Looking For Info On How Add And Ptsd 'work' Together

[freefloat]

Until 2 weeks ago I had not talked to any relatives in many years. I reached out to an aunt who is a T. I'm progressing to get a good T in the area for more formal diagnosis and treatment. I was surprised a few nights ago in being told I have ADD. Apparently this was well known in my family(used against me) but no one ever told me this. I'm almost 50.

I had been ribbed a few times at work for having the music on too loud. One doc stuck his head out of his office and yelled '..turn done the Meatloaf...'. Well the place erupted in laughter as Bat Out of Hell played on.

I did well in college and studies at the graduate level in two fields. A few others things didn’t seem symptomatic of me having ADD. But I just learnt that many of my cousins are ADD.

I always wondered why I never became a cruel/sadistic NPD's like the rest of my family. My aunt feels the ADD protected me. Still need to discuss that more. Haven’t found anything of value on the net and searches on add are problematic as are A.D.D..

Anyone have some thoughts on the interactions of those two. Or possibly have some references to some information. More specifically I have C-PTSD with ADD. I am also a recovered pre-teen alcoholic and drug addict. I have always wondered if the natural rejection i felt for them with the substances allowed me to cope better with the PTSD, ADD and other. As not to become what was modeled. But for now any info on ADD/PTSD would be helpful.

 

[anthony]

There are again, plenty of scholarly publications on ADHD and PTSD that you can read through.

Dead Link Removed

Who diagnosed you with ADD though? You mentioned that your family told you you have it. Did they diagnose you? The only diagnosis worth any salt is from a psychiatrist. Anything lesser is conjecture and speculation at best, as only a psychiatrist has an actual qualification for diagnostic medicine, being the doctor of mental health. Psychologists get it wrong more than right, and use way to much empathy to base their assessments upon versus medical science and proven assessments that psychiatry utilise.

I question it as well for the CPTSD diagnosis, as there is no such diagnosis. It is speculative as well, and no diagnostic criteria exists for it. Very long standing issue that one, since DSM III, and outright rejected now for the DSM V. Saying that, now the APA have shifted some diagnoses into a new trauma category, it is anticipated that a complex trauma diagnosis may appear in the more substantial form that Vander kolk created, being DESNOS. The APA have ruled out breaking PTSD apart into trauma specific diagnoses, as they ruled that there are adequate specific comorbid and Axis II diagnoses that adequately cover complex trauma, ie. PTSD + BPD and/or Dissociative Disorder.

 

[freefloat]

I was diagnosed by a T with a PhD that had known me my whole life. 2/3 of my cousins have ADHD, as i just found out. The struggles i have had lead me to accept the diagnosis. Just as when many read of PTSD they can accept that is the issue. I have symptoms are classic PTSD. For which I have been diagnosed with twice. Scoring the max in all but two indicators. That T was around when things were crazy in my home. She knows the history. I have had PTSD since about the age of 4 due to the home life.

Just as C-PTSD doesn’t exist nor does ADD. It's officially called ADHD/PI.

I agree(C-PTSD) is not a DSM IV diagnosis. I believe it relates to the long term effects of untreated PTSD as a child. At this point it's descriptive more than diagnostic. As in the area of personality disorders that can develop from PTSD. Such as one indication of BPD is trauma as a child. I don't fit the BPD criteria but possibly another. However that is similar to some of the main criteria in ADHD/PI. From the reading I have done the co-morbid may be BPD but can be any PD in that cluster. Such as avoidance PD.

There is always a bun fight, on some issues, between T's and shrinks. The DSM is a good guide. However it does have controversies and is a constant work in progress. Wasn't until DSM IV that homosexuality was removed as a psychiatric disorder. Even though Kinsey showed it wasn't abnormal behavior in 1948. It was a moral statement portrayed as a medical/psychiatric condition. The DSM-IV is a conservative document that hasn't been materially updated in over 18 years. There have been other mistakes due to cultural norms and poor data. It's a guide and accepts that there is still a lot to learn.

I've had two assessments by shrinks in the early and late 1990's. Both felt I had nothing but historical family of origin issues. The first one also indicated chemical dependance. 2 T's diagnosed me with PTSD. T now diagnosed me with ADHD/PI. I meet the DSM-IV criteria as well as the tests for both conditions.

Just as a bad T can be ineffective and potentially harmful so can a bad psychiatrist. I've seen both. Also depends on where you live as to who's diagnosis is accepted. Some areas you can be a psychologist with a BA. Others require a PhD. Where I live it has moved form a requirement of a MA to a PhD in recent years. Legally anyone can call themselves a counsellor here. Most medical doctors here accept the diagnosis of psychologists for a DSM-IV diagnosis.

I've seen several counsellors and one psychologist here in the past few years. Of no value. One wanted to do 'energy work'. I use the T designation to be for licensed psychologist.

I think we both agree its complex part science, part art. Defining 'disorders' merely helps in guiding people to certain interventions that may work. CBT can help for a wide variety of issues. Anorexia, PTSD, PDs, addictions, etc. Shrinks can offer medications that may work to treat a DSM-IV diagnosis. I look at both professions as having a valuable contribution and being able to diagnose. Depends on the practitioner. Both are susceptible to a bad diagnosis. As consumers of those services we have a right and a responsibility to accept or reject the diagnosis. From my experience, education and understanding I accept the C-PTSD and the ADHD/PI diagnosis. I find that helpful in my understanding and in seeking appropriate treatment.

 

[pinopan]

I was diagnosed with ADHD and found stimulant medication very helpful last year. Then I found out I have long-term PTSD, as traumatic events triggered debilitating PTSD symptoms. I also have many cousins with ADHD, however, child abuse (whether or not they know it) is everywhere in my family too. My friends with ADHD also have traumatic histories.

I have wondered if ADHD is just a baseline condition of complex PTSD and dissociation. If my trauma work leads to an alleviation of ADHD symptoms, it will be all the more difficult for me to trust that they are independent disorders.

Thank you freefloat for your post; it is good to see that others are thinking about this as well. (I can't believe your relatives' disdain!) And anthony, thank you for the link. I look forward to reading up on it.

 

[freefloat]

I followed Anthony’s link and did some other searches. All that I have found is that they feel ADHD may predispose some to PTSD. Some studies found a coorelation but nothing casual between the two 'disorders'.

Yeah I cat believe it either. On of my cousins was told by her father that if she alienated him he'd spread rumors she was 'crazy'. She complied. I was told she was bi-polar nope has a little OCD. Was told other things about my cousins but it wasn’t ADHD. So when I sought help i said there was no family history. Therefore not meeting some of the criteria. The generations I came from have NPD. Another new revelation as I put their behavior down to being alcoholics. A lot of cross over of behaviors in the official NPD diagnosis and the lay term alcoholic. I see it as self medicating.

With my realtives i was the scape goat for all their dysfunction and abuse. Odd as at 4 I had all that power. Must have lost it along the way. ;)

I have an appt on Friday to discuss Adderral with my GP. When i took speed I never got speedy felt relaxed and calm. Same with other drugs with an amphetamine or methamphetamine component. Good thing I wasn’t jailed for possession.

I found that some my riskier behaviors made me feel right even though it clearly placed my life in danger. When I'd have a close call it didn’t matter as I'd just keep going trying to feel calm again. So possibly the ADHD was/is protective. However those behaviours were of my choice and expectant so naturally less traumatising. But as we know ADHD has a high risk component to it. Even if its the PI type or non hyper.

I've done trauma work and found it helpful in the short term for some of the ADHD symptoms. Your results may vary.

I hope to pick my aunts brian some more on the ADHD/PTSD thing next time we talk. I'll post what I find.

 

[anthony]

I know you don't want to hear this, but a PhD means nothing in the scheme of trauma or diagnostic medicine.

You need to seek out a diagnostic assessment from a psychiatrist, not a therapist. A therapists evaluation is considered speculative in a court of law for the exact reasons I have mentioned above already, being they don't have an actual medical qualification to diagnose. They have limited training to help remove the burden from psychiatrists... a good majority get it wrong and over-diagnose based on a tick and flick symptom approach, which is not how mental illness is diagnosed.

You can see the exact point I am making, you have stated you have two psychiatrists assessments from the 90's:

I've had two assessments by shrinks in the early and late 1990's. Both felt I had nothing but historical family of origin issues. The first one also indicated chemical dependance. 2 T's diagnosed me with PTSD. T now diagnosed me with ADHD/PI. I meet the DSM-IV criteria as well as the tests for both conditions.

A therapist tells you what you want to hear, or what you attempt to present with, because they do not have the medical expertise or training to accurately diagnose.

I would seriously seek a more recent psychiatric assessment to be perfectly honest, to confirm or deny the legitimacy of what your therapists views are.

 

[freefloat]

No the shrinks were incomplete in their assesments. Maybe where you live PhD are court qualified but they are here. I had a PhD write a critique for a Parental Supervison and Access assesment done by a shrink. If the shrinks recomendations would have been followed my son would likely be more injured or dead. The assesment was so poorly done the Judge foudn it of no value as well as the shrinks assesment. The Phds report was held as valid and he wasnt even asked to testify.

You cant generalise like that. You have your experience but its very narrow. I know what you say is opinion so it's neither what I want or do not want to hear. It's valable but I respectfully disagree.

Where do you get this therpaists tell you what you want to hear from? Are you saying I wanted a diagnosis of PTSD and ADHD. Huh? Gets me nothing. No fat disablity cheque for me. I get no free therapy and the shrinks here are through our local mental health. I found them to be a bunch of rookies, clowns, incompetant and wreckless. Way out of their league. There workers with a BA can give you DSM IV diagnosis.

