Friday
Sponsor
@potager & @Exitmusic
PTSD can exist AND a person can have a severe reaction to drugs/meds all the way to drug induced psychosis, etc. but the PTSD won't be from the drug use & it's effects. It's excluded in the diagnostic criteria because of a few reasons. First off there's a lot of very heavy shit that can happen neurologically when a person is in an altered state of mind that doesn't happen when a person isn't. Changes the brain in certain ways that doesn't happen otherwise. Another big one, is that the brain reacts differently under situations that are real, versus a situation that is imagined. It's a lot harder to deal with imagined situations, in many ways, because the brain itself came up with it. When a reality based thing happens, there's the cognitive dissonance between what the person thought they would do, and what they really did, that can very much help keep the distinctions clear.
As a case in point; someone who is raped (sober or not) is going to respond differently both in the short term and long term, than someone who has a dream of being raped, or someone who has a delusion of being raped (like while in drug induced psychosis).
When the lines of reality v imagination get blurred? It creates a far different picture, and different set of problems. In addition to similar problems (shared symptoms with other disorders). It also means the solutions to the similar problems/shared symptoms? Often look very different.
To continue with the example; To tell someone whose brain believed they were raped by their family while they were having a drug induced psychotic episode that it was REAL? That it happened? Seriously bad news. Not only does it destroy relationships, but it blurs the line between reality and fantasy even further. Which makes symptoms worse. Conversely, the exact same thing happens -serious cognitive/emotional/neurological problems- , when you try and convince someone who was raped by their family that it never happened. And that's only one example of literally hundreds. Treating the symptoms of one disorder, as if they were the symptoms of another disorder? Shudder. Bad. Really, really bad.
It's why exclusions exist, in the DSM. A whole lot of disorders share symptoms. The exclusions? Point people towards what might really be going on. So it can be treated appropriately. So someone with PTSD isn't being treated for Bipolar Disorder, and people with Drug Induced conditions, aren't being treated for PTSD (or bipolar disorder, or, or, or)... But are actually getting the help they need.
From the DSM5 PTSD Diagnostic Criteria, Exclusions, CriterionH
Can people have both? Be comorbid in 2 or more disorders? As above, yep. Absolutely. But that means that each disorder needs to be treated, not lump them together, or ignore one for the other.
PTSD can exist AND a person can have a severe reaction to drugs/meds all the way to drug induced psychosis, etc. but the PTSD won't be from the drug use & it's effects. It's excluded in the diagnostic criteria because of a few reasons. First off there's a lot of very heavy shit that can happen neurologically when a person is in an altered state of mind that doesn't happen when a person isn't. Changes the brain in certain ways that doesn't happen otherwise. Another big one, is that the brain reacts differently under situations that are real, versus a situation that is imagined. It's a lot harder to deal with imagined situations, in many ways, because the brain itself came up with it. When a reality based thing happens, there's the cognitive dissonance between what the person thought they would do, and what they really did, that can very much help keep the distinctions clear.
As a case in point; someone who is raped (sober or not) is going to respond differently both in the short term and long term, than someone who has a dream of being raped, or someone who has a delusion of being raped (like while in drug induced psychosis).
When the lines of reality v imagination get blurred? It creates a far different picture, and different set of problems. In addition to similar problems (shared symptoms with other disorders). It also means the solutions to the similar problems/shared symptoms? Often look very different.
To continue with the example; To tell someone whose brain believed they were raped by their family while they were having a drug induced psychotic episode that it was REAL? That it happened? Seriously bad news. Not only does it destroy relationships, but it blurs the line between reality and fantasy even further. Which makes symptoms worse. Conversely, the exact same thing happens -serious cognitive/emotional/neurological problems- , when you try and convince someone who was raped by their family that it never happened. And that's only one example of literally hundreds. Treating the symptoms of one disorder, as if they were the symptoms of another disorder? Shudder. Bad. Really, really bad.
It's why exclusions exist, in the DSM. A whole lot of disorders share symptoms. The exclusions? Point people towards what might really be going on. So it can be treated appropriately. So someone with PTSD isn't being treated for Bipolar Disorder, and people with Drug Induced conditions, aren't being treated for PTSD (or bipolar disorder, or, or, or)... But are actually getting the help they need.
From the DSM5 PTSD Diagnostic Criteria, Exclusions, CriterionH
Can people have both? Be comorbid in 2 or more disorders? As above, yep. Absolutely. But that means that each disorder needs to be treated, not lump them together, or ignore one for the other.
Last edited:
