Lets Create A Ptsd Diagnosis - Off-topic Discussion

[joeylittle]

PTSD revolves around a real trauma, and therefore it is not a mental illness.

By this, do you mean that mental illnesses are illusions and do not relate to/cannot be caused by real, physical, things?

they exhibit a symptom pattern that nonetheless clusters around traumatic events in the past, even if they display amnesia for the major details of the event(s) themselves.

But they do have at least a base memory, however indistinct/buried, of a key trauma event, no? Asking for clarification.

 

[lostforgottensoul]

PTSD revolves around a real trauma, and therefore it is not a mental illness. It is a reliving of the trauma in the present as if it were still upsetting the person in body and mind both.

But this is not what Im understanding. Isnt reliving past trauma thats not happening today but both body and mind think it is still happening, define a mental illness?

 

[Powder]

@joeylittle at the time of my diagnosis, I had memories of abuse but not the specific Criterion A traumas, no. I had traumatic amnesia, couldn't remember much of my past. Traumatic amnesia will suffice in the place of Criterion A, apparently, if every other diagnostic criteria is checked, chronic, from the time of the amnesia, and all other conditions are ruled out.

I doubt all would concur. My psychiatrist was top of my region. He used this formula for Dx. All his assessments, which I even doubted for 18 years, were entirely accurate. The DSM when used correctly by a highly intelligent and well trained experts is of value as an accurate clinical tool.

@lostforgottensoul if you look up PTSD, it is not deemed a mental illness; it is a biological stress injury. In other words, aka it is reality based and there is no actual psychosis. That is not to say that there is no possibility of comorbid mental illness. There is no known physical inferiority or pathology basis for PTSD. It is not known exactly how PTSD is caused (etiology). Most conditions of physical disease have no known etiology. In other words, no doctor can explain how many diseases are created.

PTSD, first called a form of Shock is entirely accurate. Someone's body going into shock from an injury is not a mental illness.

Definition of mental illness and severity has to do with the amount of breaks from reality.

Even when in worst flashbacks and severe physical pain in my body is occurring, I am fully aware and able to answer to what was going on in my environment during the flashback. Even if I'm crying or having difficulty breathing or in shock, as if in the trauma time, I am aware of this, and am able to exert control over my actions nonetheless. I am aware of what is happening to me. Not so with traditional mental illness, which iteself is a problematic phrase as we find the physical basis for most disorders because they can be treated readily via the body, not just through thoughts. Mind-Body connection is implied.

Even with dissociative tunnel vision, or narrowing of focus of perception, the observations are reality based, just more focused and accute (hyperfocusing). This is an alteration of consciousness that everyone can do under the right conditions, so it is not an illness. It is not crazy. It is a normal reaction to abnormal environmental stimuli.

I'm sure it's debated, and depends on who you ask, but most sources do not claim PTSD as a mental illness.

Just for example: http://medicalwhistleblowernetwork.jigsy.com/ptsd-injury-not-disease

 

[Powder]

@EveHarrington I looked up the change from arousal to re-experiencing for B5. Pg 296 of
Assessing Psychological Trauma and PTSD
edited by John Preston Wilson, Terence Martin Keane 2nd Ed. 2004.

I agree with the book about this change.

When cued to the trauma, the survivor experiences emotions, sensory feelings, and trauma-related stimuli. The distress does NOT generalize to all other Non-trauma-related yet stressful stimuli, so it's not just 'arousal.'

Something triggered a specific trauma, and I felt frightened and I smelled an odor specific to that traumatic memory. It was upsetting, but I got through it and it passed within about an hour.

Every time I got stressed at work that week, I did NOT smell that odor again. In fact, that hasn't come back since.
It was specific to the trauma and trigger to that trauma. So it was re-experiencing, not arousal. I didn't act more stressed after the flashback that week. Sometimes I do from having emotional distress about what I learn from a flashback. But I don't have the trauma stimuli return.

The more you dig away at PTSD, the more it all comes back to the traumas themselves and the way they affect someone very much so down the line.

 

[joeylittle]

most sources do not claim PTSD as a mental illness.

Seems odd, then that DSM stands for Diagnostic and Statistical manual of Mental disorders...

Personally, I don't have a problem with mental illness - I was diagnosed a depressive before PTSD. If you are speaking more philosophically, that's fine. Otherwise, saying it's not a mental disorder seems to me like giving in to shame, wanting to avoid the 'mental' label. Many mental disorders have biological/physical origins. And, they are experienced physically.

it is reality based and there is no actual psychosis.

This would therefore mean that psychosis is somehow not based in reality. I think I understand what you are trying to say, but you are combining concepts in a way that strikes me as unnecessarily convoluted.

Yes, PTSD is a result of trauma - a real, not imagined event. But many other mental disorders are the result of real, not imagined causes. What is the true difference between cause and event? No, PTSD is not a psychotic disorder. That's a classification, holding schizophrenia, schizoaffective, delusional, catatonia, I'm probably leaving one out.

PTSD is a trauma and stress related disorder. It's not identified by the DSM - or by the APA - as being in some completely other category that is 'not really mental illness'.

