Cognitive Behavioural Therapy (CBT) Provides The Best Result For PTSD

[anthony]

I have a large list of issues. PTSD from my childhood abuse. (really bad stuff) I also have PTSD from Combat and in addition I am also Bi-polar... ...Do I try the EMDR? or just stop working with the therapist? Those are my options. Thoughts? thanks,Dan

Hi Dan,

I would first be interested with why you have a Bi-Polar diagnosis in combination with PTSD diagnosis! Bi-Polar is 99.99999999999% misdiagnosed if PTSD is present, if Bi-Polar was not clearly identifiable prior to trauma.

As you stated, you have endured childhood abuse, I somehow think you may be able to rule Bi-Polar out of your life as a misdiagnosis due to your PTSD from childhood abuse, followed by combat.

Unless you got diagnosed with Bi-Polar prior to any abuse occurring. They present near identically in many aspects, Bi-Polar and PTSD, and when trauma has been endured, it is PTSD.

Second point... if you have limited local resources, then give whatever is available a shot. EMDR is getting better and better, and its also a lot to do with the practitioner themselves as to whether or not things go really bad, quickly or not. EMDR is a safe treatment, and if you have childhood trauma you remember, without issue, then it should be fine. Its when EMDR is used with complex trauma where a lot is just not remembered / unknown, it can have devastating effects, but the practitioner should find that in their initial assessment prior to treatment as to whether its right for you or not.

 

[reddevil1111]

The bipolar is real. I did sit down and read a few books about it. I have rapid and intense mood swings. I also respond well to the medication for bi-polar as well. I have suffered from depression that seems like a black hole. The mania is when I used to be super creative and I was able to paint, draw very well. Most of my real good work was done rapidly like my thoughts. (still good stuff when off the mania lol)
And the changes to the depresion were very fast sometimes from depressed to mania and back in 5-6 hrs.
I also know the evil side of the PTSD. A different type of dark depression, rapid mood swings towards violence and back. The lashing out towards family and friends to make life somehow simpler and to avoid the stress of being around others. Flashbacks, nightmares,sweats and headaches. Confusion as to reality from the rapid flashbacks and just feeling like you could murder someone for something they said or did that in my mind is 100% justified. But a family member or friend might say I was crazy to think that way and just let it go.
Then the childhood PTSD adds another layer. I hate bullies and people who torment others. I can't stand agressive and mean parents or figures of authority. I really dont like people who think they can push me around. Even in a crowd. Throw all of that into a blender and I have made it 20 years by biting my lip a lot, staying out of public places and moving to a quiet place where I dont encounter a lot of the stuff you get in the citys. I am able to cope somewhat but I am hoping to slay some dragons so I can get some sleep for once.

 

[reddevil1111]

Willis, wow! It is real nice to meet you and know I am not alone in this! I have some medical combat injuries that were treated by the VA as part of my discharge. I was discharged while in a VA hospital in Chicago in fact. Hines VA hospital.
I have been to the "big city" local VA in Denver. It is filled with a bunch of drunk older viet nam vets that I swear half were just there for a bed. (this is prior to the 2nd gulf war, now its got to be even worse with all the kids from Iraq and all.)
Nope I wont go to the butchers hell of the VA. I know you might have a good hospital. But both Chicago and Colorado, the hospitals are way understaffed, it takes half a day to get an asprin let alone treatment. And they look at you funny when you say you need help for PTSD. you become a lab rat passed on from dept to dept. not to be helped but to be viewed. (and judged) I even ran into a buddie from the Marines who was there (he was state side his entier 4 yr hitch) He pulled me aside and told me to suck it up and act like a man. And he was working for the VA at that time. yeah.
Back to what your doing. I am in the same place. I do the disapearing act a lot. my wife hates it but if i didnt go out to sort myself out i would go mad or hurt her and I dont want to be that kind of guy. Thanks for the heads up- I will keep in touch with you if you dont mind. -Dan

 

[willis williams]

Of coarse I don't mind we are all brothers and sisters here. I was not in any means saying the the spokane VA is perfect. The triage takes a minumum of four hours. The psyciatrist are quiting let and ringht because they are not aloud to give proper diagnoses. I had a really good Dr. that swore up and down that I did not have Bi-polar. But when I was put in the hospital fora med reaction the Dr. automaticly labeled me Bi-polar this has only been 11 months ago. I have not resonded to the meds. But I took lots of classes to learn to manage my symptoms. The only way to get off the meds safely is to go back in the bird cage. I am a somalia veteran so I know what you mean about the age differances and drunks. My fiance wants me off the meds because she say that they have made almost no change beside my kidneys hurt like hell, and my liver is enlarging with the enzimes way out of wack. The med that put me in the hospital gave me something like a minie stroke. I have tried so many it is unreal ones that make you impetant, to ones that give me tachacardia so bad it is like I just ran a triathalon and it won't quit around 135 beets a minute. So I think we all understand the whole ginnie pig thing. But if you can work the programs they work and they help with building a social net work at home. Be safe and good luck! TEX

 

[anthony]

Hey Red...

