Upset over Diagnosis Change

[Nuance]

My last 3 therapists (my last one specialized in PTSD and trauma, created a trauma-based organization in my state, but got deployed) over the past 5 years have all diagnosed me with PTSD. I am even got social security on the first try for PTSD and other medical issues. I felt like the diagnosis explained the symptoms that I have had for so long and actually helped me to get better. However, my new one is hesitant to give me the diagnosis and seems to want to downgrade me to "trauma-related" anxiety.

This makes me really upset and I feel the urge to regress because I don't think she believes the severity of my symptoms. Any thoughts or advice?

 

[susannahsays]

You said the diagnosis helped you to get better, so wouldn't it make sense that your diagnosis might be "downgraded" (if that's how you want to put it)?

If you're getting better, you will not always meet the criteria for PTSD. Have you asked her why she feels you don't meet criteria? Try to resist this temptation to regress because you haven't received the diagnosis you want. That is not going to help your case. There's a good chance it could actually turn things in a direction even less to your liking than trauma-related anxiety, like a diagnosis of BPD (nothing wrong with BPD, but it is heavily stigmatized).

 

[Gs172003]

My last 3 therapists (my last one specialized in PTSD and trauma, created a trauma-based organization in my state, but got deployed) over the past 5 years have all diagnosed me with PTSD. I am even got social security on the first try for PTSD and other medical issues. I felt like the diagnosis explained the symptoms that I have had for so long and actually helped me to get better. However, my new one is hesitant to give me the diagnosis and seems to want to downgrade me to "trauma-related" anxiety.

This makes me really upset and I feel the urge to regress because I don't think she believes the severity of my symptoms. Any thoughts or advice?

Get another opinion. If you had that many saying you have it and one saying you don't...what makes the one right?

 

[Nuance]

You said the diagnosis helped you to get better, so wouldn't it make sense that your diagnosis might be "downgraded" (if that's how you want to put it)?

If you're getting better, you will not always meet the criteria for PTSD. Have you asked her why she feels you don't meet criteria? Try to resist this temptation to regress because you haven't received the diagnosis you want. That is not going to help your case. There's a good chance it could actually turn things in a direction even less to your liking than trauma-related anxiety, like a diagnosis of BPD (nothing wrong with BPD, but it is heavily stigmatized).

You're right. I have resisted the temptation. The funny thing is I asked my last therapist what is the difference between my official diagnosis (PTSD from attachment trauma, developmental trauma) and BPD. He said, "not much". I guess I finally felt understood by my last therapist (we terminated just a few months ago) and diagnosis, and I feel hurt that I have to prove myself to yet another professional. It took me 20 years to finally get a diagnosis that seemed to encompass the vast majority of my symptoms.

 

[susannahsays]

Hmm, so if the PTSD was from attachment/developmental trauma, is that not what people call complex PTSD? I am absolutely not minimizing the traumatic nature of that type of trauma, but I am wondering if the reason this new therapist doesn't want to diagnose you with PTSD is because complex PTSD isn't really an official diagnosis yet. While many therapists and psychiatrists are fine with diagnosing and billing complex PTSD as "PTSD," they aren't actually the same and the specific criteria for PTSD often don't cover people who experienced attachment or development trauma (hence the movement for recognition of CPTSD). Maybe this therapist is more by the books and adheres to the DSM criteria. Are you sure you meet the criteria for PTSD?

 

[Nuance]

Hmm, so if the PTSD was from attachment/developmental trauma, is that not what people call complex PTSD? I am absolutely not minimizing the traumatic nature of that type of trauma, but I am wondering if the reason this new therapist doesn't want to diagnose you with PTSD is because complex PTSD isn't really an official diagnosis yet. While many therapists and psychiatrists are fine with diagnosing and billing complex PTSD as "PTSD," they aren't actually the same and the specific criteria for PTSD often don't cover people who experienced attachment or development trauma (hence the movement for recognition of CPTSD). Maybe this therapist is more by the books and adheres to the DSM criteria. Are you sure you meet the criteria for PTSD?

You have a good point. I am not sure if my current therapist is more black and white.

My last therapist said it was PTSD from complex trauma. Abandonment as a baby, living in several orphanages, painful reconstructive medical surgeries, emotional neglect (lack of consistent support and care) and adoption to another country before the age of 6 is what I perceive to have contributed to my "PTSD". I have struggled with and feared attachments/intimacy and people so much over the years that I didn't get into my first relationship until this year (almost age 30).

 

[bellbird]

So diagnoses are supposed to help us get better, right?
Not the diagnosis itself, but the subsequent treatments/therapies/medications that have been backed by research and patient trials to show they aid the recovery from the particular diagnosis.

They serve a purpose. And when we no longer meet the diagnosis, because we are better, then we no longer need it :)

For example, I used to have a diagnosis of MDD since early 2015.
I went to therapy and was put on a combination of antidepressants (with a lot of trial and error till we found the right combination).
Both helped to the point where in Feb 2019, I no longer met the MDD diagnosis; all my (much less frequent) depressive symptoms can be explained under my PTSD diagnosis. So I no longer had a need for the MDD diagnosis.

I felt like the diagnosis explained the symptoms that I have had for so long and actually helped me to get better.

However, my new one is hesitant to give me the diagnosis

You say that it helped you to get better; have you considered that it might be a good thing that you no longer meet the PTSD criteria?
Less invalidation, and more your condition has improved and your medical professional can see it too.

After all, that's what we're all aiming for, right? :)

 

[Ronin]

if the PTSD was from attachment/developmental trauma, is that not what people call complex PTSD?

Got a few threads about that lying around...

Developmental trauma aint yet mean complex, the two terms are not synonymous.

& In attachment trauma theories, last I knew what makes the issues PTSD worthy & not something else is never attachment alone... but legit criteria as a result of bad or absent parenting.

@Nuance
You can absolutely have debilitating symptoms from any condition...
Its not invalidating to say you no longer meet the criteria for one of many trauma disorders, being PTSD, but instead meet it still for other trauma disorder.

 

[susannahsays]

Got a few threads about that lying around...

Developmental trauma aint yet mean complex, the two terms are not synonymous.

& In attachment trauma theories, last I knew what makes the issues PTSD worthy & not something else is never attachment alone... but legit criteria as a result of bad or absent parenting.

I'm not 100% sure what you mean because your wording is a bit fuzzy. I didn't mean that attachment is an excluding factor. My intention was to honor OP's identification as having PTSD while also suggesting that there might be a technical distinction, as per the DSM, that this current therapist is using that means OP does not have PTSD.

The only way you can know is if you ask, OP.

 

[Nuance]

Got a few threads about that lying around...

Developmental trauma aint yet mean complex, the two terms are not synonymous.

& In attachment trauma theories, last I knew what makes the issues PTSD worthy & not something else is never attachment alone... but legit criteria as a result of bad or absent parenting.

I did qualify because I was an abandoned child with special needs, lived in several orphanages, had significant medical procedures, emotionally and sometimes physically neglected, and then got adopted to a foreign country all before the age of 6. It was beyond just bad parenting. :)

 

[Nuance]

Thank you all for adding perspective to this. I think I will sit on it for a bit to see if I feel like she's a good fit for me. :)

 

[Jade-]

No longer having a diagnosis is a good thing,not something to be upset over.

Are you upset/worried that you may no longer be eligible for social security @Nuance?