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PTSD: Sleepwalking or Dissociative like episodes with Night Terrors

PTSD: Sleepwalking or Dissociative like episodes with Night Terrors 

This is a topic we actually got on in another posting regarding binge eating at night, unknowingly, when awakened from nightmares/night terrors.

This is something that I am actually very familiar with and “seems” to be what Craig has been experiencing since his PTSD anniversary time back in October, when PTSD and Depression symptoms were higher than everyday normal.

We could not figure why Craig was experiencing weight gain, especially when I am the one that monitors his eating, and makes sure he eats. His cognitive dysfunction does not allow his brain to relate feeling/being hungry to the need to eat. For awhile we thought it was medication related and lack of exercise, which reality is part may be related, however not to this extent.

Then it happened. He was found in the kitchen at night after being awoken we will say, from a nightmare/terror. He was eating all sorts of things, and had no recollection of even getting out of bed, and sure did not know he was up eating. It was not like normal sleepwalking. He was fully alert… and sure could make a peanut butter and jelly sandwich… one right after the other.

So we kept a close eye on him throughout the nights to follow after discovering this. This is part of the reasoning behind us taking shifts sleeping, when I sleep he stays near me and does not leave so I can get sleep, when he sleeps I’m awake. Physical nightmares are the other reason behind this “for now” sleep shifts pattern, which we are working on changing and getting back to a better normal.

Sure enough, I noticed he would be having a physical nightmare, terror I believe would be the correct term for it, very stressed, then he would come up out of the bed and head to the kitchen.

For awhile I could not understand why when I woke in the mornings, there would be food out on the counters, bread left open, and there were those pb&j containers sitting there, along with other things. I honestly thought one of the kids were getting up at night, until we discovered it was actually Craig. But, he had absolutely no memory of it, to him he never got out of bed and had slept the entire night.

So we spoke to the doctors regarding it. It still has not been defined as dissociative episodes or sleepwalking and night terrors. However, since PTSD symptoms have decreased some, and we are past the PTSD anniversary time frame, this binge eating unknowingly at night has eased off as well.

After hearing that someone else has witnessed something similar from their PTSD loved one, I thought this was a good topic to touch on. You know how it is, if one person experiences it, there are probably more that do as well… and may think they are alone in what they are experiencing.

I located a study this morning that I wanted to pass along to those interested in reading it. I found it quite interesting and relates to this topic. The examples are civilian, but I have a feeling it really does not make a difference of trauma type a person experienced. Now, I do know that Craig’s has nothing to do with any childhood trauma, his traumas were all military related (respectfully, without going into details of his traumas, because there are traumas he has not told publicly.)

“Is there a dissociative process in sleepwalking and night terrors?”
D Hartman, A H Crisp, P Sedgwick, S Borrow
Postgraduate Medical Journal

It will be interesting to see if others with PTSD experience night terrors and sleepwalking. Also, are dissociative episodes common during the day as well or not, if you experience this.

(To see comments by others please visit my facebook page for this posting)

~Bec
A Spouse’s Story PTSD : Facebook page

Have you thought about the effects of Nightmares? Other than the obvious…

Has anyone ever thought about the effects of nightmares?

The most obvious is your sleep schedule and the effects of having the nightmare/terror in the first place.

I want to talk about the not so obvious effects of them. We have some huge ones going on here, and finding a way around them has not been so easy.

Just to note, Craig has nightmares every night, I honestly can not recall a night he hasn’t had at least one, many nights they come over and over again. He’s on medications for them, he uses coping skills and relaxation techniques, he watches what he does and even what he eats/drinks before bed, we watch that no conversations that could be intense happen before bedtime, we make sure everything is calm and relaxed environment… we do everything that we have been taught or learned on our own to do.

But there are still nightmares, and they are bringing different issues that ones may not always think about.

These are some of the things I hear a lot of each week, some daily:

“Why aren’t you in bed?” or “Why are you up?”

