PSJ Mental Health: Story #9: PTSD (SeattlePI)

PROVIDENCE HEALTH

JANUARY 2021

MMA fighter faces off against stigma surrounding post-traumatic stress

Post-traumatic stress disorder, PTSD, affects approximately 3.5 percent of adults in the U.S. every year. About 1 in 11 people will be diagnosed with PTSD in their lifetimes. And many more will likely go undiagnosed and untreated because they either don’t know how to identify what they’re going through, may not think they need help, or may not know how or where to ask for it.

"As time has gone on, we’ve seen that PTSD is something anyone could have and is far more common than we’d like to believe,” says Crystal Blankinship, a licensed clinical social worker and manager of behavioral health with Providence Medical Group in Everett, Wash. “It can be experienced directly or indirectly by witnessing it happen to someone else. You can also experience vicarious trauma by learning about a traumatic event that happened to someone else.” Another barrier to post-traumatic mental care is right there in the name PTSD—the “D” standing for “disorder.” “We hear ‘disorder’ and think there’s something wrong with me,” says Blankinship. “No. That is a normal human response to threat of death or injury. Our body is doing what it’s supposed to do. We haven’t recovered from that experience.”

And as with any mental health issue, it’s difficult to make ourselves vulnerable and admit that we have a problem and seek treatment. As with Zingano, there’s uncertainty, a multitude of feelings and emotions, and assumptions about how one is supposed to handle themself especially if they’ve never been through something like this before. To combat these stigmas, Blankinship says, Providence has taken steps to make mental health care easily accessible to people experiencing post-traumatic stress. One method has been a system-wide push for an integrated approach to behavioral health. Specialists are often placed within clinics and hospitals where they are easily accessible to patients who have come for regular checkups or illness or injury. Now, instead of having to be referred to a mental health specialist, make the appointment, and then make the effort of going to another building, patients who think they might be experiencing behavioral issues can simply walk down the hall—or have the specialist come to them in the clinical setting. The presence of these behavioral health clinicians not only makes seeking help convenient, but it also reduces stigma by making mental health an equal part of any routine checkup. Further, Blankinship says, Providence is working to better educate its clinicians and caregivers to screen for and spot behavioral issues in their patients and give them tips on initial treatment. This includes creating a friendlier trauma-informed perspective in clinics and hospitals.

“I chose to speak publicly about this in order to break the stigma of shame and judgment that is often passed on people going through PTSD,” says Zingano. “I had a fear of people judging me for not coming out of it like a badass. It’s important to connect and heal. There are many paths toward feeling better, but the most important part is to communicate and open your mind to solutions. We can emerge better, smarter, and stronger.”

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It’s hard to seek help when you can’t clearly distinguish between what’s real and what’s perceived.

POST-TRAUMATIC STRESS DISORDER AFFECTS APPROXIMATELY 3.5 PERCENT OF ADULTS IN THE U.S. EVERY

Cat Zingano is as tough as they come. The Colorado native is a two-time NCAA Division III champion wrestler and All-American, a purple belt in Brazilian Jiu-Jitsu, and a mixed martial artist who has notched 11 professional wins, including five by knockout and three by submission. She was the first mother to have competed in the UFC and the first woman to have won a UFC fight by technical knockout. She’s also been a single mother, raising a son through difficult times. But Zingano knows all too well that mental illness affects even the toughest individuals.

Zingano knew she and her son needed help. But there was always a nagging sense that this post-traumatic stress was something she could and should work out herself through her own grieving process.

In other parts of the world you don't have to ask for help; it's built into the way things are. Here, you have to humble yourself.

“It’s about limiting chaos and making expectations for patients clear so there’s no confusion and added stress,” says Blankinship. “Where do you go when you arrive? Where do you stand while you wait? It doesn’t take much to make some people feel insecure. Some patients may look like they are just being difficult when they’re actually experiencing a fear response.” And because doctors, nurses, and caregivers are often repeatedly exposed to traumatic events, Providence also reminds its employees to pay attention to their own mental health. There is systemwide training for self-care, guided mindfulness, and other methods to provide trauma-informed care to both patients and caregivers. Providence has also worked with influencers like Zingano to raise awareness of PTSD and help break down the public stigma that prevents so many from seeking help.

In 2014, her husband and trainer, Mauricio Zingano, was found dead by suicide in his Denver home. Suddenly, she was dealing with the immediate sadness and instability of losing a loved one and the father of her son. And as more time went by, Zingano found that she and her son were experiencing long-term effects. She had bouts of sudden and extreme anxiety, most prevalently at night or in public. She was afraid to leave the house or the car, to be in large groups of people, or to even have a casual conversation with anyone new or unfamiliar. Any unexpected fast movement, any flash of light or blast of sound would startle her so badly it physically hurt her chest, arms, and stomach. Her son, only 7, was experiencing his own stomach pains that would bring him home from school, but the ER X-rays and exams always came back negative. He was edgy, angry, sad, and tired.

“It’s hard to seek help when you can’t clearly distinguish between what’s real and what’s perceived,” says Zingano. “Your first instinct is to talk to family or friends. But explaining your thoughts and feelings and risking being dismissed as ‘paranoid’ when you’re already feeling vulnerable is exhausting and dejecting. The aftermath of Mauricio’s suicide also made it rightfully difficult to be trusting and open, which made seeking help even more difficult.”

Much of the problem is the stigma surrounding PTSD, which has come to prominence only in the past decade or two and is widely known as a soldier’s disorder, something that veterans bring home from the battlefield. As a result, people feel that any experience, no matter how traumatic, that falls short of all-out combat, is unworthy of the designation. But the truth is that PTSD can affect anyone who has faced even the threat of death, injury, or sexual violence.

If you or someone you know is in need of assistance with mental health concerns, please visit work2bewell.org/wellnessresources. Please know there’s always help available whenever you need to talk to someone. Reach out to the Crisis Text Line (Text TALK to 741741) or the National Suicide Prevention Lifeline at 1-800-273-TALK to talk to someone who can help.