Ptsd Sub-type: Brain Channels Stress Into Physical Pain

[Lionheart]

I was told by a trauma specialist that I have a certain sub-type of PTSD in which stress and emotional pain are channeled into physical pain.

This is very problematic for me because I also suffer from CFS (Chronic Fatigue Syndrome), FMS (Fibromyalgia), Arthritis, and Bursitis all of which cause muscle, bone, joint, and soft tissue pain and result in more stress (leading to more pain).

I also have MDD (Major Depressive Disorder) which creates emotional pain and stress (and thus, more physical pain).

It's a viscous cycle of pain / stress, (which has increased fatigue as well).

At this time, I am being treated for FMS with Lyrica which is partially helpful for physical pain. I plan to talk to my regular doctor about an increase in medication or adding a pain reliever and muscle relaxer to take as needed.

Anyway, it all gets so overwhelming and I wondered if anyone else has this specific sub-type of PTSD. (I can't remember the number associated with it, but think it is 20-12).

Does anyone know if this sub-type is caused by dissociation or if it considered a somatic illness? Has anyone got any suggestions for effective self-help measures for muscle/bone pain or how to deal with this specific sub-type?

 

[Echo]

I have this to a certain extent, having myself had CFS in the past for some years. I found Belleruth Naparstek's Invisible Heroes book really helpful. She writes at some length, in layman's terms, about the biochemical effects of trauma and traumatic stress. The way to deal with it is to get our cortisol levels balanced again and get those biochemicals out of our systems, but rather than me rabbit on about it, I wholeheartedly suggest you start with her.

I got better from CFS in a number of ways, but the prime thing was taking a nutritional path. I am already vegetarian and generally eat as much organic food as I can afford. I detox gently on a regular basis and supplement my diet with various minerals and vitamins in order to support the elimination of toxins and to get my gut working optimally (the key to good health really). I also find I do best when I eat according to GI (glycaemic index) principles. It helps deal with the highs and lows of blood sugar caused by stress and cortisol imbalances (I am not a diabetic, and these regimes are not intended for diabetics, but all of this is interlinked). Unless, I am really hideously stressed, which happens too often thanks to PTSD, the benefit is also that I lose weight, sleep better and feel so much clearer in my mind and body. I find there is a strong link with sugar, wheat and alcohol consumption for me, even in small amounts, directly relating to sudden onset fatigue symptoms, so I do best when I avoid sugar and wheat and only occasionally drink, when it is ok to feel crap the next day.

 

[Lionheart]

Thank you Echo,

I will take your suggestion into consideration. I appreciate the book recommendation as well and am happy to know that you got better from CFS!!! * (I have had it since 1998 with little to no improvement).

I am pretty sure that the sub-type of PTSD that I have is called 20-12, but I am not 100% positive on that so please don't hold me to it. I think I will Google it and see if that is the correct sub-type, as I honestly can't remember for sure.

Thanks again for your reply and I hope you continue to do well!!!

Peace,
Lionheart777

 

[Echo]

@Lionheart777 - I've never heard of these sub-types, but I will check it out, too.

I am sorry you've had CFS for so long; it is a vile thing. Bizarrely, my friend got it at a similar time to me and it took her longer to heal, but she got there, too. We spent an enormous amount of time talking to one another, trying to work out why this had happened to us, and asking ourselves what we could change. Lots of self-development work, if you like. And then the PTSD hit and I'm having to deal with much of it again on another level, but with recovered memories which explain an awful lot more about the root of the stressors. I think my PTSD would have finished me off, had I not done this work beforehand.

I wish you every healing, and faster than you think.
Echo

 

[Lionheart]

@Echo - I could not find anything online about the sub-type but I am willing to bet it is in the DSM V (or whatever the current psychiatric diagnostic manual is at this time).

It's kinda funny because I "got into it" with the trauma therapist who wrote on my evaluation that people with this sub-type tend to complain a lot. I told him that if he felt like me he would complain a lot too and he agreed that he would!!! It was funny, we call that crawl-fishing around here, He definitely did a back-stroke. :playful::laugh::woot:

*(The sub-type number may be 21-12 rather than 20-12), I wish I knew the number for sure, but I honestly can't remember.

Thank you for your condolences. CFS is vile, it robs of us of so much vitality and is difficult to overcome, but I will follow your lead and who knows, perhaps I too will improve.

Thank you for giving me some hope for a better future.
It means a lot to me,
Lionheart

 

[Echo]

It's kinda funny because I "got into it" with the trauma therapist who wrote on my evaluation that people with this sub-type tend to complain a lot. I told him that if he felt like me he would complain a lot too and he agreed that he would!!!

!!! Walk one day in our shoes, Mister, and then see how much you complain !!! Glad he did that back-stroke and that he's maybe even got a sense of humour![DOUBLEPOST=1399753200,1399753029][/DOUBLEPOST]

It's kinda funny because I "got into it" with the trauma therapist who wrote on my evaluation that people with this sub-type tend to complain a lot. I told him that if he felt like me he would complain a lot too and he agreed that he would!!!

!!! Walk one day in our shoes, Mister, and then see how much you complain !!! Glad he did that back-stroke and that he's maybe even got a sense of humour!

 

[Powder]

Subtypes of PTSD is being studied.

There are some that hold to a 3 dominant subtypes model: internalizers, externalizers, and "simple."

Internalizers are more depressed and have more medical and body issues, and display problems in the areas of depression, anxiety, hypochondriasis, social avoidance and withdrawal, and they also exhibit features of schizoid and avoidant personality disorders.

Externalizers tend to act out their negative emotions immediately, and are more impulsive. They tend to have substance abuse issues that crop up as a health issue. E's have high comorbidities of impulsivity, aggression, delinquency, and substance abuse, including features of antisocial, borderline, histrionic and narcissistic personality disorders.

Both I's and E's have cardiovascular problems as a cause of death or disease.

Simple PTSD sufferers have fewer comorbidities and are called "Low Pathology" sufferers. They have relatively stable career, relationship, and lifestyles. I'd call them "high-functioning" PTSD. They probably would be the hardest to diagnose and would be able to blend in and appear almost normal.

(I propose that current life stress is likely to influence how a PTSD sufferer appears to others. Therefore, the temptation to categorize a PTSD sufferer as essentially one of these 3 subtypes would need to consider how the person is despite external forces and circumstances.)

Some have proposed a 4 model, with two sets within internalizers, with one of them being more schizoid, or socially isolated. However, since many think that culture is why being more solitary is viewed in a negative light, not functioning, the majority have rejected the need to add this 4th subtype of PTSD.

(source: Dead Link Removed)

I'm not convinced this is a valuable distinction in itself, but it may help those diagnosing to simply realize that PTSD can look different in various personalities.
I could not find that any recommendations for treatment have been studied for the different subtypes.

 

[EveHarrington]

I'm not sure if the assessment that the PTSD subtype is problematic as it adds to current issues. Isn't the explanation of PTSD/trauma being the cause of all your physical maladies just as plausible? That is your view is that these are all separate entities but the truth is that it may all be related with a common cause. Modern medicine puts everything into discreet little cubby holes while ignoring possible interactions.

 

[Powder]

I have done the internalizing thing often. Before I heard of subtypes, I figured out that I would be better off letting off some steam by coming onto the forum, taking a walk, talking about what I'm experiencing, etc. If I do these things, it does take time. But it does help prevent the high blood pressure, headaches, fatigue, back aches, and stomach problems. The more I vent, the better my body feels.

So that's one way for me to work with this subtype for a betterment of my life. Of course it all stems from PTSD at the core, but my mentor who also suffered from PTSD for twice as long as me, and was successful taught me, there is uncontrollable suffering and then there is the suffering that we mount upon ourselves needlessly.

His point is that we all (not even just with PTSD) can locate in life ways that we can achieve a more balanced life that creates the least amount of extra suffering.

I do not adhere to thinking that we are making PTSD worse for ourselves just by how we are. No. Like when I'm in severe pain or stress, I hold my breath, yes due to early conditioning from traumas, but this makes me dizzy, more out of control, spacy and more anxious. I don't blame myself for doing it because it's unconscious.

But when I catch myself not breathing, or shallow breathing, I think kind thoughts of myself and say gently "breath, honey. " Then I try to go inside and figure out what I'm trying to not feel, and I find the body sensation and its emotion. Then, when I can I talk about it with my spouse because he can sense it anyway and will usually ask "Are you okay?"

I was just asked this in a meeting during a time when I was internalizing all my stress again.

It is very, very difficult to break the pattern because of PTSD. I already am an I, and PTSD takes what I already am and amplifies it until it becomes self-sustaining stress. Then, it is almost unbearable in my body.

For a healthy, active, nutritional kind of person, I have high BP and heart symptoms. So I would identify with Internalizer, while working and being a parent. During times of low stress, I'd identify as Simple or Low Path.

Not to tick a box and feel I've sufficiently been categorized, but to find a model that helps me conceptualize how to manage stress better so that I feel better.

I hope this discussion can help someone. :)

 

[Lionheart]

there is uncontrollable suffering and then there is the suffering that we mount upon ourselves needlessly.

Yes, I can relate, there are conditions that I can do little to nothing about then there is the guilt and fear that I heap onto myself.

Not to tick a box and feel I've sufficiently been categorized, but to find a model that helps me conceptualize how to manage stress better so that I feel better.

I hope this discussion can help someone.

Knowing my sub-type helps me to understand my symptomology better and, therefore, give me ways to fight the effects. Your posts have helped me a lot. :happy: