Unsure on diagnosis

[piratelady]

@Chris-duck, I know you’re stepping away from this thread until you’re less frustrated, but this is something I just thought of and didn’t want to forget.

So, as you may have noticed, in my diary I often claim that I’m cured. I often say that when my symptoms start to lessen. One thing I’ve learned, thanks to Therapist, is that I’m also super skilled at avoidance. If I avoid all things ptsd related I do really well. Then believe I’m cured when I’m not.

Avoidance is a part of having ptsd. So my question to you is (I have no idea, so I’m not presuming to know the answer): Are you avoiding those things which would bring about the symptoms you’re stating you don’t have; then using that to say you don’t deserve the help that is being offered because you don’t fit the diagnosis? Again, I’m not assuming because I truly don’t know. Just something to think about.

 

[Movingforward10]

Sorry if my posts are making you feel frustrated and needing to explain yourself.

I have no idea about the answers.

 

[Chris-duck]

Sorry if my posts are making you feel frustrated and needing to explain yourself.

I have no idea about the answers.

They're not. I'm sure everyone who has experienced me in the past week will agree that I'm just an angry human. Not your fault at all.

 

[One step at a time]

How much do intrusive symptoms impact your life?

I hold down my job. I pay my bills. I constantly believe I'm on the verge of losing my job, but for now we'll call that a distorted cognition that sometimes impairs my ability to do my job well.

My symptoms impact my ability to work, but not to the point of being fired. If I did not have a job I could do from home on semi- flexible hours (a few online meeting times, and then lots of work I do outside of those meetings whenever works for me), I probably could not hold down a full-time job in the area I'm trained for.

Outside of that? My symptoms impact my life. Some days, I can't drive safely. I lose time, forget to eat, stop talking to anyone for periods.

ETA - I accidentally hit the post button before I had decided whether or not I wanted to. Guess I'll leave it up.

how does feeling unsafe impact your life?

I do not trust easily and I periodically stop trusting everybody, regardless of how trustworthy they've proven themselves. So, I have fewer friendships/social connections, and the ones I have are weaker. This reduces the resources available to me - usually, people who have more, stronger connections end up having more help available to them in times of crisis/when they need a ride to the bus station. Not always true, of course. There's other downsides, too, but I've got a mushy brain and dinner to cook.

 

[siniang]

has it given me PTSD? Cos that's currently up for debate.

By whom? As in:
- why is it up for debate?
- who initiated the debate?

He's asking you to diagnose yourself?
Or is he asking you if you believe you have PTSD?

Yeah, I stumbled over that, too.

Seems odd.

Couple things, wile admitting I haven't spent time in your diary for a while, Chrissy.

1) You have been diagnosed with (c)PTSD not only once, but twice.
2) You have a history of doubting your diagnosis (if I recall correctly from reading your diary when I did)
3) PTSD is an episodic disorder. Symptoms come and go. People can be in remission for long periods of time. They still have PTSD, because symptoms can rear their head at any minute due to a multitude of different factors (loss of coping mechanisms, triggers, stress-cup, new trauma, ...). Also, how and how frequently symptoms show is subject to sooooooooo many external factors. PLUS internal ones, such as a tendency of minimising (and as such not recognizing symptoms).

Also ... difference between "PTSD up for debate" and "cPTSD up for debate".

I find it extremely odd that your treatment team is asking you to decide for yourself whether or not you have a disorder. That's their job.

In my opinion, the diagnostic criteria and the way PTSD is portrayed in the media do a disservice, because they plant a very specific image into our minds of "how" PTSD is supposed to be.

Keep in mind, PTSD is a spectrum and episodic. You will not be able to discern whether or not you have it by asking what and how often others experience certain symptoms.

Hugs, if you allow.

 

[Chris-duck]

Thanks guys

Not a stranger's assessment of whether I do or not

@somerandomguy this wasn't directed at you specifically, sorry for sounding snarky

I have received absolutely zero psychological help from the nhs so I would say that your lucky to be getting help and you should make the most out of it

I am grateful that I've always had access to NHS support etc, but making the most of it only really applies if I am entitled to it, if I'm not then I'm kinda just taking advantage and causing other people to have to wait longer etc. I'm not unappreciative, I'm unsure if I'm wasting resources.

Are you avoiding those things which would bring about the symptoms you’re stating you don’t have; then using that to say you don’t deserve the help that is being offered because you don’t fit the diagnosis?

There's no physical things I avoid, like no places/people (excluding the duh unsafeness of some people)/things, and I live in a kinda zoned out bubble and avoid along with the best of them but I dunno. I'm conflicted because denying a diagnosis sounds a helluvalot like something I'd do, and have done, heh. But also, who knows.

