Your Labs Are Fine

Chronic Illness After Emotional Abuse

Yesterday, as I sat in a shabby medical clinic waiting room for another round of bloodwork, I noticed a sudden, painful sensation in my throat. It felt like a hand grabbed the inside of my throat and squeezed. Immediately, I began to wonder if I had potentially ingested some unknown allergen, but before I finished the thought, the pain moved simultaneously down into my chest and up into my lower jaw.

The pain was sharp and so intense it about took my breath away. I’m no stranger to panic attacks. I’ve had panic attacks where it felt like a solid brick was put on my chest, but this one arrived without warning and with different symptoms. As the first wave of pain began to lessen, I wondered if I was dealing with a panic attack or if I was experiencing a medical emergency. If so, being in a waiting room was probably the best place, but the room was too small and crowded, and all at once, my nervous system chose flight.

I got out of my chair and ran to the front door, seeking the quiet solace of the inside of my SUV. The blast of hot air hitting my face as I yanked open the door felt like pure bliss. I turned on the air conditioning and practiced my deep breathing as I drank some electrolytes and downed some Tums after googling and learning that it could be A. acid reflux, B. Panic attack, or C. heart attack. I figured I might as well hydrate if my heart was about to give out.

I was there to test again for Celiac disease after my first round, which may have been inaccurate. To solve the mystery of “why is my body like this?” I’ve been exploring every medical avenue I can think of with my range of symptoms, yet so far, the only thing I’ve been diagnosed with is PTSD. I didn’t go back into the clinic, knowing that going back in would only bring about a repeat panic attack. The pain in my chest and jaw lingered just enough to remind me that it would be happy to return if I dared face the dreaded needles once more.

Once I was safely nestled in my pile of pillows and weighted blankets, I began tracing my thoughts back, which is a crucial step for me to understand my triggers so I can be prepared for the next time. I wasn’t aware of any thought processes while sitting in the waiting room. My primary emotion was discomfort due to the severe bloating eating gluten gives me. I sat and doomscrolled on my phone to dissociate, but I noticed a few thoughts popping up as I thought back. I swatted them away like little gnats, but the thing about doing that is that some thoughts demand to be known. The idea that kept coming up was, “What if this test is negative too?”

I have a lifelong major needle phobia. Whenever I go in for bloodwork, I prep the medical staff working with me by telling them that my veins are tiny and obnoxious. Going in at my elbow is useless, and I show them the vein on top of my arm or my hand and say it’s easiest to go in here with a butterfly needle. I say this to explain that, even before I had PTSD, bloodwork was a whole ass ordeal for me. I’ve sucked it up and acted like my own hype girl in the name of a possible diagnosis, but at every turn, my results have been negative.

My doctors agree that my symptoms are pretty concerning and shouldn’t be happening, but my labs are fine. That phrase is one I’ve heard a lot of chronically ill people use, but it’s hard to express the heartbreak that comes with hearing it. I know I’m not OK, but I’m running out of avenues to explore, and let’s face it: medical care in America is a luxury. It’s insanely expensive, and I don’t have the kinds of funds necessary to finance a prolonged investigation into my health.

The thought that these tests might be negative was so distressing that it sent my body into a tailspin. I was embarrassed as I thought back on my flight from the lab, especially as I knew it meant I’d have to work myself up to do it all over again. The worst part is sitting with the knowledge that there literally might not be answers aside from my PTSD making me physically ill, PTSD that I developed after months of prolonged stress.

I believe PTSD should be classified as a physical illness because the physical symptoms those of us with PTSD have are very real. The pain may have originated psychologically, but there is no denying that there are physical issues that come with having this mental disorder. I started to wonder, even though PTSD is not classified as an autoimmune disease, what would happen if I treated it like it was?

In addition to the physical damage done to a brain with PTSD, people who live with PTSD live with near-constant levels of high cortisol. Cortisol is a stress hormone that plays a crucial role in your body. High cortisol can affect your metabolism, immune system, and blood sugar, which, again, shows very real physical issues.

