Unsure about my diagnosis

agender.exe

New Here
Hi everyone!
I've recently been diagnosed with PTSD, but I'm finding it difficult to accept it. I can't stop thinking that my psychiatrist may have got it wrong. One of the things that creates the most doubts is that I'm unsure whether I actually have avoidance symptoms or not. In fact, I wonder whether I actually do the opposite of avoiding, when it comes to trauma-related thoughts. I find myself sort of indulging in traumatic fantasies, both ones that actually happened to me and imaginary ones. Sometimes I would say the fantasies are intrusive, but other times I find that I purposefully try to imagine painful scenarios just to find something concrete that allows me to externalize that unexplainable pain I feel. But isn't that the complete opposite of avoidance? Does anyone else experience this?

Thanks for reading,
Lex
 
P

Paula

Lex, Hi my name is Paula. Just from what you have written,you have PTSD. My suggestion is that you ask your therapist about doing EMDR. This method is the gold standard for people like us. I have been doing therapy with EMDR for 3yrs now. Its tough,emotionally drawing at times,but it works. Its important to give yourself the best chance for recovery. You deserve it.
 

arfie

MyPTSD Pro
hello lex. welcome to the forum. sorry for what brings you here, but glad you are here.

the part i most identify with is the continual wonder if my psych pros have gotten it wrong. i started psychotherapy in 1972 and it is a simple fact that virtually all of the diagnoses(pl) have changed since 1972. strikes me as a guarantee that they got at least part of it wrong. i'm not ready to swear that the current generation is an improvement over the theories which were in play at my first therapy appointment. still. . . even a missed guess is more healing than more insistence to suck it up and just get over it.

as for the symptoms behind the labels, such as indulging in traumatic fantasies, i've experienced that compulsion, but never found a good name for ^it^. now that i'm thinking on it in this context for the first time. i'm wondering if the quirk has served more than one purpose on my healing journey. just wondering. . .
 

coraxxx

Sponsor
Compulsively think about the trauma would enter into the intrusion criteria for PTSD. Avoidance is generally more about physical triggers than thoughts the trauma itself (like, avoiding certain feelings or sensations that preceded the trauma by example), even if avoidance or even forgetting the trauma can happen. You can forget about something and still be avoiding chunks of it.

I have avoidance towards smells of alcohol (feels like a dysphoria and a urge to get away from it) but not towards drinking in itself. Or not in all contexts. I have avoidance towards mopping floors but not of the idea of why. In fact, I can remain stuck ruminating about why.

I think I have more of an avoidance for situations that I know can catch me off guard and trigger a flashback or unpleasant memories but as long as I'm ruminating myself I'm not really avoidant of thinking about it. Recently it's been more the case than before. So it also can fluctuate. It's hard to tell what your brain will be sensitised to or not.
 

Friday

Moderator
Misdiagnosis is always a possibility, so it’s a fair thing to consider.

Just trauma alone isn’t enough for PTSD. Put 10 people through the same trauma, and you can get 10 very different results. Some that look very similar, some wildly different.

Kicked it around with your shrink, at all?
 

agender.exe

New Here
Misdiagnosis is always a possibility, so it’s a fair thing to consider.

Just trauma alone isn’t enough for PTSD. Put 10 people through the same trauma, and you can get 10 very different results. Some that look very similar, some wildly different.

Kicked it around with your shrink, at all?
We (my psychiatrist and I) didn't have a long discussion about it, I'll admit. That's why I intend to go see someone specialized in PTSD, since neither he nor my therapist are and they said they wouldn't be able to properly treat me for it. Hopefully the specialist will be able to quell my doubts, or alternatively tell me if it's a misdiagnosis.

Compulsively think about the trauma would enter into the intrusion criteria for PTSD. Avoidance is generally more about physical triggers than thoughts the trauma itself (like, avoiding certain feelings or sensations that preceded the trauma by example), even if avoidance or even forgetting the trauma can happen. You can forget about something and still be avoiding chunks of it.

I have avoidance towards smells of alcohol (feels like a dysphoria and a urge to get away from it) but not towards drinking in itself. Or not in all contexts. I have avoidance towards mopping floors but not of the idea of why. In fact, I can remain stuck ruminating about why.

I think I have more of an avoidance for situations that I know can catch me off guard and trigger a flashback or unpleasant memories but as long as I'm ruminating myself I'm not really avoidant of thinking about it. Recently it's been more the case than before. So it also can fluctuate. It's hard to tell what your brain will be sensitised to or not.
What you say makes sense, I did read that avoidance has more to do with external things than with thoughts. I am a very avoidant person overall, especially when it comes to social scenarios, but I'm not sure whether it's simply social anxiety. I guess my issue is that I'm not sure exactly which traumatic event(s) would have caused me to develop PTSD. I mean, there are a few I can think about, I ruminate about them a lot, but I'm constantly second-guessing myself. So it's difficult to be able to associate avoidant behaviors with any specific event.

I know that this is off-topic, but speaking of intrusive thoughts: would you say that even fantasies about scenarios that haven't actually occurred (e.g., something that could have happened in a bad situation that you were actually in, or something completely made up like, say, imagining the death of a loved one for no particular reason) still count as intrusive thoughts? Or is it something else?

