Discussion Of Ptsd Diagnosis Discussion

[joeylittle]

Totally fair. And did not mean to minimize your experience.

 

[scout86]

So, @Chava , do you want to discuss the other discussion, or do you want to discuss the topic from different points of view that might have been found "disruptive" or what ever, in the other discussion?

I honestly only dropped in and read bits and pieces of the other thread. I have my own way of looking at all of this and I had a feeling that it wouldn't have been in harmony with the other thread (I was probably right), so I stayed out of it almost completely. I'm not all that interested in discussing the other thread. I AM interested in the topic. (And I hope you end up staying. You have a different way of experiencing and expressing things from my own way. Sometimes I don't get it, sometimes it bugs me, but a lot of times I get a chance to stretch my brain a little and learn something in the process. I value your presence here.)

 

[EveHarrington]

I was quoted, so I am responding.

My definition of inside vs outside is quite simple.

"Inside" means that you've experienced PTSD from the......inside! That is, you have a first hand experience of PTSD. (You have it yourself.)

"Outside" means that you do not have PTSD yourself.

Example.

Someone can become an expert on child birth. Read all there is to read. See hundreds of births. Learn about every nuance of every little thing that can go wrong.

But-----in the absence of having given birth themselves, simply cannot-----know what it is truly like.

It would be insulting for a man, never having given birth, to profess to knowing literally everything giving birth, even though he hasn't experienced it himself.

This is all I am saying. That as someone who has PTSD myself, I will always have a body of knowledge that will forever allude most experts, and that is the knowledge gained by first hand experience.

I'm not saying experts are stupid. I'm saying that there are simply things which most will never know. (As certain things you "know" only through experience.)

I'm sorry that my arguments weren't made clear. I'm sorry that I'm being quoted in an offshoot thread as I feel I perhaps wasn't making my point clearly. My goal wasn't to upset people. I have very clear ideas about what I believe PTSD to be but it seems that my ideas flow very much against the current tide. That doesn't mean I'm wrong, just that I see things differently, that's all. We all have a right to an opinion and a right to be heard. I'm not sure what to make of all this divisiveness though. I thought we were all having an intelligent conversation so I'm a bit befuddled as to the accusations of being a "hater" (the OT thread) and such.

I just want to discuss the diagnosis itself so I will be sticking to the main PTSD diagnosis thread from now on, only adding ideas when I have something to say about the criterion at hand.

 

[Deleted member 28740]

@Chava Glad you posted. Your knowledge, experience and eloquent voice appreciated. Not likely to stick my neck out again either. @KwanYingirl thanks for a wise and compassionate voice of reason.

 

[scout86]

@EveHarrington (after a brief pause to consider whether or not venturing further is even a good idea......) like I said, I avoided nearly all of the other threads. Your point makes sense, that you know your experience from the inside in a way no expert who's not had PTSD could. Makes sense to me.

I'd like to back up a few steps (one of the reasons I stayed out of the other discussions). What do you see a "diagnosis" as being, exactly? Granted, it's a label. It's an attempt to lump people in a group, based on things they have in common. But, how do you know what's a valid definition for a "group"? If you're diagnosing measles, there are external symptoms, You can actually find the virus, if you look for it. Same with most physical diseases. Even things like Alzheimer's. With "mental illnesses", you have sets of traits. Do you think you have bright clear lines between one condition and another? Seriously asking, just because I want to know how other people see this!

 

[Deleted member 28740]

I just want to discuss the diagnosis itself so I will be sticking to the main PTSD diagnosis thread from now on, only adding ideas when I have something to say about the criterion at hand.

Many of the posts on the 'off shoot thread' were not posted there by choice. It was a cut and paste out of context from the main thread, edits too. Removal from the general discussion, and threatened with banning, or banned.

Reason for this thread is the purpose, intent, process and openness to discussion in the community here.

 

[Sideways]

@scout86 :bag:
A diagnosis as a 'group who have things in common'?
I still struggle with the idea that I have an 'illness', because it seems more like an experience. Describing 'trauma' is one thing, but the symptoms??? We all experience them differently. Really differently.

Like, "nightmares" - that's an easy one, right? Nope.
I got 'told' recently that I have nightmares. Really? I have some pretty macabre dreams, sure. But I wake up & it's fine. I like sleeping! But apparently they're nightmares because someone else decided the content of them was messed up, and I'm thinking "piss off, I like zombie films for chrissake!"

Other people have dreams that they describe as far less macabre. But they're having nightmares. I know they are, because they toss and turn and call out in their sleep, and when they wake up they're sweaty and really distressed.

So what the hell is a nightmare? How could you possibly assess that?

Same deal with hypervigilence. Apparently I'm that as well. But mostly, for me, I'm just paying attention & it's usually not a problem for me. Or anyone else. But another person, paying "less attention" all the time, gets really distressed by it.

