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Falling down the rabbit hole again?

I feel like I am hanging in a very delicate balance right now.  One bit of bad news could send me over the edge.  Today has been filled with anxiety and depression.  It’s hard to think what to do to pull myself out of it when I’m in the middle of it.  The only pro-active thing that I have done is take half an Ativan.  I’m still waiting for it to fully kick in, I think it is helping some, but I may need to take the other half.

What put me in this tailspin?  I’m trying to pinpoint it and the only thing that sticks out in my mind is that school starts in 8 days.  My last semester in grad school.  My internship starts in 9 days.  I am so afraid I’m going to lose it at the site and they are going to kick me out.  At my last job before I went out on disability, I just cracked up one day and crawled under my desk crying.  I went straight to the hospital from there not knowing that was the last time I would work for years.  I envision something like that happening again.  Or this scenario:  I wake up one day on a day like today and feel shitty and just can’t make myself go.  So I call off.  And then I feel guilty about it and that increases my anxiety which causes me to call off again.  Pretty soon I have a shitty track record.  This is my worst fear.  I’m trying to prepare myself by forcing myself to go do things I don’t want to do/feel comfortable doing.  Like I went on a photo safari with my photo club the other day.  And tonight I have to go to a meeting about the trip.  I don’t want to go, all I want to do is lay on the couch.

Today I want to talk about Complex Post Traumatic Stress Disorder (Complex PTSD, C-PTSD).  I didn’t even know it existed until my therapist and I were talking about my diagnoses last week.  According to the Department of Veteran Affairs’ National Center for PTSD, the difference between PTSD and Complex PTSD is a matter of length of exposure to the trauma.
For instance, car accidents, natural disasters, and rape are considered traumatic events of time-limited duration. But chronic traumas continue or repeat for months or years at a time.   Some examples of traumas associated with Complex PTSD include:
- concentration camps
- prisoner of war camps
- prostitution brothels
- long-term domestic violence
- long-term child physical abuse
- long-term child sexual abuse
- organized child exploitation rings
WHAT ARE THE SYMPTOMS?
Although PTSD isn’t split into two types yet “officially” in the DSM-IV manual, many mental health professionals see it as a necessity.   The diagnosis of Complex PTSD requires that the individual experienced a prolonged period (months to years) of total control by another. The other criteria are symptoms that tend to result from chronic victimization:
* Alterations in emotional regulation. May include persistent sadness, suicidal thoughts, explosive anger, or inhibited anger.
* Alterations in consciousness. Includes forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one’s mental processes or body.
* Changes in self-perception. May include helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
* Alterations in how the perpetrator is perceived. Examples include attributing total power to the perpetrator, becoming preoccupied with the relationship to the perpetrator, or preoccupied with revenge.
* Alterations in relations with others. Examples include isolation, distrust, or a repeated search for a rescuer.
* Changes in one’s system of meanings. May include a loss of sustaining faith or a sense of hopelessness and despair.
Survivors of Complex PTSD may abuse alcohol or drugs, avoid thinking or talking about the trauma, or self-mutilate to escape.  Or a combination of these things.
According to Roth et. al, sexual abuse might be a critical risk factor in developing C-PTSD (1997).  As someone that has experienced prolonged child sexual abuse, I can see why it could be a critical risk factor.  Child sexual abuse is damaging on so many levels.  This is not to say that other forms of trauma “don’t count,” they do, but child sexual abuse happens when we are still developing our minds, bodies and personalities.

