being a professional skier since I was in elementary school when teachers asked, “What do you want to be when you grow up?” And it took a lot of work to make that happen. Then, I was struggling with physical injuries, mental illness, and concussion problems and the neurological fallout of that [post-concussion syndrome]. And it really seemed like everything that I had worked for was going to be taken away.

I really felt like going through this experience was going to define me as someone who had thought about killing myself. When I was in therapy and really deep into depressive and suicidal episodes, that was how I was defining myself. Those diagnoses are really easy for someone on the outside to see as an explanation of my identity or an explanation of how I act, and so I felt like I was getting my identity boiled down to that.

But the experience of being able to come into acceptance with all these different parts of myself ultimately comes down to: All of these things can be true. I am my own person. I am defined, and my identity is defined, by who I am and who I am when I look in the mirror. It doesn’t matter what other people define me as. It doesn’t matter what other people see my identity as. … Who I am is so many different aspects and adjectives, and it’s how I carry myself in the world. It’s not just a job or a diagnosis. 

WM: How do you define yourself now?

DP: I am a deeply passionate, spiritual being and human who is intimately connected to the earth and to the mountains. I am someone who enjoys celebrating the beauty and vibrance of being alive on this planet. I am also someone who embraces the depths and the pain of the human existence. I am someone who is very grateful to still be alive and to be on a path to help other people. I’m also someone who is on a lifelong path of personal growth. That’s who I am. 

WM: What was going to therapy like for you?

DP: A flaw and a strength of mine is that all-or-nothing mindset, so when I went, I was committed, but it took a really long fucking time to go. It was 15 months after that accident, and I was in a really dark place. It took a really long time to actually follow through with asking for help. Then, once I did, my very first appointment, my therapist asked me if I was thinking about killing myself, and I said yes. That was the first time in my whole life that I’d said yes. Even with those memories that I have of being a kid, I’d never actually said it to anyone. I mean, what’s empowering about that is that finally someone knew. It wasn’t only me. 

It was pretty obvious to me that it was PTSD, and I think I maybe got too locked into like, “If I heal this PTSD, I’m fine.” I went about it with a goal that I was gonna be alright if I took care of this. I processed the accident and got myself to a good place with it, but I wasn’t fine ’cause we had just kind of broken the lid on what I had bottled up for my whole life. … I do still see [this therapist].

WM: What message do you have for people who are on the fence about going to therapy?

DP: Therapy is just a structured way to learn how to live your life better, and that can help every single person on this planet. So, if you’re wondering if therapy’s for you, or you’re like, “Well, I’m not struggling that bad,” or like, “I don’t think anything’s actually wrong with me,” you don’t need any qualifier to benefit from therapy.

I think that there are a lot of people who are curious about therapy, who are questioning their self-worth and questioning if their struggles are valid [enough] to need help from another person. And ultimately, if you’re a human being on this planet, you are worthy of help and love and understanding and a place to be yourself. That’s it. 

This interview has been edited and condensed for length and clarity.

If you or someone you know is experiencing suicidal thoughts, the 988 Suicide and Crisis Lifeline, formerly known as the National Suicide Prevention Lifeline, is available 24/7. 

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