Complicated case of ptsd

[lostforgottensoul]

For the record, GAD can be used as a catch all by some but where I work it is not good enough.

I was insured by GAD alone for about a year. Just saying.

 

[Deleted member 42783]

Not meaning to come across as hostile @lostforgottensoul . Sorry if I came across that way.
Think I'm gonna need to bow out of this one.

 

[lostforgottensoul]

Basically I am saying that if the PTSD diagnosis doesn't fit then all the other handfuls of disorders in the catigory need to be checked. If none of those fit and if something like GAD won't allow for insurence coverage to allow the person to be undiagnosed and then the best possible answer should be listed, if that is PTSD then so be it but you cannot do what was listed on this thread. Not check and disreguard those other handfuls of disorder this could be completely and insist that it must be PTSD, bending the PTSD diagnosis to fit. I am not saying you did that @valkeasisu, I am saying that is what was done here and what we are all (or at least I) am talking about. The boy that tripped over a curb and came back up with PTSD. The "got cheated on" is a common one here. People have pain, they define that pain with PTSD and then insist that they have PTSD for asurb reasons. People want PTSD and I do not get it. People want answers but they don't seem to want the correct answers. That is what I am not getting. Personally I am a research-oholic. I research EVERTHING. If I came here under the belief I had PTSD or asking if I did and if people said, not lilely because of XYZ reasons, its more likely to be one of these, I would research the f*ck out of those disorders and probably 20 around each one and then book the next appointment with my therapist with all the research in hand and advise hom what was advised to me. I do not get why people fight for PTSD. Seriously! People that were cheated on come here and then fight in a thread about why being cheated on causes PTSD. That is just another day here. It's ridiculous! If PTSD were cancer people wouldn't do that. Why pick PTSD to want? Why want any mental or medical disorder?

If it is for insurence reasons, there are MANY disorders to choose from. GAD was just an example that my therapist says is used a lot. There are plenty of disorders that will get insurence coverage. And, like I said, if those other disorders were checked and PTSD is the cloest one and you need insurence, cool, but thats not what I am speaking about.

So you and I maybe agreeing. I am unsure if I am just reading the posts wrong but that is what I am saying, in a nutshell.

 

[Deleted member 42783]

So you and I maybe agreeing. I am unsure if I am just reading the posts wrong but that is what I am saying, in a nutshell

I think we are agreeing. I think I just have less frustration built up over the issue. I'll probably get there some day.

 

[shimmerz]

I don't think it was me that said that this stuff happened rarely. I have no idea how often it happens to be honest.

What I do know is that I fought and kicked and screamed and temper tantrumed in order to have my catatonia diagnosis. Why? Not because the cool kids had it. Not because I wanted it. Not because I thought people would feel sorry for me. Quite honestly, I feel like a freak because I have it and it has absolutely ruined my life beyond words.

I needed the diagnosis because I needed treatment for it. And why couldn't I get treatment for it? Because the DSM of the time said that I could not have that unless I was diagnosed as psychotic.

This DSM? It says I can have it. Yeeeehhaaaaah! I knew that 8 years ago, when T-doc, who wasn't all wrapped up in 'it isn't in the book so it can't be happening. For chrissakes, I could have died 20 times over if it hadn't been for people who saw it and helped me. Uneducated (in medicine) friends saw.that.it.was.happening and didn't have some stupid freaking book that kept them rigid regardless of what was going on right in front of everyone's faces.

I had no idea that I had a traumatized background. Took me 3 years before my T-doc would even let me look at the Chrilden's Aid documentation. I wasn't posting here at that time, but thank god others accepted me. Without some form of validation I would have thrown myself in front of a train.

I'm just saying we should leave the diagnosis to doctors. We have no idea the past of these people and I think it can be damaging to convince people that they don't have PTSD when we are not qualified to say they do (as is stated here consistently) or that they don't. We aren't deluding people if we state that we can't know one way or the other.

 

[mamachick]

I have not gone back and read all the posts, but agree with LFS and shimmers.
The problem with diagnosing the closest thing is that a therapist must be able to defend their diagnosis according to the current DSM. If they cannot do so, they could find themselves in some real trouble. I do think there are some people that are suggestible so if they have some symptoms, they want the diagnosis. They may want to explain their behavior.

