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Getting Right Help Without Label Possible?

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Klo

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Hello. I am a woman in my late 20s who went through a lot traumatic abuse when I was growing up. I can't even remember all of my years but what I do remember is bad. I had my first major breakdown when I was 15, and I was diagnosed with depression, given zoloft and sent home. Since then I have been to multiple therapists and psychiatrists and it's like nobody wants to diagnose PTSD.

I don't really care about the label itself, but I want to make sure I get treatment that actually works, and when professionals try to label me with everything but PTSD, my treatments go all over the place, as well. Been through depression, generalized anxiety, bipolar, schizoaffective and the latest thought I had dissociative identity disorder despite me not having multiple personality states. With that last one I was glad the trauma was at least acknowledged, but I wasn't about to fake having DID to get treatment, and I had to quit seeing her because it was like she was pressuring me to act like I had it.

SO the treatments have included anti-depressants, benzos, anti-psychotics and talk therapy (where I was just supposed to talk about whatever I wanted for an hour, and that was it). One therapist years ago who said I had bipolar disorder suggested we try EMDR (yes EMDR for BP, seriously, thinking back on it makes me so mad, why not just diagnose me correctly, what the heck is the deal??). Well I didn't know it at the time, had never heard of EMDR before, but apparently you're supposed to learn important things like grounding and so on before attempting stuff like that. We did none of that and she just went for throat with the theme of the EMDR exercise, I had a massive panic/rage attack, was messed up for over a week and never went back.

The symptoms I DO have are all in line with PTSD. I'm not sure what the trigger policy here is, so I won't go into details without knowing for sure what would be considered too much, but I am tired of being drugged for illnesses I don't have with drugs that don't help, or expected to magically recover by just talking about things for an hour once per week. It's so stupidly frustrating.

The last psychiatrist I saw, by that time it had occurred to me that maybe they are worried I am trying to get disability benefits, so I made sure to state upfront that my goal is to get stable and normal enough to work again, and that I don't care about what any papers say, I don't need the label on a paper, I just want to be understood and treated properly. The psychiatrist prescribed me olanzapine, even after I explained that my "hallucinations" and paranoia are not typical in that I retain insight and know things are not real, but they still affect and scare me half to death, and that I had been on Seroquel in the past and it hadn't helped at all with anxiety and other symptoms, had just made me sleep 20 hours a day and made my anxiety and other symptoms worse.

So what I am trying to find out now is what treatment methods have been the most effective for people who have PTSD, and then how to get those treatments without needing a label.

If anyone has any information/advice to share, I would really appreciate it.
 
Sounds like you're going about it the right way.

I was in huge denial about PTSD when I first saw my current therapist, and he has been very reluctant to talk to me about labels (less so, after we'd been working together for 5 or 6 years, but that's a fair wait).

Cognitive-Behavioural Therapy is good for all kinds of things, and good for PTSD. The treatment described in "The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization" is the thing that works best for me. My impression is that it's reasonably harmless if PTSD is the wrong diagnosis, too.
 
Have you sought out help from professionals who specialize in treating trauma survivors? I think these types of therapists are more validating and will tell you if they suspect a trauma disorder.

Are you using insurance or paying for treatment out of pocket? If paying out of pocket, a diagnosis is a bit less important. If using insurance, a diagnosis may be required for certain treatments, but of course this varies from one insurance company to the next.

EMDR is a common therapy. There is also exposure therapy. Many gain powerful coping skills through DBT and CBT. There are additional therapies out there, but IMHO true trauma therapy is a bit more involved than just going to a therapist weekly and talking about your problems.
 
Have you sought out help from professionals who specialize in treating trauma survivors? I think t...

That was the last therapist I saw, but it was a major disappointment. The way my mind works is that I want a plan, I want to know what I need to do to get better, I want to have goals, etc. This therapist refused any of that. She just wanted me to talk about whatever I wanted every session, and she would just occasionally shows signs of life, like making a comment like, "That must have been hard for you." I would get so agitated with her and try to explain that I was becoming extremely agitated, and then she would say something like, "Well sometimes when I'm in the grocery store, I get agitated if I'm in a hurry and the line is long." I just couldn't even. Then she wanted to convince me that I had DID, but not because I had any symptoms specific to actual DID, but because she was convinced that every symptom I had was being caused by "alters". Alters that never appeared or caused me time loss, but they just had to be the cause of everything, because unknown reasons. Maybe I got a dud therapist, I am not sure, but that was about 7 months ago that I quit seeing her, and I just felt so frustrated that I took a break.
 
