I Feel Like I'm Being Underdiagnosed Because I Don't Abuse Drugs, Alchohol.

[Barberian]

I've read a lot of posts, in a lot of threads on a lot of sites in the last few months. I've read the DSM definition of PTSD. I've read many articles on the interwebosphere on PTSD lately. They all have alcohol and or drug addiction/abuse as one of the major diagnostic criteria. When I have been interviewed by various mental health workers I have always been asked about drug and or alcohol use/abuse/dependancy. I have always answered very close to the truth. I don't drink often because I am afraid of becoming an alcoholic. I don't use drugs because I'm afraid of losing my VA/retired benefits. I have other escapist behaiviors like spending the day in daydreams, or online gaming all day, every day.

All the stuff I have read about PTSD diagnosis leads me to believe that if I did have an alcohol and/or drug abuse/dependancy I would rate higher for my disability. I'm not just talking about the VA rating percentage, but my level of care as well. I'm not about to run out and get hooked on something for a higher rating, but it makes me go Hmmm...

I write this as I indulge in my occasional drink of wine... lol. (last drink was two tall beers, equivilent to 4 American beers over several hours three or so weeks ago).

 

[Deleted member 1860]

I understand where you're coming from. It's as if some professionals only take you seriously if you are the worst of the worst, and if you don't have certain "markers" of mental illness per se, then you're somewhat dismissed.

I don't drink much either, only when I'm on vacation or at a special occasion. In the past year I drank only three times. (TBH, it's also a function of keeping my tolerance low, two drinks and I'm gone, lol...it's more fun that way)

But my issue isn't so much with the drinking, it's with my appearance. I don't get taken seriously because I "scrub up well"...yes, I take pride in my appearance and try to look as normal as I can when I go out in public. (But no, I don't believe I'm shallow or superficial. It's more my way of faking it till I make it, trying to fit into a world that would reject me if they knew/saw the truth.) I belonged to a community mental health group and the director actually told me I didn't belong because I looked better than most of the people who worked there, and definitely didn't look like a client! Well damn, I didn't realize I had to look the part of a mental patient in order to be taken seriously! Suffice to say, I no longer go there.

Sorry I've been rambling! But, I do believe the issue is not being taken *seriously* because you don't fit into what the perceived vision of what a PTSD person should be. I think it's even worse when it comes from mental health professionals!

I don't have any experience with the VA, so I can't comment on that.

However, in my experience, drug/alcohol abuse wasn't necessarily expected with PTSD. Then again, the only other PTSD people I've been around were in the trauma unit at the hospital. If anyone had a drug/alcohol problem, they wouldn't have been in my unit, rather the dual diagnosis unit. So perhaps others have more experience with this, dare I say "expected" link between PTSD and drug/alcohol use?

 

[KP the nut]

They all have alcohol and or drug addiction/abuse as one of the major diagnostic criteria. When I have been interviewed by various mental health workers I have always been asked about drug and or alcohol use/abuse/dependancy.

I'm in the UK and it is similar here. The questions about drogs and alcohol.

Some are affected by those, however IMHO a lot more are affected by other dependencies and dare I say addictions. You say you spend your,

day in daydreams, or online gaming all day, every day

This could be seen as addictive behaviour. I spend a lot of time on the forum and playing computer card games. Maybe we need to speak out and let the health professionals know that there are other dependencies.

 

[Zipperhead]

I don't know where you are from so can't speak to you VA. I do agree that the inclusion of substance abuse as an indicator does affect how you're rated here in Canada though. But as far as care goes, the level of availability of therapy and drugs seems dependant on your needs rather than the assessed level of your rating. I was rated at 45% and yet I still get weekly sessions until they deam that I no longer require sessions (as determined by my therapist, not the VA). I am also entittled to Psyciatric care although I am on a waiting list. Perhaps the priority of where I was placed on that waiting list was affected by my rating, but then again, I am less likely to run out of time then someone who is heavily involved with substance abuse. I guess the rating does affect to some degree.

 

[Barberian]

I understand where you're coming from. It's as if some professionals only take you seriously if you are the worst of the worst, and if you don't have certain "markers" of mental illness per se, then you're somewhat dismissed.

~ I don't get taken seriously because I "scrub up well"...yes, I take pride in my appearance and try to look as normal as I can when I go out in public.