- why is it up for debate?
- who initiated the debate?

Why is cos I don't have enough intrusive symptoms and I don't feel unsafe, (with intrusive symptoms, avoidance and feeling unsafe) being criteria, I fit avoidance pretty hard, but not really intrusive symptoms, and I dont feel unsafe n I'm not particularly jumpy, I'm observant but not overly.
T initiated the debate. Cos of lack of symptoms, he believes trauma and believes it has affected me etc. Just unsure if it fits PTSD criteria (the symptoms, not the trauma)

2) You have a history of doubting your diagnosis (if I recall correctly from reading your diary when I did)

Heh, yeah. Which makes me more confused, cos now T is unsure, so am I unsure cos I *always* doubt it? Or cos I was right to doubt it the whole time? This argument (in my own head) breaks my brain tbh, I have no idea how to be objective.

Also ... difference between "PTSD up for debate" and "cPTSD up for debate".

He splits CPTSD (only thing he is allowed to treat) into two categories, says there's the PTSD symptoms and the cognitive distortions etc that come along with CPTSD, I'm drowning in the C part of CPTSD, but not much of the PTSD part, except that avoidance thing. Which may or may not skew everything up. And the C part without the PTSD part would be a different diagnosis, right?

And I dunno how to reply to how it's weird that I'm allowed to decide, it's not particularly weird to me, weird that I'm aware and therefore influenced by the consequences of my answers, but not weird that I'm asked to decide. Dunno, not really first time I've been asked that sorta thing.

Thanks for replies folks

 

[Friday]

I'm not asking for opinions on me, cos like I live with me n if I can't work it out, neither can you but just people's experiences. How much do intrusive symptoms impact your life? (Nightmares n flashbacks etc) or how does feeling unsafe impact your life?

As often as 20+ hours a day, and as little as 2 or 3 times a year.

Quite a lot to be honest, if I *don't* think I have PTSD then I get discharged, and no other NHS T will take me cos they don't feel equipped to deal with "my level of trauma".

This. You don’t have to decide if you have C/PTSD or not.

1. You’ve been diagnosed... more than once, although once is all that’s necessary.
2. Not only have you been diagnosed but the level of trauma is outside of most therapist’s ability to deal with ethically/effectively. Which means that someone who not only specializes in C/PTSD but in the level of trauma that’s your normal? Means you’re in exactly the right place.

 

[siniang]

cos I don't have enough intrusive symptoms and I don't feel unsafe, (with intrusive symptoms, avoidance and feeling unsafe) being criteria, I fit avoidance pretty hard, but not really intrusive symptoms, and I dont feel unsafe n I'm not particularly jumpy, I'm observant but not overly.

Did you *never* have those symptoms or do you not have them *now* (and for a while)?

Also, not sure whether NHS uses DSM-5 or ICD-10/11, but look at the DSM-5 criteria ... pretty much all of the criteria require you to have ONE or maaaaybe TWO of the symptoms. And it talks about "persistently". Not about "frequently".

When my T put PTSD on the table during my initial assesment, me and my imposter syndrome, when asked about nightmares, immediately objected "but I don't have them frequently/reguarly". To which she replied "doesn't need to".

My PDoc too reemphasized repeatedly that PTSD is and can be very episodic with long stretches of no or little symptoms. You don't *always* have to have ALL the criteria symptoms ... particularly not if you've ALREADY BEEN DIAGNOSED.

Also, what Friday said! (I was hoping she'd chime in and there she was :) )

I'd personally be suspicious if a trauma T suggests you might not have it or lets you decide. It has a taste of other - insurance - underlaying reasons. Maybe trauma therapy isn't the right thing for you *right now*. Doesn't mean you don't have PTSD. Only means you don't need "PTSD-related therapy" right this moment because your PTSD symptoms don't bother you that much *right now*.

Irks me that you'd loose any and all therapy as the only alternative to "trauma therapy". (maybe I missed something, I'm kinda on my way out the door, sooorry!)

 

[user27357]

Which is why I asked for other people's experiences of PTSD symptoms. Not a stranger's assessment of whether I do or not.

