Oh Lordy, I've been through the spectrum on this.
Early on in my PTSD, when it was its worst and totally untreated (no therapy or anything) I
could not figure out how to do the simplest things to clean my home ... couldn't figure out how to clean the garbage off the kitchen counter ... couldn't figure out how to clear enough crap off the carpet to vacuum it (and that brought up the question of how to use the vacuum?) ... cleaning off a surface in any room was out of the question.
I was feeling a couple of different things:
1. I was physically
exhausted all the time, literally 24/7/365. It was as if I had just run a marathon. I had
no energy. (I now understand this was the stress hormones working their magic in my body)
2. I was intellectually stupid, literally, in trying to figure these things out. I could not even identify what order the steps went, to do something. Like, I knew that the kitchen counter required a garbage bag, and the goal was to have a clean counter. And that garbage went in the bag. But what was garbage and what was not? And where should I start? What do I do first? I was literally stupefied. :(
3. The prospect of taking on a project (like cleaning the kitchen counter, or vacuuming the floor, or cleaning off the bathroom counter, or taking the garbage out) was
overwhelming. Not like, I-can-work-through-it overwhelming. I mean, deer-in-the-headlights, flabbergasted,
frozen, inconceivable sort of overwhelming. I could not fathom the kind of energy such a project would require, and I was frozen-paralyzed by it, unable to even remotely conceive of how to do it.
4. When I would try to think through the steps to do any sort of simple thing, it was extremely difficult to even remember the steps; I often needed several minutes to recall each. Then once I
felt I had all the steps (I wasn't intellectually sure, but it
felt right) trying to put them together -- and especially to figure out
where do I start? -- was
exhausting. Literally, after 15 minutes of trying to sort out what to do and especially where to start, I was physically and mentally
spent. It was all I could do to stumble my way to bed, where I would take a 4+ hour nap from the ordeal.
5. Repeat.
6. Repeat.
7. Repeat.
I did get some smarts and energy back, a little at a time (we are talking baby steps over the matter of 8+ months) once I started therapy. The way I handled therapy, I read about PTSD like crazy to learn about it, which in itself was a HUGE turning point for me. Therapy focussed more on core issues (personality traits, how I react to things, family baggage), which had a ripple effect on everything else. Once some of those core issues were figured out, some of my unrest went away. But it was
s-l-o-w. For instance, although I now know how to create and take out a full bag of garbage, I still am completely missing most of what I learned in college... information that was very much intact the day before my trauma.
The next improvement was going on a 2nd med, Wellbutrin, for depression. (I was already on Paxil) My doc was prescribing it due to the depression symptoms he observed in his office, but fortunately the Wellbutrin has helped with my PTSD symptoms too. My paranoia and anxiety decreased, my flash-anger was gone (I still got mad! but like,
normal mad), and I have a more positive outlook just in general. However the paranoia and anxiety still break through, they are not gone by any stretch, and they wash over me full-force like a
huge tsunami if I miss even 1 day's dose of Wellbutrin. :( So it's not like the PTSD is gone. It is still roaring up there in my brain, IMO it's just that the Wellbutrin has corrected a certain element of brain chemistry or function that some of the PTSD symptoms are lessened.
Another thing the Wellbutrin has done for me, is it has made me
able to work through mild paranoia or anxiety. It makes the paranoia and anxiety
responsive to coping strategies; I
can work my way through a full-blown attack even though I feel like I'm dying ... my rational brain now recognizes it as paranoia, and panic, and "this is the PTSD" and I can work through the attack with controlled breathing and repetitive thoughts/rational reasoning. The overall ordeal will still last for several days, but at least I
can breathe and talk myself through the acute attack part. Identifying the PTSD in black-and-white was impossible, and coping strategies were not effective, pre-Wellbutrin.
It has also given me strength to stifle the flash-anger when it occurs. There is a whole pile of agitation and continued irritation that goes with it, but I
can breathe and talk myself through it. Previously, this has been
impossible. Previously I have gone into full-blown attack, which set off the suffocating cycle of PTSD crap (fear, shame, unworthy, afraid of judgment, feeling horribly ugly, feeling inept, incapable, stupid, broken, at fault, in danger, etc.) and I had to physically run away from where I was ... and I couldn't go back there (wherever it was) for
weeks.
Thanks to the Wellbutrin, I'm able to do "normal" things some days, in short chunks -- clean the house, vacuum the carpet, take the garbage out, even work on finances and personal paperwork. I still can't open the mail :( (
*terrified* of the mail) but I can at least sort it into a box labeled "Mail." Sorting means I am cleaning out something, or getting rid of a pile

and that's obviously a
HUGE improvement. I hadn't been able to figure out
how to clean out a box, or get rid of a pile, in
years.
Life is not all better and dandy for me, but I have at least gotten back
some of the ability to do normal life-maintenance activities in very small, very spaced-out chunks. Sometimes I can do stuff for a few hours/day for like 3 days in a row (woo hoo!) ... other times I go a whole week without having the energy to do much of anything. But this is much, much better than I was before.
I'm not touting Wellbutrin as "The Fix" or anything... I'm just mentioning it in terms of it being one of the turning points for me, as well as how it's helping. For most people it would probably be another med that works for them, because of how different our brain chemistry is. And for many there might be no medication that works.
The whole point is to say "I totally understand" and share my similar experience. These are symptoms that I have never seen mentioned in a brochure or a book :( so I hope it helps someone feel reassured about this if they're going through it.

Bailey