22. juli-senteret

Life after 22 July – To be diagnosed with PTSD and the journey towards recovery

22 July 2011

On film, the sound of a bomb is like thunder: A lasting sound that keeps on ringing out. In reality, the explosion was a short, insane, deafening, all-consuming bang; the loudest sound I have ever heard.

Immediately after the explosion, I feel as if I’m part of a war film, or that what’s happening in the government building complex doesn’t really concern me. It’s like being alive in the middle of a maddening nightmare. An unreal, numbing feeling spreads out in my head and body. I struggle to find an emergency exit that hasn’t been blown to pieces, while the sound of the fire alarms cuts through my ears.

I happen to look down at my hands; they are shaking so violently that it’s hard to open doors or hold on to the railing as I’m walking down the stairs towards the emergency exit. Are these really my hands? Shaking like this? But I’m not afraid; I feel fully awake and alert.

When our lives are threatened, our body seeks to protect us without us knowing about it and without a conscious effort on our part. The body starts producing loads of hormones, which make us stronger, more alert, protecting us against pain and panic. The body knows best how to protect us without the need for us to be conscious about it. A feeling of extreme goose bumps, like an oral sedation in my whole body; feeling numb makes me better equipped to protect myself against pain as I try not to step on concrete, shattered glass, large piles of paper and broken furniture. Adrenalin is pumping through my body, helping me to get myself out of the chaos.

I only remember fragments of what happened. The paper I’m stepping on, the coat of arms

stamped on a letterhead; perhaps all these documents lying around outside the high-rise building are confidential? In the corner of my eye, I see one or two injured people receiving help from someone. I can’t help them, I don’t have the balance it takes to kneel, I can’t run. My colleague is just as unstable as I am, and we help each other through the debris as best we can. I fear possible snipers, she is scared there might be more bombs. We don’t share our thoughts as we walk arm in arm, as we don’t want to scare each other even more.

The situation feels just as surreal after a few hours. The news from Utøya start coming in, as images of the government building complex are shown on the TV. I was interviewed by various journalists and by the evening news, which would otherwise have made a great impression on an anonymous bureaucrat, but I barely remember it. The feeling of being outside my own body, of being part of a film, or a dream, arises while I take part in crisis management, work in front of my computer or while talking on the phone for hours. Is this really happening? Is it all just a bad dream?

 

The aftermath

My feelings are still switched off, it’s as if I’m just observing what is taking place around me. I don’t cry when I see interviews with terrified adolescents who have escaped Utøya, or when I see photos of the destruction in Oslo. It’s as if the world doesn’t concern me, in a way that is difficult to explain. Videos and images from the government building complex still make me struggle to breathe and give me palpitations, the massive press coverage makes it hard to find peace, to escape it all. And these strange, intense goosebumps spread across my entire body every time I remember something that happened on 22 July.

Sleeping is unthinkable, I’m not tired anyway. It’s as if I’ve had a whole pot of espresso; I’m wide awake, while my heart is pounding. I have always slept soundly at night; now I lay awake twisting and turning, night after night. When I finally fall asleep early in the morning, any kind of sound will wake me up again. Cars driving past, someone talking outside my house, the mailbox closing when the morning paper is delivered…

Something strange happens when I wake up. My body is relaxed and soft for a second or two, until I notice how stress takes hold of my entire body in a split second; it’s a very specific feeling of anxiety. My heart is pounding, and I get an extreme feeling of being nervous, geared up, worried and scared. But I’m not really afraid of anything, it’s only that what happened weeks and months ago is still affecting my body.

I don’t understand that I’m getting ill, that I’m gradually developing what is known as post-traumatic stress syndrome (PTSD). Every time I am reminded, consciously or subconsciously, of what happened on 22 July, my body starts responding with the same defence mechanisms as when the bomb exploded. If I’m stressed at work, my body thinks the stress reactions are due to something dangerous and scary, and so I feel even more stressed. A loud, unexpected sound, someone suddenly coming up behind me, the smell of dust, fire alarms, the sound of flying paper: The world has become a scary place with many dangers lurking and my body is constantly preparing to defend my life at all times.

I lack sleep and it drains me of energy. It gets harder to concentrate at work, but I fix it by working more. My memory keeps getting worse, but I don’t give it much thought.