Unfortunatly, I don't take very good care of my personal hygine during the week. I do clean up before I leave the house though. I've always felt this has worked against me during evaluations also. Even when I've been so bad off I've committed myself, before I left the house, I cleaned up, put fresh cloths on etc. It's ingrained in my psyc, if I'm around others, dont offend them with hygine issues. To do so would make me feel even worse than I already am. I would fixate on it and it would push me even further over the edge.

 

[Barberian]

~This could be seen as addictive behaviour. I spend a lot of time on the forum and playing computer card games. Maybe we need to speak out and let the health professionals know that there are other dependencies.

Oh, it's definatly an adictive behavior for me. I don't know how to get through the day unless I'm on the computer. I can't handle reality all day. Days I can't get on the computer I just daydream when I can, sometimes good but usually reliving the past. On the computer I daydream as I do stuff. I think of something, look it up on the interweb, think/fantasize about it, rinse repeat, and/or I game all day.

 

[maddog]

Yep, I'm another one who portrays a consistently neat, tidy and functional appearance to the world, and experiences a degree of the confusion and awkwad misunderstanding from the world as a result. I almost always go to work every day, neat, tidy, presentable (though far from glamorous) and superficially just the same as anyone else.

I have long held an almost obsessive fear of drug/alcohol dependency and strenuously refrain from overindulgence as a result. I often have almost overpowering urges to drink to excess and so try to drink only very occasionally, which has contributed to my actually having a fairly low alcohol tolerance. I also have a medical condition that kicks out of control if i drink too much, so there has been some blessing in that.

But yes, hanging out on the forum, journalling/writing lengthy e-mails to my T (which I sometimes send and sometimes don't) and general wallowing all count as rather obsessive maladaptive addictions for me at times, and if only people could contrast what's going on in my head with what they see on the outside, they just wouldn't cast me in the same light I don't think.

We're lucky here, the type and level of mental health care you receive isn't dependent on how you score or rate - it's more dependent on what you can afford to pay for, which professionals you happen to link in with and how much you're prepared to commit to your own recovery. Or that's the way it is in the private sector anyway. Makes me realise that I shouldn't whinge about our health system quite as much as I do.

Maddog

 

[intothelight]

I have one the most socially acceptable "isms", and that is being a workaholic. I can go 12, 14, 16 hours and not even bat an eye. But it really has always been my escape. It is my own little world, it was the place where I was safe, it was the place where I was validated.

I did work regular hours when my children were younger, but after they went to bed, I went into the office and before the days of internet worked, the files and later dialed in remotely. The sad thing is, I missed a lot of time with friends and exploring other pursuits. I can't make up for the time lost, but I can learn to balance the future.

 

[Ricanoland]

All the stuff I have read about PTSD diagnosis leads me to believe that if I did have an alcohol and/or drug abuse/dependancy I would rate higher for my disability. I'm not just talking about the VA rating percentage, but my level of care as well. I'm not about to run out and get hooked on something for a higher rating, but it makes me go Hmmm...

I agree 100%, everytime I have to do an "intake" somewhere. They ask me if I take drugs, AT LEAST three times, in different ways.

1. Do you use any drugs?
2. Have you ever been dependent on anything that might cause you to think differently?
3. Was there ever a time in your life where you were treated for something that you put into your body?

No. NO. NO! >.>

I have been abused, that doesnt mean I abused drugs. I am mentally disabled, that doesnt mean I "dont know" what drugs are.

Again, I agree they want to "treat" when you have more than just your emotional pain.

 

[Mina]

I hear ya! My new therapist didn't seem to believe me when I told her that I've never tried drugs, I don't abuse drugs or alcohol, don't smoke, am not on any meds nor have I been, have never attempted suicide, have never been hospitalized or committed or in a psych ward, etc. I don't fit the mold, apparently :rolleyes:

 

[Sandstone]

I've always thought that I rarely drink and have never smoked or tried drugs is precisely because I have PTSD. I've learned that I'm the only one I can rely on, so I'd never risk depending on anything/anyone else.
I hate feeling out of control, so when I do drink it's never to excess.

I've also wondered if it's to do with arrested development. I was abused from the age of two and a lot of me has never grown up. Smoking is something grown-ups do.

 

[Zef]

I read this shortly before going into an intake interview. I intentionally did not mention that my drinking had recently increased until I was well into the interview. I just wanted to see/test whether there was a change in attitude or behavior.

There was. It was almost like I said the secret code words. The tone changed from 'When would you like to start?' to 'Are you sure you don't want to start today?' "Let's get you into the co-whatever program"

There definitely seemed to be some 'trigger' there for the nurse that increased the seriousness level.