As shimmerz stated, not only do sufferers have to push for correct diagnosis,the DSM changes. For example, the current criteria for BPD does not require a history of trauma, after all the years of a person either not meeting the criteria for that diagnosis, or if the behavior is undeniable, the therapist has concluded that they were minimizing, denying, or unable to recall their traumas. (filling in blanks to meet criteria). Many do not have the insight to report their own behavior accurately and the T only gets to observe for one hour a week and not in their daily setting.
I think it is hard enough for the clinician to make an accurate diagnosis or rule one out with the client sitting in front of them. I know I have read where person thinks they have ptsd due to being cheated on and such, which of course does not cause ptsd. Yet there are instances where the cheating brings a person into therapy only to discover abuse/neglect in their childhood or their belief that a rape wasn't really a rape, etc.

Sure is nothing to wish to be diagnosed with!

 

[anthony]

No? I don't think I implied that anyone should be lied to.

Sorry, that was more general... just using your context upon it.

 

[lostforgottensoul]

I don't think it was me that said that this stuff happened rarely.

No, it was JL.

It's super-shitty to be in those rare percentages of people with very complex symptomology, like you had, and to not have the opportunity to be working with a doctor who was really capable of understanding, and being up to speed enough to know where the research was moving at the time.

With so many disorders in the DSM in the same catigory of PTSD, I also feel it is rare to be stuck in the "I don't know what is wrong with you" catigory.

I'm just saying we should leave the diagnosis to doctors.

I personally never try to diagnose anyone but I do educate of diagnosic criteria and I do not feel that is bad or wrong to do. And personally, that is all I was trying to do here but people do fight to say they have PTSD when their only "trauma" was, say being cheated on for example, and that is super frustrating to me. And that is all I am expressing here. No, I do not know their life or past but if they state that is their only "trauma" and you educate and they fight you at every turn, that's frustrating, for me.

I know what it feels like to be told it isn't possible to have something (Stolkholm Syndrome) but have a therapist that said I fit it and was in an odd area where I would fit that definition (again, years back) but everyone else saying "no, you don't fit because of XYZ" but what i was told I fit by everyone else I didn't fit correctly or fully. So, I get that. But the way people fight and seem to want PTSD and PTSD alone and cannot look beyond PTSD to see other possible disorders (I did a lot of research on Trauma Bonding vs SS) that could fit better is super frustrating to me. So I do get both sides. I really do. But, again, why not go to at least look and consider those other disorders? Why fight tooth and nail for PTSD, disreguarding any other possible disorders that would fit?

 

[joeylittle]

But, again, why not go to at least look and consider those other disorders?

To be honest - it is hard for a layperson to find the designations for the "not otherwise specified" or equivalent inside of each disorder category.

I think it's helpful stuff to share info about, but perhaps the real point is to encourage the individual to know that it's OK to really ask questions about your diagnosis, and have them teach you how it fits, and how it doesn't.

I also think docs can and should be transparent when they add diagnoses in order to support treatment coverage (insurance). I have a GAD diagnosis, among others, because my psych wanted it there to eliminate a potential barrier to certain meds. But I know I don't have GAD. We talked about it.

So: I don't think it's reasonable to expect someone to figure out how to code their own disorder. I do think it's reasonable, once the intake is completed, to ask and be given answers about how your doc is interpreting your symptoms and why they are deciding what they are.

And it's reasonable to ask questions when you don't understand.

And ultimately, if it seems to you that they are not understanding your situation fully, you may need to go to another one.

I mean, it's medicine. No amount of internet research is going to substitute for the comprehensive understanding that one gets through obtaining a medical degree.

 

[lostforgottensoul]

Oh, I fully agree @joeylittle. I didn't mean that people should know GAD would give the insurence a code. The doctor should most certianly be doing all of that and I fully agree about the doctor. It falls on them in the end anyway. And it is totally cool to ask questions. I am known as the person to ask the most questions (like in my training class at work) as I want to make sure I am fully understanding.