There is a lobby to change the name, and remove the 'disorder' moniker. The reason given is that it causes discrimination and adversely affects the sufferer, who should not be labeled as having a disorder, but rather, an injury. That more people would seek treatment, feel less shame and stigma.

I am of the camp that believes that the effect of PTSD can be identified as a physical change to the brain, and that said injury occurs at the time of trauma. That's not a proven medical fact, but I'm a believer in the research. So conceptually, I think I'm completely aligned with your point of view, @Muse.

But, as a person with Depression, which - last I checked - is not due for a name change anytime soon, I wish that people didn't think the road toward destigmatization of PTSD has to do with changing it from a disorder to an injury. And certainly, insisting that it's not 'mental' because it has a cause in reality - that's just mixing apples and oranges. Schizophrenia is understood to have just as organic an origin as PTSD does. A major depressive episode is presaged by an inciting incident, often some kind of emotional shock or crisis.

/end soapbox

 

[anthony]

it is not deemed a mental illness; it is a biological stress injury

I want to see your sources on this, for credibility. I think it is more a play on words... so to some level, I agree, but another, I disagree, depending on which side of the psychological fence you want to sit right now. I agree they have no idea what the hell PTSD is, or biological form it actually takes, because they just don't know... however; at the end of the day what they do believe, is that the brain controls everything in the body, so if you resolve the brains inner workings to mental acuity, then at some level, PTSD is a mental illness, a mental health disorder, an injury to some unknown psychological level, and so the list goes onwards of apparent politically correct versions depending on who you read nowadays.

Honestly, I would just toss PTSD into the mental category for the time being, whether you call it mental illness or mental injury, I don't think either really matter, because the experts have no idea exactly what form PTSD takes in the brain, whether physiological or purely synaptic, so no physical form and just mental firing if off.

I will agree though that it is a shit storm and nobody has the exact answers to such questions with certainty.

 

[The ANP]

I wonder if anybody has looked into the evolutionary psychology perspective on PTSD diagnosis? There is a body of literature on psychological impact on current v future time preference (short term risk taking v long term goal building) and the relationship between evolutionary based factors that would predict shorten ended life expectancy obviously trauma, also child abuses, social rejection, etc. I think this work has potential to inform diagnosis.

Also in relation to C-PTSD the idea that childhood traumas not only cause symptoms but when children are not provided nurturance there is the added impact of failure to learn appropriate life skills and coping mechanisms and attachments that result in additional life long impacts.

 

[oasis2003]

Yes I find evolutionary psychology totally fascinating . It seems to relate to everything !

 

[SeanCharles]

Hmmm... I just found this :wideeyed: http://www.ptsd.va.gov/professional/PTSD-overview/ptsd_children_6_and_younger.asp At what point should one (age wise) be diagnosed or should the onset be set? This article, what I've read is interesting...

 

[SeanCharles]

Without getting too graphic here, my primary abuser did threaten (empty threats) me repeatedly (every encounter). At one point he even made an empty promise to me which he never kept. (likely because he got arrested on drug charges). I do like this thread even though I've been a silent participant.

 

[oasis2003]

Well I thought that PTSD was a type of brain alteration ( changing in size of the amygdala, and the hippocampus being affected by trauma and being unable to create further memories ) due to trauma. With the circular repetitive re living and re firing of neurones that there is a threat, when in fact in present time there is no life threat.

The brain just sort of is re triggered to respond to the trauma by firing in a fight or flight freeze type of a way . It goes into survival mode. Where in fact you may be just walking down the road. Instead your brain is reminded eg a smell that last time it meant oh shit I need to actually survive ( the actual trauma ) This is the reptilian part of the brain save the human.

The trouble is we humans also have 2 other brain developments and the survival mechanisms get messed up. This is where the depression anxiety and mental illness come in . We try and justify the responses and it just does not make sense. The smell takes us right back to the trauma, but the other parts of our brain says no this is not right . No wonder there is all the confusion.

The brain can be rewired supposedly by setting up new neural pathways but will this include the reptilian part of the brain? This has evolved purely for survival ( OMG there is a sabre toothed tiger it is going to eat me act immediately or die ) fight freeze or run like hell to get away!!
This is what the problem is people with PTSD act like this in just normal every day situations just because of an individual reminder of their trauma. So what can we do to heal this as we don't even know properly how the brain works. As for consciousness this is one of the three big unknown questions .

Sorry I am just burbling and thinking out loud at how complicated it all is. Any thoughts any one?

cPTSD is different to Bpd in my view but a lot of the symptoms and mal adaptive coping strategies are the same.

 

[Whyteferret]

Threads have been split before, and posts moved. It's not incredibly common, but it's not unheard of...

@joeylittle
It's already six months for formal disgnosis.
Before that, it's a stress reaction or adjustment disorder.
A normal reaction to trauma immediately after mirrors PTSD. But it resolves in time. Sometimes with therapy. Sometimes no

That's why the delay to formally diagnose.

You also don't want to hang a diagnosis on someone too early. It's like grieving after someone dies. It's not depression. It's not abnormal.. But, it can progress into problem or resolve.