Would Going Back On Medication Be A Step Backwards?

[Anarchy]

I guess I just assumed everybody who suffers from PTSD also experiences depression to some degree.

There is an interesting question in there, of whether what is termed depression in general and in PTSD in particular, is one state or several different internal states that all look similar from the outside.

Arguably, what a lot of us with long term traumas and early traumas experience is a state of learned helplessness and loss of self agency, we are not down so much as triggered into a state from the past in which resistance was counter productive or futile, often that is accompanied by hyper arousal with raging stress hormones, anxiety and physical states associated with massive stress arousal and activation of the sympathetic nervous system; tense muscles perhaps even going on to fibromyalga, stomach churning and acid reflux, tight chest and high blood pressure perhaps even difficulty breathing, constipation and possibly irritable bowel, and a mind that races away trying to find ways out

Tied in with that is the impossibility to make plans - because when you are in that state, immediate escape is the only priority your brain has.

In the extreme of triggering or stress, the parasympathetic nervous system (which normally relaxes the systems once the danger has passed, that the sympathetic nervous system had activated) shuts everything down,we dissociate and go limp like a rag doll, there's a good chance of our bowels and bladder emptying, that's a survival trick for when our ancestors were captured by a predator, to fool the predator that we were already dead and so didn't require a killing bite or killing blow to finish you off. Ive gone like that a few times, normally while getting the crap beaten out of me - literally.

I'm not sure how frequent a "depressed" depression is, but what gets called "depression" in PTSD, isn't - it's a state of learned helplessness, or of exhausted long term hyper arousal.
_________________

I'm currently reading this http://www.bookdepository.com/Neuro...elopmental-Trauma-Sebern-Fisher/9780393707861

If the results are widely replicable, then it seems to offer the possibility of a quick route to calming the limbic system, and allowing you to make gains in therapy. It's still considered "alternative" but then it does have to compete with big pharma and it's marketing department budgets of £billions

As soon as I get my job situation and finances straight, I'll be giving it a go.

 

[Anarchy]

Hi Mit,
Hoping you are ok,
Read something last night that I think will interest you. I'm going to be posting the guts of it in a thread of its own as there seem to be several members struggling with suicidal feelings at the moment.
Hugs and best wishes

:hug:@

I've started reading Miller, Rathus & Linehan "DBT with suicidal adolescents" http://www.bookdepository.com/Diale...uicidal-Adolescents-Alec-Miller/9781593853839

In one of the early chapters there is a review of clinical evidence for the effectiveness of different approaches for reducing suicidal ideation, behaviours and completions.

They break this into two basic approaches;

• Addressing "conditions" such as depression which are associated with elevated risk of suicidal behaviours, in the hope that once the "condition" is gone, the suicidal behaviours will go too.
• Directly targetting suicidal and para suicidal ideations and behaviours, including non suicidal self injurious behaviour (NSIB).

Bear two things in mind while you are reading what follows, The book was published in 2007, a lot could have changed in the academic literature in the 8 years since then, that I am not aware of (I'm an interested amateur, not a full time academic).
Also, bear in mind that absence of evidence does not constitute evidence of absence.

OK, The first approach of treating underlying "conditions" such as depression, using medications had only 2 studies! neither showed any statistically significant effect on suicidality. The raw results - and these are not statistically significant, they could be due to purely random factors, showed lower suicide rates with the placebo than with either SSRI or SNRI anti depressants. That said, the SSRIs are known to double the rate of suicide completions in depressed adolescents, and several of the clinical trials of SSRIs specifically excluded suicidal individuals.

Again, there do not seem to be studies showing an decrease in suicidality from treating depression with talk therapies such as CBT.

In terms of directly addressing suicidality, There are various codes of practice/ procedures / whatever in various places for dealing with people presenting with suicidal ideation, plans, actions etc. Again! there is an absence of studies demonstrating a positive effect.
One thing which did work for two years after presentation, were personal letters from the person who had received the suicidal person and dealt with them - wishing the suicidal person well. By five years, this effect was no longer demonstrable.

There was also no evidence that hospitalization or inpatient stays were any more effective than the person attending appointments and living at home.