I thought that about mine for years.
Did you ever manage to overcome that?
 

coraxxx

Sponsor
What you say makes sense, I did read that avoidance has more to do with external things than with thoughts. I am a very avoidant person overall, especially when it comes to social scenarios, but I'm not sure whether it's simply social anxiety. I guess my issue is that I'm not sure exactly which traumatic event(s) would have caused me to develop PTSD. I mean, there are a few I can think about, I ruminate about them a lot, but I'm constantly second-guessing myself. So it's difficult to be able to associate avoidant behaviors with any specific event.

I know that this is off-topic, but speaking of intrusive thoughts: would you say that even fantasies about scenarios that haven't actually occurred (e.g., something that could have happened in a bad situation that you were actually in, or something completely made up like, say, imagining the death of a loved one for no particular reason) still count as intrusive thoughts? Or is it something else?
Oh yes future tripping really is part of intrusions. Can also be comorbid generalized anxiety disorder. (Which I also do have).
 

agender.exe

New Here
hello lex. welcome to the forum. sorry for what brings you here, but glad you are here.

the part i most identify with is the continual wonder if my psych pros have gotten it wrong. i started psychotherapy in 1972 and it is a simple fact that virtually all of the diagnoses(pl) have changed since 1972. strikes me as a guarantee that they got at least part of it wrong. i'm not ready to swear that the current generation is an improvement over the theories which were in play at my first therapy appointment. still. . . even a missed guess is more healing than more insistence to suck it up and just get over it.

as for the symptoms behind the labels, such as indulging in traumatic fantasies, i've experienced that compulsion, but never found a good name for ^it^. now that i'm thinking on it in this context for the first time. i'm wondering if the quirk has served more than one purpose on my healing journey. just wondering. . .
I think some of the doubts regarding how PTSD is classified/what counts as a symptom are disputed by professionals themselves. When my therapist and I talked about the possibility that I might have PTSD she would often stress how in her opinion the traumatic event criterion shouldn't be restricted to the events/scenarios that it currently is, and that there are other traumatic events that should be counted in. Keep in mind, however, that she is not specialized in PTSD, so I don't know to what extent specialists would agree with her or not.
 

arfie

MyPTSD Pro
I think some of the doubts regarding how PTSD is classified/what counts as a symptom are disputed by professionals themselves.

i believe those doubts are a sign that you are paying attention. psychiatry is an infant science. however promising the infant, it is not disrespectful doubt their discovery of the week. they have allot of learning to do.

from a patient perspective, i work with what's available. i was in desperate need in 1972 and combat PTSD was still being called, "shell shock." if i had waited until the late 90's when the PTSD dx became available, i doubt i would have escaped the throw-away kid camps. now that i am officially validated with a dx that makes sense to me, i'm still doubtful of some of the expert theories which have come into authority.

sigh. . . is there such a dx as PDD? (psychiatric disorder disorder) all these experts arguing in my head are disorderly, to put it mildly.
 

joeylittle

Administrator
I find myself sort of indulging in traumatic fantasies, both ones that actually happened to me and imaginary ones. Sometimes I would say the fantasies are intrusive, but other times I find that I purposefully try to imagine painful scenarios just to find something concrete that allows me to externalize that unexplainable pain I feel. But isn't that the complete opposite of avoidance?
I think what you're describing fits more under the idea of maladaptive coping - potentially, a thing called "maladaptive daydreaming", combined with ruminating. It doesn't so much confirm that you don't have avoidance symptoms around a trauma - it more just indicates that you've got some ways of coping with your internal pain that are potentially causing you more pain.
would you say that even fantasies about scenarios that haven't actually occurred (e.g., something that could have happened in a bad situation that you were actually in, or something completely made up like, say, imagining the death of a loved one for no particular reason) still count as intrusive thoughts? Or is it something else?
As far as PTSD criteria (for adults) are concerned, the intrusive thoughts will relate to the factual event, and they don't extend into imagined thought or fictional events. If you find that these fantasies are creating tangible problems in your daily life - like, they are leading to your inability to function, they are creating problems in your relationships, they are leading to acts of self-harm or self-destruction...that's when it graduates to the level of being a behavioral problem, and it's worth taking seriously. Maladaptive daydreaming isn't a disorder on it's own, but some would say it's similar to other behavioral addictions.

It generally arises out of an attempt to internally manage one's response to a traumatic or highly stressful event or series of events.

Like others have said, the best way to get a clear take on what's going on could be to see a more experienced psychiatrist or psychologist....but also, as Arfie pointed out, this is a science in it's infancy. Diagnosis can help point sufferers to the best toolkit for recovery, but it's not always done correctly or even done well.
PDD? (psychiatric disorder disorder)
You know, there really should be, given how easy it is for wrestling with diagnosis to become overwhelming.
 

KayW

Learning
There are some people in the field of psychiatry that would like to reframe the question - what is wrong with you? (focus on symptoms and diagnosis) to - what has happened to you? (focus on causes and treatment). I think there are for and against reasons for both of those.
For me personally, when first diagnosed trauma had taken over every waking moment and I feel that identifying too much with the label could have hindered my recovery because I needed to see that I was more than a traumatised person. Sometimes, a short moment of denial helps me to believe in the functional aspects of myself.
On the flip side, when something happens that triggers intrusions and particularly emotional flashbacks, accepting how past experiences still affect me helps me to manage those symptoms. If Im in denial, then I blame whatever the trigger was and cant see that my reaction is out of proportion. When this happens, I need that reminder that I do still experience symptoms of PTSD and that I have to take steps to manage them.
 
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