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I have a friend that says he has PTSD. He hasn't worked in over 10 years. From what I can see, he is perfectly normal, but who am I to say how mentally healthy he is. Anyway, please tell me about PTSD. If you feel comfortable sharing, how did you get it? Is it something you can overcome? How is it diagnosed? I'm trying to understand my friend better. Is it always stemming from a single incident or can it come from a string of similar experiences? Does it show up immediately or is it a delayed reaction sort of thing?
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Apr 4, 2019 22:57
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| # ? Apr 25, 2024 05:28 |
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Most folks who meet me probably wouldn't think there was anything wrong with me. For instance, there was a time when I was in graduate school and I was basically having a slow mental breakdown as I first started realizing I had been abused pretty badly as a kid. I had a classmate who I'd shared a few classes with, and when she found out I was taking a year off from school, she was kind of shocked. I think she had this "You? But you're the most together person in the class!" sort of reaction. There were a few subjects in class that I had a knack for, and I was able to discuss them pretty readily, and I usually dressed pretty formally for classes, so I think people saw me and thought I must have been having an easy time with things. But the truth was, I took 3 semesters of graduate school over the course of years and I wasn't able to fully complete a single one of them. My mental health was just horrendous. I would cry in my car almost every day. I had nightmares and flashbacks all the time. Taking a shower would trigger me, so sometimes it would take me twice as long to finish taking a shower just because I'd find myself freezing up in the middle of washing my body, and I would feel mentally drained afterward. I spent most of my time totally wound-up and on edge. I think something that you see pretty commonly in people with PTSD is dissociating from what's going on when you need to scrape by. Basically, part of your brain turns itself off and pretends like things aren't happening. It's one of the things that keeps you from looking hysterical in public. Instead of having an outburst, you kind of quietly shut down. You store all the tension and stress inside yourself so that it comes out at some other time. For what it's worth, my best friend/ex-boyfriend lived with me for 5 years, and when I told him I had PTSD I think he thought of it as me being overly sensitive and kind of emotionally weak. I want to underscore that: he lived with me for 5 years. It wasn't until after I moved out, and ended up having a mental health crisis that was bad enough that I admitted myself to a hospital psych ward, that he finally realized that I wasn't kidding about having PTSD, and that it was a serious condition. I had flashbacks, dissociation, and hypervigilance, literally all the textbook symptoms of PTSD--right in front of him for years, and he still didn't really recognize it was happening. The best way I can describe having PTSD is that it's like trying to live a normal life while you're simultaneously fighting off an invisible tiger. I took a college class last year, and it was one of the most difficult periods in my life. It was an anatomy class that I absolutely had to get an A on in order to be eligible for a specific program. At the start of the semester, I was acing every single assignment. But a couple months in, something happened in my personal life that caused my PTSD to kick in again. It was like suddenly I had to go about memorizing the body's muscular system while keeping myself from getting killed by a tiger. Studying became incredibly difficult, because I was always trying to prevent myself from having a mental breakdown, from thinking about the things that had happened to me as a kid, from thinking about killing myself. It was literally a life-and-death situation for me, and I was losing. So I had to admit myself to a hospital for three days, take 2 weeks of outpatient rehab, and use the college's disability resources to put the anatomy class on hold so I could finish it when I was in a better place. My best friend told me, "I guess you were better at hiding it than I had realized." I also want to answer some of your questions: 1. PTSD is something that can be alleviated, but I don't think it can be cured. The most effective PTSD treatment I have had was EMDR therapy, which is basically a specialized type of exposure therapy. For a couple of years after doing EMDR, I was almost symptom-free. Last year, however, I had some hostile contact from the parent who molested/physically abused/emotionally abused me, and it led to having a really vivid nightmare about some of the molestation that I think I had been repressing. My PTSD came back in full force. That's when I ended up having to go to the hospital, because I didn't think my odds were good of staying alive by myself at home. I think you can live in a state where your symptoms have been alleviated. You will still be vulnerable to being retraumatized and having your PTSD resurface. That's why the single most important thing for someone with PTSD is finding an environment that is safe, stable, and supportive. And why you would absolutely need to sever from toxic individuals. It's like--you can't erase the virus from your system, but if you find the right treatment and environment to live in, you can render it harmless. 