Numb, confused, questioning validity of my dx

[sunkenharpy]

Is it common to question PTSD dx? Absolutely. I do it myself about twice a day, right now.

<edited by anthony to add attempted links for copyright requirements>

Can I get a citation on your assertation that they cannot be comorbid? Or what credentials you have in saying so?

No offense, but I'm going to take the word of my psych over a stranger, and as far as I know (and have done my own research about) they absolutely present comorbidly.

I can't post links but here's some tidbits I found concerning this:

Clinical and Diagnostic Implications of Lifetime Attention-Deficit/Hyperactivity Disorder Comorbidity in Adults with Bipolar Disorder: Data from the First 1000 STEP-BD Participants

"Lifetime ADHD is a frequent comorbid condition in adults with bipolar disorder, associated with a worse course of bipolar disorder and greater burden of other psychiatric comorbid conditions. Studies are needed that focus on the efficacy and safety of treating ADHD comorbid with bipolar disorder."

Comorbid ADHD is associated with altered patterns of neuronal activation in adolescents with bipolar disorder performing a simple attention task

"ADHD in children of bipolar probands might identify children at highest risk for development of bipolar disorder."

"The proposed comorbid syndrome is fairly common (present in up to 47% of adult ADHD and 21% of bipolar disorder populations), with a more severe course of illness compared with that of bipolar disorder alone, and high rates of comorbidity with other psychiatric disorders."

"While the disorder in children is most often described as a disorder involving hyperactivity and impulsiveness, ADHD presents with very different characteristics in adulthood, notably with less externalizing symptoms and with a higher rate of psychiatric comorbidities, including major depressive disorder, bipolar disorder (BD), anxiety disorders and substance abuse."

There are SO MANY scholarly articles on this...

I see there is some controversy in the psychiatric community, but considering my experiences I am pretty confident in that DX.

I should also mention I have dyslexia, and it's estimated that 30% of those who have it also have ADHD. Not to mention, family history checks out big time.

I'm on 20mg Adderall XR and it absolutely calms me down, allows me to have linear thought, and my mind feels tranquil instead of constant branching non-linear thoughts and impulses. Before trying to sit down and focus on a task such as reading made me want to jump out of my skin. This was actually the first medication I was put on a year ago, and it helped me tremendously. I wish I had this growing up, I would have excelled, but instead I flunked almost all classes save for English and art.

My moods didn't get much worse (in fact it helped a lot with depression and my ability to be motivated and get things done even when I felt crappy), but I still had a cycle of depression/mania every other month. I went for years not realizing it was BP because when I was manic, I'd think I was "doing better finally" due to all the energy and motivation I had... etc... although sadly, in high school, I told my mom I thought I was bipolar and nothing was done, until this past year when my psych called it almost immediately.

I've been on 100mg lamictal for a while now, and my moods have evened out TREMENDOUSLY. Even now in my time of grieving and confusion, I can function and am not ping-ponging around like I used to (rapid cycling), getting thoughts of grandeur during and having insane bursts of energy and taking on a million tasks at once (mania), or so depressed I am unable to get out of bed for a month.

So, my meds work wonderfully together and before this traumatic event, I was on my way to really getting on track with my life...

 

[sunkenharpy]

Yes. Its very common. At times I felt like a PTSD fake. Many others here have as well. Its a common the...

This resonates a lot. Especially because I compare myself to others way too often....

I keep thinking because my symptoms are presenting differently (seeming mostly through aversion/avoidance right now) that I don't have it, and must be faking, but I still have a ton of symptoms otherwise and have for a long time... I think having PTSD since I was a child (which is quite likely because I presented 100% of the symptoms associated with young children) probably means it presents differently now that I am an adult and was on my way with understanding/recovering.

Sometimes I wish I was having nightmares and more distinct flashbacks again because I'd feel so much more valid than this awful dissociative state.

 

[Friday]

No offense, but I'm going to take the word of my psych over a stranger, and as far as I know (and have done my own research about) they absolutely present comorbidly.

<grin> As well you should! I'm just a chick on the internet, regardless of what my credentials & experiences are in real life. This was mostly just a word to the wise... Get a 2nd opinion. From someone who specializes in ADHD (or Bipolar Disorder) not just general psych, but either of those; AND Trauma. Because they're hard enough to distinguish from each other, often times, even without adding the effects of trauma & PTSD into the mix.

Most of my knowledge of ADHD is anecdotal. Why? Because until the DSM5 (released just a few years ago) it was still classified as a childhood disorder. There has been vast information share within the ADHD community (and allied health professions) over the past several decades, (conferences, symposiums, etc.), which is also how we got ADHD reclassed... but the actual studies to prove the huge wealth of info? Are only just now getting funded and commencing. It's a very exciting time in ADHD-land, in many respects, and very "Yes. Water is wet." in other regards.

ADHD =/= Bipolar is a water is wet subject. Walk into anywhere (diplomas on walls, not just chick-on-the-Internet) that specializes in either disorder diagnosed with both, and not only will people be banging their heads against the wall, but will probably want to be reporting your PDoc*. Our local psych ward has a 30-90-120 day program for that double misdiagnosis (30-90 if proven to be ADHD, 120 if Bipolar) just to pull people off of the stupidest cocktail ever invented, let them normalize, reevaluate/reassess/rediagnose, and then if bipolar find a new working cocktail. (ADHD meds are fast, both fast acting and super short half lives. Bipolar meds are an individually tailored cocktail that usually takes about a year to find the right components, and usually take at least a month to wean off, and another month to slowly come up to functioning levels. It's extremely rare to get the foundation correct on the first go, so usually at least 3 months just to get to the point where they can be fiddled with. Sometimes longer. Tweaking dosages & fiddling with components doesn't need inpatient observation, and is usually done at home)

From what you've written? You could easily be either. That's the problem with adding trauma/PTSD to the mix. It adds layers of complexity to what's already often a difficult diagnosis to distinguish. Cognitively, emotionally, behaviorally, & chemically.

