CPTSD

[NaToth]

My GP thinks I have cPTSD as a result of abuse of varying sorts throughout my life. She offered me anti-depressants, which I refused, and referred me to IAPT. They confirmed that I am not depressed, but I did acknowledge some anxiety, although it is specifically targeted. I am not generally anxious.

IAPT referred me to another organisation, who have assessed me and put me on the waiting list for counselling. The assessment was very hard. It lasted nearly two hours, which was much longer than I was expecting.

I came out feeling exhausted and went straight to bed when I got home. That was two days ago. I still feel exhausted and as if I am detached from life around me and sort of floating along, in it, but not part of it. it's a very strange feeling.

I’m worried about being assessed and then having to wait months to actually start counselling. It feels like prising the lid off a box, looking at the contents and then slamming the lid again. I know what’s in the box, but I can’t do anything about it. It's not a nice feeling.

I've got a review with my GP next week, but I'm not sure how to play it. In view of what she thinks is the diagnosis, even though I don't think she's qualified to make that diagnosis, should she be doing more than leaving me to wait well into next year for support from a voluntary organisation?

Anyone?

As I understand it, there's little more she could do for you on the NHS these days, I'm afraid. She has offered you medication, which you declined, and referred you to IAPT, who have referred you on to a voluntary counselling organisation. (Presumably because they felt you needed something other than a short course of CBT?) Although you've found the assessment deeply upsetting, that's an unfortunate experience which many people seeking help for mental health issues through the NHS are having at the moment, because severe cuts to provision in the last 10 years have created a situation in which state provision relies more and more heavily on charities to take up the considerable slack.

You might be able to push your GP for referral to a psychiatrist, who would be able to make a qualified diagnosis, if that's something you feel is important for one reason or another. (It can help with claiming sickness and disability benefits, for some people, for example.) But assuming your GP referred you (many will resist doing so these days for funding reasons) the psychiatrist would also ultimately only offer a medication recommendation in addition to any diagnosis. As far as I'm aware, there's little or no scope anymore for more in-depth psychotherapy or counselling on the NHS.

Can you afford to self-refer to a private therapist/counsellor? That would mean you may get relief more quickly from the uncomfortable and painful feelings your recent assessment has evoked.

IAPT would be totally inappropriate for CPTSD as it necessitates longer term therapy.

So although it's really frustrating and distressing it is a good sign you've been referred and already assessed by a more appropriate organisation.

still feel exhausted and as if I am detached from life around me and sort of floating along, in it, but not part of it. it's a very strange feeling.

Sounds like dissociation, which is common with trauma.

How much reading have you done about CPTSD? Starting to read and learn a bit about it and what's known to help may be useful to you generally and make you feel like you're not totally helpless while you're on the waiting list.

Maybe you could start with looking at dissociation (the mind website might not be a bad place to start) to help you with coping strategies for how you're feeling right now?

The assessment was gruelling and sent your nervous system into such a heightened state it's basically disconnected you from everything possible as a way to protect you. If you can find ways to comfort and reassure yourself and reconnect with the present, it will hopefully help you reduce that state back down to a normal level.

Be aware as you reduce it you'll reconnect with your emotions at some point. don't panic, remind yourself they're old feelings and will pass, and keep taking care of yourself until you get back down to baseline.

You're in hypoarousal (red traffic light) right now where everything has switched off, if you can reduce your body's sense of being threatened you'll come down to hyperarousal (amber) where your emotions will be there again, and then down to normal arousal (green) where you feel connected and in the present. (If you Google trauma arousal states traffic lights there are resources that might help.)

Oh, also, it's a really good thing a GP has recognised CPTSD for what it is. You would normally have had to have made it to a clinical psychologist to get that recognised.

I would be wary of pushing for a referral to a psychiatrist unless it's as a route to a referral to clinical psychologist.

CPTSD is not a diagnosis a psychiatrist will make. It hasn't been added to the DSM/ICD. A psychiatrist will only diagnose PTSD.

But you'd be at risk of ending up with a toxic psychiatrist who'd label you as having a so-called personality disorder and block you from the treatment you need. (I'm not anti psychiatrist, but unfortunately this area is grossly inconsistent and traumatised women can be badly let down.)

If you're already on a pathway for CPTSD treatment in accordance with NICE guidelines I really would stick with it.

Excellent posts from penguin

My post reads back badly, I realise, because what I meant was that charities are often under-resourced and under-funded, so they struggle to provide shorter waiting times between assessments and starting treatment. Not their fault, the govt have crippled the NHS and left it up to voluntary organisations to rescue people with serious mental health problems

But as penguin said, you might already be on a good treatment pathway, even if it takes longer than you had hoped, and in the meantime there's some literature on cPTSD you can read for support. Pete Walker's 'Complex PTSD' is pretty comprehensive and he writes about us very empathically.

I know BPD (EU) gets a bad press from many, and can leave a lot to be desired as a diagnosis at times, but not every mental health professional disdains sufferers. I was assessed for a pain management programme this week and the psychologist I saw was brilliant with me. We discussed my BPD diagnosis and she was the first one to talk about it in terms of complex trauma and the early invalidating environment. So take heart ♥

Hi op, just a couple of points from me, as you already have some good advice here.
Unfortunately a lengthy wait after a good assessment is the result of appropriate assessment/treatment. Be reassured that the information should be forwarded, so you don’t need to repeat your conversation fully.
Opening up is very difficult, and you have control over that right now. Don’t overshare too early if it is too difficult. Let the experts guide you if you’re unsure, and tell them how this has made you feel. Your readiness is important.
Sometimes people decide they’re not ready to open up due to this process, and that’s ok, but remember you are in control of that part.
There are usually helplines or handouts your gp may be aware of that could help you with some self help grounding/stabilisation work while you wait.
Good luck op, And well done for getting help

Thanks everyone. That’s really helpful.

I have now seen the GP again and she seems happy to let me wait for me to come to the top of the waiting list for counselling, although I know that is going to be months. I explained that I am still not sleeping properly and she has given me Zopiclone, although she says it won’t give me any restful or restorative sleep! I’m holding off taking them for the time being. I need to be up early for work and I’m not sure they’re compatible.

I still feel pretty awful, but I guess I am just going to have to be patient.

I'm in the same boat so sympathise. Over a year of being pushed from pillar to post, 4 assessments and now waiting for yet another assessment for the service who referred me in the first place. No help on the horizon until at least February. It's just not good enough.