Other Peritraumatic full tonic immobility

[amelia_i]

Perhaps due to incompetence on the part of treatment personnel, it has taken me quite a while to figure out that the symptoms that I experience at times are part of tonic immobility. When I dig around the interwebs for information about peritraumatic (post-trama) tonic immobility, there seem to be a lot of mixed data, and little of it seems to pertain to TI during re-experiencing.

When I experience TI, it's full-blown. My muscles go rigid and I freeze like a wax statue, eyes close, eyebrows furrow as to look anxious, mouth drops open. I can hear everything around me. Dopamine floods my system. My breathing shifts to 95% exhale, long and slow, with quick shallow inhales. People have asked if I was still breathing. If it goes on for more than a few minutes, the rigidity leads to convulsing, sort of like when you hold something really heavy for too long, and sweat soaks my clothes. The room feels cold as hell. 30 minutes feels like 2 or 3. In more lengthy or intense spells, I come out the other side crying hysterically because of how it feels. I dissociate hard for up to the entire rest of the day.

I know that TI is on a scale, and is not uncommon to present in survivors of sexual abuse (I read as high as 40% in one study), but if that's the case, how have my symptoms seem to have confounded every psychiatrist, counselor, therapist I've run across? "I don't know what's happening, what do I do to help?", to my fiance, was the latest. One of them outright said "that's unheard of", the doctor the gov't sent me to for my SSDI claim saw a video of it my fiance took and said "that is ~extremely~ uncommon".

I was on here a while asking about catatonic-type symptoms in general, but lack of information about how I experience TI has lead me to really want to reach out to you all. Do any of you experience this? Do you experience any TI symptoms in general; any of the stuff I listed? Do you know of any pertinent reading material?

 

[sun seeker]

I think I remember you from the previous time you posted about this. Sorry to hear you still haven't found adequate help with it.

I know that TI is on a scale, and is not uncommon to present in survivors of sexual abuse (I read as high as 40% in one study), but if that's the case, how have my symptoms seem to have confounded every psychiatrist, counselor, therapist I've run across?

This really puzzles me, too. Wish I had an answer.

I too experience tonic immobility, but not to the degree you describe it. I think it's a lot more common than people think and I have no idea why it is so little discussed.

 

[amelia_i]

How does it present with you, if I may ask?

 

[sun seeker]

Let me see...

Something triggers me. I feel a sense of immense dread and as if time were slowing down and my mind focuses on the trigger almost to the exclusion of anything else. All systems slow close to a stop. Breathing becomes very shallow, with long gaps where I'm not breathing at all (or they feel long, anyway). My muscle tone doesn't change, but if someone tries to move me, I stay in something at least close to the position they put me in. Sometimes there is a little time between the trigger and complete freeze, where I can either ask for help or get myself to a safe place. Sometimes not.

I don't know about the dopamine, and would be interested in what you know about that. It does feel as if my mind is shutting out the extremes of fear, sort of numbing me. I have a flight response that involves major anxiety; it feels like I go into freeze if that either fails or the trigger is connected to something that happened when I was too young to get away.

It can last from a few minutes to... I don't know, an hour maybe? I'll be frozen and telling myself to move, but it's as if two sets of instructions were going on simultaneously, one telling me to move and one not to. Eventually the one telling me to move wins, but it can take a while. I don't have convulsions related to these episodes.

 

[amelia_i]

As per the dopamine, as soon as my muscles go rigid and all of the aforementioned symptoms hit, I feel it flood my body. Don't quote me, but I think the term is "opioid-mediated analgesia", something your brain does when you're pinned down by a predator (and under other circumstances, probably). I suspect it is part of the process. I know it's part of the slow, odd breathing pattern, 'cause it doesn't happen otherwise.

I definitely relate to the short onset time. I have had it happen so quickly that I've been mid-kiss, or chewing food, or cooking. And then bam, wax statue.

 

[sun seeker]

My onset time is a bit longer than that. :-)

What confuses me about your episodes is, if I am understanding right, there doesn't have to be an identifiable trigger. Is that right? If so, well as I say I am confused.

Have you tried sublingual Ativan in one of these episodes? As I understand it, if that works, it would signify catatonia. Again, don't take my word for it, but that's as I understand it.

 

[sun seeker]

I also have less extreme freeze states, where I can still move parts of my body. What I described is as deep as it gets for me.

 

[amelia_i]

Ativan seemed to have no effect. I have had them between minutes and an hour before an episode, and it happened anyway. Catatonia, I believe, includes TI, does it not? Just kind of a blanket term. I can tell you, I am fully unresponsive. If there was a fire in the room, I'd be BBQ.

Sometimes a trigger will fire up other PTSD symptoms, often that feeling of dread and such that you describe. PTSD mode, idk. And then I will ease into the TI from there. But sometimes, if I'm even feeling mildly symptomatic, I can pop in without notice.

The video he took of me looks ~exactly~ like videos I found on Youtube of animals in TI whilst experiencing acute trauma. Even the deep breath to catch up I've seen in videos of mammals in TI is spot-on. I don't have any other diagonoses either. I'm pretty sure it's just really bad, or full on TI. Beginning to think that it's to a level that is very uncommon. :/

 

[sun seeker]

If someone were to rub an ice cube over your face and neck while you are in an episode, would it help you come out? It seems to help me.

I don't know... I am really no expert, but if Ativan doesn't work it would point to something else. I should stop here though because I really don't know what I'm talking about.

Have you read anything on polyvagal theory? That might be a place to look for information.

Again, I have no idea why psychiatrists seem so ignorant on this topic.

 

[amelia_i]

Nope, and I've had other strong stimuli fail to make me snap out. Should Ativan be able to snap you out of TI, being a natural defense mechanism? I mean, my heart rate and breathing slow so much from the opioids that I don't see how benzodiazepines, slowing things down more, would do the trick. Of course I don't know what I'm talking about either, just kind of talking out of me arse at this point.

I'll check out the polyvagal theory.

Psychiatrists may have an understanding of how it presents in most, but maybe they just aren't used to seeing it present like this.

 

[shimmerz]

I have this. I can't talk about it right now as I am in one of them to a degree tonight. I will come back to this posting with more information when I am out of what I am in right now. My sympathies to you. It is a horrible state.

 

[amelia_i]

Sorry you are having a rough time. I hope it subsides soon.

I remember you talking about it in the last thread, but nobody was throwing around 'tonic immobility'. Does what I described line up with what you have? :(