If you want more information about Complex PTSD, please visit:

http://www.ptsd.va.gov/professional/pages/complex-ptsd.asp

http://ptsd.about.com/od/ptsdbasics/a/ComplexPTSD.htm

http://www.miwatch.org/2007/11/complex_ptsd.html

http://www.svfreenyc.org/survivors_factsheet_97.html

references:
Complex PTSD – National Center for PTSD. (n.d.). National Center for PTSD Home. Retrieved October 1, 2010, from http://www.ptsd.va.gov/professional/pages/complex-ptsd.asp
Roth, S., Newman, E., Pelcovitz, D., der Kolk, B. v., & Mandel, F. (1997). Complex PTSD in victims exposed to sexual and physical abuse: results from the DSM-IV Field Trial for Posttraumatic Stress Disorder. Journal of Traumatic Stress, 10(4), 539-555.

friday’s reflections

And the weekend is upon us.  It is a special weekend; it is my birthday weekend.  On Sunday, I will turn 42.  Here are some things I have reflected on today…

Wow, never thought I’d see that age.  I’ve been through so many bad things, not only in childhood, but as a young adult as well.  My mental illnesses, and things done by me and to me.  I really never thought I’d live past 30.  My motto back then was to try anything, and try anything I did.  Now I am paying the price for my choices.  All the hallucinagenics that I was so curious about, and tried, fried my memory.  Trying to make a buck fast (while escaping a very physically abusive relationship), I ended up getting convicted of a felony.  I married a man I only knew for 6 months, and is it a surprise that I tell you that after 2 1/2 years, we divorced?

I have so many regrets.  But I also have done wonderful things.  I’ve traveled to foreign countries, got an education, re-married (and this time, I chose a good one), met wonderful friends, truly learned to love and live life but not to the extent that it is going to end up hurting me either now or in the future.

I still have a lot to work on.  The self-destructive side of me is constantly trying to sabotage.  For instance, running up credit cards.  I am making progress on this problem:  I cut up all but a few cards.  I am still in a little trouble with them but the situation is getting better.

Another thing I am working on is being more assertive.  Cognitive behavioral therapy is really helping me with that.  It’s all about those DEESC scripts, baby.  (See my previous post )  I never realized how bad I was at asking for what I need or want.  Using the DEESC script got me what I wanted.

My next step is to contact one of my siblings that I have a strained relationship with.  My goal is to find out why it is strained, find out where I stand, and try to grow closer to this person.  That is going to take a lot of courage.  My therapists in the cognitive behavioral therapy program had me do a pros (of not contacting the family member) and cons (of contacting the family member) list.  Although there were some serious reasons not to contact them, in the end I decided that I wanted to make this call.  I am hoping to do it on Skype.

That about covers my birthday weekend reflections.

Hamlin's Wizard Oil, the greatest family remed...

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While I am in the cognitive behavioral therapy program, I get to see a psychiatrist once a week.  I’ve seen mine twice so far.  He added 15mg of Remeron to my Rx cocktail.  So, to recap, I am on:
- Lamictal, 200mg twice a day
- Paxil, 40mg once a day
- Abilify, 20mg once a day
- Ativan, .5-2mg as needed
- Remeron, 15mg once a day

I decided this past weekend that it is too much.  I am on too much medicine.  I want them to take me off everything but the Lamictal, Ativan and one thing for my anxiety and depression, so 3 meds total.  I can’t afford 5 medicines.  I wouldn’t mind so much if it was making a huge difference, but I am still depressed and still anxious.  My goal is to talk to Dr. J. tomorrow at the program and tell him that I want off all but the few I mentioned.  I don’t know if it is a good idea or not, but I don’t think it can do harm either.  Actually, right now, the Remeron is causing some side effects; I am getting acne, intense hunger, and I am paranoid about my husband all of the sudden.

According to drugs.com, the following are a list of side effects for Remeron:

Abnormal dreams; abnormal thinking; constipation; dizziness; drowsiness; dry mouth; flu symptoms; increased appetite; weakness; weight gain, severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); decreased ability to fight infection (fever, chills, sore throat); mental or mood changes; mouth sores; thoughts of hurting yourself; tremors; worsening of depression.

Everything in bold is a side effect that I am experiencing.  I do believe it’s causing the paranoia too because that is new since I’ve been on it.

It’s important to always check with your doctor if you feel you are experiencing anything odd or out of the ordinary while on any medication.  For more information on psychiatric drugs, see the following:

depression medications

bipolar disorder medications

anxiety medications

schizophrenia medications

more psychiatrist medications

All of this week, my husband has been…distant, detached.  When I asked him what was wrong, he would say “nothing”, quietly.  I began thinking that he was hiding something from me, perhaps cheating on me.  I was ruminating and just going crazy.  No matter how many times I asked him, he would say the same thing:  “nothing”.

Yesterday at the cognitive behavioral therapy program, we talked about DEESC scripts.  They are a way to be more assertive, a way to get you to express your needs.  They do not guarantee that you will GET your way (who gets their way all the time anyway?).

D.  —- describe the problem, e.g.  “Yesterday, when you came home and didn’t talk to me…”

E.  —-  express (emotion) e.g. “…I felt sad and confused.”

E. —- empathize e.g.  “I understand you are tired when you get home from work.”

S. —- specifics (I want… I need…) e.g.  “I want you to communicate how you are feeling more.”

C. —- consequences (If… then…) e.g. “If you do communicate with me, then I will understand what is going on more.  If you don’t, then I am going to continue to be suspicious and our relationship will suffer.”

So, it would go:

“Yesterday, when you came home from work and didn’t talk to me, I felt sad and confused.  I understand you are tired when you get home from work.  I want you to communicate how you are feeling more.  If you do communicate with me, then I will understand what is going on more.  If you don’t, then I am going to continue to be suspicious and our relationship will suffer.”

Sounds simple, right?  Just 5 sentences.  It actually isn’t so easy.  In the lecture, we practiced doing a DEESC script.  I did this particular one.  The therapist played my husband.  He kept interrupting me, rolling his eyes and not wanting to listen.  This was to get me prepared for a different reaction than I wanted.  It was difficult.

This morning in the car, I did this DEESC script on my husband.  He asked how I was feeling and I said sad.  He asked why and I immediately went into the DEESC script.  It worked beautifully.  He told me why he was not talking when he came home and it had nothing to do with anything suspicious.  The therapist warned us though, this doesn’t always work and sometimes you need to do them over and over again until you are satisfied with your results.

It’s not easy to communicate your needs, but using a DEESC script makes it much easier.

I went extremely downhill two weeks ago, shortly after creating this blog.  I just fell down the rabbit hole into a deep depression, with suicidal ideation and impulsive acts.  My psychiatrist gave me two choices:  either go inpatient, or enter the Cognitive Behavioral Therapy Intensive Outpatient Program (COG-IOP) at the local mental hospital.  Of course, I chose the program.

The COG-IOP at the hospital is centered on the methods used by Dr. Aaron Beck.  Dr. Beck is often thought of as the father of cognitive therapy.  Cognitive Behavioral Therapy (CBT) aims to negate negative thinking through specific psychotherapeutic techniques.  The treatment is recommended for sufferers of PTSD, OCD, depression, bipolar and anxiety.

I started COG-IOP last Monday.  The program is intense:  1 hour of lecture on CBT techniques and 2 hours of group therapy.  In the group therapy, there are two co-therapists that run the group.  They also hand out homework assignments, such as thought records, responsibility pies in which you take a situation that you feel guilty or shame for and you reduce your guilt/shame by looking at factors that contributed to the event.

Here are some websites for more information on CBT:

Wikipedia – Cognitive Behavioral Therapy

David D. Burns’s Feeling Good website

NAMI’s information page on CBT

Dr. Steven M. Melemis’s website all about CBT

Speciality Behavioral Health’s downloadable PDF worksheets and info

Hello and good tidings to you.  This blog is all about mental illness and my personal experience with it.  Sometimes I have good days, and sometimes they are bad…very very bad sometimes.  Some topics featured in this blog will be PTSD (Post Traumatic Stress Disorder), EMDR (Eye Movement Desensitization and Reprocessing), Bipolar Type II, General Anxiety, Social Anxiety Disorder, Agoraphobia, Depression, child sexual abuse, suicide, verbal abuse, domestic violence, medication news, hospital information and more.

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