The obvious answer is because he is restless during #nightmares and I have to leave our bed. It’s a touch one! There’s more that comes with that then you may think.

Do you have any idea how difficult it becomes to tell one with PTSD that you are not in bed with them because they were having nightmares? It wasn’t difficult at first. But when you start hearing the same question every morning, then you see what the answer does to them, it becomes really hard to answer.

I have actually tried saying things such as, “I doesn’t really matter, how are you doing this morning?“. And even avoiding the question by moving into conversation “Hey are you ready for coffee” or “Hey I read this….“.

I’ve even looked at him and kindly stated, “Craig, do you really need to ask that question?“, in a loving tone. But you know what, it doesn’t matter, he has to hear the answer even if it’s the same thing over and over again. It’s like it’s a cycle of need to know that can’t be broken. He has to know if I am out of the bed because of him. And don’t even say it, there is no making up a reason, I have to be truthful or trust will be tampered with. And his IQ hasn’t dropped lol, he would know if I didn’t give him the correct answer. He knows if the sheets are are messed up and pulled off the bed, he knows how the dog is responding to him, he knows if there is sweat on the bed… there’s no altering the truth.

There are occasions that I do just wake up early, how could I not? LOL. My time clock has changed because of him having so many nightmares. You would have never caught me awake at 2, 3, 4 o’clock in the morning before. And that leads to the next issue…

“I never get to wake up to you in bed with me.”

See, before Craig’s PTSD became so severe, we woke up together. Most morning, apart from occasional nightmares, we woke to seeing each other’s faces right there beside on another. We would lay in bed and talk, just snuggle. It was a fresh start to every morning.

It’s very rare for us to be able to do that now. Craig states it very clearly, “I ran you out of bed again.” When he wakes up now, he instantly looks towards my desk. He knows that if I’m not beside him in bed then most likely I am across the room in my safety zone.

I use to leave the room when I had to get up, but that wasn’t working out too well for him, or me. He would wake up with a migraine and need me there, or not grounded and then once becoming grounded would not know where I was and panic, even though I was in the same place every time. So we were told the best thing for us, was for me to stay in the room to ground him or be there to help him if he woke with a migraine. So I am, it’s the best thing for both of us.

But back to the statement, “I never get to wake up to you in bed with me.” That’s a difficult one to get around. I see the damage it does to him, I see the look on his face, the guilt he feels… and it’s not good.

It’s something that has changed our relationship because of PTSD. It sounds so simple and small, but in reality it is something very large.

I have even tried going back to bed once a nightmare passes. But guess what happens? Yes, another one just follows and I’m out of the bed again. These are things he can’t control, there’s no reason for him to feel bad or guilty, it’s just a part of how life has changed with PTSD being a part of it. But you know what, it doesn’t make a difference to how it makes him feel, and in return how it makes me feel when I see the look on his face and know what he is thinking.

I have even explained to him that I don’t mind being up early. The house is quiet, I sit here and write before the day gets started. I always say no big deal I can take a nap during the day to make sure I am getting sleep. But you know what, it still does not make a difference in the way he feels. It makes him feel as if he is a burden and that I deserve better then what PTSD causes me to go through.

I accept PTSD, I understand it, and I sure don’t put him down or hold it against him, and I have adapted to what comes with it and how to handle it when it does. That early morning up gives me some “me” time to write, I actually love that. Sure I would much rather be in bed with my husband, but that’s just not possible during parts of many nights. I’m there when I can be there. But it still doesn’t change how it effects him.

When he wakes up, the first feeling he has I am sure I can describe it as he feels alone. PTSD causes that in the first place, but when you have a relationship like we have had, that waking up with your partner not beside you does effect you greatly. There’s no just getting over it, letting it go, or accepting the facts it’s okay. It’s right there, in your face, with waking each morning that PTSD is indeed a real part of your life, and it hasn’t just gone away.

That’s tough! Something that seems like it should be so simple but yet carries such great meaning and emotional pain.

I don’t know the answer to these. All I know is I keep trying new things, new ways of saying things, reassuring that it’s okay and I still love him just the same… and hope one day the effects PTSD change, at least some.

Moral to me sharing this…

Don’t dismiss the things that seem so simple. PTSD effects people in ways you may not realize, and differently then things may effect you. Always take all things into consideration and never give up on trying to find ways that work and finding things to ease what comes with #PTSD.

And to Craig,

I love ya babe! And even though I may have to be across the room when you wake, I’m still here. 

~Bec
A Spouse’s Story PTSD

PTSD vs. Non-PTSD Nightmares

I have had several people mention that other people don’t understand their nightmares and the impacts the nightmares have. I guess it would be difficult to understand if you do not understand PTSD, or don’t understand it very well.

PTSD nightmares get compared to non-PTSD nightmares. The “Oh I have nightmares too but I don’t let them bother me” or “I have nightmares to, get over them”. It’s something that is really easy to think and get in the mind set of just get over it, IF you don’t suffer from PTSD. 

However, to one with PTSD there is no “just get over it, it was just a nightmare and not real.” There are key words there being misunderstood… “not real”. See to one with PTSD, their nightmares are not like others, those nightmares are indeed very real. No, the event of the nightmare is not really happening… but it’s of a real event that did happen!

One with PTSD relives the trauma that happened to them, over and over and over… it’s what their nightmares are of. They can not wake up, say “oh I just had a bad dream” and go on about their day. They just relived their trauma through a dream, so when they wake up from it, it’s like that trauma really happened all over again. It brought all of those feelings, thoughts, visions, etc. of their trauma right back to them.

Many times when they do wake up they may be disoriented and have to be “grounded”… Brought back to the actual time and place of the present. To them, they are still there and it is still happening, and it is very real based around a real event which they went through that changed their life.

Ones with PTSD relive their trauma psychologically, it’s not something they can just get over, suck up, or move past. It was a very real event that was severe, and nightmares are one of the things that effect them.

So please have consideration when voicing about nightmares. One with PTSD does have different nightmares then a person without PTSD, their nightmares are real life events of severe trauma(s) that keep replaying themselves. Those nightmares/terrors can not be compared to your average nightmare of psychologically “made up” bad dreams of things that did not happen or won’t happen, they are based around real life traumas that were experienced.

~Bec
A Spouse’s Story PTSD

Nightmares/Terrors… What comes with them/ How to respond…

Nightmares/Terrors

Okay, we all know what they are, we know that they come greatly with PTSD, the demons of the night as they are referred to as, but what else?

It is important to know what can come with nightmares/terrors and how to respond when those things do.

Spouses and loved ones, you really need to tune in to this! Many loved ones fear nightmares. Fear comes from the unknown and not understanding things that could help, so let’s go over a few things that I personally have found that help.

* Loss of sleep.
This one is one we all know well. Nightmares/terrors leave you with restless nights filled with anxiety no matter which side of the fence you are on with PTSD. You HAVE to get sleep, a walking zombie is not good to or for anyone! When you have a sleepless night, or one that was not true sleep and restless, make time to take a nap during the day, get rest when you can even if it’s a power nap of 10 minutes. Every little bit can help. If you have young children, put your mop and bucket down and nap when they do!

Before going to bed, the hardest part for one with PTSD is getting into bed knowing what most likely will come, relax, watch what you eat or drink, listen to soothing music, don’t watch tv/movies or news that could effect your anxiety, use coping skills and/or meditation. And try to think positively that tonight is going to be a good night, I am going to get some sleep and be rested. It’s almost like tricking your brain into finding peace before bed, I know it’s not easy, but with practice it could help.

* Movement while sleeping.
Loved ones, pay attention! Nightmares/terrors can get rough during the night. Don’t freak out over this, it is normal in many cases of PTSD! This is where you have to use safety protocol.