These are quite common and normal reactions after a traumatic episode, but I don’t know that at the time. The doctor at the company health service explains to me that I’m suffering from post-traumatic stress disorder (PTSD), and that I’m eligible for treatment. But I don’t want to, because I don’t feel ill. I’m only lacking sleep, but I don’t understand how harmful it is to get that little sleep and feel that stressed over a long period of time.

Perhaps it would have been easier to understand that I was getting ill if I could compare my days then to the days before the bomb exploded. But my place of work is torn apart, the Y Building stands empty and abandoned. We are now squeezed together in provisional premises, and it’s so cramped that we have to go outside to change our minds. For a while, there are 105 of us in a space designed for 55. Three of us are sharing an office for one person. We are rebuilding the ministry, and I have the responsibility for a lot of the work. It’s only normal that I feel tired, no?

The breakdown comes on the day of a planned fire drill. I know it’s happening. Those of us who were at work when the bomb went off have received advance notice; I’m standing with my coat on by the nearest emergency exit when the fire alarm starts ringing. Nevertheless, the panic takes over – I’m back in the Y Building; it’s the fire alarm in the government building complex that’s ringing in my ears. I’m the first person down the steps, and by the emergency exit, I almost panic while I struggle to open the door even though I know it’s just a drill. Afterwards, my body refuses to budge; my back starts aching and my stomach churns. It feels like my head is full of cotton wool and I’m unable to concentrate. My body is exhausted after being replete with stress hormones for months. I’m granted a sick leave.

 

The way back

Some people get sick after experiencing a traumatic episode. In Norway, 55,000 people currently suffer from post-traumatic stress syndrome (PTSD), but few are aware of the diagnosis. You can develop PTSD if you experience a natural disaster, an accident, blind violence or assault. Many people also develop PTSD if they have experienced bullying over time, had an unsafe childhood or fled from war zones.

It is possible to recuperate from PTSD. I did. My doctor insisted that I take sleeping pills and get some rest, and to gradually go back to work. A supportive and understanding boss temporarily relieved me from my position in management, and let me do work that wasn’t in a rush and that didn’t make me feel stressed. Good colleagues took over for me. A lot of support from friends and family also helped.

I came back to work full-time after nine months, and I carried on as a manager. But I couldn’t think clearly, I didn’t find the same pleasure in work or have the same work capacity as previously. I saw a psychologist, from whom I learnt a lot about PTSD. I also learnt that traumatic episodes can leave deep marks long after what scared you happened, and that your body can react by becoming very scared, even after many years. And it can happen even if you’re not afraid any more. There are clever tricks and techniques you can learn if you’re still experiencing issues after a traumatic event. I learnt a few such techniques, and I still use them at times.

I’m back in a full-time job now. I’ve written a book about trauma for people who have experienced similar things. My life is good, and as normal as it can get. Nonetheless, 22 July is always with me; what happened that day will influence the rest of my life. I have a strained relationship with fire alarms, large crowds of people and I’m more scared of terrorism than I was before. I’m more easily scared. But I’ve also become more tolerant to people who are in a difficult situation; I understand that you cannot simply pull yourself together if you’re struggling psychologically. I have also learnt that accepting help is important if you’re in a difficult situation.

 

Recommended further reading:

Anstorp, Trine og Kirsten Benum (red.). Traumebehandling. Komplekse traumelidelser og dissosiasjon. Oslo: Universitetsforlaget, 2014.

Lauvås, Nille og Rolf Marvin Bøe. Etter sjokket. Traumatisk stress og PTSD. Oslo: Aschehoug, 2015.

Lauvås, Nille. ‘22. juli – min historie’. I Tidsskrift for Den norske legeforening, 2015:14.

Strøm, Kristin Lilletvedt (red.). Tiden etterpå. Historier om posttraumatisk stress. Oslo: Humanist forlag, 2016.

Skartveit, Gro. Livet etterpå. Om vegen vidare etter alvorlege kriser. Oslo: Samlaget, 2016.

Øverlien, Carolina, Hauge, Mona-Iren og Jon-Håkon Schultz (red.). Barn, vold og traumer. Møter med unge i utsatte livssituasjoner. Oslo: Universitetsforlaget, 2016.