Ptsd: It's Not A Competition

[Nebulustrix]

I've been following this without comment so far, as I like the topic and discussion but was uncertain where to add my input. Then I just read the below:

I'm just confused, you say that you have near-extreme PTSD, yet you also say PTSD is not a competition. So long as it fits the criteria, and is professionally diagnosed, PTSD is PTSD, whatever the cause. I don't understand what you mean by extreme-end of PTSD, is PTSD divided somehow into mild, moderate, severe, extreme?

I think this is an issue in all of us - we each have a natural tendancy to compare ourselves to others and rate ourselves based on how we measure up. We do this in everything! Sports, education, work, etc. So of course our PTSD is not an exception. We tend to look at others and say things like, "well, mine isn't as bad as what they are going through, so mine is mild" or "they aren't suffering anywhere near as much as I am - I have it bad!" when these comparisons to other people are exactly what cause us to feel invalidated!

We invalidate ourselves by comparing our suffering to the suffering of others!

Certainly, it is aggravating when people claim they suffer a disability but don't seem to show any of the characteristic symptoms or understand what we're really going through. But I think what makes it so aggravating is our irritation with ourselves as we think "IF you really have PTSD, you definitely don't have it as bad as I do and cannot understand what I'm going through, because you don't seem to be suffering the way I am suffering". Those very thoughts are the problem!

Does it really matter who says they suffer from Post-traumatic stress disorder? From a clinical perspective, it is definitely important for a proper diagnosis and sticking to the criteria, but as fellow sufferers does it really matter who says they also suffer? Does it really matter whether or not another person's claimed trauma is comparable to our own? Does it really matter? ...

I treat my diagnosis like a challenge to be overcome, a puzzle to solve, as I try to work past my difficulties and accomplish the life goals I have set for myself. I seek out other sufferers only for advice in dealing with symptoms or problems I haven't been able to get past on my own, and likewise offer support and advice in areas I feel I've done well. Do I compare my PTSD to others? Unfortunately, sometimes I do find myself doing so, usually on the end of saying mine is "mild". But as stated above, I am then invalidating myself and my own suffering. Does it matter how much I'm suffering? No!

What matters is that I am suffering, and that this suffering has been given a name to help me understand and overcome. Others who have been given the same name to their suffering may be able to connect and understand what I am going through, but I shouldn't be making comparisons. Each of us struggle through a very different and unique path, and any labels we give ourselves should serve constructive purposes in helping us learn about ourselves and connect with others.

With the title, I emphatically agree, and hope I can do better - PTSD is NOT a competition! :)

 

[JustBe]

This topic reminds me of my daily struggle to live my life as best I can with the help of a Service Dog by my side. I cringe every time someone says "I wish I could bring my dog everywhere with me. You are so Lucky!"
Yeah...Lucky:wtf:

 

[cherryblossom]

We invalidate ourselves by comparing our suffering to the suffering of others!

That is kind of my point. However, yoshixvx states that PTSD is not a competition, but also tries to justify the comment by saying that they are

someone on the near-extreme end of the posttraumatic spectrum

What does that mean? I have never compared my suffering to others. As far as I'm concerned, trauma is trauma. And PTSD is PTSD, whatever the cause.

I just don't understand how anyone can classify their PTSD worse that someone elses. That in itself is invalidating, to all of us who have been told we 'just' have PTSD.

 

[yoshixvx]

@cherryblossom @Nebulustrix I mentioned my personal experience and severity of PTSD as it is the only perspective I have to go on. My life has been particularly tumultuous from the get-go, so I wasn't allowed the privilege of having a sole event affect my mental health. I can't often relate to those who have had relatively happy lives, have something tragic happen, and then have a supportive family or partner to help them through it. I don't have a family, I don't have any friends and I only recently got a therapist. This has been my life for 32 years.

It's not about competition at all and I'm sorry that you are both interpreting that way. Your experiences are equally as valid! It's literally because I know no other mode of living other than what I have been through.. and the point of this post was to draw out some sort of resolution for that by asking why people do said things - and to point out that it is hurtful. This, for me, is part of solving the puzzle because interpersonal relatedness is the elephant in the room when it comes to C-PTSD.

Does it really matter who says they suffer from Post-traumatic stress disorder?

