Life as a multiple has many aspects that we share in common with others who live with the diagnosis of dissociative identity disorder. But besides the existence of alters and the chaos that brings, I think the anxiety that comes with DID is one of the hardest.
The anxiety I’m speaking about here isn’t from dealing with the antics of alters. No, I’m talking about the pervasive and ever-present feeling that something bad is about to happen. You know, waiting for the other shoe to fall.
Living with Constant Dread
I know most multiples out there know what I’m talking about. That nagging feeling in your brain telling you to be ready to run at any moment. That internal alarm that is constantly listening for something or someone to hurt you. The horrible feeling that the world is going to explode, and you are helpless to escape.
I live with my brother, his wife and their young son. When they are home I feel wrapped up in knots in my head. I find it impossible to relax when they are home even though it is a reality that they are safe people.
But just knowing they are here and that someone might get angry or that my 3-year-old nephew might get himself into trouble fills me with dread.
I know very well that my home is no louder than any other and that I am safe here. But I can’t shake the feeling that I need to hide or run away.
Anxiety on a Daily Basis
These emotions are strong, yet on a typical day, I manage to avoid thinking actively about them. They just play in my head like background noise. But on days like today, when they have left for a few hours to attend church, I notice the anxiety. Not by its presence but by its absence.
All of this means that I not only live with dissociative identity disorder but also with an anxiety disorder. This is extremely common among those of you like myself who also live with DID.
Let’s examine the anxiety disorder I have, and the brain changes that cause it.
There are several different types of anxiety disorders. These panic disorders include obsessive-compulsive disorder, post-traumatic stress disorder, and the development of phobias. However, I although I certainly fit into more than one category, I think that generalized anxiety disorder is the best fit to describe me.
Generalized anxiety disorder (GAD) is best defined as feeling worried and tense when there is no reason to feel that way. The description even gets more personal to me when it states that GAD makes people living with it having constant apprehension, anticipating disaster and being overly concerned about their health, finances or work for no reason.
Oh, but it gets better.
The site I read also said people like myself are frequently unable to relax and have insomnia and poor concentration. Physically there are symptoms too like restlessness, fatigue, irritability, and high blood pressure. The list goes on to include sleep disturbances, avoidance of social situations and sometimes isolation.
The Structural Brain Changes from Chronic Stress
If you have the diagnosis of DID like me, then you lived as a young child under huge amounts of toxic stress that negatively impacted your brains development. This stress may have been caused by chronic exposure to abuse, war or a natural disaster such as a massive earthquake.
What this toxic stress does to the developing brain is only now becoming known as researchers delve ever deeper into the subject.
Some of these brain structural changes are well-established and documented.
Normal Brain Development
To better understand the structural changes from chronic stress, let’s first take a brief look at normal brain development.
The brains of children who are not facing chronic stress develop in a world where when they cry or babble a caregiver responds. What I mean is they get to meet their needs met and become securely attached to their caregiver (usually mom).
These interactions cause the baby’s brain to make and strengthen neural pathways.
Let me explain the term neural pathway better.
A neural pathway is a connection formed by axons (long nerve fibers) that make synapses (the space between the brain cells) connecting one brain cell to another.
Neurons (brain cells) are connected by axons to form a neural neuropathway.
Also, in children who are not living with chronic stress, there is normal development of some key areas responsible for our fear response and the consolidation/storage of memory. These areas of the brain are called the hippocampus and amygdala.
What Happened In Our Brains
Chronic stress changes a child’s brain chemically first and then anatomically.
Chemically the chemicals released into our bloodstreams that normally helps us respond to danger and experience the fight or flight response never go back to baseline.
One result is that we had decreased connectivity in some parts of our brains, the ones that regulate emotion and behavior.
Since as children we lived in a threatening world where our needs were met with our caregivers responding with abuse or neglect, we become hyperalert for danger.
Changes to the Hippocampus
The hippocampus is the brain region responsible for learning and memory. The function of this small brain region is to consolidate and place into long-term memory storage for new information. It is also responsible for making new memories easily accessible by filing them away with similar experiences from our past.
Toxic stress sets off a complicated chemical reaction and can reduce the capacity of the hippocampus. That means that not only can we experience lack of concentration and some difficulty learning, our memory is impaired too.
The memory impairment usually occurs in people with dissociative identity disorder in consolidating new memories and filing memories so we can retrieve them.
In 2006, researchers look at the brains of people living with DID to measure hippocampal and amygdalar volumes through the use of fMRI technology. The results were astounding. The hippocampal volumes were found to be 19.2% smaller compared to healthy subjects.
The toxic stress we endured as children changed is the reason we experience loss of time amnesia.
The hippocampus is our alert system and the first part of our brains triggered automatically to a perceived threat.
Changes to the Amygdala
The amygdala consists of two almond-shaped structures located near the hippocampus in the brain. Its purpose is to make you feel emotions and to perceive them in others.
These small structures are part of the sympathetic nervous system which tells our bodies we are in danger and triggers the fight/flight/freeze response.
When the hippocampus perceives a threat, the amygdala goes into action. Automatically our sympathetic nervous system takes over and makes our bodies prepare for either to fight, flee or freeze.
Adrenaline is pumped into our bloodstream raising our blood pressure and heart rate. Temporarily digestion and other bodily functions are halted as blood is redirected to our legs, arms heart.
In the same study conducted in 2006, the amygdalae of people who were studied using fMRI technology were found to be 31.6% smaller in volume than healthy subjects.
What that translates into is that our brains are incapable of not only not properly recognizing danger, but also in our response to it.
We experience the world as a much more dangerous place than in reality and we respond to this perceived danger inappropriately.
Bringing It All into Focus
Toxic stress caused by childhood trauma is responsible for the development of dissociative identity disorder and many other psychiatric problems.
Because of the damage to our hippocampi and amygdalae, we are prone to feelings of sudden panic (our hippocampal perceiving danger) and panic attacks (our amygdalae overreacting to the perceived threat).
The severe trauma we experienced in childhood keep us from experiencing the developmental milestone where we would have become one cohesive self.
And now we know that our very brain structure itself was affected.
These changes are permanent.
Perceived Threats that Aren’t Real
Now you can probably understand why I and you are always waiting for the next shoe to fall. Our bodies are on hyperalert status all the time. And when we do perceive a threat or are reminded of a past one we respond drastically.
For example, my feeling intense stress when my family is in the apartment with me.
Not only that, but we wait in apprehension sure we will need to react suddenly at any moment.
What Can We Do?
We cannot change our brains back to where they should be, that is absolutely impossible.
We can change ourselves and the first step is becoming aware of what is going on. You’ve already taken this vital step forward by reading this article.
However, we can find many other ways to cope when we are triggered.
Thus, enter our learned coping skills.
A Very Brief List of Coping Skills
I’m calling this list very brief for a reason. There are as many coping strategies as there are people who need them. Everyone is different, and what works for one person may t work for another.
Look at the list below, modify them and either add to or reject them as you wish. There is no right or wrong, so long as the strategy you discover doesn’t do harm to you or someone else.
Use a pinwheel
Use a feather
Cuddle up with a stuffed animal
Cuddle up and stroke a pet
Take a long walk
Imagine your favorite place
Picture in your mind someone you care deeply about
Recite the alphabet very slowly either out loud or in your head
Sing a song you love
Wash your hands in cold water
Hold an ice cube
Carry a small object you can look at, feel and touch that means something pertinent to today
Take an inventory of the things around you
Keep a very large calendar nearby with today’s current date and year
Do a challenging crossword of Sudoku puzzle
Laugh-it’s tough to laugh when you feel bad, but start with a small chuckle and let it build
Use your imagination. As you can see, many of these things appeal to the littles in your system as well. Allow them to have fun and you will find your entire system is more relaxed.
Waiting for the Next Shoe to Fall
I know that the feelings that nuclear war is going to start any moment often flood you for no apparent reason. Hell, I experience that too.
But by sharing information like is in this article with each other, we can begin to understand why and then take steps to help ourselves.
I don’t have all the answers to this problem. No one does. But I know one thing for sure, I’m going to keep on living despite what happened to my brain five decades ago.
After all, living well is the best revenge.
“The one thing you can control is yourself. And that one thing can change everything.” Leanna Tankersley