I wrote this a few years ago when a friend suspected I was manic depressive after seeing me in the midst of a PTSD episode. I was trying to give her a sense of what it was like to go through a PTSD episode and I thought someone here might find it useful in some way, so I am posting it below:
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For what it is worth, bipolar and other mental disorders are common differential diagnoses when Complex PTSD is identified. I've been evaluated by multiple PHD-level psychologists and psychiatrists in the past few years and I have never been diagnosed with anything else, other than, of course, accompanying depression and anxiety. As you know I've also periodically struggled with substance abuse.
So why am I writing this letter to you and why does it matter?
While some people may have co-morbid Bipolar Disorder, many other people with PTSD and especially complex versions of it are often initially misdiagnosed with thought and mood disorders, like bipolar, because their behavior may appear erratic to others. When old trauma is activated, people can seem very charged and generally elevated. Yet, for people who are in the grip of that old trauma, their behavior, internally makes perfect, rational sense.
When you have lived through the experience of grave harm to your body and mind, and that memory is re-activated in your being, while you may logically understand the threat to be long past, in the body and in the feeling-self, it is re-experienced as though it is happening in the present moment.
Things which may seem banal or, at least, much less threatening to those around you are experienced by you as a shifting combination of the current upsetting event fused with much older and more powerful events which now feel present again and carry with them all the original feelings of danger and desperation.
Accompanying this is the very deep need to be able to communicate your experience, as you may not have been able to when the traumatic event first occurred. It feels as though your survival depends on others recognizing and properly responding to that threat. Because this is so emotionally elevated, it can, certainly, add to the seemingly erratic quality of one's chosen words and communication. But that desperation and upset makes all the sense in the world to the person living through it.
Depending on the extent of the now-triggering incident, it can take some time to settle and to gain enough calm and clarity to parse apart the old feelings from the new events.
The greatest harm done to me was the near annihilation of my ability to trust and maintain healthy interpersonal relationships of mutual care, respect and dependability. As a result of this, important relationships in my own life sometimes have a tendency to re-activate all kinds of complicated feelings as well as the extraordinarily deep desire for real, genuine connection and intimacy. This can be very confusing to me and clearly it happened in my friendship with you. You were an important friend to me and I wanted to be close to you and I didn't know quite how to work with that so I did so unskillfully.
You have called me "dramatic" in the past. And it's certainly true that I have a tendency to present things in a dramatic fashion. But, as this note has tried earnestly to explain, that is an old habit that I'm still working with. It was borne of being unheard in a time when I was in danger. It has outlived its usefulness, for sure, but it came about as a child's way to seek help and to be heard, not of any organic mental illness.
-------------------------------------
For what it is worth, bipolar and other mental disorders are common differential diagnoses when Complex PTSD is identified. I've been evaluated by multiple PHD-level psychologists and psychiatrists in the past few years and I have never been diagnosed with anything else, other than, of course, accompanying depression and anxiety. As you know I've also periodically struggled with substance abuse.
So why am I writing this letter to you and why does it matter?
While some people may have co-morbid Bipolar Disorder, many other people with PTSD and especially complex versions of it are often initially misdiagnosed with thought and mood disorders, like bipolar, because their behavior may appear erratic to others. When old trauma is activated, people can seem very charged and generally elevated. Yet, for people who are in the grip of that old trauma, their behavior, internally makes perfect, rational sense.
When you have lived through the experience of grave harm to your body and mind, and that memory is re-activated in your being, while you may logically understand the threat to be long past, in the body and in the feeling-self, it is re-experienced as though it is happening in the present moment.
Things which may seem banal or, at least, much less threatening to those around you are experienced by you as a shifting combination of the current upsetting event fused with much older and more powerful events which now feel present again and carry with them all the original feelings of danger and desperation.
Accompanying this is the very deep need to be able to communicate your experience, as you may not have been able to when the traumatic event first occurred. It feels as though your survival depends on others recognizing and properly responding to that threat. Because this is so emotionally elevated, it can, certainly, add to the seemingly erratic quality of one's chosen words and communication. But that desperation and upset makes all the sense in the world to the person living through it.
Depending on the extent of the now-triggering incident, it can take some time to settle and to gain enough calm and clarity to parse apart the old feelings from the new events.
The greatest harm done to me was the near annihilation of my ability to trust and maintain healthy interpersonal relationships of mutual care, respect and dependability. As a result of this, important relationships in my own life sometimes have a tendency to re-activate all kinds of complicated feelings as well as the extraordinarily deep desire for real, genuine connection and intimacy. This can be very confusing to me and clearly it happened in my friendship with you. You were an important friend to me and I wanted to be close to you and I didn't know quite how to work with that so I did so unskillfully.
You have called me "dramatic" in the past. And it's certainly true that I have a tendency to present things in a dramatic fashion. But, as this note has tried earnestly to explain, that is an old habit that I'm still working with. It was borne of being unheard in a time when I was in danger. It has outlived its usefulness, for sure, but it came about as a child's way to seek help and to be heard, not of any organic mental illness.
