Relationship Ptsd Episode Or Some Other Terminology?

[Deleted member 17302]

I've been thinking a lot about the term "PTSD episode" as it relates to spans of time that certain symptoms are contained within. It seems there are two types and am not sure if there is a better term for the longer version.

Scenario 1 - There is the episode where the person goes from acting fairly normal to freaking the hell out and yelling and raging and maybe even throwing things or doing other things that are drastically different than moments before and are in general filled with non-rational statements and actions. These seem to last minutes to hours.

Scenario 2 - The longer type seems to be rest of the day, week/s, or month/s, or even year/s. These seem to be way more subtle in that there can be fairly reasonable conversation and actions and even going to work and other events but there is a definite shift in their actions and statements and general perception of what is going on in that time period. These seem to include the loss of trust, emotional numbing, and other subtle things that are destructive like substance abuse for example. This is the situation where people say that the person isn't the person they generally came to know and love and seems like a bit of a stranger. It seems there are conflicting actions done during this scenario in that the person subconsciously very much loves their partner and does actions and statements that line up with that but also do destructive things that could rip the relationship to bits. It all seems to be quite subtle too which makes it harder to really understand.

It seems that "Scenario 1" is the common thought that goes through a persons head when someone says "PTSD episode" but other times "Scenario 2" is also referenced as a "PTSD episode".

Personally I tend to reference "Scenario 1" as a "PTSD episode" and am not quite sure what to term "Scenario 2". Anyone with more technical knowledge of PTSD know how these two scenarios are referenced technically? I'm quite curious to know so I can go do more reading on "Scenario 2".

 

[dnp]

I'm no expert, but for me Scenario 1 is what I call an "episode," though for me instead of raging I tend to have panic attacks and suicidal thoughts.

I'm not sure what Scenario 2 is called. Some aspects you mentioned I would call "isolating," thought that probably doesn't cover everything you were thinking.

 

[Sweetpea76]

Scenerio one seems to describe a reaction to being triggered... panic, fight or flight, etc.

Scenerio two seems more like when a sufferer is symptomatic. Those are typical PTSD symptoms, although the substance abuse example is a coping mechanism and not a symptom.

 

[Friday]

People use the term "episode" as a catch-all phrase to indicate "something symptom related" for some specified/unspecified period of time, but a finite one. For example someone can have had a bit of an episode yesterday, or was in an episode for a few weeks/few months, or was having a lot of episodes last year, last month, recently, etc.

What's actually involved in an episode? Can be subtle or blatant, and is going to change a great deal depending on who's talking. We all have different symptoms, that express differently, in different combinations, for different periods of time.

When someone uses the term episode? I have no idea what they're referring to (except symptomatic in some way for some period of time), until I ask (or they tell me).

The example you listed of freaking out? (Agree with Sweetpea, sounds like you're describing one way of being triggered, or stressed past capacity.) Only one of a couple dozen possibilities.

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The second bit, also agree, just sounds like someone is being symptomatic. Also, again, that's only one of dozens of way that people get symptomatic.

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It very much feels like you're trying to reverse engineer an answer, here. Trying to use meta-data to get a specific set of results. That never works. Like the reverse logic fallacy; all squares are rectangles, but it doesn't reverse. Not all rectangles are squares.

You can look at your wife's symptoms (periods where she's getting or is symptomatic, & spikes in symptoms) to find patterns... But her specific patterns aren't going to translate to everyone with PTSD... Nor will the general trends & tendencies of PTSD tell you what your wife's specific patterns will be.

 

[EveHarrington]

"Episode" is very much a non-technical term. A PTSD episode for one person can and will be very different from a PTSD episode for another person. PTSD episodes can and will vary over the span of someone's lifetime as healing progresses or regresses. There is no standard for what is involved in an episode other than "a spike in symptoms" and those symptoms can pretty much be anything that is PTSD related.

I think your post would be a bit more accurate if peppered with "IME", "IMHO", and "what I see in my sufferer".

I advise you to be careful with the language you use. Saying things like

"the person goes from acting fairly normal to freaking the hell out and yelling and raging and maybe even throwing things or doing other things that are drastically different than moments before and are in general filled with non-rational statements and actions. These seem to last minutes to hours."

can and will be hurtful to someone with PTSD. That is, using terminology that indicates to your sufferer that she's not normal.....well, I'd be hurt and I'm sure other sufferers would be too. (Yes, I've been there.) The last thing I want to be told is that I'm not being normal. The same also goes for "freaking the hell out" and "non-rational statements". I hope you don't use these terms with her. It may be what you see but it isn't what she experiences IMHO. Episodes like the one you describe are fear based and as such it's impossible for someone on the outside who does not/cannot experience this fear to really understand.