The impact of long-term levels of high cortisol:

• Immunosuppression: Chronic high cortisol can suppress the immune system, making it much easier for you to become sick. There is science behind this, but the constant inflammation that comes with high cortisol leaves you more prone to colds and other illnesses.
• Inflammation: Prolonged high cortisol means your immune system becomes resistant to cortisol and begins to store this stress hormone wherever it can, which causes chronic and widespread inflammation.
• Hormonal Imbalance: ask most women out there, and we’ll tell you hormones are a pain in the ass. Still, chronically elevated levels of cortisol will interfere with other hormonal systems and can mess with reproductive health and cause fertility issues or an irregular menstrual cycle.
• Cardiovascular Effects: Long-term high cortisol levels increase the risk factor for heart disease. Living with a constantly racing heart leads to high blood pressure and other heart-related issues.
• Cognitive Issues: High-stress levels associated with cortisol can cause memory loss or trouble forming new memories. They can also contribute to feelings of overwhelm, which leads to executive dysfunction.

PTSD is classified as a psycicatric disorder, however, ashs shown above, living with PTSD means living with your stress hormones running rampant and leaving a world of damage in their wake. Let’s take this discussion a step further. What if we directly compared the physical symptoms of someone with PTSD with autoimmune conditions?

• *Please note: the symptoms I am describing below may not cover every symptom of PTSD or specific autoimmune disorders, as both have a wide range of physical symptoms.**

Physical Symptoms of PTSD:

• Widespread muscle tension is similar to the sensation of “bracing for impact” before a car crash. Your body tenses up and can’t relax, leading to pain spread throughout the body, including back and joint pain.
• Increased Heart Rate: You know that feeling when there is a good jump scare in a movie? Your heart races with fear as your body fills with adrenaline, reacting to the perceived threat. Living with PTSD is like living with that feeling and not knowing when it will end. You may also sweat profusely and shake like a little chihuahua in a sweater.
• Weight fluctuation: You may gain or lose weight at times. Your body's reaction to stress can cause these weight changes.
• Fatigue: PTSD and constant exhaustion go hand in hand. It’s hard to fall asleep and stay asleep with PTSD, especially with the nightmares that plague our brains.
• Digestive Issues: This includes stomach cramping, bloating, acid reflux, nausea, and diarrhea. High cortisol levels can also erode the lining of the digestive tract, causing inflammation and inhibiting the stomach from digesting food properly.
• Inflammation: There is some research out there that shows the connection between PTSD and inflammation, which suggests a connection between mental stress and physical health.

Now, let’s look at autoimmune diseases. In these diseases, a person’s immune system perceives everything as a threat and attacks its own tissues.

Physical Symptoms of Autoimmune Diseases:

• Fatigue: chronic fatigue is an autoimmune red flag. You could get a whole night of deep sleep and wake up completely exhausted. Daily activities can feel exhausting, and many people with autoimmune diseases must carefully limit their energy reserves.
• Inflammation: the body’s immune system mistakenly attacks its own healthy tissues, causing inflammation. This inflammation can affect many body parts, including joints, skin, and organs.
• Skin rashes: Certain chronic illnesses or autoimmune diseases have hallmark rashes. Others may have hives, itchy, easily irritated, or painful skin.
• Joint and muscle pain: Many autoimmune conditions cause painful joint swelling, muscle stiffness, and deep muscle aches.
• Weight changes: Unexplained weight loss or gain. This could be due to medication, hormonal fluctuations, or stress.
• Digestive Issues: Autoimmune diseases can also affect the gastrointestinal tract, leading to symptoms like bloating, diarrhea, or constipation.

There are overlaps between the physical symptoms of PTSD and autoimmune conditions. Not every symptom between the two will match, as both autoimmune diseases and PTSD are very complex, and people experience them differently. However, both autoimmune diseases and PTSD lead to chronic pain. Overwhelming fatigue is another key factor that both autoimmune diseases and PTSD experience. To complicate matters, as said earlier, PTSD is linked to an increase in inflammation, which again is an autoimmune red flag. I know there are differences, but both conditions are so complex and challenging to find help for. The more we talk about the similarities, the more awareness we can raise for complicated health issues that deserve solutions. I hope that people like me who are sick and searching for answers will be able to find solutions for the complexities of the pain they experience.

**Please note: I am not a mental health professional. I am writing based on my own experiences with emotional abuse. If you are experiencing abuse and need professional help, please seek out a trauma-informed therapist**