Questions About Therapy

[bitterfight_]

Where do I begin?

Well I am doing Trauma-Focused CBT (or I think she called it CPT for Cognitive Processing Therapy), and it's hard as hell. I was diagnosed with chronic PTSD (delayed onset - approx 6 years) and I'm 6 months into this therapy, and let me just say it's the hardest thing I've ever done in my entire life.

I was recently put on Zoloft for my anxiety and depression (only at 25mg right now) and I don't even know if it's doing anything. I don't want to spend all my time messing around with meds to see which one works, but I'm guessing this is my new life - one I didn't ask for 6 years ago. Should I tell my GP about this, or considering seeing a Psychiatrist to look at the best meds for me? I just hate feeling so low all the time, like there's no purpose for me. I feel so shitty a lot of days, and the anxiety is driving me crazy. I tried EMDR online with a website my therapist recommended, but I couldn't watch it. Halfway through I started sobbing uncontrollably, and I felt like I was back there again in the horrible memories. People say the meds are supposed to work, but I am going on my 5th week with Sertraline and I have seen no noticable difference.

Also, I just don't know why but lately I feel like I'm floundering (I guess that's the saying? Almost like treading water). For the past 2 sessions (I have sessions every 2 weeks) I have been very distant, and trying not to process the harder stuff. I would absolutely LOVE if someone could give me advice on the extreme anxiety I get before our sessions (I often get so nauseated to the point of throwing up knowing that I have to bring up all of my past). We (my therapist and I) have both come to the conclusion that I need to process this stuff to move forward, but if I stay in this state, I will continue to prolong this recovery stuff. Last session I told my therapist about my previous suicide attempts (5 of them) and this has probably added to my state of anxiety about processing because hardly anybody in my immediate life knows about these attempts. She's been great about it, and mentioned in her last email to me that she is in no rush for me to "get better" and that these things take time. She said she has all the time in the world which is comforting, but the more we get into the processing, the more my anxiety and avoidance symptoms increase. Not even that, but my emotional regulation while I'm talking about this becomes so out of whack. I start crying (ugly crying) in front of my therapist, and she tells me it's okay and to take my time, but this is so hard!

Another random question, but this came up in my psych class the other day: once you get a "label" of a mental illness/disorder, does it ever go away? My professor said no, but my therapist said I should be "better" in a year.. It just is so confusing because I've had PTSD for 6 years but never saw a professional, and I'm only just working on getting better now. I know I've heard that we learn to cope with our symptoms in a healthy manner, but does it ever really "go away"?

There's probably an answer to all of this somewhere on here, but I'm so tired tonight. I probably won't get much sleep either. Just needed to post it myself.

I hope this isn't too much to read/answer. :( I just need some opinions before my therapy appointment in 2 days.

 

[Justmehere]

Where do I begin?
I was recently put on Zoloft for my anxiety and depression (only at 25mg right now) and I don't even know if it's doing anything. I don't want to spend all my time messing around with meds to see which one works, but I'm guessing this is my new life - one I didn't ask for 6 years ago. Should I tell my GP about this, or considering seeing a Psychiatrist to look at the best meds for me? I just hate feeling so low all the time, like there's no purpose for me. I feel so shitty a lot of days, and the anxiety is driving me crazy. I tried EMDR online with a website my therapist recommended, but I couldn't watch it. Halfway through I started sobbing uncontrollably, and I felt like I was back there again in the horrible memories. People say the meds are supposed to work, but I am going on my 5th week with Sertraline and I have seen no noticable difference.

I think you should definitely tell your GP about this. Some medications used to treat PTSD, depression, and anxiety can make all those things worse. It may or may not be the right medication for you. Some medications take time, some can really help some people, and sometimes they can backfire. The more you talk to the prescribing doctor about how you are feeling, the better they can help. I would highly recommend seeing a psychiatrist. I found it to be very helpful. I had to take medications for a little while, and then with treatment and therapy, I no longer needed them. I am still in therapy, but I have healed enough where I don't need them anymore.

I went to a PTSD intensive treatment program associated with Harvard Medical School and I will tell you what the folks there told me - PTSD is a mental illness. It is also the "most recoverable major mental illness" It has the highest rate of recovery (i.e. no longer qualifying for the diagnosis) of any mental illness out there.

Your professor is right in the sense that the label of being mentally ill is highly stigmatizing in society these days. For some people, once they see you as mentally ill, that label never goes away. It is a label to handle carefully. Having a label of PTSD is less generally stigmatizing than more general term of "mentally ill." It is all changing, but it is still highly stigmatizing to be labeled as mentally ill.