* I wouldn't be surprised if you were definitively diagnosed with PTSD, and provisionally diagnosed with either Bipolar Disorder or ADHD (waiting for the trauma to be dealt with, to ascertain which). I also wouldn't be surprised if some of the trauma symptoms you're experiencing are medication side effects reacting badly with whatever baseline disorder you have. But definitively diagnosing all 3 is unconscionably lazy, as well as harmful.

Again, just a chick on the Internet. Strongly recommending you seek out a second opinion from a specialist.

 

[joeylittle]

Irregardless: the main focus needs to be on trauma processing. Hopefully you will be able to work through the trauma event and get back to managing your other diagnoses effectively, as you were doing before.

Denial? Absolutely. I was in complete denial for a good number of months. Thought it was just depression plus...bad memories? Yeah, no.

It's very normal to struggle with a PTSD diagnosis.

 

[sunkenharpy]

<grin> As well you should! I'm just a chick on the internet, regardless of what my credentials & experie...

Thanks for clarifying and taking the time to lay this out, I really appreciate it. Apologies for being argumentative, as you can imagine I'm going through a weird/rough time and keep taking it out on people over the internet :dead:

This is something I'd really like to look into more, as you're the first person I've spoken to that laid it out in this way.

While my psych DOES specialize in ADHD, trauma, and mood disorders (why I sought her out to begin with) her manner is a bit...causal? Which I always read as a bit of a red flag. Seeking a second opinion is not at all a bad idea, and has been on my mind for a while.

I'm still a bit lost on why the two can't present comorbidly, but I'm always up for learning about this stuff and would be keen on looking into it more, if you have any resources. Otherwise I'll just be mindful of that advice and try to read more about it.

Especially because I think I need more intensive trauma therapy. I'm not sure what, but EMDR has been difficult because of how cut off I am from the trauma/my emotions, and the fact that I don't even totally comprehend what my triggers/flashbacks mean, or am able to fully recall the events that caused them--especially in childhood. I have the bits and pieces and the dread that accompanies, but as far as knowing what actually happened? Not entirely sure.

Guh. I thought I knew a lot about myself but I feel in many ways back at square one.

 

[sunkenharpy]

Irregardless: the main focus needs to be on trauma processing. Hopefully you will be able to work t...

Thank you <3 You're right in that I need to focus on this trauma and get to the point where I can -actually- process it, not be stuck in this avoidant/fearful state so often...

I was in complete denial until mmmm... my early twenties? After a tumultuous 4 year abusive relationship (that I was also in complete denial of), I just snapped. Everything started pouring out and hasn't exactly stopped since then.

 

[j123breatheandbe]

I've been diagnosed with chronic (delayed onset) PTSD from childhood trauma & going to a psych for...

It's a beautiful and brave thing to question your dx! Most people rely on doctors, psychiatrist, and therapist to correctly diagnose them. Yet the DSM has so many "dis-orders" that have similar symptoms. This makes it extremely easy for misdiagnosis. With that being said, everyone in this world has some form of PTSD, it's a human condition that no one can escape from because life is traumatic. The degree to which an individual experiences trauma and how they react and internalize/externalize is unique to the individual. To doctors, the expression of trauma can be seen by any given individual as bipolar I/II/unipolar, depression, borderline personality, OCD, ADHD, ADD, Addictive tendencies, etc. Do your research my friend, get second and third opinions. You questioning your dx is smart! I was misdiagnosed from an early age and have continued to be misdiagnosed. Education, self reflection, self care, self responsibility, and self honestly/trust is key to knowing, growing, accepting, and learning to live and develop a healthy relationship with every aspect of yourself. On a side note, just based on the information you shared, it seems to me that you most definitely have a form of PTSD, but the bi-polar diagnosis seems incorrect. I believe, based off the information you provided, that you may be experiencing borderline personality disorder. Do some research by creditable sources, such as peer reviewed articles and assess may thoughts for yourself. Do lots of research but please be kind to yourself while doing so. You are perfectly imperfect, as we all are. Blessings to you and lots of love and compassion to you on this journey called life. Peace.

 

[nately]

I've been diagnosed with chronic (delayed onset) PTSD from childhood trauma & going to a psych for...

I tried EMDR, which was made optional if difficult. Maybe 3 sessions of that and we stopped.
There was also a clarification of problems that may have existed before PTSD. Though afterwards I was much more of a loner with a few friendships, however any talent or sense of
what I could accomplish was awash. Previous aptitude in areas went completely sideways.
I had amnesia of the complete set of events, which was so much worse then the simplified version of an MVA. What you describe is what I didn't realize until much later afterwards.

By the time (decades) most digression in talent or practiced events, I came to realize were more attributed to the MVA then I had assumed, the blame was on myself. So everyday choices may have put my life on a better trajectory. Perhaps a possibility of making the best of some undiscovered attributes.
Though if nothing would come of me anyhow, then following personal interests instead of stronger, more integrated networking at my own behest may not have led later years to feel what was stated from the top of your list.
That is #1) a fake, fraud, and a real downer to conclude later in life. Wasn't to cool along the way either.