Certainly, by the time the book went to press (2007) the only approach with multiple clinical studies showing reductions in suicidal and parasuicidal behaviours was Dialectical Behavioural Therapy. The early studies were with chronically suicidal women, diagnosed with "borderline personality disorder"

That is as far as I've got with my reading to date.
@

 

[The Albatross]

Check in Mit? How you going?

 

[Mit]

Hi - thanks for the information and messages. @Anarchy the book looks really interesting, I'd be glad to hear more as you work through it, if you have time.

I was on an upswing, or so I felt for a couple of weeks, but I couldn't hold on to it. I'm not sure exactly sure why (and never have been). My youngest son has been subject to some pretty awful bullying type behaviours very recently which have left him very isolated (he's 14). I've done my best to find out what is going on, which hasn't been easy because it's taking place outside of school in the village in which we live, but I had suspicions which have been confirmed. I was incorrectly 'labelled' as being a potential risk to children five years ago by social services. I was forced into telling close friends by social services what they thought about me. Since then we lost all our friends and rumour and gossip has spread so that many more people believe they know something about me. Word has reached local kids that are or were friends of my youngest son and now this misinformation is being used to bully and isolate him. I don't know how to protect him from this and as you would guess feel I am totally responsible. Seeing him so alone and upset is more than I can bear, it's so destructive.

I've not been sleeping much so asked my GP for tablets for that. I didn't know the therapist I have been seeing recently had written to the surgery because of my mood and warning about requests for tablets. They won't give me anything unless I go with my partner and she takes control of any medication. I haven't told her or gone back to the surgery yet. I did want tablets to help me sleep. I also wanted to accumulate some, like I did before, so I have options. I'm still going to work, just, but I don't do anything - it's a matter of time before I get caught out.

Therapy has been postponed for three weeks at least. It may be coincidental but two weeks ago, the therapy session was amazing. Initially I felt exhilarated, I actually started to believe some things I had been denying or hiding away all my life. Then some how these positive truths became problems for me and it turned inward. The therapist says I'm twisting things so I can continue to beat myself up, and maintain responsibility for distant past events beyond my control, the opposite of what we were trying to achieve. The therapist has postponed future sessions. She thinks we are moving much too fast, but because I am limited to six sessions she also has little choice but to try and get to the root of issues within the time constraints imposed by the NHS. It's the one thing I can see, that the approach to mental health services here is so bad that it is dangerous.

Thanks for the kind thoughts, you are very kind friends. mit

 

[Mit]

I thought it might be nice to update this thread, particularly in response to the warm and caring support I've received.

I haven't gone back on medication, or obtained means to self harm. Over the last three weeks I've calmed down, and had no major anxiety attacks. This is despite some significant events that could well have triggered anxiety. My youngest son who was being subject to bullying and isolation by local Kids because of rumours that his father was a sex offender has responded by finding new friends. He's been amazing and now has a new circle of friends with whom he seems happy, at least at the moment.

My eldest son (15) spent three days in hospital this week due to a severe asthma attack. I stayed in the hospital with him the whole time. He's out now and doing ok. I didnt react, either to the distressing sight of him being unable to breathe or having to virtually carry him into A&E. Neither did I react to being in the hospital despite my own history of medically induced trauma. I've been very scared for him and had memories triggered being in a hospital. But I've not had a major anxiety melt down, which I think is pretty remarkable.

I saw the nhs therapist yesterday. First time for a month. I was able to tell her how I had coped with recent events. And I was able to tell her that over the last month, thanks to her help I finally did recognise that I suffered enough during my childhood to be affected and traumatised by it. I could now see it and accept it as the truth. I no longer believed it was my fault or I was weak to have been so affected, or to have developed the coping strategies I did.

The therapist was so moved by this she cried, as did I.

I fully expect some bad spells to occur in the future. But I feel I am making progress, and in no small part thanks to the care and support from you all. So thank you. X

 

[ms spock]

That is so great to read @Mit!

 

[Anarchy]

That is one hell of a set of personal achievements.

Congratulations:hug::tup::hug: