To ask about PTSD?

[MiMiPies]

Hi all,

I've had an appointment with a psychiatrist today as I'm under the CMHT and she strongly believes I'm suffering with PTSD. It's not something I've considered although I've had a traumatic childhood/teenage years e.g. emotional, physical and sexual abuse. I've thought I may suffer from BPD, bipolar, adhd or something along those lines but never ptsd.

I've looked online and don't feel I relate to the symptoms like don't get me wrong of course my childhood impacts me daily however I don't have flashbacks or nightmares about them and I'm just really confused about this diagnosis.

She prescribed me 50mg of anti depressants and 5mg of anti psychotics and will review me in 3 months and if this medication stabilise me they will then look at referring me back to the GP. I asked about talking therapies and she said I'm not ready for that yet and to take the medication but I'm confused because if I do have PTSD surely I need therapy and not just the six sessions a GP offers.

I'm feeling a bit deflated and not sure what to do? I'm not disagreeing with her as she's a doctor and obviously she knows what she's talking about but I'm just a bit worried and was wondering if with ptsd do you always have to have the flashbacks and nightmares?

Have a look into cPTSD which is a pretty different presentation to PTSD. And bear in mind that trauma can lead more to emotional regulation issues which can look like BPD or bipolar instead. It sounds far more likely that you have cPTSD than PTSD.

If it resonates, have a think about trying the medication as it might help but you also want to either access dbt (which is good for more than personality disorders), schema therapy or some EMDR. The Crappy Childhood Fairy is a great free resource on YouTube too.

Sorry, cPTSD = complex PTSD. PTSD is really a diagnosis attached to having experienced one traumatic incident. cPTSD is more relevant for repeated traumas and attachment issues.

Thank you. I could have misheard her as it was a bit of a stressful experience.

Cptsd seems more likely and has similar symptoms to what I do experience. I'll have a bit more of a look into it. Thank you so much z

I have cPTSD. The good news is it's iminently treatable. EMDR therapy has given me my life back - which I never realized had been impacted upon to the extent it was in the first place.

At first I thought it was a veteren's condition and was unable to relate it to my own experience. I had no idea what a 'flashback' was, or how it manifested. I had somehow pictured it as a kind of cinematic narrative: something visual that sort of unfolds in front of your eyes in montage. This isn't the case and it turns out I did have these, but for me the experience of a flashback was more a suffocating feeling, as though the emotions I felt at the time of the trauma were engulfing me, right there in the present. A smell, a quick trigger, could send me almost back into the experience. My DH said that on occasion when I talked about my abusive father, who I hadn't seen in years, my account was so vivid it sounded as though the event had happened yesterday. I realise that this is because, in my mind at that precise moment, it felt as though it was happening in the present.

Not all sufferers will experience all symptoms, but it does concern me that you've been prescribed anti-depressants. These will not work on cPTSD. What is needed is targeted trauma therapy. The go-to seems to be CBT, which is the first thing you'll be offered on the NHS. My own (private) therapist was of the view that this therapy was designed for use in a controlled, group environment and was never intended as a catch-all toolkit that you reach into every time you experience a symptom.

EMDR works by stripping the situation of all its emotion and enabling a clarity of vision and understanding, one that I at least had previously never thought possible.

cPTSD/PTSD are common, textbook responses to trauma. They are your mind working entirely normally, in response to an abnormal set of circumstances. I've heard it said it isn't possible ever to entirely recover - if a new trauma occurs you can certainly be retraumatised - but my therapist believes recovery is possible and now, so do I.

Wishing you all the best

Not all sufferers will experience all symptoms, but it does concern me that you've been prescribed anti-depressants. These will not work on cPTSD.

Anti-depressants don’t cure cPTSD but can lessen anxiety levels or raise mood enough to enable the person to engage in therapy to address the trauma. The first step in any trauma treatment is to establish safety - that might mean practical things like being removed from places or people that are unsafe, or addressing presenting symptoms so that the person has enough bandwidth to process their experiences through whatever therapy is appropriate.

@MiMiPies youre right in thinking longer term therapy may be needed but a short course of trauma based CBT will give you some skills to cope with dysregulation which is part of the cPTSD cluster. There’s a lot of overlap in presentation between cPTSD, ASD, ADHD and BPD so I’m not surprised you’ve thought it’s been one of those.

Thank you for the replies.

I don't know if she said C-PTSD or just PTSD. It's really very confusing.