If your spouse moves around in their sleep, swings/punches and the fight is on, don’t stay in the bed waiting for it to end! What works for me, get out of the bed calmly without a lot of movement, slide out of bed as I say it. Go to the other side of the room out of arm reach. If your spouse is one that comes up out of the bed, a good position is out of reach and at an angle that would not be a normal response movement for them to get to quickly.

Many doctors state that a certain level of nightmares is useful, it helps the brain process the episode which happened to the person. Others believe differently. So do what you feel is best for you as far as handling nightmares/terrors.

Some have found themselves in a situation where they “need” to sleep in a different bedroom or separate bed. If this is your case, make sure you take the steps to keep intimacy in your relationship. Having to sleep in different locations can make a relationship very difficult. Take time before bed to sit with each other, talk, have personal time, etc. before moving to where you now have to sleep. This helps keep the relationship bond between the two of you.

I myself was faced with being told we needed to separate sleeping arrangements a few years ago, however I needed to be in the room to ground him when he wakes…this did not settle well with me at all! Alex, my dog, was specifically trained to handle getting myself out of bed when nightmares start and then return to Craig, so this has been our solution to the issue even though many do not have this option. Point is, yes, we found a way to still be able to sleep together at this point and my safety comes first.

* Having to wake someone.
DO NOT touch a person who is having a nightmare/terror!!!
Doing so could place you in the middle of their trauma! And that’s not a very good place to be. Remove yourself like I mentioned above then if they need to be wakened, simply talk to them calmly from out of arm reach. Tell them who you are, where you are, and that they are dreaming. This helps to ground them back to the current time, place, and who is actually there.

* Once awake.
Once one is awake after a nightmare/terror, make sure they are grounded. It’s okay to ask them what they were dreaming, but never demand it! By asking, it gives them an open door to talk IF they want to. If not then let it go with an “okay, are you okay now?” It shows the concern is there and leaves the door open for conversation if they choose.

Many do not remember what they dreamed. This is normal! It’s a way the brain protects itself, by locking it away. When the brain is ready for one to remember, don’t worry, it will. Many times with traumatic events portions of what happened will not be recalled, over time it might come back to you, other times it never will.

* Talking during nightmares/terrors.
This leads on from the last section. I have found that I know more of what happened then my husband remembers due to him talking in his sleep. If your loved one talks in their sleep, you do NOT need to tell them everything they said when they come to. Leave that door for them to decide if they want to know or not.

Again, the brain protects itself and in some cases if the loved one says “you said this and this and this” you have a very good chance of triggering something or an argument starting… fight or flight, come on now, they just had a nightmare and don’t know what it was then you start in on them? DON’T! Don’t overwhelm them with what came out while having nightmares/terrors. This is something to be cautious with. Sometimes it might be best to discuss what came out, with a doctor present just in case the one with PTSD does not know how to handle what they are hearing. Do what’s in the best interest of them! A doctor may want to speak with you alone first then address or decide if it needs to be addressed yet to the one with PTSD. So loved ones, don’t be a motor mouth on this one.

You as the loved one my also find times where the one with PTSD believes you are someone else while they are dreaming, they may talk directly to you and respond to you as if you were the person at the traumatic event which happened. This is when I personally go back to the step of talking him back to time and place and who I am to ground him. Think about it, you don’t know what is going on in that nightmare and you might not want to play the role of who they think you are… so don’t put yourself in a role play position!

To sat the least there are many things to consider and keep in mind on how to handle nightmares/terrors. These are just a few from my opinion and what works for us personally. Nightmares/terrors are no joke, so never just brush them off as they are. They are the brain’s way of processing what happened to them when their defenses are down while sleeping.

Have a plan in place to handle what comes with nightmares/terrors and never over react to them. No one with PTSD purposely harms their loved one that gets caught in the middle of their nightmares/terrors, and they sure feel the guilt when something does happen. So to avoid this, do what you can to take precautions and use safety protocol. Nightmares are not their fault, it’s what happened to them, remember that!

