Post Traumatic Stress Disorder – Stats and Facts Part 3

Approximately 25% of those with BPD/ERD also meet the criteria for post traumatic stress disorder.
So let me tell you a story. I had to go to a counseling session because I made a very poor decision concerning alcohol and driving. I had to have a psychological evaluation and talk to a social worker about my past and stuff. First off, let me tell you that I hate, HATE, talking to shrinks that are not of my choosing. I don’t believe it’s any of anyone’s business to ask me such personal questions, intimate, details of my life. Especially when they inevitably make snap decisions and diagnosis because one session is not enough time to understand anyone. So anyways, I had this session. The guy (the only male counselor other than my psych I’ve ever talked to) started asking me questions off of a list of psych questions. It was clear that he cared precisely zero about me as a person. He just needed to get through his checklist. Throughout the interview he ask me questions, then instead of letting me talk, cuts me off and proposes his own theories and tangents. So he’s asking me these questions when he gets to the section on pysical/mental/emotional abuse. It’s at this point I’m debating whether or not I want to tell him the truth or just get him to skim past this. I decided that the truth would work to my benefit as it was part of why I landed there in the first place. So as soon as I start saying yes to some of his questions his eyes light up and he proclaims that I have Post Traumatic Stress Disorder. WTF? He didn’t even ask me to elaborate on the situations he was asking about. He just went on and on about PTSD, cutting me off when I tried to elaborate, and got way to excited about my potential mental disorder. It was clear that PTSD was his pet subject. So while I have technically had a diagnosis of PTSD, I don’t believe it. It makes me wonder how accurate some diagnoses are too. People are human and therefore subject to their own biases.
And while I might fit the technical criteria for PTSD, the incidents that made him jump to this conclusion had less lasting traumatic effect on me than did a really bad car accident I was in while I was at university (years after my BPD emerged).
So let’s take a look at what PTSD is (and how I potentially fit the criteria):
Causes – Psychological trauma:
“PTSD is believed to be caused by either physical trauma or psychological trauma, or more frequently a combination of both. PTSD is more likely to be caused by physical or psychological trauma caused by humans such as rape, war, or terrorist attack than trauma caused by natural disasters. Possible sources of trauma include experiencing or witnessing childhood or adult physical, emotional or sexual abuse. In addition, experiencing or witnessing an event perceived as life-threatening such as physical assault, adult experiences of sexual assault, accidents, drug addiction, illnesses, medical complications, or employment in occupations exposed to war (such as soldiers) or disaster (such as emergency service workers).  Traumatic events that may cause PTSD symptoms to develop include violent assault, kidnapping, sexual assault, torture, being a hostage, prisoner of war or concentration camp victim, experiencing a disaster, violent automobile accidents or getting a diagnosis of a life-threatening illness. Children or adults may develop PTSD symptoms by experiencing bullying or mobbing. Preliminary research suggests that child abuse may interact with mutations in a stress-related gene to increase the risk of PTSD in adults.”
The diagnostic criteria for PTSD, stipulated in the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as.
A: Exposure to a traumatic event
– This must have involved both (a) loss of “physical integrity”, or risk of serious injury or death, to self or others, and (b) a response to the event that involved intense fear, horror or helplessness (an event was “outside the range of usual human experience.”).
Yep. Definitely had a few such instances involving abuse and a particularly bad car accident.
B: Persistent re-experiencing
– One or more of these must be present in the victim: flashback memories, recurring distressing dreams, subjective re-experiencing of the traumatic event(s), or intense negative psychological or physiological response to any objective or subjective reminder of the traumatic event(s).
You be the judge. I often have distressing dreams but they’re no longer terrorizing. Intense negative responses: If you consider an inability to let most guys touch me without utter revulsion, freaking out and regretting any instance where it occurs outside of my comfort zone, constantly disavowing any intimate male companionship (this never sticks) and quickly second guessing, overanalyzing their motives… or… when I’m a passenger in someone else’s vehicle I often have knee jerk reactions with braking too hard, or getting to close to other vehicles. This causes me to pull back, hard knees to chest, my heart rate to speed up, grabbing onto the ‘oh shit’ handle and my breath catching in my throat. I prefer to drive.