So what are we actually describing here? What I'm experiencing might cause another person distress, but when it comes to the 'easy' symptoms like nightmares and hypervigence, someone else is deciding that I'm ill because of experiences that I have that generally don't cause me, or anyone else, any issues...but those same experiences cause other people a lot of very real distress.

I'm not a great example, because I'm pretty close to insane (my diagnosis for me).

But if the experience of these 2 'symptoms' can be so completely different, what are we describing here? Idk. But then, I wouldn't take medical advice from someone like me!!!

 

[joeylittle]

What do you see a "diagnosis" as being, exactly?

I interpret this question to mean, 'what's a diagnosis to be used for?'

So, people do seek out ways to communicate about things they experience. To me, a diagnosis provides a way to understand and hopefully remedy a set of symptoms that are distressing.

Let's say you've got a stuffy nose, runny eyes, but no fever or aches, and a sore throat that comes and goes, plus you feel worse after you eat. You'd like relief. But how to go about getting relief? And it sounds like maybe a cold, except for the eating part. What's up with that? Related, or not?

You want a treatment plan - and you wonder if other people have felt that way, and if so, is there a name for feeling all those things? Are all the things actually related?

After you have tests to rule out infections, and probably end up seeing an allergist, you might be diagnosed with seasonal allergies to pollen, and put on benadryl. Stuff gets better. But you still have the sore throat, and the food problem. You go through a whole bunch of scratch tests, but they can't find a food allergy. You run out of tests to take; no-one knows what it is - until someone puts it together with being acid reflux. You go to an ENT, you get scoped, the diagnosis is confirmed, and you adjust your diet, get some OTC acid-reducer, and feel much better.

A diagnosis is a name for a clump of symptoms. While searching for a diagnosis, you are dealing with finding the right 'fit' for your symptoms. Having a partial diagnosis, or a wrong diagnosis, can lead to lots of dead-ends. It's all in service to feeling better. It assists physicians in knowing what else to look for, and rule out - having one symptom of strep throat means it's very likely not strep throat, but you have the test to rule it out anyway.

In mental health, we don't have the objective measures - tests - to rule things out, or in. We have words for feelings, shades of meaning, things we don't always understand. But having a structure - diagnoses - is an attempt to make it as coherent as possible, and a way to keep track of how things change as research slowly happens.

That's what I think a diagnosis is, and what it's for. Super-wordy.

A good diagnosis:

• reflects the most current scientific understanding of a condition
• captures with accuracy the experience of the ill person
• Points the way towards the most effective treatment (most effective being the one that will provide the most relief with the least amount of additional suffering).

I think that applies to any health condition, not just mental health.

 

[scout86]

@joeylittle , that totally makes sense! I have kind of a personal issue with labels and being labelled. Now and then, it leads me to see a "diagnosis" as being a box you stick someone in so you can deal with them. Which actually kind of fits your description too. LOL Sounds like we agree it starts with symptoms.

I've seen other discussions here that somewhat discuss diagnosis been seem, to me, to get side tracked into causation. Two different things! Both interesting, both important, but NOT the same thing. So, for me, rather than get in a big debate right off about what meets "Criteria A", it makes more sense to first agree (if possible) on what set of symptoms we're talking about. "Criteria A", to me, has always seemed to be a list of potential causes. If we saw that "PTSD is something caused by the mind's response to a "Criteria A" event, how DO we know those things are the only things that can cause it? Yeah, we can choose to define it that way, but is that sensible. Seems like we need to agree on what PTSD "is" and then deal with what might inspire it. Mind you, I'm not arguing for "the dog ate my homework and now I have PTSD". I seriously doubt anyone comes up with the symptoms from something minor.

 

[scout86]

@Ragdoll Circus , I've had the same thing happen in a discussion of dreams. I described what I thought of as "a dream" and the person I was talking to said they'd "never want to sleep again!". Who knew? :wideeyed: LOL

 

[Sideways]

@scout86 - somewhere in the pages and pages of posts in the original diagnosis thread, there was a brief exchange about how maybe we need to actually come up with the symptoms first, rather than the 'trauma definition'. I'm not entirely persuaded by how that issue was dealt with, but it's in there somewhere!

 

[joeylittle]

I guess, the only reason I think it's sort of apples and oranges, where one starts, is that PTSD was codified as a way to make sense of symptom sets that people had specifically after experiencing 'trauma'. So it's kind of chicken and egg; you have to have trauma in order to move past 'go' and start sorting it out - so, at some point, you're going to need to articulate what is meant by 'trauma'. Hence, criterion A.

A little like when dealing with radiation poisoning, they were trying to describe what happened to a body of people who had a bunch of the same symptoms, and one common cause - exposure to radiation.