~Bec
A Spouse’s Story…PTSD

“PTSD vs Nightmares”

“PTSD vs Nightmares”

Oh the one we all know so well! One of the true signs of PTSD. Even though it’s the one symptom that we all are use to being there, they are also something that are just chalked up to PTSD and accept are there without really talking in depth about them, and what comes with them.

Craig can have anywhere from 2-12 nightmares in one night. Something we have adapted to over the years. He can come “to” and fall back asleep and 10 minutes later here comes another one. To be honest, I have learned a lot about what caused his PTSD because of these nightmares, even before he could tell me everything that he experienced, and some he still has locked away…but I hear them in his sleep. Those I refer to as the missing puzzle pieces for him.

Many doctors do give medications to “help” with these, which Craig is on. Do they stop them, no, not really. But they do help to the point that he’s not always up pacing the floor all night anymore, and he can fall back to sleep after having one.So, we all know nightmares exist with this. But what do you do? How do you cope? What all comes from this happening? There is a lot more to it then someone just having a nightmare.Nightmares are associated directly with the event(s) which caused PTSD in the first place. Reliving it over and over in your sleep. We personally have had doctors tell us different things on how to handle these. What’s the right way? Got me! LOL! We’ve tried it all!One doctor said to wake him up when they start. Well, now that can be a tricky one for many. It sounds like something easy to do, but it’s really not that easy. Not a doctor here, as I always remind you, so can’t and am not giving medical advise. Just telling what we have gone through. You have to always keep in mind that the person with PTSD is having a nightmare, that means they are not coherent to the present time, when they are waken they are not grounded to real time or place. You can’t just grab their should and say hey wake up. That in some cases, and many military related cases, end up with someone getting hurt unknowingly to the one with PTSD so not on purpose. When the doctors told me to wake him during these, I looked at them like they were crazy! I think originally my words were something along the lines of “why don’t you come wake him up.” LOL! So, me knowing that touching him to wake him was completely out of the question, I tried different things. I found that sitting across the room, at an angle, which means out of reach or possible quick reach, was the easiest way. And just talking to him and calling his name along with telling him he is at home with me and everything is okay, was the easiest way to bring him out of them. That left safety at hand for myself.

Another doctor recently told me to let him dream through them. Oh that’s a fun one. I was told that the nightmares are the brains way of processing what he experienced, it’s when all of the brain’s defenses are down. We’ve tried this and I don’t see it helping at all in his case. It seems to lead to rough days even when this has been tried over a long period of time. This also leaves it to where he is extremely worn out and tired the next day…and so am I. But we’ve tried what we were told to do.

The other thing, and one that everyone does not have the opportunity for and some do not need, and I have my reasons for wording it that way so bare with this. I have trained Alex, my dog, to tend to Craig through the nightmares. It goes back to that animal human relationship. Alex can pull Craig through the nightmares and ground him when he does wake up, which in many cases is easier and the response from a human is different to an animal then if a human woke them or touched them. (Just to note, this posting is not about service dog conversation, that will be for another time because it is quite lengthy and I want to focus on nightmares here. 😉 ) Alex has seemed to be the best source for getting through the nightmares as of this time.

So, that is a simple covering of that part. But there is so much more to it. What about the spouse if there is one? I remembered as a child never understanding why there were two beds in older people’s bedroom. Or why you would find an elderly couple’s house set up with him in one room and her in another. That was a huge puzzle to me lol! No one ever explained why. Well, live with PTSD and you can kind of figure it out now. 😉 My first guess would be nightmares.