I think it does. As I said in an above example, dissociative identity disorder (then called MPD) was in the spotlight in the 80s after a woman wrote a book about her experience. It was considered to be the most severe mental health diagnosis at the time (or at least on par with Schizophrenia). After that book was written, people started coming forward to share their stories and they also were privy to a slice of fame. Later it was uncovered that the woman, along with her psychiatrist/therapist, had made everything up. Other therapists had also been accused of coddling and brainwashing their patients into thinking they had MPD/DID, even though they had not. The public and medical communities were outraged, and turn against them - and anyone who had a previous diagnosis of MPD.

The effects of this are still experienced 30 years later. I have friends who have this disorder and they are treated like, for lack of a better term: circus freaks; Dismissed by the medical communities as malingering narcissists - which is the last thing that any of them deserve, as they have already been through so much.

Another example would be to look at the self-harm community. It's no longer about recovery, or the fact that it's a legitimate mental health issue - it's about competition. *Trigger Warning* It's about seeing who can cut the deepest and then posting photos of it on Reddit and having your peers "rate" how you mutilated yourself. I bring this information up because even though PTSD is an invisible illness, the mentality of the people who do so for attention is exactly the same. Exactly. And now cutters are known as "just doing it for attention", and the individuals who want to come forward for help are scared to because their suffering will be dismissed, or worse - they will be locked up for being a danger to themselves (which isn't always true) and smacked with a label like BPD.. which IMO is the worst thing to be labeled these days. *End Trigger Warning*

So yes, I do think it is particularly harmful to go around saying that you are anything, especially having a diagnosis that isn't backed and maintained by medical professionals. And I think it is particularly important that these issues are addressed so that history does not repeat itself.

 

[Ladyghosthunter]

Everyone has their own experiences and we cannot walk in one anothers' shoes and sit there in judgment; it's just stupid. We are all suffered and are suffering, we are trying to better ourselves while bettering one another no matter what the circumstances. Suffering comes in different forms; physical, mental, you name it-it doesn't matter who has the worst PTSD-heck, we all have it in different forms, different phases and different degrees. When I was diagnosed with PTSD, I was completely shocked because I thought it was a military condition from combat (showed my complete ignorance). However, I have accepted this disorder because of my lifelong struggle of dealing with dysfunction in my family, my misaligned marriages and I know, no matter what the therapist tells me, I will never get over the damage done to me, even at 44. Too much damage has been done to me with not an inkling of apology, remorse or even a hug from the people who damaged me with words, neglect and at the end of a leather belt. The scars bleed constantly but it's up to me to sew them up on my own and continue despite it all....

 

[Deleted member 1860]

I just don't understand the need for a level playing field, the understood tone of "we all suffer the same". Uhm, no, we don't. It's like saying everyone with cancer suffers the same, from those with 99% cure rates to those who are incurable. So no, it's not a competition, but don't for a second think that we're all equal in all of this.

 

[anthony]

PTSD is PTSD IMHO in the scheme of the diagnosis. The people who claim CPTSD are often guided by therapists who tell them such, but have zero legal diagnostic application, let alone any two therapists claiming such things using the same criterion to diagnose their clients.

Symptom severity and symptoms suffered change from person to person, which you can clearly read within the symptom clusters.

Trauma endured is quite unique, and IMO, you can grade. Anything of a multiple, compounding nature, is often classified as worse trauma than any singular event, let alone anything during childhood is often considered worse because it can impact on personality development.

Trauma endured during both adulthood and childhood both have pros and cons, of which there are always cases fore and against all aspects and must be uniquely classified for overall severity.

JMO though.

 

[yoshixvx]

Hi Anthony, just wondering if you have any information to support your statement about CPTSD - journals, studies, etc. I would be interested in learning more about these claims. Thanks!

 

[anthony]

There are two... the DSM V and the ICD 10. Go try and find CPTSD in either, being the only two mental health diagnostic manuals in the world today used by health professionals globally. They all use one or the other, even both.

There is no secret book containing a CPTSD diagnosis, let alone agreed diagnostic criterion. The proof is in you finding it exists, not proving it doesn't.

