Poll I Was Wondering How Many People Have A Diagnosis Of Desnos

[anthony]

I agree with everything you said @Lucycat which brings me back to... should you really be crossing something as distinct as personality with something as indistinct as trauma symptoms? One is like DNA, the other is like wind. There is a reason why we have disorders uniquely and call them comorbid, i.e. PTSD + BPD!

If your personality disruption is that severe, then it warrants it's own recognition and not to be confused with trauma symptoms. Personality is not a symptom, which is why the majority of physicians disagree with CPTSD so much.

 

[Lucycat]

If your personality disruption is that severe, then it warrants it's own recognition and not to be confused with trauma symptoms.

But if the personality disruption is caused by the trauma then why the need for 2 labels if one covers it ( even if that means a new one?).

If I have a migraine caused by - say flashing lights, and one symptom of my migraine is headache and another is nausea then I only need the one label as both problems are caused by the one problem - the flashing lights. Just because it is possible to have nausea alone in other circumstances and headache too should not mean that for all those people who suffer both they have to have 2 diagnoses.

I get that personality is not a symptom, but personality disorder can be a symptom of something greater.

There are so many with developmental personality disorders related to early trauma that I feel that should be more widely recognised.

 

[anthony]

If you introduce personality as a symptom into this disorder, but not that one, then where does it stop? Suddenly you will have people with every disorder crying fowl because they feel their personality has shifted as a result... or someone will try and find some early childhood aspect to prove their point.

It's a fine line... one that must be very carefully stepped around.

I could as easily ask then... why isn't depression a symptom of PTSD so it doesn't need to be diagnosed separately, considering nearly 80% + of sufferers also suffer a major depressive diagnosis. Why not include panic disorder? Not every has it with PTSD, but hey, why not? That is your methodology going down this path. I've just opened two possibilities above, even though not everyone with PTSD is affected by them.

So now justify CPTSD? DESNOS even? Because a small number or large number of people endure something, it doesn't mean you should add it to put it under one diagnosis, which is your argument.

 

[Abstract]

I do understand both points of view (Lucycat and Anthony) and Anthony, you describe very well the reasons the DSM haven't gone the whole hog down the CPTS route. But I am with Lucycat for a few reasons.

Other than that though and importantly I think those with CPTSD often don't have enough personality issues to warrant a personality disorder diagnoses. That is the crux of it for me - there are significant affects that don't get covered by personality disorders and that do require a different approach to treatment.

I don't think those with significant attachment and sub clinical personality issues and severe dissociative issues react to treatment in the same way. It seems to me you have to get through all these things to get near to the trauma and over and over and over again we see people being damaged by therapists approaching those with these issues in a way that would work for someone with "straight forward" PTSD. Once that happens it gets even more complicated as there are then issues with therapy itself. If this doesn't happen then the other common outcome is that the person leaves therapy.

I understand the concern that most psychological issues are from trauma anyway and that changing the approach to CPTSD would cover too much of existing disorders but think there are ways around that. I was interested in a few lots of research that show that BPD is a separate issue to CPTSD. That some people will have both and others not. I will see if I can find it again as it looked like a credible study.

The main aim of a diagnoses needs to be about treatment. Thats all diagnoses are really as they are constructs or concepts . If a diagnoses is repeatedly not getting people the type of treatment they need from the word go then I think things need to change.

 

[therapybankrupt]

@Lucycat and @anthony I agree and it all makes more sense than ever why no one can agree. The more symptoms thus more cormorbids. I believe that some people have individual trauma leading to personality issues usually those who have childhood trauma. Because of all the CPTSD talk I wanted to understand my symptoms. It puts it all in a nice little package.

I get hung up on personality disorders. It feels like I no longer have a disorder but it now attaches mental illness . None of my fault. In my case it would be the traumas that caused the changed in my early childhood development and self esteem. It also made me vulnerable for future traumas. Which came first the chicken or the egg is thought I am left with.

When diagnosed I was told the PTSD began with the first trauma at three. Funny thing is that the severe symptoms of the PTSD did not affect me until over forty years later. I was told I no longer carried the diagnosis of a personality disorder because they had overlapping symptoms. It is a some what correct statement. Yet it doesn't explain everything. This leaves my head spinning.

 

[therapybankrupt]

I do not understand why two additional posts from much earlier just came up after I posted. I apologize if my last post seems out of order it is........ Ugh I do not like when that happens.

That is the crux of it for me - there are significant affects that don't get covered by personality disorders and that do require a different approach to treatment

Yes, it is not all about fitting patients into sub comorbid or personality diagnosis that are not correct either.

I don't think those with significant attachment and sub clinical personality issues and severe dissociative issues react to treatment in the same way.

Yes over and over again I read about people reacting horribly to EMDR. They were not properly front loaded for the extent of damage they acquired from there traumas. Affected childhood development also has a major need for adjustments in this treatment. I pray someone in there research sees the need for updates the original rigid constrains of the EMDR and develop guidelines to know when it is safe to administer exposure therapy. It is my opinion these treatments fall short in the inclusion of personality disorders complications also.

Those deciding on these diagnosis are responsible for trying to make it into cookie cutter trauma treatment You can not just throw a Complex in front of PTSD, or add a list of ill fitting subs on and say deal with it. Thats exactly why they cant make up there minds.

These symptoms call for another whole specialty including more intense training. They need more education than just the basics for psychiatric treatment and outdated certification criterion for trauma treatments. People suffering without a proper diagnosis deserve more. They need a flexible highly trained therapist / psychiatrist proficient in many specialties, therapies and PTSD. They need to educated to handle all that may come up so they know how to switch and adjust therapy for the individuals needs.

There are a few awesome therapist out there already. If you are luck enough to find them. They have experienced differences in needs for adjusting the trauma therapy. Because of the dissociative symptoms, amnesia and buried memories. Some patients do not even know about some traumas and I would want a therapist who new enough to stop EMDR and re-evaluate me so my treatment did not re-traumatize and fail me. That must be awful.

If a diagnoses is repeatedly not getting people the type of treatment they need from the word go then I think things need to change.

This is what makes me crazy Abstract. After this conversation I conclude the need of treatment for people with childhood trauma compared to adult trauma need to be severely different. Wether they change the name of the disorder does not concern me. The knowledge of the differences in trauma experiences and treatment adjustments are in desperate need.

 

[Angelwings]

No, I do not have this, and blessings to those of you that do!