C: Persistent avoidance and emotional numbing
This involves a sufficient level of:
– avoidance of stimuli associated with the trauma, such as certain thoughts or feelings, or talking about the event(s);
– avoidance of behaviors, places, or people that might lead to distressing memories;
inability to recall major parts of the trauma(s), or decreased involvement in significant life activities;
– decreased capacity (down to complete inability) to feel certain feelings;
– an expectation that one’s future will be somehow constrained in ways not normal to other people.
Heh. After some such events I severed contact with certain people, wanting nothing to do with them or those that are involved with them. Avoiding situations where I might even have the possibility of running into them. Not places that I was sure they would be (though of course I won’t go there) but places they might be, where there is even a small chance of it. After one incident in my early 20’s I completely repressed events, only recalling it years later after I found a journal that I had written immediately after and then completely forgot about. I still only have flashes of this, not a full recollection. Decreased capacity to feel certain feelings. ::smirk:: I often have a complete inability to feel feelings at all. This problem is what lead to the diagnosis of my Dissociative Disorder. When I have extreme stress, loss, and/or conflict I depersonalize and derealize from my life and even my own body. I do absolutely expect that my future will be constrained. My present is currently constrained in ways not normal to other people. I have a Borderline Personality Disorder. I’m pretty sure, by definition, this qualifies for ways not normal to other people.  I believe this has more to do with my depression than any traumatic experience that I suffered after this problem began.
D: Persistent symptoms of increased arousal not present before
-These are all physiological response issues, such as difficulty falling or staying asleep, or problems with anger, concentration, or hyper vigilance.
Long posts need more pictures
I think they need a better phrase than ‘increased arousal’. This did not immediately inspire thoughts of heightened awareness if you know what I mean. I have always had extreme difficulty with sleep. I had insomnia for years that still occasionally creeps back (last night for example – so freaking tired). Even with the prescribed medication that I’m on specifically to help me sleep I have a hard time falling asleep, staying asleep, and once I wake up, calming my brain down enough to return to sleep.  Anger, hah, see this post. My therapist just brought up my sense of hyper vigilance yesterday as a form of self protection. All of these things, however, were a problem well before any real trauma that I suffered and were not the result of bad experiences that I can recall. I imagine that some of the experiences I’ve had since the onset of this most likely exacerbated the problem.  
E: Duration of symptoms for more than 1 month
– If all other criteria are present, but 30 days have not elapsed, the individual is diagnosed with Acute stress disorder.
How about years? Does years count? Acute stress disorder seems more accurate to me though.  Don’t ask me why. Maybe I just don’t want to have PTSD too.
F: Significant impairment
– The symptoms reported must lead to “clinically significant distress or impairment” of major domains of life activity, such as social relations, occupational activities, or other “important areas of functioning”.
– I’ve had significant distress and impairment in social relations since I was 12 years old. This was at the onset of my clinical depression and anxiety disorder. Both precursors to my BPD. By this point my abandonment issues were also in full swing. But, again, not due to an experiences that could be considered very traumatic. I think it has more do to with a predisposition to feel things in a way that is not normal to most – BPD.
So yeah, after this very long personal assessment, I am still not a psychologist or psychiatrist and am therefore not qualified to diagnosis myself. Thoughts?
Abuse is very common in the lives of people with BPD. It is often one of the root environmental contributors to the emergence of the borderline disorder. I do not have any doubt that many people with BPD also suffer from PTSD. Recognizing this is very important for treatment because it helps understand some of the underlying factors that need to be worked through and healed.
I do wonder if PTSD leads to BPD, or if being predisposed to BPD leads to an increased sensitivity to situations that feel traumatic but would not normally be considered a traumatic event required to define PTSD.  Then again, if something feels a certain way, a situation is perceived a certain way, doesn’t that make it reality for the person experiencing it? Therefore the event occurring is in fact something very traumatic.
I don’t know.  Most likely it is a co-morbid issue building and feeding off of each other.