Craig and I were told by a doctor once that I needed to sleep in a separate bedroom. I looked at the doctor and asked what the other choices were? They didn’t know how to answer me. Then I explained that I personally have an issue with that arrangement. For several reasons. One, I have to be and was told by the doctor that I need to be there for Craig when he wakes to ground him back to the time and place we really are in. Two, I’m not elderly and like sleeping with my husband, I don’t think fondly of a room mate living arrangement, which in some cases is needed, but I’m not ready to do that. Of course the doctor was thinking of my safety, and that has to be addressed up front in all cases and never taken lightly. So I addressed it. I made ways that Craig and I could remain in the same room. Alex has been taught to wake me, if I don’t wake myself, at the first sign of any movement of Craig waking or a nightmare starting. I did not train him to go to Craig first, but to me, so I can get out of the bed safely and out of possible reach. There are many nights I have spent in my chair, across the room and at an angle, so I am there but out of reach. Then at times I make a thick pillow pallet on the floor so I can get some extra sleep…until I get that bay window bed built. 😉 I always go to bed with Craig and if it comes time for me to leave the bed, then I do. But I stay in the room for when he needs me.

Now what able when you are sleeping together? First and foremost, I will tell you that it weighs heavily on the person that has PTSD to know that because of “them” the spouse is losing sleep at night. It makes them feel guilty and like they are a burden. And nothing you say will change that feeling. However, I view it differently, if they can not control, which they can’t, their nightmares, then how is it their fault? They are not purposely keeping you from sleeping. It’s PTSD, and a part of what comes with it. They are NOT to blame! I’ll admit, sleep positions do change when PTSD is there. Craig and I use to always sleep with one of us wrapped around the other. That is not something that can be done anymore. It took time for me to adjust to that, but when you keep in mind it’s not their fault, you can adjust. The easiest, and safest sleep position? With our backs to each other. Out of Craig’s guilt he was feeling of actions coming from nightmares and such, he started sleeping with his back to me. I still believe in the kiss goodnight and I love you, sometimes he will put an arm around me but when he starts to fall asleep he rolls over. This is something that you can’t take personal! It’s not a lack of love, it’s a sign of caring about you and your safety. Once you can grasp that concept, it makes things a lot easier on your relationship. Be grateful that you still get at least some night time in the same bed, many don’t.

So, you had a rough night and there wasn’t much sleep. Everyone needs sleep. In our case, even though the doctors don’t like the idea but we found that it works for us, we take a nap while the kids are at school. There is something about napping during the day that is different in our case. Very rarely does Craig have nightmares during that time. I believe it’s linked to the actual clock time being different then when the original episodes causing PTSD occurred. During the day we can actually spoon on the couch, sometimes on the bed, without nightmares coming. I thought it was linked to napping on the couch, a different area, but that’s not it. (Just to note on that, doctors sometimes will say to avoid naps because they can interfere with night time sleep, but in our case they have allowed sleep and not made a difference.) You can so to speak, set your clock to his nightmares. Same time every night they start. Doesn’t matter what time we go to bed. Anyway, naps are of great help to us. They don’t change the time we go to bed, he’s still exhausted by that time, but allows us to get needed sleep.

Talking about your nightmares. This is something that is rarely done. But at times in our case, Craig will open up right after a nightmare and tell me some of it. Talking does help, that’s proven by doctors or there wouldn’t be talk therapy. 😉 I don’t know if helping right after they happen helps any or not at this point, but it’s something that we are trying. Craig does talk in his sleep, so I already know much of what he experienced. And i have been told that talking or screaming during nightmares is normal. I think it gives the spouse an insight that can actually help you understand as well as find ways or things that can help them.

*Also, if you have children in the home. Safety protocol should be in place. Children have to be taught not to wake a parent with PTSD, even taught that if the parent nods off or falls asleep to go to another room until they wake. A rule of no children in the master bedroom unless invited is a good one to have in place as well. If they need a parent, a knock on the door without opening it is a good rule. It gives the PTSD parent time to wake and ground themselves before going to the child.Always keep in mind that these are not just “bad dreams”, they are actually reliving a traumatic event over and over. Work on finding ways to adjust and cope as well as being supportive, it will pay off.
~Bec

From Craig…

 

From Craig:

Night after night I toss and turn, with nightmares and little sleep. In turn Bec does not get much sleep as she sleeps with one eye open watching out for me. She finally managed to get a little sleep today as we celebrated Thanksgiving with our family. I love ya babe, and thank you for taking care of me.

A Spouse’s Story PTSD