It is ABSOLUTELY false what he said if he meant it in the sense of once mentally ill, always mentally ill. Take schizophrenia. 25% of people with schizophrenia GET BETTER with treatment and no longer have it. This is a highly researched but little known fact about a mental illness that most professionals assume is an illness people never get better from.

PTSD is a mental illness with a much higher recovery rate. It can take years, and a hell of a lot of hard work, but it is very possible. Your therapist is much more informed on recovery from PTSD. I would listen to what she said - especially because she knows you and what you are specifically dealing with.

Plus, some people really don't see PTSD in the same category as other mental illnesses.

Most importantly, having PTSD and/or mental illness does not make you a bad person. No matter what anyone says, you are a survivor and an amazing person with a lot of good qualities about you, PTSD or not.

 

[EvenStrongerNow]

A psychiatrist who is well versed in PTSD would be ideal.

Big hugs to you!! Welcome to the forum :)

 

[bitterfight_]

Justmehere: I don't know.. My GP really sucks. I told her about the fact that I wasn't really feeling an effect of the Sertraline and she brought up that I "might not need medication" which to me seems a little messed up considering all the symptoms and difficulty I'm having.

I mean, I don't feel more or less irritable, nor more or less depressed (and/or suicidal), and the anxiety (overall) is alright, although it still gets way too high in certain situations (I end up vomiting from the anxiety) and yet she thinks that I don't need medication to regulate that? It doesn't necessarily seem like a good thing to me.

She's very rigid on listening, and will often just push her patients out the door. It's very frustrating, but most of the docs around here are like this. Should I suggest to her that I think I should see a psychiatrist?

I believe that where I live you have to get a referral before you see one. Your words have really given me hope. I just fear that because I have had it for so long, that some of these behaviors and feelings will be much harder to break.

I've also had another teacher at that school say that "PTSD is kind-of a life-long diagnosis" and I thought "what??" but thank you for your words! They gave me a new perspective on this whole thing. I don't find the label of PTSD to be too much, I guess I was just worried that because mine is chronic/delayed onset that it might be harder to break those behaviors. You know what I mean?

Anyways, the stigma doesn't bother me much anymore. Thank you so much for your input and your view on it, as well as what others have told you. I think you are right in regards to my therapist, and I think I will ask her what she means by "being all better in a year" because she said that once before, and then took that statement back.

StrongerNow: thank you, I think I agree. Now to find one haha. Big hugs to you too!! Thank you :)

 

[Justmehere]

Gosh, your GP doesn’t sound very helpful at all! The average psychiatrist appointment is longer than a GP and generally will listen to you a lot more than a PCP. They have a lot of expertise in finding the right medications and adjusting them so they do work, if that is what is needed. Just because one medication doesn’t work, that doesn’t mean you don’t need medications. Because PTSD comes with a mix of anxiety and depression, it can be tricky to treat and find the right meds for to help you manage and get through this time period of having so many PTSD symptoms. I think you will have a lot more success with a psychiatrist.

It may or may not be harder to break because you have been battling these behaviors for awhile. I know people who have had a lot of the same symptoms you have had who are mostly symptom free now, after lots of work in therapy. My own PTSD symptoms had a delayed onset of 6 years – and then after the symptoms started, new traumas happened... it's been a hard road. I am still in the middle of my own journey to heal, but a lot has changed for me and improved. I have stopped behaviors and habits I NEVER ever thought I would be able to stop. There were many times I never thought I would make it even this far.

Once a habit is developed, and the more it is repeated, it is true that it is harder it is to break, but it is by no means hopeless. I have personally known people with and without PTSD break much more entrenched habits and behaviors they have had for decades. They did it by taking it one step at a time, one day at a time, and changing slowly but surely. Sometimes it can feel like climbing Mt Everest – a nearly impossible task - but even climbing Mt Everest is done by putting one foot in front of the other. You will improve, just keep taking the next step, and the next step after that.

…and don’t listen to the nay-sayers who say people don’t get better! Keep fighting the good fight to heal - so glad you are working with your therapist and reaching out here.

 

[DharmaGirl]

You might ask your therapist to suggest a psychiatrist to your GP. My therapist will call my doc from time to time. I was on 200mg of Zoloft for PTSD, so maybe she just needs to up the dose.

There seems to be a debate on whether PTSD is "curable". I've been working my butt off in therapy for over two years, and I am better than I was, but not "better". I asked my therapist if I would recover, or if I would just learn to manage the symptoms, and he said it's a little of both. Zen Master therapist.

I have Severe PTSD with Dissociative Features, sometimes called Complex PTSD. I used work as a coping mechanism, and after I could no longer work, I had a breakdown and was diagnosed with PTSD and Major Depressive Disorder. Some days I feel like I will be mentally healthy again, many other days I don't. I hope you get better fast, but it takes as long as it takes, and if you need more time, you just do. I was going to be done in 6 months, lol.