2. PTSD is simultaneously easy to diagnose and even easier to misdiagnose. The way PTSD is currently diagnosed is by looking for specific symptoms following a traumatic event. A traumatic event can be something putting you at risk of death, like a car accident, or it can be something that puts someone in front of you at risk of death, like witnessing a comrade die in war. In the DSM-5, the traumatic event has also been expanded to include things that threaten your personal integrity in some fundamental way, such as rape or kidnapping. PTSD doesn't always have to be from something extreme like a car accident or napalm. Being chased by a swarm of bees as a young child, or seeing a brick fall from a tall building and barely miss hitting you, could both cause PTSD. It's your body's reaction that constitutes the PTSD, rather than how "bad" the experience itself was. And it really is about your body's reaction. Specialists consider PTSD to be a limbic system/nervous system disorder as much as it is a cognitive-behavioral disorder. PTSD disrupts the normal function of your sympathetic and parasympathetic nervous systems (because you're always on edge, or replaying life-threatening experiences, your body gets used to being in Fight or Flight mode, which leads to various parts of your overall body function being impacted by chronic exposure to stress hormones). At the same time, PTSD can be a bitch to get a diagnosis for. It took me 4 therapists before I found one who took me seriously when I said I thought I might be having PTSD. She was about to write me off until I had a flashback in the middle of therapy. Before her, I had been told I had depression, anxiety, or adjustment disorder. I had a college psychiatrist who almost seemed like she was fishing for me to say that I might have a mild form of bipolar. Part of the reason it's so hard to diagnose is because of stigma, I think. Soldiers get PTSD. Civilians? Even trained therapists sometimes don't want to acknowledge that the majority of PTSD cases are civilian. And for a case like mine, when it happened to me when I was younger, and I was still having trouble articulating what had happened to me, it was easy for therapists to misrepresent what I was going through. Like--oh, you didn't have an easy relationship with your mother. Oh, you were sad that your father died. I had a therapist who showed me the DSM criteria for adjustment disorder and for anxiety and said "if you cross-reference these two, the symptoms that you thought meant you have PTSD could also be interpreted to be adjustment disorder and anxiety." I can only assume she didn't want to think that something really bad had happened to me in the past. When you've lived your whole life carrying a horrible burden, and a therapist says "I think you are just upset at your mother and sad about your father's death," it shuts down the conversation. I wanted to talk to this therapist about how I wasn't just angry at my mother--I was both terrified and enraged at her for molesting me over the course of 18 years and for choking me on the kitchen floor when I was a little kid. I wanted to talk to the therapist about how my dad was a complete alcoholic, and how one day he drove me home from high school while he was completely drunk, and he spent the car trip telling me how much of a disappointment I was to him, before he collapsed at the front of the house and I literally had to drag him inside while trying not to bump his head on anything on the floor. Those were things I had never shared with anyone. They were things that, in some ways, were only the tip of the iceberg. But because I had difficulty opening up about them for the first time, I had several therapists who assumed I was just young and emotional and I was jumping to conclusions about my mental health. 3. PTSD can come from either a single incident or from a string of incidents. My more acute PTSD flashbacks involve my molestation and my physical abuse. However, there is also a type of PTSD known as Complex PTSD, or CPTSD, which is basically 95% of the way toward being recognized as legitimate by the larger medical community. Due to internal political nonsense it wasn't included in the DSM-5, but many clinicians use it and it's just a matter of time. CPTSD refers to pervasive damage done by long periods of abuse, neglect, or endangerment from which there was no way to escape. Children who were raised by consistently abusive parents, or narcissistic parents, or child soldiers, or sex slaves, for instance, might have Complex PTSD. Any one event someone with CPTSD describes might not sound like enough to be a threat to their life or personal integrity. For instance, a parent publicly humiliating them might be weighing on them terribly. But compared to being trapped in a flaming building, it doesn't seem like it compares. That leads to easy misdiagnosis, because the "life-threatening trauma" clause might fail to recognize that the person might have been in a chronically unsafe situation where a series of bad but not catastrophic things were going on around them all the time, and that it could have induced a state of post-traumatic stress as readily as any single acute event could have. PTSD normally occurs soon after a trauma. In a case like mine, where I had been repressing what had happened to me as a kid, it would be described as Delayed Onset PTSD. There's also a dissociative subtype for people who have PTSD and experience things like depersonalization, derealization, or dissociation. Hope this is helpful. Cephas fucked around with this message at 04:57 on Apr 5, 2019 |
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Apr 5, 2019 04:52
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Thanks for the response. That was very helpful.
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Apr 6, 2019 04:10
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I just stumbled in here but that was an immensely informative and well-written post.
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Apr 15, 2019 12:32
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Yeah I thought I would have things to add but that really covers it. PTSD is the diagnosis that fits me best and has historically done the most good in getting treatment, so it's what I'm sticking with. As pointed out above, it was not a straight line in getting that diagnosis. My trauma happened over a period of time, I was retrauamatized, and only then sought therapy. This means that it was hard to nail down and took a few therapists until I found one who was willing to listen to and believe my symptoms and respond in a helpful way. I don't think anyone would know I have PTSD if I didn't tell them. I'm an outgoing, positive dude with a fractured lizard brain; it just doesn't show when I'm making jokes is all. I personify my PTSD as an iguana that sits behind my eyes and has access to the adrenaline switch. Anything it sees that makes it jumpy, that switch is getting pushed and it's getting pushed hard. Iguana's have notoriously poor judgement; things that would not tweak a human brain can seriously freak him out! But a human (i.e. me) has to deal with all the adrenaline, and here we are. If you have any questions about living with lizard brain problems, shoot.