Without that diagnosis my condition doens't exist? I'm smarter than most PhD's and Dr.'s. I am also my own best expert in my experinces and way of being. ADHD and PTSD are not hard to diagnose. The hard part for a professional is knowing where to look, as your not inside their head. I am trained in addictions counseling and as you may guess am some what confontational. Sometimes its appropriate, sometimes it's not, other times not relevant. Diagnosis is such a small part of their training. It's the treatment that takes up the other 95% of their time and education.

The T that diagnosed me as C-PTSD and ADHD didn't make a cent on it. No motivation there. I am seeking a second opinion as she suggested and I would do anyhow. By the way that T married into my family and is one of the sane ones on the periferal as I grew up.

Anyway the idea that my diagnosis isn't correct is ..well think I'm ok with it. As I am with yours and the path you took to diagnose and treat. Your your own expert as well. As it should be. Cheers.

 

[freefloat]

Oh and in the trial my kids mother was stated by the shrink that she was totally sane. The decision continued my sole custody of my son and she lost supervised access(didn't even go once), joint guradianship and now must seek leave of the court before making any other application. I got that last part on my application. LOL.

BTW The T's that diagnosed me used the standardised stress and trauma instrument. The shrinks winged it.

 

[unalaa]

I just wanted to add that here in the States, psychiatrists rely heavily on T's to gather the information needed to diagnose because they do not have the luxury to spend the time needed to do it properly themselves. That is fallout from our wonderful healthcare system here. Many psychiatrists bemoan that their practices have turned into medication management rather than a more comprehensive therapeutic service.

Here insurance pays for short-term therapy and assessments done by T's, then they pay for the psychiatrists to prescribe the medication. Many mental health consumers also relay on their family physicians to prescribe their medications for their mental health needs.

To my mind, a good clinician or T works in conjunction with the psychiatrists, doctors, nurses and other professionals to treat a mental health consumer properly as part of a team approach. The diagnosis evolves as more information is gathered from all the different parts. However, we see this approach more in larger mental health clinics here than in the smaller clinics or private practice.

So, I guess now is as good a time as any to out myself as a T. I've worked in this field for the past 25 years or so in several different incarnations - in large clinics, a hospital, smaller clinics and agencies. I work in a correctional facility at the moment. I just wanted to put my 2 cents that it is my observation that psychiatrists are not always the best diagnosticians because of their limited contact with the client while managing medication. I believe that input from the other professionals working with the same person is a crucial aspect in getting a good, accurate, working diagnosis.

edited for missing word, bad spacing

 

[freefloat]

Pretty much the same here in Canada.

any thoughts on ADHD and PTSD...unalla???

 

[pinopan]

Before life exploded with awareness and I was given the chance to heal with trauma work, I was a student with a research project in a biochemistry lab. I was surprised to learn that scientific frameworks are only models that help us learn by grossly oversimplifying - and segregating - reality. If you are trying to purify protein 1, which serves to bind and activate protein 2, you have to take into consideration the possibility that protein 1 might bind to protein 17 or 1003 instead, because a positive charge bumped into a negative charge. You hope to maximize yield with good odds.

Perhaps this discussion may benefit from this reminder: we use concepts like titles for disorders to help us compartmentalize and understand, but in actuality, human experience is more smooth and messy than labels. Who knows where one disorder ends and another begins? The point I want to stress is that they aren't like two regions on a map, one yellow and the other gray, but more like the walk up the hill on the border, or in that part of that valley, which is a variation on the theme of valleys.

Amusing thought: a diagnosis of life happened. Another: DSM-IV gains a new title, Humpty Dumpty Falls - Trends and Maps. All I know is that sometimes I feel 'textbook trivialized', and sometimes I find solace in how I specifically relate to my diagnoses. Regardless, the more I learn, the more overlaps I see, and the more I heal, the more unique my experience is for me.

Good luck with the Adderall, freefloat. It was a good choice for me, and if it doesn't do much for you, other stimulants with different chemical structures might do the trick.

 

[jeeps for now]

The truth of our painful past hurts. It is no wonder we learn to quickly turn away whenever reminded of it. One can only hope to remember these moments long enough to understand the origins of our wanting to 'jump out of the frying pan' and excape the same feelings, over and over again, later in life.

As soon as we begin to explain ourselves to someone else, that meaning is usually lost by the fact that everyone sees and understands life differently, even those who abide by manuals or bibles. No amount of qualification can justify an outside person's lack of accurate perspective of your own unique history, or their own. Symptoms can have more than one plausable cause and statistically-derived antedotes/cures can consequently and easily be non-effective in the long run. Whether psychological, psychiatric, or voodo-shop, success stories involving long-lasting rehabilition strain to rise above the 15% range.

Of all my experiences in dealing with personal growth endeavors, none have had nearly the impact on me as hearing another person earnestly say "I am sorry all this has happened to you". You need to get the feeling work done.