9 comments on “Post Traumatic Stress Disorder – Stats and Facts Part 3

  1. Put yourself in the psychologist's shoes for a moment. You can diagnose someone with something that is somewhat treatable, or something that is considered almost incurable. One that holds sympathy, and one that holds contempt. If I had a conscience, and I saw enough dots to connect both BPD and PTSD, I'd be more inclined to go with PTSD.Also, take into consideration that just because you have the same traits as another "disease" doesn't mean you have it. Look at Narcissism vs Sociopathy. The two are almost the same. The underlying difference being in motive and thought patterns, not actions. What psychologist could truly make a distinction when conversing with a notorious label of liars? Most likely you have BPD, and PTSD is just something similar but not the same.And last but not least… Sometimes a psychologist will see something that you don't. It might be there, it might not. But they did see it. They didn't pull it out of thin air, which means you showed them something that they thought connected it. I guess you should be asking yourself, do I really this trait that I don't think I have, without judgment. I know that can be difficult.

  2. I am in total agreement with you on most, if not all of your opinions. One in particular, the issue of the human condition, if you will. We are prone to err. For a number of years, a close family member of mine was clinically diagnosed and treated as being bi-polar. Recently, the diagnosis was changed from BiPolar to Baseline. There are many commonalities between the two. PTSD was also mentioned. All three have similar symptoms and can easily be confused with one another.

  3. @TNP … The problem with giving a sympathetic diagnosis is that it probably won't be effective when trying to treat the disorder. Different problems require different techniques and approaches. Treating someone for the wrong problem just isn't going to provide the best results. You certainly have a point that he may see something that I do not. Heh, and I really don't like the idea of having yet another disorder, but I've also learned to deal with the things that he latched onto. Part of my problem with this guys diagnosis was that he seemed utterly unconcerned with my explanations and for the most part wouldn't even let me finish speaking before going on about his own theories. He didn't bother to take any time getting to know me, which makes it difficult for me to believe that he knew what he was talking about in regards to me. I'm inclined to be more open to what you said about 'diseases' that have similar symptoms. Just because my symptoms fit well with multiple diagnosis it's really a matter of finding the one that is the best suited for my problems, not just meeting a checklist of criteria.

  4. @ib… this is why I think longer term therapy and multiple opinions are so important. It allows clinicians/therapists to really understand the patient and get to know the root of the problem, not just the surface manifestations thereby providing the means to accurate diagnosis and by extension more effective treatment.

  5. Having a Post Traumatic Stress Disorder is never easy. It’s like getting lost in a trance of traumatic events that caused lives to turn upside down. Some were lucky enough to stand up but those unfortunate ones are still down on their knees and they feel no escape at all. But the truth is, sometimes we just need to reflect on our own with a mindset to heal ourselves by looking at the bright side of things.

  6. I have PTSD – I used to get 'episodes' or 'fits' if I drank alcohol and had relationship issues. I know it sounds a little prescriptive, but its true. Since I've been on seroqual they stopped (well after being on them for 6-12 months they did). I definitely do have it though. I still do, though the fits stopped. I have BIG issues with sex due to childhood sexual abuse. IT never goes away. My poor husband got the cold wife who sees sex as a favour I do for the man I love.It's easier some at some times than others. I just wish it would go away, therapy hasn't helped AT ALL! I'm intellectually able to talk of it without issue, but emotionally dissociated from it so that I cannot grab it and work it out. I'm almost 40 – its ever present. My abusers also left me childless because one of them infected me with something which rotted my tubes, and they left so much scar tissue I can neither conceive nor carry full term even if I did. Shah. X

  7. "I'm intellectually able to talk of it without issue, but emotionally dissociated from it so that I cannot grab it and work it out. "I understand this completely. I'm sorry for what you've been through though I thank you for sharing with me.

  8. According to a pilot study published in the latest issue of the peer-reviewed International Journal of Healing and Caring, veterans with high levels of PTSD saw their PTSD levels drop to within normal limits after treatment. They reported that combat memories that had previously haunted them, including graphic details of deaths, mutilations, and firefights, dropped in intensity to the point where they no longer resulted in flashbacks, nightmares, and other symptoms of PTSD. The study involved veterans from Vietnam, as well as more recent conflicts. .

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