Is this PTSD? Your opinions welcome. Scientific question, really.

[somerandomguy]

What's your end-game with this, @Gibson? Are you hoping to start a new branch of neurology? Are you writing a paper? Where are you even going with this?

Everyone has told you that none of your posts make any sense. I can guarantee that if you can't get a forum of people who actually suffer from this disorder to agree with your ... I don't even know what to call it, I guess your theory of neurology? If all of us agree it makes no sense, how are you ever going to convince even one highly trained professional? Or is that not the point?

Everyone has told you that you are wasting your time. It's frustrating that you can't understand that. But one more time: what you are writing makes no sense. What you are doing is not science. You are wasting your time.

 

[Movingforward10]

I aim to be courteous and polite when I reply, ascribing others the best intentions, so I am surprised this thread has caused ire.

The reason it has is because you're not listening to responses and just coming across as if you believe you know everything. Which is why I asked if you are asking questions to learn from people here, or just to create a space to answer your own questions to random people on the internet.
I can imagine it's hard to hear these responses, but if you are able to, it might help things a little?

 

[coraxxx]

Mind this is a support forum and not a neurology consortium. There is no "opinion of the forum" on this. For having trolled forums when I was a teenager, I also know that these definition-seeking topics are what drives everyone mad because definitions are what they are: a lens you see things through and everyone has a version. My opinion is that you can call this a pink hippo and make a pyramid graph if you want, it's not going to change my reality.

But by going into these questions and not positioning yourself while folks here have a position and a diagnose and struggle with very real issues, this entire "debate" is asymmetrical, useless and bizarre. It also stamps words into experiences and that is a trigger for many people here. You're sealioning.

These asymmetries are often employed by activists trying to pester their opponents. Sweeping statements, confusing answers, ignoring responses, reference dropping with a tone of certitude and then getting offended when people are irritated with you: I'm sorry, but these are strategies of early stages of manipulation that set a terrain for gaslighting and this is what makes your thread so triggering because hello, many of us have experienced this first hand.

If you have your reasons to try to get a diagnose for yourself because you've been bullied, you can speak of your trauma here and get a diagnose with a professional.

For the rest, you apparently document yourself better than we do, so why carrying on.

 

[Gibson]

What's your end-game with this, @Gibson? Are you hoping to start a new branch of neurology? Are you writing a paper? Where are you even going with this?

Everyone has told you that none of your posts make any sense. I can guarantee that if you can't get a forum of people who actually suffer from this disorder to agree with your ... I don't even know what to call it, I guess your theory of neurology? If all of us agree it makes no sense, how are you ever going to convince even one highly trained professional? Or is that not the point?

Everyone has told you that you are wasting your time. It's frustrating that you can't understand that. But one more time: what you are writing makes no sense. What you are doing is not science. You are wasting your time.

You're a bright guy. I like your posts. We've pretty much explored the topic of the filiation DPDR 48.1 with the rest. The question now is the new definition of C-PTSD in ICD-11.

I think it's a worthwhile question. Perhaps it should be asked in a separate thread, thus making it clear we've moved on to a new topic. I think the newer defintion of C-PTSD in ICD-11 is worth discussing, and I think forum members opinions are worthwhile.

The reason it has is because you're not listening to responses and just coming across as if you believe you know everything. Which is why I asked if you are asking questions to learn from people here, or just to create a space to answer your own questions to random people on the internet.
I can imagine it's hard to hear these responses, but if you are able to, it might help things a little?

I have not intended to come across that way. I think one learns from the opinions of others, from the experiences of others, and from the arguments from others. It's not hard to hear opinions that are contrary to mine, if well reasoned. I actually like other's contrary opinions, it's why I discuss usually.

 

[DharmaGirl]

so I am surprised this thread has caused ire.

It has not caused me ire. I capitalized PTSD since you didn't seem to understand it was a part of CPTSD.

You wrote a solid post referencing ICD-11. You made the case that C-PTSD must be stacked atop regular PTSD. I.e. if you don't meet the diagnostic criteria for PTSD, you can't get a C-PTSD diagnosis.

I did not make the case, the ICD did. It is not my hypothesis, it is what the ICD decided.

I think that your intention @DharmaGirl with bringing up C-PTSD being stacked atop PTSD was not to say things like bullying isn't enough for a C-PTSD diagnosis if case it lacks single extreme events. But I may be off. I think you meant the opposite now.

Nothing of the sort. I was saying only that complex post traumatic stress disorder is a type of post traumatic stress disorder. Nothing more. What part of any of my posts seemed to infer that?

Do you subscribe to this definition of the etiology of C-PTSD:

I'm not going to respond to something from Wikipedia. Quote from the source - the ICD. It specifically says you must meet the criteria for ptsd to have cptsd.

 

[DharmaGirl]

Also, this may be why the confusion. The DSM V is going a different direction than the ICD, and I'm in America so I follow the DSM V.

Complex PTSD
Introduction
The scope of these Guidelines has been expanded to include consideration of complex PTSD (CPTSD), a new diagnosis in ICD-111 applicable to adults, adolescents and children who have experienced prolonged, repeated or multiple forms of traumatic exposure such as childhood abuse or torture (e.g.2 ). We have explored in Chapter 2 the approach taken by the DSM-5 to accommodate more complex presentations of PTSD, through an expansion of PTSD diagnostic criteria to include a fourth symptom cluster related to negative alternations in cognition and mood (creating a total pool of 20 items), and the addition of a dissociative subtype.3 The ICD-11 has gone in the opposite direction, restricting the diagnostic criteria for PTSD to six potential symptoms (with one required from each of three symptom clusters) and including the additional diagnosis of CPTSD. This divergence may ultimately lead to differences in treatment recommendations. Although the construct of CPTSD is associated with prolonged or repeated trauma, such as that often involving interpersonal violation, the ICD-11 diagnostic criteria do not specify a certain type of trauma as a necessary condition for the diagnosis to be made. The ICD-11 diagnosis of CPTSD consists of six symptom clusters: the three PTSD criteria of re-experiencing of the trauma, avoidance of trauma reminders, and heightened sense of threat (hypervigilance, startle response), and three disturbances of self-organisation (DSO) symptoms defined as emotional dysregulation, interpersonal difficulties, and negative self-concept. A CPTSD diagnosis requires that all PTSD diagnostic criteria are met (exposure to at least one traumatic event and one symptom from each of the three categories) along with at least one symptom from each of the three DSO symptom clusters. In addition, functional impairment is explicitly identified as a requirement for the disorder. Only one diagnosis (PTSD or CPTSD) can be made; if CPTSD diagnostic criteria are met, this supersedes the diagnosis of PTSD.

https://www.phoenixaustralia.org/wp-content/uploads/2020/07/Chapter-7.-CPTSD.pdf

 

[Gibson]

Mind this is a support forum and not a neurology consortium. There is no "opinion of the forum" on this. For having trolled forums when I was a teenager, I also know that these definition-seeking topics are what drives everyone mad because definitions are what they are: a lens you see things through and everyone has a version. My opinion is that you can call this a pink hippo and make a pyramid graph if you want, it's not going to change my reality.

But by going into these questions and not positioning yourself while folks here have a position and a diagnose and struggle with very real issues, this entire "debate" is asymmetrical, useless and bizarre. It also stamps words into experiences and that is a trigger for many people here. You're sealioning.

These asymmetries are often employed by activists trying to pester their opponents. Sweeping statements, confusing answers, ignoring responses, reference dropping with a tone of certitude and then getting offended when people are irritated with you: I'm sorry, but these are strategies of early stages of manipulation that set a terrain for gaslighting and this is what makes your thread so triggering because hello, many of us have experienced this first hand.

If you have your reasons to try to get a diagnose for yourself because you've been bullied, you can speak of your trauma here and get a diagnose with a professional.

For the rest, you apparently document yourself better than we do, so why carrying on.

I see I got off on the wrong foot, from the first post, and instead of going «others aren't reading me right», I'll say the humbler and more likely thing: my writing hasn't been clear from the get-go.

I don't want this thread to be about me. My disorder is not a result of bullying, but I have the deepest compassion with those whose disorder are. Most doctors, mine included, use various ICD manuals in their daily work, they do that at least in my country. They practice medicine by using the codes they feel best suited. Quite recently the definitions of what constitutes C-PTSD changed, and this affects people and is worthy of discussion. The forum will not deliver some crushing verdict, sent to whomever, I don't care about that, but I find it's something to talk about, and I feel each members thoughts on that topic are worthy, and those who do not wish to discuss ICD-11 versus older ICDs are welcome to not participate in such a discussion.

I also see changing topics amid is thread is not easy, and I take that to account.

 

[Gibson]

Also, this may be why the confusion. The DSM V is going a different direction than the ICD, and I'm in America so I follow the DSM V.

Complex PTSD
Introduction
The scope of these Guidelines has been expanded to include consideration of complex PTSD (CPTSD), a new diagnosis in ICD-111 applicable to adults, adolescents and children who have experienced prolonged, repeated or multiple forms of traumatic exposure such as childhood abuse or torture (e.g.2 ). We have explored in Chapter 2 the approach taken by the DSM-5 to accommodate more complex presentations of PTSD, through an expansion of PTSD diagnostic criteria to include a fourth symptom cluster related to negative alternations in cognition and mood (creating a total pool of 20 items), and the addition of a dissociative subtype.3 The ICD-11 has gone in the opposite direction, restricting the diagnostic criteria for PTSD to six potential symptoms (with one required from each of three symptom clusters) and including the additional diagnosis of CPTSD. This divergence may ultimately lead to differences in treatment recommendations. Although the construct of CPTSD is associated with prolonged or repeated trauma, such as that often involving interpersonal violation, the ICD-11 diagnostic criteria do not specify a certain type of trauma as a necessary condition for the diagnosis to be made. The ICD-11 diagnosis of CPTSD consists of six symptom clusters: the three PTSD criteria of re-experiencing of the trauma, avoidance of trauma reminders, and heightened sense of threat (hypervigilance, startle response), and three disturbances of self-organisation (DSO) symptoms defined as emotional dysregulation, interpersonal difficulties, and negative self-concept. A CPTSD diagnosis requires that all PTSD diagnostic criteria are met (exposure to at least one traumatic event and one symptom from each of the three categories) along with at least one symptom from each of the three DSO symptom clusters. In addition, functional impairment is explicitly identified as a requirement for the disorder. Only one diagnosis (PTSD or CPTSD) can be made; if CPTSD diagnostic criteria are met, this supersedes the diagnosis of PTSD.

https://www.phoenixaustralia.org/wp-content/uploads/2020/07/Chapter-7.-CPTSD.pdf

This is beautiful @DharmaGirl and you got to the crux of the matter. I see the general opinion in this thread is let's not explore C-PTSD, but if I'd open a thread about that I want to say I'd value your opinion, if you'd choose to weigh in, and likewise for other forum members; I feel this is a statement that cannot, or at least should not, result in rankle. It's been my position all along.

I know you are not saying this, not at all, but I feel exploring C-PTSD isn't like exploring calculus, where we already got the answers. The definition of C-PTSD has changed in America, the definition of C-PTSD is different in other parts of the world, the definition may change in the future. What are people's opinion on the definitions, and those who wish to contribute may do so. I am hard pressed to see how that could be problematic.

Anyways. Thanks @DharmaGirl for your post. I really appreciated it. Glad to see it.

 

[joeylittle]

Yes, you must meet the diagnostic criteria for PTSD in order to have CPTSD.

Not quite - the trauma itself as an additional qualifier, which is that it is multiple events occurring over time that may or may not have a single, inciting incident (and most articles you find will explain this further). The conditions under which the trauma needs to have occurred are also described.

Really, the definition in the IDC uses a different schema for the rest of the criteria, so it's difficult to compare DSM 5 to ICD-11 directly. Conceptually, though, the IDC-11 makes it clear that CPTSD arises from multiple traumas occurring under one circumstance.

@Gibson:

I aim to be courteous and polite when I reply, ascribing others the best intentions, so I am surprised this thread has caused ire. But I'll summarize the discussion we've had, making it easier to see where we talked past each other.

I can tell you very simply - it's caused ire because it's full of people who live with these disorders - both CPTSD and PTSD. Some people here also have dissociative disorders, but the relatively new Depersonalization Disorder isn't one of them. You're conflating the symptoms of depersonalization and derealization - which are two different symptoms - as the abbreviation "DPDR". That abbreviation is used to refer to Depersonalization Disorder - which is new as of ICD-10, and still being field-tested, frankly.

PTSD and CPTSD - they are not conceptual for the members here, they are the lived experience.

My view is anyhow that prolonged duress over time (such as bullying) should qualify for a C-PTSD even without single extreme traumatic events. What's the forum's opinion on this?

Aha - you can search threads on this. The forum's opinion tends towards "no" - bullying isn't sufficient.

Not because it's lacking in a single traumatic event - because as I said earlier, CPTSD is not limited to a single event, and that's been made perfectly clear in the literature.

But because of the circumstances under which it occurs.

This is a very, very good paragraph.

The 11th revision to the World Health Organization’s International Classification of Diseases (ICD-11) (WHO, 2018) includes two distinct sibling conditions, post-traumatic stress disorder (PTSD) (code 6B40) and complex PTSD (CPTSD) (code 6B41), under a general parent category of ‘Disorders specifically associated with stress’. PTSD is comprised of three symptom clusters including (1) re-experiencing of the trauma in the here and now, (2) avoidance of traumatic reminders and (3) a persistent sense of current threat that is manifested by exaggerated startle and hypervigilance. ICD-11 CPTSD includes the three PTSD clusters and three additional clusters that reflect ‘disturbances in self-organisation’... typically associated with sustained, repeated or multiple forms of traumatic exposure (e.g. genocide campaigns, childhood sexual abuse, child soldiering, severe domestic violence, torture or slavery), reflecting loss of emotional, psychological and social resources under conditions of prolonged adversity

From here

As far as I'm concerned, bullying does not meet the intention of the diagnosis.

 

[Gibson]

I am reading the «Epilogue to the 2015 Edition» of Herman's book, and I've picked up some new articles she recommends on trauma treatment, and I see she delves into the recent change in diagnostic criteria and lets us know which of the versions best fits her theory of C-PTSD.

The DSM-5 includes aspects of what I have called Complex PTSD (see Chapter 6) in its broadened definition of the basic disorder and also recognizes a dissociative subtype. The current draft for ICD-11, by contrast, narrows the basic definition of PTSD but also explicitly recognizes the category of Complex PTSD resulting from prolonged and repeated traumas, especially those originating in childhood.

Small wonder really, that her definition isn't the best with the newest diagnostic criteria, and I see she goes on to write that you needn't trauma with a capital T for C-PTSD. Her views, and the ICD-11 views, those diverge and I think diverging views are good and healthy for a field where we still don't have all the answers nor the best treatments. I think that in general as well.

Thanks @joeylittle and @Sideways . I got a couple smiles. Maybe I’ll read “trauma and recovery” again. I have it right here next to the bed.

To me it’s a lot more about if or not I feel suicidal than than what the criteria is for the condition causing it but I’m not being flip. It’s really interesting on one level to debate/discuss what the psychologists and psychiatrists say. It also is necessary if you have to have a label. What works, what doesn’t and so on. I guess I think on some level the therapist needs to be an expert not me, but lots of survivors become therapists, no wonder. I’ve been reading Jungs collective works or rather listening on YouTube.

So thanks to everyone.

Seems we have the same view. The book is the map, the reality is the terrain, and as we don't have a perfect map it's the terrain that matters. What works, what doesn't.

Is this true? I can’t find the source as it was eons ago, but I remember reading a source that said most people with CPTSD also have PTSD, but not all of them do.

I think this is at the crux of why CPTSD isn’t a separate disorder? (At least not in the DSM.)

Yeah, I've seen the same as you, and in this maze of posts, in case you missed it, I think @DharmaGirl posted a great source.

Hi @Gibson , your original question is "is this PTSD?". Are you asking if you have PTSD?
Or are you querying a diagnosis you have?

Bad writing! In the thread I meant to invite everyone (whomever wanted to) to explore the topic if "this" (that is DPDR 48.1) is closely related to PTSD, PTSD w/DPDR and C-PTSD, and if so, to what extent is the kinship. "is PTSD" in this context was later changed something like disorders unleashed by traumatic experiences involving the FFF response which then could be given an umbrella term that I coined. I see the title was completely off, and then I thought when clicking the thread these things would be clear (I posted in the General Section to make it clear it wasn't personal) but in hindsight I see both the title and first post was clearly marked by what we could call "easy writing makes for hard reading". It was written too quickly. Mea cupla!

A very knowledgeable crowd that I have learnt a lot from.

Ditto! I find that discussing (not debating) is good for getting a deeper understanding of how things are. I can't speak for us all, but I think it's not only me who have a deeper understanding of what constitutes C-PTSD after writing here. I did not know that in large parts of the world you need PTSD as a bedrock, and vice versa. Such discussions are valuable.

So. I laid out topics to be discussed, I got some great feedback, and some of my position remains the same and other parts have changed, and I appreciate that process. If you feel I am pontificating, that hasn't been my intention.

Yup, so Google Scholar the hell outta it


Phrasing like this ^^^ is likely gonna cause friction round here!! Just sayin!

Because they aren't a "jammed" amygdala, quite the opposite. The amygdala is our reptilian brain, yeah? And those F responses are the amygdala taking over the situation and doing what it does. The only thing it knows how to do. The amygdala has been activated when those responses kick in.

While PTSD is often explained, in a neurological sense, as an over-active amygdala, that's still quite different to it being "jammed" I think.

Like I said, suss out the articles on this site. They contain a shittonne of this information, and will bring you to quickly up to speed on a lot of the current knowledge about PTSD.

Lolz. Yeah, I thought the word jammed could cause friction. And I thought quotations marks around it would around it safeguard me from friction, heat and fire. I agree with what you are saying. And over-active is the apt term, thank you.

 

[Chris-duck]

Why are you asking all these questions? Like why are you interested? People are guarded because you've made few posts, caused some controversy deliberately or otherwise (I suspect semi deliberately at best) and we know zero about you. Intro threads are the standard place to start. Then read the room would be my best advice, assuming you're wanting to lessen the tension and not add to it of course..

 

[joeylittle]

Why are you asking all these questions? Like why are you interested? People are guarded because you've made few posts, caused some controversy deliberately or otherwise (I suspect semi deliberately at best) and we know zero about you.

Yep. I asked this earlier, @Gibson. As you've avoided responding to me, I'm going to take that as you're not here for legitimate reasons. Banned.