I notice your posts tend to be efforts to define what you see but are you working on ways of healing? It's a bit concerning as unless there are changes in you, your relationship isn't going to continue IMHO. This isn't a criticism, rather since there have been changes in your sufferer, the ballgame has changed----you can't "win" by playing with outdated "rules".

Scenario 1 may be the common thought of what a PTSD episode is-----to you----but it most definitely isn't what is common to all or even most.

TL;DR. You can't really redefine a technical term that isn't technical to begin with. "Episode" is a term that varies drastically amongst sufferers and isn't in any sort of official PTSD diagnostic criteria.

 

[Casey_03]

I think the Scenario 2 you describe here is your own personal experience with your wife, and it might not apply to other people with PTSD. At the same time, much of what you describe happens to people dealing with all kinds of mental issues - depression, anxiety, BPD, and on and on. So trying to come up with a specific term for such a phenomenon with PTSD seems counterproductive. Like everyone else said, I don't think the "scenario 2" is really an episode at all, it's just a set of things that tend to happen when someone is symptomatic or not getting treatment. And if alcohol or drugs are involved (because PTSD does often go hand in hand with substance abuse), then you're dealing with a whole different beast. I've known people with PTSD who behave like complete maniacs when they are abusing drugs or alcohol but are able to almost completely get their symptoms under control once they quit. Also, the same thing can be said for "scenario 1" -- this behavior manifests itself in so many different disorders, it's not just PSD. Drug addicts and alcoholics do this when they go through withdrawal, people with bipolar disorder do this .... so I guess I don't see what the point is in trying to pinpoint a specific term for PTSD episodes when they differ so greatly from person to person, and have so much in common with other disorders ... what benefit would it have for you if you were able to come up with a specific term and time period?

 

[anonymous]

I 100% agree with Fridayjones.

Also agree that what you describe is only one way of hundreds that could be someones reality and a lot of that is down to personality. For examples when it comes to fight, flight freeze I never do fight. You may find it interesting to look at Pete Walkers Four f's article: http://pete-walker.com/fourFs_TraumaTypologyComplexPTSD.htm I think for where you are in understanding PTSD it would be better to describe scenario 1 as someone being triggered. And sweatpea makes a good point that substance abuse is not a symptom and rather an attempt to cope. Eating disorders which I believe your wife had also fall into that category.

I too notice you repeatedly trying to fit all with PTSD into neat little containers that you can label and understand. If it were that simple these things would be easier to treat and for all to understand. Human beings are complex and its human beings that we are dealing with here. Your wifes symptoms will vary and what is happening internally will vary so if you try to simplify these things in this way you are likely to miss the most important support you can be to her - by truly opening your ears and listening. Finding out from her what she is experiencing.

There are some definite terms you can research and look at . There are some good articles on here about them. Such as: triggered. stressor. dissociation; re living/flashback. Understanding these in as much depth as you are able should help you both. And again how they look varies from person to person and for each person at any one time.

Being symptomatic or having an episode is a very vague concept that refers to having symptoms of some type. How severe they are, what form they take, and how that person usually experiences those symptoms all varies. And sometimes people turn to unhealthy or healthy coping methods if they are symptomatic.

I will admit to finding your reductionist way of approaching PTSD rather upsetting on a personal level and I can see others with PTSD reacting that way to you often on here too. That isn't your problem of course and we have to deal with our own feelings but I mention it as I think there is a high likelihood your wife might take exception to it too. I only mention it here for your benefit not for mine.

 

[anonymous]

Just wanted to add that scenario 1 in the way you describe it could be totally unrelated to PTSD. I know a lot of people including my father who would act that one out but for very different reasons. Especially with the terminology you use. People with personality disorders. People with anger issues. People with impulse issues. If you are referring to your wife having a triggered episode then your language use doesn't show much understanding. If this is a common thing for her it may be that some of the behaviour is just behaviour and not ptsd.

 

[Sandstone]

Isn't Scenario 2 just "having PTSD" ?

As you say, I'm no longer the same as the person my husband married. However I do consciously still love him, and work to enable our marriage to be good and successful. PTSD puts barriers in both our ways, because I live in a permanently withdrawn and detached state. He has to be more cautious about how he says things, because I'm likely to hear criticism and blame where it isn't intended. MY PTSD triggered states are not as you describe though. In fact I was probably more inclined to lose my temper and rage before PTSD. Now I'm more inclined to withdraw even more and at worst to head towards self destructive behaviour. It's never aimed at attacking or hurting my husband, though I can see that withdrawal in itself can be hurtful.

 

[joeylittle]

I've been thinking a lot about the term "PTSD episode" as it relates to spans of time that certain symptoms are contained within. It seems there are two types and am not sure if there is a better term for the longer version.

I understand why, to a supporter, PTSD could appear to show up as two 'types' of episodes.

PTSD is a label for a bunch of symptoms. That's the fact of it. Symptoms will quiet down, lessen, or altogether disappear depending on both how effectively the individual is managing them, and on environmental (situational) factors.

They will become more visible, flare up, and even overwhelm the individual, depending on same.

So, for the sufferer, there are three things going on at any given time: how successful we are at coping with/living with/managing our symptoms, how overwhelmed we can get by symptoms that we don't have the tools or tactics to manage, and then how the world we inhabit makes both those things more or less difficult.

Backing up to the concept of symptoms: every sufferer will have some things in common, and some things, not. And, because there are quite a number of symptoms that one can have - if we follow the DSM, which we kind of have to simply if we want to be having a unified conversation - there are four groupings of symptom types, and within those groupings, approximately 20 individual symptoms. Those symptoms then have multiple modes of expression.

All of this does not add up to "PTSD is so complicated, no-one should try and understand it".

There is the episode where the person goes from acting fairly normal to freaking the hell out and yelling and raging and maybe even throwing things or doing other things that are drastically different than moments before and are in general filled with non-rational statements and actions. These seem to last minutes to hours.

Parsing this - there's more information behind 'acting fairly normal' - because there is going to be some symptom management going on already. Based on how the individual has the 'freakout', you can sort-of reverse-engineer what might have been going on with them before they exploded - and that would answer whether or not this was something brought on by a specific trigger, or by multiple stressors. Also - not everyone acts out. Some implode.

These seem to be way more subtle in that there can be fairly reasonable conversation and actions and even going to work and other events but there is a definite shift in their actions and statements and general perception of what is going on in that time period. These seem to include the loss of trust, emotional numbing, and other subtle things that are destructive like substance abuse for example. This is the situation where people say that the person isn't the person they generally came to know and love and seems like a bit of a stranger. It seems there are conflicting actions done during this scenario in that the person subconsciously very much loves their partner and does actions and statements that line up with that but also do destructive things that could rip the relationship to bits. It all seems to be quite subtle too which makes it harder to really understand.

This is, to my eye, just called 'living with PTSD and having symptoms that aren't always managed'.

Again, the important part to understand (I think) has less to do with the activations and more to do with the stimulus. It's that 'fairly reasonable' time that you mention. There's stuff going on during that, and things are shifting, being managed, external stressors being navigated, and pressure shifts around.

When you have a really good self-care routine in place - the whole regular exercise, good diet, therapy or some other set of psychological tools being worked, strong support system, healthy coping strategies for the minor day-to-day eruptions/implosions - when all this is in place, a lot of the bedrock of PTSD will stay pretty quiet, and then, it's easier for the sufferer - and supporter - to identify when things are getting slightly out of whack.

I'm not sure your wife had any of that stuff in place, and so, I think your experience of PTSD is of it in it's most aggravated form. Both of those episodes that you describe sound typical, to me, of a person who is trying to manage their disorder mostly by themselves and needs more help in specific areas. That's the 'typical' I'd apply to the scenarios you describe.

All mental health disorders exist on a continuum. It's really a spectrum, not a this-or-that.

 

[Deleted member 17302]

Well that all got out of hand quite quickly...

1. Of course not all people will have the same symptoms and I never intended to say that all people with PTSD do.

2. Tried to define episodes as periods of time with higher concentrations of expressed symptoms within those spans of time whereas the non episode time would be a less symptomatic time but not completely void of symptoms.

3. I'm not just describing my sufferer when making these posts. I'm referring to other PTSD sufferers that I know on this forum and off this forum that are not my sufferer.

It seems a bit hard to describe this well enough not to get a quite intense and negative reaction from the users here.

 

[Deleted member 17302]

Eating disorders which I believe your wife had also fall into that category.

That would not be me. The post was wide scope, not focused on just my sufferer. Don't make it personal to my case because that is not the situation at all.