 

[yoshixvx]

I was more concerned with your statement that CPTSD is guided by therapists, as I received my diagnosis from the Chief of Psychiatry at UofT, who I would consider a legitimate source of experience in mental health. I am aware that the diagnosis did not make it into the DSM-V, but it's written in my charts.. so I was curious as to where this idea comes from as I am sure there are others in the same position who would agree that this attitude is unfair and dismissive.

 

[anthony]

There is a niche of therapists who use this diagnosis, what criterion they each use??? Who knows. Something they made-up? Bits and pieces of information floating around the web within authoritative areas? Combination?

The simplest information is available on the opening comments of the wikipedia page: http://en.wikipedia.org/wiki/Complex_post-traumatic_stress_disorder

Complex post-traumatic stress disorder (C-PTSD) also known as multiple interrelated post traumatic stress disorder is a psychological injury that results from protracted exposure to prolonged social and/or interpersonal trauma in the context of either captivity or entrapment (a situation lacking a viable escape route for the victim), which results in the lack or loss of control, helplessness, and deformations of identity and sense of self. C-PTSD is distinct from, but similar to, post-traumatic stress disorder (PTSD), somatization disorder, dissociative identity disorder, and borderline personality disorder.[1]

However, C-PTSD was not accepted by the American Psychiatric Association as a mental disorder. It was not included in DSM-IV or in DSM-5, published in 2013.[2]

Though mainstream journals have published papers on C-PTSD, the category is not formally recognized in diagnostic systems such as Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Statistical Classification of Diseases and Related Health Problems (ICD).[3] It may be included in the upcoming ICD 11 However, the former includes "disorder of extreme stress, not otherwise specified" and the latter has this similar code "personality change due to classifications found elsewhere" (31.1), both of whose parameters accommodate C-PTSD.[1]

C-PTSD involves complex and reciprocal interactions between multiple biopsychosocial systems. It was first described in 1992 by Judith Herman in her book Trauma & Recovery and an accompanying article.[1][4] Forms of trauma associated with C-PTSD involve a history of prolonged subjection to totalitarian control[1] including sexual abuse (especially child sexual abuse), physical abuse, emotional abuse, domestic violence or torture—all repeated traumas in which there is an actual or perceived inability for the victim to escape.[5][6]

You can read the references on that site already. CPTSD may, and that is a huge maybe, be included in the ICD 11, however; the ICD tends to follow the DSM which they did recognise the dissociative and depersonalisation aspects in the new PTSD diagnosis with sub-types, where dissociation and depersonalisation are considerable problems, but not enough to warrant their own diagnosis.

Again, this niche within the therapeutic industry still don't accept sub-types, and instead they want a unique diagnosis that is already better covered by other separate diagnoses. The board who does this are all psychiatrists, and this is a majority within an industry who reject it. A minority keep fighting for it, and still can't agree on actual symptom clusters.

It isn't dismissive if true. If CPTSD became an actual diagnosis in the DSM or ICD, then it would be an actual legal diagnosis. What any given therapist writes in your chart, does not mean they write it in legal documents for insurance or court purposes.

It isn't legal, because it doesn't exist anywhere to date.

There are two variations within both texts that do adequately cover symptoms outside of specified disorders, being DESNOS and Personality Change Due to Classifications Found Elsewhere. There is actually another in ICD, being the proposed ICD 11 of CPTSD being the existing diagnosis of Enduring Personality Change after Catastrophic Experience.

 

[duff]

I've been thinking about this for a few days since I first read the thread. My own personal dx for the past three years has been Anxiety Disorder NOS. My therapist gave it to me after one intake session and that was that. We haven't actually ever discussed it, but it's on the receipts she gives me. However, insurance doesn't cover my therapist or psychiatrist, nor would they if I had a different diagnosis such as PTSD.

I think the diagnosis definitely has a specific and very useful function in the world - getting people access to certain resources and support than they might otherwise have. But I don't think the diagnosis, by itself, is the only evidence of severe trauma, nor does it, by itself, determine how/where/why people suffer.

In other words, I'm not going to stay away from this place because I don't have the diagnosis when I know I've had trauma, and I know I suffer greatly because of it, and I know I need and want support/thoughts/advice/etc with regards to healing from it. I absolutely recognize and acknowledge that others may suffer more and in different ways than me. However, just because I don't have the diagnosis doesn't mean I don't have things to say or add, or an experience that is legitimate. Right?