What I guess I am frustrated with are those that are a closed book. It's must be PTSD and cannot be anything else. That's where I am having the issue. People that want PTSD to define any hurt they may have and cannot see anything else when educated. Those that don't have doctors and therapists, googled and self diagnosed. That sort of stuff. I personally do not mind educating someone. I do it all the time now with a service dog (who is a pitbull thus more education). I like people to ask questions and inqure, try to understand, etc. It's those that don't and are deadset on PTSD.

Not sure if that makes sense. But I didnt mean that someone should already know GAD gives the insurence a code to them cover the person. Thats the doctor's job for sure!

 

[Jim711]

I do. Because there are other, more accurate, diagnoses that cover drug usage issues, including when the dr...

So in terms of message forums this post is 100 million years ago (lol), but I returned to it out of curiosity. You have a wealth of information, and I have enjoyed reading these posts. One critique is that I think your view of psychopathology as it relates to diagnosis maybe a bit on the narrow side. Now, if you are billing for insurance then by all means apply the labels how you would like. If you are a trained clinical scientist who doesn't just read the diagnostic manuals, but studies the actual research on which work groups base their decisions, then you might actually find that some of these issues, like Criterion H, are not so clear-cut. If you are an experienced specialist, classification systems are like guidelines, and a trained specialist will not shackle themselves to each and every criterion if they know the literature and their case conceptualization supports a diagnosis. Psychopathology is complex! I guess all I'm saying is it's possible to be too loose but it's also possibly to be too rigid when applying diagnoses. Also, there are times when a particular case warrants being one or the other.

 

[MamaHopeful]

BTW, a bad reaction to medication isn't necessarily a disqualifyer for PTSD IMO. The criterion "not due to the direct effects of a substance" means the symptoms of PTSD themselves cannot be due directly to a substance. As in, a person taking methamphetamine claiming they have PTSD would be hard to diagnose because the physiological effects of methamphetamine would be mimic symptoms of PTSD. Anyway, as long as you experienced a real threat of bodily harm due to a substance or not, this is a criterion A stressor IMO.

YES! This is EXACTLY it!
The criterion doesn't say the TRAUMA cannot be from drugs, it says the SYMPTOMS cannot be from drugs. My Psych explained this to me in tremendous detail during my diagnosis.

It is VERY common for people who have bad drug experiences to then develop severe PSTD and panic disorder and meet ALL criteria. If you take a drug, or are drugged without your knowledge, and have a horrifying experience during that period of time, and then meet all criteria for PTSD a month after the event, then it ABSOLUTELY fits criteria.

My doctor explained to me, that there are no diagnostic criteria for PTSD that state what the traumatic event was. None. It can be from absolutely anything as long as the person meets the criteria.

Some people with previous trauma (such as C-PTSD) or sensitive personalities, such as HSP, might have a much smaller threshold for trauma than others. This, and many other factors, is why two people can go through the same exact situation and one will be fine and the other will go on to develop PTSD. It's not the trauma itself but what happens a month later.

But, it's not up to opinions. It is what it is.

The entirity of criterion H says:

Criterion H (required): Symptoms are not due to medication, substance use, or other illness

I am reading this and feeling quite alarmed by your assessment of this criterion.

It states that the SYMPTOMS are not due to these things, it does not state that the TRAUMA cannot be due to these things.
There are MANY people who almost die during illness who end up with PTSD. The criterion is about symptoms NOT about what brought on the symptoms.

PTSD fear (hypervigilence, flashbacks), is a totally different sort of fear and is more emotional and comes more with triggers, where as the biological fear from drugs and drug withdrawal feels more automatic and random. This effect lasted for like 4 years

I am very interested in this statement. Do you have any articles or evidence to back this up? I'm not being argumentative, I am truly looking for help and healing in my own situation. I won't go into details because I'm too afraid, but your post has me wondering if what I am going through is actually withdrawal and not my PTSD coming back.

How can you tell the difference between biological fear from withdrawal that lasts 4 years, and fear from CPTSD and PTSD and/or panic disorder?

Thanks!