"illness" Or "adverse Experience"

[Lucycat]

@Meadowsweet
I apologise. There was no need for me to have mentioned it. I am truly sorry. I came back to remove my post but seeing as there have been further replies I will leave it as a reminder to me not to be so mean.

 

[Kintsugi]

I didn't read every response. Here is my rambling take on things.

I do think of PTSD as an illness. Not a "mental illness" so much as just "illness."

Okay, so my co-workers always have Dr. Phil on TV while I'm cooking dinner for my job. Last week (or so?) the good fake Dr. Phil said something like, "She has been diagnosed with 70+ disorders and illnesses, both psychological and medical" [my emphasis]. I about flipped my shit. Both psychological and medical? Honey, can't we just go with "diagnosis"? Because it's all medical. My illness is medical.

I understand PTSD as a neurological issue. It's physiological. And I am actually relieved. I find that validating. It would be chronic either way. At least I know if I were put under an MRI, you would actually SEE something different. I like that. I hold onto it.

I don't always think of myself as "sick," because I'm not always sick. PTSD, for me, is a bit like my friend's cirrhosis. There are flare-ups. There are outbreaks. Sometimes it wants to cover my organs and kill me. Sometimes you can barely see that anything is wrong at all.

Postscript: It makes me feel like a teenager, but I just love this song...
I'm not sick, but I'm not well
And I'm so hot 'cause I'm in hell

(ETA--off topic: @Lucycat @Meadowsweet @RussH Actually the usage of "affect" and "effect" is super nuanced. Russ gave the rule of thumb, but this is a topic that varies across disciplines, and it is something the Big Dog grammarians of the world love to hotly debate about. So, everyone's inner editor can just see one of those words come up and take a coffee break. Let the Strunk and Whites of the world tire themselves out on that one. ;) )

 

[Friday]

Link Removed and Link Removed - hmmm, not really opined much on the term "disorder" itself. Reviewing my hospital file from beforehand the Doctors were contemplating whether in addition to "depression" I also had either borderline personality traits v. narcissistic personality traits...(this was upsetting) - these are considered personality "disorders" - is this what you mean, or something else?

A disorder is the entire constellation of symptoms making up the whole. It's a unique and discrete thing made up of many different moving parts. The symptoms, on the other hand, are shared with other disorders, or can exist as a stand alone thing, themselves.

A short / wildly incomplete list of disorders to example : Acute Stress Disorder, Adjustment Disorder, Affective Disorders (mood disorders), Amnestic Disorders, Anxiety Disorders, Attention Deficit Hyperactivity Disorder, Behavior Disorders, Binge Eating Disorder, Bipolar Disorder, Body Dysmorphic Disorder.... et cetera. Serious etc. I'm still in the B's!

One of the places where people get really screwed up is they have XYZ symptoms, so then they think they have ______ disorder. Like they have anxiety, so they "must" have GAD. Or they have trauma, so they "must" have PTSD.

Nope. Not the case. Anxiety exists as a symptom in a few dozen disorders, as well as a stand alone disorder in and of itself (with other symptoms in its constellation). Trauma, meanwhile is a part of many disorders, as well. Not just PTSD.

One way to help visualize these things is with cooking.

Disorder = Meal
Symptoms & Traits = Ingredients.

You may have wheat, tomatoes, cheese, olive oil, herbs. But how they combine? Extremely important. You may have pasta or pizza or bruschetta with those ingredients. All 3 of those meals contain the same ingredients / share symptoms. And all 3 of those meals can exist alone, or exist together (comorbid). But just because you have the ingredients, it doesn't mean that you have all the meals. Same token, if you have Pizza? It's redundant to say you have wheat, tomatoes, cheese, olive oil, & herbs. If you have pizza? Yeah. You've got those things. That's part of having pizza! To be comorbid, there has to be a whole other thing in addition to your pizza.

 

[Kintsugi]

@FridayJones You just explained how I could have both PTSD and DIDNOS without those being redundant... I love bruschetta with my pizza! It all makes so much sense.

 

[joeylittle]

Disorder = Meal
Symptoms & Traits = Ingredients.

You may have wheat, tomatoes, cheese, olive oil, herbs. But how they combine? Extremely important. You may have pasta or pizza or bruschetta with those ingredients. All 3 of those meals contain the same ingredients / share symptoms. And all 3 of those meals can exist alone, or exist together (comorbid). But just because you have the ingredients, it doesn't mean that you have all the meals. Same token, if you have Pizza? It's redundant to say you have wheat, tomatoes, cheese, olive oil, & herbs. If you have pizza? Yeah. You've got those things. That's part of having pizza! To be comorbid, there has to be a whole other thing in addition to your pizza.

I just had to quote this because it is probably the single best analogy I have ever, ever read regarding the importance of accurate and thoughtful diagnosis.

Side observation: I think people forget that it is possible, and not uncommon, to have a delayed-onset with PTSD. You don't have PTSD until you have the symptoms, and enough to fulfill a diagnosis. I say this as a person who was diagnosed with depression, first - and really, it wasn't PTSD masquerading as depression. It was depression. Later, when my PTSD presented itself, it would have been easy for me to look back and say - ah - these things I've been experiencing since my trauma at 13 really were PTSD, I had PTSD that whole time" - only I didn't. I was dealing with a different type of depression.

If you sit down in a psychiatrists' office and give them your entire list of symptoms minus the fact that you were raped, say - well, the psych can't diagnose PTSD.

I had the (dis)pleasure of Doctors dogmatically insisting that the reason I was depressed and wanted to die, was due to a "chemical imbalance in my brain"; a physiological illness...which to me translated as being nothing to do with my past.

In this instance, did they know about your past?

Also: the phrase 'whemical imbalance' is very, very mis- and over- used, but depression can be organic, all by itself - an actual physiological illness without any external contributors.

 

[Chava]

There is obviously overlap sometimes, but I don't see an "adverse experience" as being the same as a "trauma" (not all of my traumas are listed in the ACE score thing anyway). Being sick a lot was an adverse experience. Being on life support as a kid was a trauma. Having my parents divorce was an adverse experience. Having one of them physically abuse and make continuous physical threats was trauma (and "adverse experience"). Emotional neglect could be considered an ongoing adverse experience that compounded all of this and made it harder to recover from the traumas.

Trauma that leads to PTSD does have underlying physiological features that connect the symptoms, as others have noted here. The brain changes in response to reminders/triggers (brain scans show us this...large parts of the brain shut down while the amygdala lights up). The nervous system is dysregulated. There are symptoms, as you note, but they are different from just being depressed or maladapted. The re-experiencing, dissociating, and hypervigilance are all related to underlying nervous system dysregulation, caused by the trauma.

Not sure if that relates well to what you're saying. It sounds like you're connecting adverse experiences and illness. Many adverse experiences in childhood predispose people to a variety of illnesses. But if speaking about PTSD, an "adverse experience" and "trauma" is not necessarily the same thing (an adverse experience might not lead to PTSD, but a trauma would certainly be an "adverse experience).