I'm attending some life skill sessions to enable me to cope with therapy but I kinda think what's the point if they're looking to discharge me at the next review depending on how the medication goes.

They've actually had prescribed some medication I've said doesn't work although I haven't had 50mg of it before so I'll definitely take them to see if they help but I just have come away feeling a bit lost and confused about it all.

Several years ago I was assaulted at work by a patient. Leading to me starting with anxiety. Several people told me it was PTSD including the GP.
Someone described it to me as the fight or flight response which makes previously not very anxiety inducing situations where you might feel slightly nervous such as going to a new location, causing anxiety which is more debilitating. I won't go into all the ways it has changed my life.
At the time I had counselling paid for by my employer, didn't really help because I felt I could talk about it with friends and family anyway but what relates to your situation is that I was referred to the MH service and had a triage on the phone but was told that because I had answered 'no' to the question about flashbacks it wasn't PTSD and they made it fairly clear they wouldn't be helping me.
Still dealing with anxiety daily which I have never had in my life before and people actually think I'm a very strong person mentally because of how I act and present at work and in life.
Good luck with everything, I know I haven't had childhood trauma particularly and many people like yourself have much more to deal with than me but flashbacks is a poor phrase in my view and they should stop using it as a diagnostic.

'EMDR works by stripping the situation of all its emotion and enabling a clarity of vision and understanding, one that I at least had previously never thought possible.'

@SerafinasGoose
Hope you don't mind me asking, when the emotion-stripping is taking place, do you feel the sensations of the emotions in your body?

Yeah the description of flashbacks is really shit on most mental health websites. They usually only talk about the visual ones that some people get, but don’t mention that a flashback can also be getting sucked into the emotional stage and having a meltdown and repeat thoughts. Instead they often describe them as film like hallucinations but that’s not the case often.

I’ve been diagnosed with ptsd even I get mostly emotional flashbacks instead of visual, and the assessor said it’s still ptsd. So no point clinging too much on the division. I found CBT helpful where we went through the incident.

I don't mind at all.

No, the therapy doesn't induce flashbacks per se, not in my experience at least. Revisiting any past trauma is of course painful. But I was guided through the process - it was quite long, took around 18 months - and at various stages asked to scale my reactions to those experiences from 0-10. It was quite satisfying watching them go down.

The memories can't be removed, but the objectivity it eventually enables has to be experienced to be believed.

It's caused other shifts to happen, too. For eg. the gut instinct, what Mumset refers to as 'spidey senses', I didn't possess. Long before the cPTSD was diagnosed it did occur to me to wonder why, as a fairly clued-up person in many respects, I was such a terrible judge of character and couldn't pick up the cues when someone wished me harm. There were also anomalies in the way I interacted in my most intimate relationships, which I quickly learnt to hide.

The explanation I received was that, when you live in an abusive, threatening environment for a long time - especially dating back to childhood - those instincts are switched off. This is because no one can live in a perpetual state of fight, flight, freeze. And they didn't switch back on again until after this therapy. It must be hard to imagine, but if you've so effectively repressed those survival instincts and gut feelings, to suddenly have them switched back on again when you hit your forties is quite the revelation.

I also find it much easier to say 'no', and am no longer a people pleaser (I'd have baulked at that suggestion before therapy, but I was). It has, in fact, radically changed the way in which I interact with people (ie colleagues and those on a superficial level rather than those close to me).

I had no idea I was traumatised until a trigger (sexual harassment) caused the symptoms to intensify to the extent that I became really ill. But this therapy has been miraculous. Even I'm taken aback at the change, and my husband says I'm like a new woman!

Interesting reading these comments, I have cPTSD and tried EMDR therapy. I really didn't do well with it and im not sure If it was just the therapist and weather or not to give it another try.
She got me to tap my shoulders and talk in detail about the traumatic events while imagining a wise owl was looking on and what advice the owl would give me to move past the trauma.
I haven't internalised my trauma as being my fault though and didn't really see how this would help.
It did help me realise I carry internal shame.. had no idea and thought I fully understood that events that traumatised me were on my abuser. This was useful and explained why I sometimes struggle with friendships.
Anyone else who has had EMDR experienced similar?
(Just to add I know it's usage eye movement therapy but I couldn't do that for medical reasons, hence the tapping.)

Just to add op.. talking therapy can be hard and very emotionally challenging, I can see why anti depressants would be suggested before. Just to get you to a better place. All the best,

After speaking to the psychiatrist, they agreed with me and they have officially changed it to C-PTSD so thank you for all your help on this thread x