What Are The Main Differences Between Ptsd And Complex Ptsd?

[Butterflywings]

No I actually agree with what Havard have said about "remission" but the "remission" they refer to is not a full cessation of symptoms. No longer meeting the diagnostic criteria is not the same as being free of mental illness. There is such a thing as sub-clinical levels of mental illness. The person is still troubled by symptoms but their symptoms do not meet the full criteria necessary to have a diagnosis. Depression is a good example - there are many people who have major depressive disorder. They can have episodes of "depression" that do not meet the full criteria for a major depressive episode or dysthymia, but their function is still affected. They are technically in remission, but they are also not symptom free either.

The remission Harvard refers to is that - they do not meet enough criteria for a diagnosis, but they are not symptom free either. A person can still be trouble by borderline traits while not having borderline personality disorder.

I don't see any flaws at all in their study as to how they evaluated technical remission. Just some people misinterpret technical remission as being symptom free. Remission does not equal totally symptom free. It just means that according to the criteria they used (DSM IV) the person fell below meeting the necessary 5 out of 9 criteria for having BPD. These people who are considering "in remission" generally remain troubled by 3-4 of the criteria of BPD. They are not symptom free, they are just not technically considered to have BPD. Generally most professionals will describe them as having "borderline traits".

Have you ever come across a study that shows that a person with BPD has ever become symptom free? Meeting none of the 9 criteria for BPD? I am yet to find a study that has that and I've spent years looking.

I have seen various rates given for the suicide rates of BPD. It's not always easy to ascertain as most studies only look at the rates of suicide during the course of the study. 5% during the study is a really high rate. The lifetime rate appears to be around 10-20% depending on which study you use. Even if on the lower end, 10% is a really high rate of suicide. And that does not include those who attempt suicide and end up seriously disabled but alive as a result.

Not sure why you are linking suicide as somehow being equal to remission. I never said anything remotely like that. I spoke about remission in those that have not suicided. Because of the high suicide rate, those who are still alive in middle age are the ones more likely to enter "remission" (again "remission" does not equal symptom free).

I'm not sure where the discussion of psychotic symptoms came in, but yes, research has found a large number of people with BPD do have suffer from psychotic symptoms. link to follow "they have found evidence of a malevolent interpersonal evaluation and a significant proportion of BPD patients showing psychotic symptoms. For example, in one study, 24% of BPD patients reported severe psychotic symptoms and about 75% had dissociative experiences and paranoid ideation." Paranoid ideation being a psychotic symptom and one my exhusband had quite severely as part of his BPD.

It's not DIAGNOSTIC symptom, it is however a common symptom for those who have BPD but not one used to diagnose BPD. IT is the same as recognising that a high percentage of people with BPD have suffered trauma - it is not a diagnostic observation but it is a useful observation for treatment.

How many people do I know with BPD? If you take into account everyone I know who has been labelled with it, that would be thousands. Literally every second person I look after with at work is either diagnosed with BPD or borderline traits. Possibly higher than 50%. It depends whether I'm working in a high acute area or a long term treatment area. But people with BPD tend to come back a lot even in the acute areas so get to know them pretty well. The people I look after have their employment situation (past, present and future aspirations) documented in their file.

Or if you're referring to work colleagues who disclose, it's not exactly something that can be hidden. Yes there are a number of people I work with who have diagnoses of various things, and everyone is pretty open. And those that are open, well sadly the gossip mill gets them and as much as I try to stay out of being involved in gossip, it's impossible to not overhear. Not one single person I've worked with has ever been diagnosed with BPD or shown any traits of it. NPD? for sure. Met quite a number of doctors who fall on the NPD spectrum, but no one that shows traits of BPD at all.

Please don't conflate diagnostic criteria with expressed behaviours. Of course not being able to work in certain fields is not a diagnostic criteria. But it can be a common outcome. Parts of the diagnostic criteria of BPD are "frequently experience distressing emotional states, difficulty in relating to other people," etc. How can someone help a consumer who has come for help if they constantly are alternating between idealising and devaluing a person? how can they help a consumer if they cannot handle being exposed to strong emotions in others? Not to mention it would do to the poor person with BPD trying to cope with everyone else's problems as well as their own. Think about it for a minute...

And protest too much? Nah. It's just on my mind because I'm helping a friend prepare for their attempt to try and sue for mistreatment. Don't think it will get far, but a promise is a promise and it's professional area of interest for me and something I want to do a PhD study (misdiagnosis of BPD and the mistreatment that ensues).

