Anxiety Plus No Flashbacks?

[anon]

After two extremely traumatizing events a few years ago, I got really bad anxiety that hasn't really decreased since the events. The difference with me however is that I get no flashbacks of the events. At the time when they were happening I was very numb and dissociated, which I think might be part of why I don't think about it. In many ways I'm still kinda stuck in that state of dissociation much of the time.

Is this normal to have PTSD minus the flashbacks?

 

[Jen93]

Well, speaking from my own experiences, when my signs of PTSD first showed up, I had an auditory flashback. I only had one single sentence to go on, but it made me feel like I was going crazy. It was only after I saw my psychiatrist and he dragged out my trauma (my main one anyway); that I was diagnosed with PTSD and started getting more flashbacks.

Flashbacks come in many forms. They can come in auditory forms (a sound connected to the trauma- a sentence from the traumatic event spoken by someone, sounds of metal or such if it was a car crash. etc. etc)

They can come in visual forms- where you SEE the event happening again. (This is the most well-known usage of the term flashback, usually when people say flashback, it is assumed they are talking about this form, but not everybody gets that form.)

They can also come in body memories. These are often flashbacks which come to people traumatized by sexual abuse or physical abuse. For example, I was a victim of child abuse. When I get body memories, the place where I was hit actually hurts, and it turns red. These are terrifying flashbacks, and if you don't realize it before, they may not even be considered by a person to BE flashbacks.

If you don't get these kinds of flashbacks, you don't have PTSD. It is REQUIRED under the diagnostic criteria that a) The event must have happened at least 3 months ago. b) You must have experienced intense fear and horror at the time of the event. and c) You must get recurrent flashbacks in which you feel the event is happening all over again.

Hope this helps.

Jen.

 

[anon]

I know I have PTSD. Even if I don't get your typical flashbacks, my flashbacks come in the form of how I feel constantly. I constantly feel like how I did when these traumatic events were happening. I constantly feel like I'm about to be attacked for example. I'm constantly stressed, and get enraged very easily. Also, I have nightmares, and always wake up feeling tense and anxious with an increased heart rate. These symptoms started at extremely traumatic events and have no gone away.

I know it for sure. I absolutely have PTSD.

 

[Jen93]

Have you seen a psychiatrist? You really should see one to diagnose you. It is dangerous to diagnose yourself, and we are unable to diagnose you as we are only people on the computer.

 

[Red Feather]

There is also emotional flashbacks. I get these more than visual flashbacks. You feel like you felt when it happened. There is a thread on this forum about them.

I don't get very many visual flashbacks. I don't see that as a criteria to diagnose PTSD. Some doctors only say you have PTSD if you have visual intrusive flashbacks. Some others don't. It's confusing. Jen's right though getting a diagnosis is good and can help you get the right kind of treatment. Just know that it should be a doctor who has experience with trauma. Then this confusion can be avoided. That's my opinion.

I also think that my visual flashbacks are reduced by the amount I am constantly dissociated, and also depends on how complex the trauma is. The more I move through the numbness the more visual flashbacks I have been getting. This is real important to understand. I have been numb for 5-6 years and haven't gotten treatment. Of course because dissociation is sort of an invisible symptom. But the more you become aware of this, the more you can find the right doctors and therapist who can help you, and the more you can work throught it all. That's my opinion.

 

[maelstrom]

For me I think the worst part of it are the visual flashbacks...Unlike you, I actually don't have the typical type of dissociation. I could talk about my experience objectively and I could remember details. However, I wouldn't feel anything when I talk about my experience. It is as if I'm telling another person's story. It's not like I would tear up and get all emotional when I explain what happened, so it is okay. However, the flashbacks are terrible, terrible..the most terrible experience I've ever had in my life. If I could get rid of them, then I think I would have been cured almost completely.

 

[1stInfantry]

If you don't get these kinds of flashbacks, you don't have PTSD. It is REQUIRED under the diagnostic criteria that a) The event must have happened at least 3 months ago. b) You must have experienced intense fear and horror at the time of the event. and c) You must get recurrent flashbacks in which you feel the event is happening all over again.
Jen.