It is possible to get the right help without a label yes, but my understanding is that you may need some sort of "label" for insurance purposes in the States. The majority of my treatment was done privately and I only was diagnosed with PTSD after I was nearly 2 years in treatment. In the UK therapists don't tend to diagnose so it was only when the worst of the symptoms had settled that I properly discussed with my GP and went through a process of diagnosis.

I too was dealing with childhood abuse and have been in long term psychotherapy with someone who specialises in trauma. My therapist is way more challenging than you describe and for the most part uses our therapeutic relationship to help me heal. It's been very very hard work, and while I'm much more settled and my symptoms are more manageable, I expect to always have to deal with PTSD in some shape or form.

It's not unusual for people with a traumatic past to be misdiagnosed but there is also the possibility that it's not PTSD - most people who experience trauma don't go on to develop PTSD, it's far from inevitable that one leads to the other. Not to say you don't, but you may not have been diagnosed because they honestly don't think it fits - and PTSD is one of those things that if you don't have, you really don't want.

Good luck in finding treatment that suits you.
 
It is possible to get the right help without a label yes, but my understanding is that you may need some...

Okay well possible trigger warning for the rest of this post of mine, because I would like to explain why I think I have PTSD, and why I am frustrated with the treatment methods I have been given so far.

(Start Trigger Warning)

The reasons I think it is PTSD (or some form of it) is because I experience panic attacks, nightmares, paranoia of other people, etc, and I feel like I am always trying to avoid triggering these things. I don't even like showering because I don't like to be naked, it raises my anxiety automatically. I can't have a relationship because of these types of issues, especially because of the severe vaginismus and I just get completely unhinged when attempting to make intimacy work at all. Most triggers are easier to avoid without being a major pain, like I am very careful about approaching reading the news, or watching movies. Most of the rest of the symptoms I deal with are things that are more in line with just anxiety or depression, and very low self-esteem. However when I am medicated for anxiety and deprssion, it has no effect unless I am really doped up, which was the case with Effexor. When I have panic attacks, I have "psychosis" but it's not like the type with schizophrenia, because I know that things are not really happening. I will smell something that isn't there, for example, but I know it's not there, but I will still have a freeze response to it and disassociate, which can be problematic in public.

(End Trigger Warning)

So I am not hard-set on me having PTSD exactly, but I am not sure what would be a better fit. But when I am diagnosed with simply anxiety or depression, I just get anti-depressants or benzos which don't solve the problem, and so on. My top priority is just in finding something that actually works.

If someone thinks it could be something else from what I described, I am definitely open to ideas. It just seems like psychiatrists can only see illness, and therapists don't really have any methods to make things better (or want to make me nuts with EMDR and send me back out into the world after doing so). I am going to look into the CBT stuff though for sure and see if I can find some self-help type exercises.
 
It sounds like you're having a really rough time and I can see why PTSD seems to "fit" for you. If you're not wedded to needing diagnosis and can afford your own treatment it may be worth finding a good therapist who offers a range of modalities as a starting point for exploring what's going on for you. The other thing is that some therapists will give you a nominal diagnosis to satisfy insurers and will the just treat whatever presents itself in session so not being totally hung up on diagnosis is ok. Other people really need a diagnosis to make some sense of themselves but I don't think that's what you're saying.

Btw you don't need to add a trigger warning to posts here, we don't use them on the site because different people are triggered by different things and it's impossible to predict for other people. It's fine to just post what you need to and let other posters decide if it's ok for them or not. I did also mean to say welcome to the site, I hope being here is helpful to you.
 
Unfortunately it can be hard to figure out exactly what's going on if you have symptoms that could overlap multiple disorders. I think your last therapist was a bit of a dud. I have heard of therapists being too eager to diagnose certain disorders and your last therapist may have been one of these people.

I hope that you can give it another try with another trauma therapist. Sometimes it can take a few tries before finding a good fit. Even if it isn't PTSD, a trauma therapist is probably more able to sort through your symptoms to figure out what is what.

EMDR can indeed be a powerful tool for healing trauma. Again, I think that therapist was a dud, too, because they didn't assess your suitability for the treatment or properly prepare you for it. (And I'm not sure how EMDR would even help with bipolar disorder?)
 
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