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Apr 17, 2019 22:47
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Waltzing Along posted:I have a friend that says he has PTSD. He hasn't worked in over 10 years. From what I can see, he is perfectly normal, but who am I to say how mentally healthy he is. i have it. 2 very physically and emotionally abusive parents, very bad time in primary school and when i was 18 or 19 i was a centimeter either way from either having my spine crushed between a beam and a forklift cage or being dragged out of that cage head first to a 5m drop which hosed my back up for nearly a year. (will prob have problems later in life). that added a whole new dimension to it. i was diagnosed with it when i was 10 or 11 and then again by another psych who didnt know about my home life after the accident. its always there, its always on, nothing makes it go away and nothing ever will. for me atleast im always stuck viewing relationships with anyone (friends, colleagues, acquaintances) through the frame of the scared little kid whos trust in his parents was constantly used and abused and gaslit and im permanently switched on overanalysing every little thing, literally every little thing, from the turn of a head to someone scratching their nose. i had to be constantly looking for those small signs to survive as a kid, because signs like that were the difference between my fatass oval office of a father just shouting at me from the couch, or actually getting up and doing stuff i don't really want to talk about. theres more too it but im short on time. i can overcome it in the sense that i can supress it and pretend like nothings wrong. im very quiet when im like that, and my friends have straight up told me that im an extremely private person and its impossible to know what is going on inside my head, good or bad, at any time. i kinda like it like that. i dont want to be a burden on anyone else. your friend may feel like that too. thats not your fault or anything to do with you theres a lot more to it than that but i dont have a lot of time right now. its really good that you want to help your friend and you're a really good person. you might not get anywhere though, and don't think that has anything to do with you personally.
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Apr 18, 2019 00:21
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What your friend needs most is probably a hug. PTSD and its related stuff can make you feel absolutely alone in the world and just knowing somebody is there with you can help massively. I'm serious. If he goes quiet and is in the middle of his darkest hours you can do wonders by just showing up. PTSD is basically always comorbid with other conditions. This is one of the reasons why it's so hard to diagnose; CPTSD in particular is also often wrapped up with or outright misdiagnosed as borderline personality disorder. In any event it frequently comes with at least depression and/or anxiety but also dissociative disorders or problems that resemble bipolar but are not. The core word is really trauma. Your brain like basically every other part of you has a bunch of built in defense mechanisms. The problem is that these are not perfect and these are not invincible. You can heap a lot of stress on a bone and it'll be just fine but there's a point where it snaps. PTSD is comparable to that; your trauma responses got so overwhelmed that something broke. Staring at the sun doesn't feel all that great so you look away from it, right? Looking at whatever caused your PTSD becomes difficult so you don't look at it. If you aren't willing to even think about it it's kind of hard to talk about it with your therapist so the depression, anxiety, whatever diagnosis tends to come first. Diagnosing mental disorders really is kind of a bastard problem in and of itself, really. That in and of itself is a defense mechanism; your mind is dealing with so much other bullshit that stuff just starts getting filed away under "deal with this later." This is also why it piles and piles and piles up without you noticing until you're in full-fledged burn down your life mental breakdown mode. That's also why CPTSD has some specific symptoms that PTSD doesn't. A compound fracture is a whole different beast than a hairline fracture where the bone is still where it belongs but still needs rest. But yeah what Cephas said was pretty spot on. I too have PTSD after having unspeakable things done to me both as a child and as an adult. One thing about PTSD though is that to a certain degree it's a survival mechanism. Your brain knows that it's being overwhelmed but also knows that you have to soldier on and keep doing things to keep living. This is why dissociation can lead to pretty mechanical behaviors. This is why people with PTSD can seem functional for a very long time; parts of you just turn off. The breakdown can also happen seemingly at random but that can also be the parts that turned off going "OK we're safe we can deal with this now." My biggest breakdown happened when I had my post-college job, a decent income, and the narcissistic monster who committed actual, legitimate, serious crimes against me was finally out of my life. My situation was comfortable so my brain just kind of went "alright, I can dump all this poo poo out now." It was...uh, well...a lot of poo poo. ToxicSlurpee fucked around with this message at 03:53 on Apr 18, 2019 |
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Apr 18, 2019 03:49
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good poo poo here, good poo poo i specifically have CPTSD and i guess the thing i’d add is the extension of the tiger metaphor - for me, the things that have traumatized me are a cascade of variably-intense incidents through basically the first 25 years of my life, and it’s like having a very large number of uncoordinated hornets constantly near me. they aren’t swarming, they’re disconnected (maybe some clump together around various themes/people/particularly bad incidents), they aren’t always angry or stinging me or even generally aware of my existence, but regardless i will continue to walk thru life at constant risk of random hornet stings. there are things i can do to mitigate the danger, and to make myself less likely to run into additional hornets on my way, and to make sure that when i do get stung i take care of the wound appropriately w/o dwelling on it. even so, sometimes, out of nowhere, a hornet will run smack into my face and sting me, and there are plenty of circumstances in which this can be debilitating to outright life-threatening also any time i try to explain part of it to people who don’t Get This they have generally been like “ok yeah but... it’s just... hornets???” and that in itself can be traumatizing or hurtful relatedly, i had an interesting chat w/my therapist yesterday about how she tends to view BPD as a generally unhelpful clinical label, since in her experience, after enough processing, most people resolve out to “addiction, trauma, or both” - it’s hard to actually get a sense for what’s actually a personality disorder and what’s just “the immense weight of unprocessed trauma” until you’ve done a LOT of therapeutic work
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Apr 19, 2019 17:30
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ToxicSlurpee posted:What your friend needs most is probably a hug. But ask them first, they may not want it.