 

[BloomInWinter]

A diagnosis becomes a part of our medical history, and an important one to share with any medical professionals who are to diagnose and treat us.

Hence, a diagnosis is a part of our history. We could choose not to share, but lack of information can slow down accurate diagnosis, or mask the symptoms enough that an important diagnosis is missed. That, and our symptoms of PTSD can affect our ability to follow through with certain courses of treatment.

I don't worry about the label anymore. It's just an accurate description of a group of symptoms for which I need treatment.

 

[DharmaGirl]

Totally agree, Bloom!

 

[bitterfight_]

@Justmehere: No, my GP isn't very helpful at all, and is often quite condescending. When I was initially given the diagnosis of PTSD, she asked me "what happened to you?" and asked me to describe all of it in excruciating detail, to which I found very hard to do. She ended up triggering me so badly I had to call into work sick because I couldn't stop shaking from anxiety after my appointment.

I agree with pretty much everything you said, especially in regards to medication. I think it was very unfair of her to deem that I don't need medication right now, especially because I've found it very hard to deal with the anxiety (missing school, work, etc) many days. I don't necessarily think this is "right now" per say, as I have had anxiety and depression since this entire fiasco started (6 years ago). I pray that one day I won't be as bad as I am now, but I don't think I will ever get rid of it entirely. It would be nice to get rid of it though :)

I think I would have a lot more success with a psychiatrist too, and it might even help to get an opinion on my diagnosis (often times my mother has made remarks that I have something in conjunction with PTSD so I wonder sometimes). That's really awesome that you know people who had a lot of the same symptoms and who are mostly symptom free now, that's great! What a coincidence in regards to your delayed onset of 6 years too.

I often think she was wrong in saying I was delayed onset, because the nightmares and the stronger anxiety symptoms started (for me anyways) 6 years ago when one of the first incidents happened. I'm so glad to hear you've found that you have broken habits that you thought you might never stop - that's incredible.

I've found that I am in a better place now than I was (I haven't attempted suicide in a long time!) and I'm glad I've found the T I did, when I did. Going from T to T and not feeling that validity was hard, and when I was told by my current T that it was PTSD and she helped to explain to me each of my symptoms, well let me just say WOW I didn't feel as alone. It's been truly relieving knowing that there are others with the same symptoms, no matter the history of the person. Thank you so much. I'm gonna try not to listen to the ones who try and bullshit about this kind of stuff, and focus only on healing. Thank you so so so so much!

@DharmaGirl: That's actually a pretty good idea. I'm going to bring these things up with my T. My grandmother is actually on 200mg of Zoloft, and I shared that with my T who said that she wouldn't want me on any more than 50 mg. I understand exactly what you mean, and my therapist said I would be "better" in a year, but I am at the 6 month mark, and she has changed that statement to "I have all the time in the world" so I don't know where I am in this now. That's ironic - I have Chronic PTSD with Dissociative Features as well (derealization and depersonalization anyone? :p) and I definitely know what you mean as using work as a coping mechanism. I do that too! I agree with what you mean on feeling like some days you'll feel mentally healthy again and others not so much. I get those feelings a lot. Who knows, this is all just one big work in progress I guess, and I have to untangle the damage from the trauma, and the damage I added to it myself with years of unhealthy coping mechanisms and thoughts haha.

@BloomInWinter: I agree, and I have been working on being more open with medical professionals. It was very hard at first to tell anyone "I have PTSD" but everyday people are showing me there's nothing to be ashamed of to admit things like that. I read a quote once that said something like "PTSD isn't about what's wrong with you, it's about what happened to you" and I try to look at it that way instead of looking at it as a label. Shit happens in life, and I reacted to it in the only way I could. :)

Here's to moving forward, right? Thanks so much guys. <3 I have therapy tomorrow - I'll update on what my T thinks about all my questions and whatnot. Wish me luck (I'll need it with the anxiety I know I'll be having lol).

 

[BloomInWinter]

I'll wish you luck but honestly, you're already a strong, tough cookie! I have no doubt you'll handle this even if you don't give yourself credit for how strong you are.

 

[bitterfight_]

@BloomInWinter: Thank you!! That is so sweet of you to say. Sort of reminds me of what my therapist would say - calling me a tough cookie. I try to remind myself of how strong I am, but it's hard some days, y'know? Nonetheless, you are strong too, my dear!

 

[DharmaGirl]

Bitterfight, my name here used to be Monster, I just changed it a few days ago. I think those who were "high functioning" before will be able to be "high functioning" again. I am hoping to find a nursing job that would suit me in the next 6 months. I don't know what that would be, or if it will be part time or full time but some days I feel like I could make it back all the way. I'm going to keep that as my goal,