I need to stop getting distracted though if I'm going to actually help my poor friend.

 

[Lady of Longbourn]

Literally every second person I look after with at work is either diagnosed with BPD or borderline traits. Possibly higher than 50%. It depends whether I'm working in a high acute area or a long term treatment area.

Where do you work?

 

[Butterflywings]

It won't let me put the link in. But the study I was trying to link is: Borderline personality disorder and psychosis: a review. Curr Psychiatry Rep. 2010 Jun 12(3) 186-95.

Actually, she does change her mind on that for exactly that reason, and she writes extensively about why she does.
You don’t seem to ever take responsibility for your own writings or actions. You tell others they are making broad generalizations while making them yourself, again and again. You state very clearly that people with Aspergers can’t change their minds, and then you attack others for saying the same, and then you say they took your words out of context. Could it be possible that your words were not clearly written by you to begin with?

I've read a lot of Temple Grandin's work and never once come across where she has changed her mind about whether or not something is the right thing to do because someone told her "oh that's just because it's the socially accepted thing to do". She might have changed her mind to follow the socially accepted way of doing things, but never once have I heard her say it's the correct or best or better way to do things. Just that she will do it. There is a huge difference between agreeing to do something and agreeing that is correct. I do a lot of things to please my husband because I love him... doesn't mean I'm remotely agreeing it's the better way to do things. Changing behaviour to fit in or make someone (or lots of people) happy is in no way the same thing as agreeing with that behaviour.

I never once said aspies can't change their minds. I said you have to approach them with logic to get them to change their minds. There is a huge difference. You have taken my words out of context.

What I have repeatedly said is you cannot get an aspie to change their mind, UNLESS you have to give them a logical reason to do so. How does that in any way even imply you cannot change their mind? Perhaps you are mistaking half a sentence for the whole and missing the conditional nature of it. The first half of the concept (before the word "unless") is conditional on the second half of the concept (after the word "unless"). To only read the first half of the concept and ignore the second half is very much taking it out of context.

I did not write it. Please re-read. I quoted an article. Again, you confused my quoting researchers, and linked articles, as my own statements.

And now you're just being pedantic. You wrote it. It's not someone else's post. I never said it was your own belief. Although you did imply it was your belief. What I said is just that you wrote it - no one else typed it in for you, no one else hit send for you etc. Or would you prefer I write "you cut and pasted it" if you'd like to be pedantic? I have not confused anything. I know exactly what you meant. Ok let me rephrase if you have an obsession with semantics:

I think what you typed into your reply that is quoted from researchers that I repeated using the quote feature sums up what I'm trying to say about BPD "relapse, or the recurrence of full-blown symptoms after remission, is rare." Full blown symptoms do not come back after remission, but the underlying less severe symptoms never full go away. I would consider that only partial remission not full remission.

Is that sufficiently semantically correct for you?

You state very clearly that people with Aspergers can’t change their minds, and then you attack others for saying the same, and then you say they took your words out of context. Could it be possible that your words were not clearly written by you to begin with?

Some other things weren't clear, but that was and I never stated (clearly or unclearly) that people with aspergers can't change their minds. I honestly have better things to do than have my words twisted by someone trying to pick a fight. My baby is due for a feed in 15 minutes and while I'm happy to discuss the topic at hands, there is nothing to discuss if you're going to argue wording and misrepresent stuff I've said into being the opposite of what I actually said.

If you have anything related to the discussion and not discussing the semantics of how something is worded, I will probably be back tomorrow.

 

[Butterflywings]

Where do you work?

For privacy reasons all I can say is I work for public mental health. I work across multiple facilities include inpatient units, crisis assessment team, in hospital assessment unit, older persons inpatient units, a boarding facility for people with schizophrenia, community mental health and more. I wish I could share, but while I'm open with my colleagues about having PTSD and depression, it's not considered appropriate (by either me or my employer) to share that I have those diagnoses with consumers (actual or potential). I don't think they're going to approve me to do the PTSD consumer presentation I volunteered for the same reason even though I think it would be good for other people with PTSD to see that it really can effect anyone and that professionals (at least some) do understand it.

 

[Lady of Longbourn]

So you have a psychology or social work degree?

 

[Butterflywings]

Plus... I have revealed personal information about my family in posts and in my line of work, it's not something that is always safe to have all consumers know that kind of information. It's rare, but every so often stalking cases happen. Half of my coworkers will even hide their surnames on name badges for fear of that. I'm not quite that worried (paranoid?) but I have just enough worry to not give out too many personal details.

 

[Butterflywings]

Ayesha I have a nursing degree, a psychology degree and a science degree (in stuff related mostly related to mental health). The psychology and science were a dual degree done at the same time -basically so I could do extra subjects in related fields. I went into nursing despite having the grades and passing the exam to study medicine because nursing has part time study options, medicine does not and I had a family to take care of (including my very unwell first husband at the time). I'm currently in the middle of doing postgrad studies. My mum keeps nagging me to go back and do medicine and become a psychiatrist, but I don't see the point. I love my job, I have far more patient contact and follow up than psychiatrists do and I am not on call for long periods of time like the psychiatrists are. And baby is awake so I will say goodnight for now

 

[Deleted member 1860]

@Butterflywings,
It sickens me that you're a professional who has no ability whatsoever to remain objective about anything! A lot of the "evidence" you push as fact is nothing more than your own opinion with no scientific research to back up what you say. I'm glad we're on opposite sides of the planet as I won't risk running into you in a professional setting!

Edited To add...
I think you should examine why you are here. Is it in a professional capacity or in a sufferer capacity? Honestly, most of us don't need lectures from professionals. We come here for peer-to-peer support. I advise you to choose your position wisely as most of us can get "therapized" out in the real world. We come here to find others in the same boat.

 

[Lucycat]

For those actually interested in the original topic of this thread I have now added the links in my previous post as promised.

here.

 

[Justmehere]

@Butterflywings - for a mental health care professional, the way you state your opinions certainly makes me feel like crap. I find these subjects very interesting and helpful for me to understand other viewpoints. I keep asking for clarification and data so I can understand your viewpoint better.

Instead, you give more acedotal stories that I don't follow well, and now throw in what feels like character attacks and belittling comments towards me.

This is not about "semantics" and your comments to me feel very demeaning to me. My statements are about content, which is apparently not coming across clearly to you because you say you agree with things that you then misrepresent the content of. I attempt to clarify, ask you for support of your opinions and claims, and you respond with character attacks - that doesn't really help me understand your position or complex PTSD vs PTSD (the whole point of this thread) any better to just attack me as pendantic or caught up in semantics or obsessed. If that's all you got, then your claims hold even less weight.

You say you have Aspie traits, and many loved ones with Aspergers -- I am surprised that my high attention to detail is something you attack and criticize and belittle.

And now you're just being pedantic. You wrote it. It's not someone else's post.

Actually, it is someone else's published article. It would be plagerism to claim I wrote it. It's an important detail.

You said you disagree with me, my opinions, what I wrote and then quoted my quote of an article written by researchers as what you disagrees with. You didn't actually lost an opinion or statement of my own that are my own words as something you disagreed with but quoted the researchers.

If you feel this is pedantic fact to point out, a useless focus on details... then we disagree about the importance of using data, authoritative sources, the value of not commiting plagiarism, and making sure details are correct - something I personally do highly value. For a reason.

Let me restate my point in clarifying this important detail more clearly: Disagreeing with me, a random girl on the internet is one thing. Disagreeing with multiple researchers and their published data is another thing.

I think what you typed into your reply that is quoted from researchers that I repeated using the quote feature sums up what I'm trying to say about BPD "relapse, or the recurrence of full-blown symptoms after remission, is rare." Full blown symptoms do not come back after remission, but the underlying less severe symptoms never full go away. I would consider that only partial remission not full remission. Is that sufficiently semantically correct for you?

Since you ask, no, I do no believe you are semantically or factually correct. (You just repeated what you wrote before, and I disagreed with it as being correct before.)

This is the quote from the article that you say you agree with;
“Some symptoms of borderline personality disorder may come and go, but the core symptoms of highly changeable moods, intense anger, and impulsiveness tend to be more persistent.34 People whose symptoms improve may continue to face issues related to co-occurring disorders, such as depression or post-traumatic stress disorder.4 However, encouraging research suggests that relapse, or the recurrence of full-blown symptoms after remission, is rare. In one study, 6 percent of people with borderline personality disorder had a relapse after remission.4”

They say the patients suffer from symptoms of co-occurring disorders, not BPD. Only 6 percent of people with BPD relapse.

You believe no one can have any remission, or that if there is remission, it is only partial. That is not at all the position of the article you say you agree with.

The researchers feel the disease does go away, i.e. no symptoms qualifying for a diagnosis - not that the symptoms are less severe or that there is partial remission.

In fact, in the studies they make a big deal out of the difference between patients in the studies who did have a decrease in symptoms, which you call partial remission, ****and they did not include people with a decrease in symptoms who still had less severe symptoms in the data as people who had full remission.****

You incorrectly assume that the people the researchers classified people as being in "remission" still had symptoms, only less severe ones. The researchers make it clear in the study that there are some patient who do only have a reduction in symptoms, but they are not considered in full remission by them. You can not discount the percentage of patients in remission in the study as just being less symptomatic but still having symptoms and still have BPD. That's a factually incorrect understanding of the researchers claims.

The researchers state so so clearly in what you date you agree with that people may have symptoms.... but of other disorders, not BPD! If I have diabetes and asthma, and my diabetes goes into remission, but I have symptoms of asthma still, my symptoms of asthma that are still there doesn't mean that I have diabetes again! Asthma was the co-of cuing disorder that is remained. That's similar to what the researchers say.

They are not saying BPD symptoms are still there or come back, in the studies they link to, and briefly in the quote, they talk about how people with BPD and PTSD, who experience remission of BPD will often still have PTSD. That doesn't mean the BPD came back. Or that it's not full remission of the BPD.

I'm not going to discuss Autism any further as it is way off topic from what this thread was originally about.

Going back to the original topic of this thread, complex PTSD...
In regards Io Judith Herman, she is a huge proponent of replacing BPD with complex PTSD as a diagnosis.
Dead Link Removed
"Attachment theory, BPD and C-PTSD
C-PTSD may share some symptoms with both PTSD and borderline personality disorder.Dead Link Removed Judith Herman has suggested that C-PTSD be used in place of BPD.Dead Link RemovedDead Link RemovedDead Link Removed"

I do hope you post the links to evidence to back up your many claims about complex PTSD and BPD. To post links, all you have to do is copy and paste the URL into the same screen you type the post. I would love to read where you get your information from. Let me know if you need more information on how to post links to your sources.

 

[Justmehere]

Please don't conflate diagnostic criteria with expressed behaviours. Of course not being able to work in certain fields is not a diagnostic criteria. But it can be a common outcome. Parts of the diagnostic criteria of BPD are "frequently experience distressing emotional states, difficulty in relating to other people," etc..

How can someone help a consumer who has come for help if they constantly are alternating between idealising and devaluing a person? how can they help a consumer if they cannot handle being exposed to strong emotions in others? Not to mention it would do to the poor person with BPD trying to cope with everyone else's problems as well as their own. Think about it for a minute....

I have thought about this, and I don't understand what you are saying. I don't see how I'm collating anything inappropriately. You are the one who is so convinced BPD = unable to do certain jobs in all cases. I do not feel that those two things belong together.

How can someone help a consumer who has come for help if they constantly are alternating between idealising and devaluing a person? .

As a mental health care professional, I would think you would know DBT therapy is extremely well suited to helping clients who split (idealize and then devalue) a helping professional. If the helping professional insists on always being seen as being the "helper/savior" role by the client in order to help them, then yes, perhaps that helping professional couldn't help them. But BPD can be and is treated and does improve and go into remission for many people - even without treatment (see the studies I cited).

It seems like you believe people with BPD can't possibly care for others and their problems because their own problems are too big. DBT therapy, originally. developed to help BPD, encourages people with BPD to help others as part of the way to recover from BPD.

It seems clear that no matter what, you are convinced people with BPD are quite incapable folks and do not really ever get well or recover.

So, what does this have to do with Complex PTSD? Is your premise that BPD can not be a part of un-official complex PTSD diagnosis because people with PTSD get better, while people with BPD don't?

Is that your whole point in trying to claim again and again that people with BPD don't go into remission? Do I understand correctly?

 

[Lucycat]

that people with BPD don't go into remission? Do I understand correctly?

My interpretation is;
'people with BPD don't go into remission therefore I can't have BPD'

I can understand that. Many people - whether diagnosed correctly or misdiagnosed- are afraid of that particular label. I think Health Professional could do much more to reduce the fear and help people to accept and understand their diagnosis. Education is key, and no professional should be able to give a diagnosis without the associated psychoeducation and further sources of information.