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Apr 19, 2019 17:34
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I have it. I had to spend some time as a family caregiver for my abusive father (Alzheimer's) and disabled brother (autism). The pressure of trying to keep everyone, including myself, safe was brain-shreddingly stressful. Not all my friendships survived it. I was a mess. I had to be constantly vigilant to every sound and movement around me, which just isn't a state anyone can sustain for long without going a little nuts. One of my biggest pet peeves is that PTSD uniquely carries a lot of assumptions. When you're a woman and say you have PTSD, folks tend to assume it was a sexual assault. (Same way they probably assume dudes were in the military.) Leaves me in a weird place of either a) not admitting it, b) admitting it and letting the assumption stand, or c) admitting it and oversharing the context. I usually went with d) just saying I have a stress disorder. I'm doing really well these days, but when I was Not Okay, you had to be quite close to me to see it. It's like walking a tight-rope no one else can see, so they think you're just walking along fine. The instinct is to hide it when you lose your balance. No one sees you cry in your car or the washroom. I haven't needed one in maybe a year, but I don't go anywhere without a couple tabs of lorazepam in my pocket. I think there's still a "panic attack kit" in my car, containing a chemical cold pack, water bottle, kleenex, and back-up lorazepam. It used to be in my purse at all times. Panic attacks suck, but there were other invisible symptoms too. I still struggle with hyper-vigilance and a needing to know exactly what's happening around me at all times, which is exhausting. When I was studying in the library I'd waste huge amounts of time staking out the computer stations that didn't turn my back on a busy path. I've asked strangers to give me more space in line at Walmart. Nightmares also were a real treat, and my sleep was so disrupted that I'd just stay awake for 2-3 days at a time unless I snowed myself under with benzos. I stopped exercising because as soon as my heart-rate elevated, I'd have a panic attack or start crying. I had constant headaches and struggled to stay alert in classes. I missed a lot of fun times with my friends because I was too tired or stressed to enjoy their company. Things are good now, however. Therapy helped a lot. I have great friends and a job I like. I dunno that I'll ever be quite the same as I was before, but maybe that's okay.
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Apr 22, 2019 18:30
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i have cptsd as well, everything everyone has said so far has been right on the money. i'm not articulate enough to write about my own experiences but this thread has already been very helpful to me as i showed these posts to a friend op i sincerely hope you didn't tell your friend about how they seemed like they were just fine, or that you thought they were just being lazy or something. it feels absolutely rotten my cptsd comes from my father dying early, child abuse (physical in terms of regular beatings and psychological abuse), bullying and sexual assault from both a classmate and one of my mother's boyfriends. i'm in therapy and i take benzos/smoke weed which has helped considerably, but i'll never be "ok" nishi koichi fucked around with this message at 07:57 on Apr 24, 2019 |
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Apr 24, 2019 07:04
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| # ? Apr 25, 2024 05:28 |
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bad posts ahead!!! posted:op i sincerely hope you didn't tell your friend about how they seemed like they were just fine, or that you thought they were just being lazy or something. it feels absolutely rotten Nope. I know what the source is so I have always accepted it. I just wanted to understand better because he seems the same before/after. I suspect things are different w/ me because we've known each other for a very long time so there is a trust/comfort there. He knows I'm not a threat and I don't see him when he is off on his own.
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Apr 24, 2019 08:01
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