Your post is very misleading. Flashbacks as you referenced in all five of your paragraphs can lead to a misdiagnosis in a heartbeat. There are far to many times that people use this word loosely and interpretation of what a 'flashback' is varies widely. The investigating Psychologist will sometimes only ask, and refer heavily upon that word as you did, as being the only determining factor to meet criteria B.

A person that has watched many war movies where the guy/gal wakes up in a cold sweat after reliving the event like in a movie might think that since that does not happen to them they must not have PTSD. Although I concede that the word flashback is defined by reliving or re experiencing an event or trauma, reliance on this one word alone during interviews often leads to a mis-diagnosis and mis-understanding by the patient as to what the actual intent is. If an examiner fails to follow through with item 4 and item 5, and explain them thoroughly to the patient, then the examination is flawed and a mis-diagnosis can often follow.

That is why the DSM IV specifically leaves that term out of 4 of the 5 criteria in B. where only one symptom is necessary in that section to diagnose. PTSD rquirements under DSM IV (the bible for psychiatric diagnosis):

309.81 DSM-IV Criteria for Posttraumatic Stress Disorder

A. The person has been exposed to a traumatic event in which both of the following have been present:
(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror.Note: In children, this may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:
(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to have loving feelings)
(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response
E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more
Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor



And the three month requirement you said must be present to meet the diagnosis of PTSD is only for the Chronic PTSD diagnosis. One can be diagnosed with Acute PTSD.

 

[freakofnurture]

Yup, flashbacks can be subtle and hard to identify since the media promote such narrow expectations as to how a flashback feels.

Mine manifest mostly in very unpleasant emotional reactions to cues about the people who abused me and the place where I was abused. I couldn't face them or go there, even if I wanted to. I'd simply die; that's how it feels. I'm also very scared of people in general because they could turn against me, just like it happened when I was abused.

I occasionally have fear dreams about my abuse, although those have markedly reduced over time. I also feel like a child sometimes, though that can be very subtle and I'm only now figuring it out.

 

[ClairBear226]

I know it for sure. I absolutely have PTSD.

You DO NOT want it to be PTSD. Trust me. Best to have a therapist make that assessment, rather than make the decision yourself. The people here that have been diagnosed suffer a life sentance when they're told they have this thing. I truly, truly hope that you are incorrect. Please see a therapist that specializes in trauma, be completely honest about what you are experiencing, and allow them to make the determination. You cannot diagnose yourself from what you read here, or anywhere else.

 

[freakofnurture]

I agree with ClairBear. Go see a therapist and get a professional diagnosis. It's the only way for you to get the help you need in order to get your life back together.

 

[Bubba]

Everyone is correct - you want to go get an official diagnosis and find someone who specializes in trauma.

I, personally, don't have visual flashbacks - mostly just emotional. I do, however, have nightmares consistently. Here is an example of a visual that I do have: when I go to get on an escalator, I have immediate panic and can picture my knee dislocating and me tumbling down the escalator. I can feel the pain of my knee dislocating and I break out in a cold sweat. Now, I have never had this happen, but my knees have gone out on me so many times and in so many situations, that I often feel like it could happen again.

But quite often, I will suddenly be overcome with emotion - and at the most awkward times. My eyes well up with tears or I get extremely lightheaded or I simply have just an intense emotional sensation.

I have had these for as long as I can remember. I've had PTSD since I was 7 - now 42. I think it just varies person to person and what their personal make-up is.

But do get into a therapist - get a true diagnosis. It is beneficial to your recovery.

Hugs and prayers coming your way!!!

 

[piratelady]

I know of one flashback I had and one might be one, I'm not sure. When I was in Florida in April, I was fine and then I was in a situation and suddenly I remembered something that had happened to me a long time ago; something that I had forgotten about. When I told my therapist about it, he asked if it was like a vivid memory. I said yes and he said that was a flashback. One other time, I know what I experienced was a flashback and it was much more emotional and it was more like the description of a flashback - like I was back there again.