I have rapid and intense mood swings. I also respond well to the medication for bi-polar as well. I have suffered from depression that seems like a black hole. The mania is when I used to be super creative and I was able to paint, draw very well... ...And the changes to the depresion were very fast sometimes from depressed to mania and back in 5-6 hrs.

What you explain here, is actually all perfectly normal as PTSD symptoms, ESPECIALLY military.

This is why I ask... when was BiPolar diagnosed? Prior to military, after childhood trauma, before childhood trauma, at the same time you got diagnosed with PTSD?

PTSD mood swings are even worst than BiPolar, which is why the two are never given to a person, unless misdiagnosed, unless Bipolar was clearly present prior to any trauma endured, as PTSD trumps the Bipolar diagnosis.

PTSD also responds the same to Bipolar medication to manage mood swings.

The DSM V have actually moved PTSD out of "Anxiety Disorder" and into its own new classification due to this, and many other reasons, being a new category for "Trauma Disorders".

Because PTSD crosses over with manic mood disorders, depression, anxiety, dissociative and personality disorders even, it is reclassified.

Everything you explained above, fits squarely within PTSD symptoms... which is why I ask. Sooooooo many people get misdiagnosed by over-eager physicians with both PTSD + Bipolar, which according to the traumatology experts, is a big no-no, unless Bipolar was diagnosed prior to any abnormally traumatic events occurring.

 

[reddevil1111]

Bipolar was what I was called about 2 years after getting out. I was swinging moods, drinking like a fish. I had a lot of issues with my injuries and I just lost it one day. I drank 2 fifth bottles of whiskey and every medication I had. Everything from muscle relaxers, pain killers, sleep meds. Everything it the damn cabinet. Then I took my Gerber mk2 fighting knife and opened an arm.
I came to and it was fuzzy. I realized a cop was standing over me and I could barely keep focus. (family member had stopped by and found me)I still had the knife in my hand and I was folded over it so they didnt see it. I sat up and tried to put the knife into my heart. I only got the knife in about 1 inch and they took it away.
About 4 days later I came to And was told I had crashed several times. That they brought me back every time and then kept me in a drug induced coma while the pumped me full of charcoal several times.
forward one week of "funny farm time" I was told I was bi-polar.
They had me on Lithium for 6 days or so and I had a real bad reaction. So I was put on tegretol. I stayed on it for about 6 months and gave it up. I couldnt stand the effects it had on my. I felt nothing.Like a zombie. My friends all said I was much better. Bullshit.
So I entered 6 years of deep depression. One thing I really didnt think that much of until now, I had eased up on the booze around this same time that I went off the deep end.
My PTSD is both childhood from several thing including long term beatings- the Military is something I have figured out over time. I really did at first think this was how everyone was. Just the other day my wife mentions from something she saw on TV that I had loaded guns all over the house when we first met. So I guess I really only began to face this in the last 4-5 years.
I do have the extreme highs from bi-polar. How do you explain those? I understand the deep depression could be PTSD alone but the mood swings seem different at times. I have read books on bi-polar and I seem to fit into bi-polar 1 completely. I do plan to mention this to my therapist. But I would love to hear more of your thoughts on this.-dan

 

[reddevil1111]

To be more clear, I never had a doctor call me PTSD ever. I have been told bi-polar after childhood trauma and after military. PTSD only came up as a possability in the past 5-6 years as I read more about what I was feeling and what it meant. Unlike most of you guys, I never sought VA help for PTSD and never asked for help with any of this until 5-6 months ago. The therapy I am doing is bring everything back to the front of my memory. Every day I remember more of what I had forgotten. I was ok with this for the first few months as things went slow and most of the talk has been about my childhood problems. But the changing of therapists and the begining of talkingabout my military past as well as just comeing in here and posting and reading everything you guys say....it just bring more and more stuff to the surface every day. I feel a lot like I did when I first got out.
Rage. Frustration. The disire to f-up my life and to just walk away from everything.

 

[Jimmy1]

Dan,

I think what Anthony is trying to tell you is that you may have been wrongly diagnosed right back from early childhood. You said you were bi-polar after childhood trauma. Well to me it sounds like you had PTSD from your childhood trauma. Bipolar is similar in its symptoms, but a totally different kettle of fish. You just have had a double edged sword. PTSD from childhood and PTSD from your service. I was actually reading an article where they said that children who are exposed to PTSD symptoms at an early age are more likely to more easily attract PTSD after traumatic service.

It does get better mate. I describe it like the surfing at the beach. At the start, you can only stay up for a short time before you smash down, and sometimes you get torn up on the reef. But eventually manage to ride the wave for a fair while and sometimes all the way in.

But even the best surfer still comes a cropper every now and then.

It has to get worse before it can get better, even with therapy as you are opening old wounds.
Your other option is to drink yourself to death or pop pills for the rest of your life.

We are here for you mate.

 

[anthony]

Dan, Bipolar is the most misdiagnosed diagnosis when PTSD should have been given. If you are talking about the US military, then they also use Bipolar whenever they can, because it removes them compensating for PTSD.

With childhood trauma + military trauma, I think you could fairly accurately say, they misdiagnosed you and your only diagnosis should be PTSD. Depression is not a symptom of PTSD, it is a comorbid diagnosis (an addon) that gets added to the PTSD diagnosis. Saying that, the latest findings have shown significant implications that even the depression elements are wrong due to PTSD, as the depression is a mood based one, not an actual chemical depression, therefore anti-depressants aren't effective, which answers why many who are treated with anti-depressants don't change or get worse, because they're actually being made chemically depressed by a medication when they were never chemically depressed, but mood depressed... there is a vast difference between the two. The mood depression is what is believed to be the majority now in PTSD, not chemical as pharmaceutical companies have made us believe... neuroscience is allowing us to prove theories wrong or right with more accuracy now.

Exactly what you stated about falling apart... you could write the exact same thing for me. That is where it began... I just suddenly fell apart, into alcoholism, all sorts of nonsense... and even then, my shrink told me that Bipolar was the largest misdiagnosis for PTSD, because they present near identical in major physical aspects, yet when reviewing the trauma aspects that you fell apart due to the trauma, that is why PTSD trumps Bipolar as a diagnosis.

You don't have to have flashbacks (actually they are extremely rare for anyone to have), you don't have to have many things... PTSD is about the trauma, which is why the DSM V have recategorized it into a new trauma category, and no longer as an anxiety disorder, as PTSD extends beyond anxiety due to its relationship with so many other disorders being diagnosed comorbid (being secondary to the PTSD and they wouldn't exist without the PTSD).

 

[william]

I am definitely bringing this up in my appointments today. I wish I had a printer, but I will try to stop in the library tomorrow to print some of this off to give to my psych. Great info

 

[reddevil1111]

I have not had flashback in a long time. I had a few when I got out. Lately I had a real stressed out period and had some super bad ones that were layered ...I was having multiple (in a row) and I was losing large blocks of time. I would be downstairs and then an hour later I would be upstairs and yelling at my kids and I would snap out of it. And I didnt know why I was mad or yelling. My wife told me I had been ranting for almost the whole time and pacing back and forth. I was moving room to room and was agitated. (her words) I was sleeping about 2 hrs a night in 5-10 minute naps at the time -was like that for 5 days in a row.
I am getting better from that. Its been about a month and I am not stressing as much. I dont have any flashbacks now but my nightmares are real vivid and seem to be nonstop. Sleep is still at 3-4 hrs a night.
I brought up the idea to my therapist that I might just be PTSD and not bi-polar. We are talking about it. She is not convinced either way yet. She does say I have severe PTSD. I was like well...yeah?Duh!
BTW? no booze or drugs...just stressed out to the max.

 

[Ned]

Bugger. This is spot-on. It's the mood, not a chronic disposition. Bugger. This nearly got me mis-diagnosed and only a very sensible GP stopped that.
Hence the anxiety medication working so dramatically better than the anti-depressants.
I used to think CBT was a bit fluffy. Now I think it's a bit Zen/ Machiavellian and a very good strategy. It comes from within and that hits the button.
Dan, I don't know much but I agree with what's been said, PTSD 'nuff covers it.