Symptoms: Much the same as they were back when I was diagnosed with depression. It took a while to realize that my depression as seen by my counselors as a constant was actually just so many bouts of severe PTSD that it looked to them like I was just constantly severely depressed. I was worried about being manic-depressive because I knew that there were times that I felt better and times when I was in a very dark place. It took time to accept that I was classic PTSD, with intrusive thoughts and severe triggering episodes that could send me reeling for a week or more of loss of place and sense of self. Nightmares that would wake me up standing next to the bed in a rage.
I couldn't tell you why I didn't openly share all this with my counselors, looking back I think I was afraid of being diagnosed manic depressive or worse I guess. It all came out in one session with a very new to me and EMDR counselor that probably still shudders when she remembers it. Instant diagnosis. Instant start on the road to Recovery?

as a guy that designs things and builds them, I have had to accept that anything I make can be made better. To say my design is the best it can be is sheer foolishness and can only lead to mediocrity at worst and pointless nostalgia at best. I have to accept that ANYONE can look at my design and add to it, and I need to gladly accept it (and hopefully add one more better to it). Harley Davidson has been building motorcycles for over 100 years (?) but every one of their bikes wears the improvements placed upon it by it's owner. You would think that would upset their designers, right? Nope. they embrace it as I have learned to embrace the people that add one more level to my designs.

And to my healing process.

I have accepted that I can be better, and anyone willing to try to show me how is my friend. To not accept it is sheer foolishness. After all, anything can be made better, improved upon, embellished, polished, set right again and on it's way and better for it.

 

[Survivor3]

Do you feel that you benefit from trauma therapy?

 

[Chris-duck]

Not only have you been diagnosed but the level of trauma is outside of most therapist’s ability to deal with ethically/effectively. Which means that someone who not only specializes in C/PTSD but in the level of trauma that’s your normal? Means you’re in exactly the right place.

So T today and I went with yeah to PTSD symptoms but sometimes often n sometimes rarely. I think part of it probably is not really getting why my #trauma even meets his criteria. But yah. We talked about it n yah.

Did you *never* have those symptoms or do you not have them *now* (and for a while)?

Not had for the past year or whatever. But since we agreed PTSD and did narrative exposure therapy on a memory I think we both kinda agree PTSD for now heh. And I guess that's one way to determine whether someone has symptoms

It has a taste of other - insurance - underlaying reasons

Not so much insurance here, but waiting lists are over a year and all staff are under pressure to kinda keep taking new patients which involves discharging old ones obv. It's free n I don't feel that entitled to it tbh. Which I dunno, kinda might influence things.

Do you feel that you benefit from trauma therapy?

Ugh. Do I feel like I could potentially benefit? Probably. Currently I'm a bit muddled n unsure either way.

Thanks everyone for replies, sorry for being an irritable mess. I'm just stressed n irritable n I dunno. Thanks.

 

[siniang]

Glad you were able to get to an agreement that works for you both (more or less ;) ). Consindering all the problems with long wait lists and such in the UK, I'm genuinely glad you came to this conclusion, even if right now it doesn't feel like you have PTSD. But that might change again and *then* you don't wanna be on a long waitlist.

I think part of it probably is not really getting why my #trauma even meets his criteria.

Which is a pretty classic PTSD symptom, just saying ;) Just look around the forum, I'm pretty sure we all or at least most of us have been at that particular question at one point or another.

Not had for the past year or whatever.

Doesn't matter. Once PTSD, always PTSD. Remission is a thing :)

Also keep in mind, we're all currently in crisis mode and you particular because of your profession. A lot of people tend to become asymptomatic in crisis mode. because they switch to "just functioning to get shit done". (which is also the reason why workaholism is such a common coping mechanism. Excessive workload creates stress creates crisis creates distraction from symptoms)

Right at this moment, I probably wouldn't be diagnosed with PTSD. Probably wouldn't have for the last year'ish. But when I did get diagnosed back when, it was very clear for both my T and my PsyDoc independently within the first session. And that's even with my rather atypical and high-functioning representation.

I'm very similar to you in symptom presentation, btw. Shit ton of avoidance and emotional dysregulation. Very little instrusiveness and fear reactivity and I don't *generally* feal unsafe in life. Doesn't mean it isn't there. Only means those aren't my dominant symptoms. But when they do show up, they're really specific to my trauma, so yeah... pretty sure it's PTSD.

But, yeah, the cyclic nature of PTSD has thrown me off in the past as well. Took me a while and many discusions with T/PsyDoc on imposter syndrome and me questioning my diagnoses, before that clicked. So, I'm still kind of irritated by your T questioning it, because he of all people should know that.

Kinda an acceptance thing. Which... well...classic PTSD thing. ;) ("If I don't aaaaaactually have PTSD my trauma wasn't really thaaaaaaat bad" ... accepting your diagnosis means accepting your trauma, and we all know we struggle with this particular one)