mental health; poetry elsewhere

[kaberett]

So on Thursday morning I have an appointment with my GP to discuss my mental health - she's very keen on us having regular check-ins. So I want to tell her: that increasing to my winter dose of citalopram has worked very nicely, by and large; that there's Something Wrong with my ankle and I'd like to know what (it's a 20-minute appointment; we can probably fit this in!); and that I think it would be very useful to investigate getting a PTSD diagnosis. (Also that I need refills of Buscopan, psych meds, codeine, and preferably benzos.)

So, er -- those of you who've done this before, I'd really appreciate advice on talking to doctors about PTSD? And also reassurance that it's not The Worst Biggest Scariest Thing In The Whole World and getting a diagnosis will be a useful step towards consciously addressing the issues & acquiring coping strategies & getting doctors to be less ridiculously twitchy about prescribing me benzos. (For the record: this calendar year I have taken 50mg of temazepam and I think 2mg of diazepam. I do not think I am displaying behaviour they can have any legitimate concerns over. :-p)

ETA: I think it is probably worth mentioning that I am feeling extremely tender about all of this, so -- not that you wouldn't be, but -- please be kind?

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jjhunter and I wrote a collaborative poem, and I am really very pleased about both the process and the result.

Comments

[untonuggan]

I have talked about PTSD with doctors and they have generally been very sympathetic and yes, there's the requisite "tick boxes on the DSM ticky box criteria form", but I think generally when I have seen people and gone "I had [traumatic experience X number of years ago] and it's still bothering me" their primary priority has been not so much labels but how to help make it better. (Maybe not 100% better, but, y'know, less terrible.) YMMV, of course, and my experiences are in the US with good insurance (although it is kinda so-so with mental health coverage).

♥

You are so brave.

[kaberett]

Thanks for helping me articulate some more of what I'm scared of - I don't have a single big event to point to (mm, maybe I do? But it feels like any one thing I could point up would be telling only part of the story), and -- yeah. Also the fairly standard "clearly I'm just making it up" angst, but given that I reread diagnostic criteria at work this morning and that turned out to be a really bad idea... :-p

Thank you. ♥

[untonuggan]

I have...a series of events to point to (my abuse happened over a period of 3-4 months), and then it has been retriggered later so I guess that counts as fresh abuse? But I didn't even realize it was abuse for years because "boys are just like that sometimes." *facepalm* *cue women's studies class* Which is why I kind of have a brief summary that I give the average health care provider who asks ("I was assaulted over a period of months by my then-boyfriend when I was in high school") and if I think they need to know more I will tell them, but in most cases that just triggers massive memories unless I'm in a therapeutic environment.

Note that a lot of the diagnostic criteria -- and treatments -- for PTSD in the US at least are developed by the Armed Forces, which is helpful in part because funding but also not necessarily aimed at what victims of sexual assault need, for example.

Hope some of this is mildly helpful. <3

[kaberett]

I also need to chase up endo and GIC referrals.

[liv]

Very very good luck with the discussion. I really hope you get taken seriously and get the medication and other support you need.

I don't know if this useful or not, I don't even know if it's true or not, but I read an article recently that suggests that PTSD resulting from chronic abuse may be a different syndrome from classic PTSD from things like a single event of extreme violence or war. Lots of the article is about the peculiarities of the American healthcare industry, but it may offer some fine distinctions of language, which is the sort of thing I'd find helpful if I were in your situation.

[kaberett]

Thanks for the rec; reading through it. Bits of the way it's written for a popular audience are predictably deeply uncomfortable for me (that it's focussing on women; the way physical symptoms are treated as somatisations rather than merely co-morbidities; etc) but that doesn't mean I'm not getting value out of it!

[liv]

Those are completely fair criticisms. My impression of the article was that it wasn't intending to put across the view that only girls are abused as children and only women have psychological problems resulting from such abuse, but it's sort of a bit sloppily written such that it does slightly come across that way.

I'm fairly agnostic about the concept of somatisation; many objections to the concept are extremely valid, certainly. I suspect that when it's a psychiatrist or counsellor talking about somatisation, what they mean by it is, I can do something about this symptom, yay. Which is a bit different from a physician dismissing stuff as somatisation as if that were synonymous with "imaginary". Still, sorry for pointing to you an uncomfortable article.

[thefairymelusine]

Really good luck with this.

[kaberett]

Thanks! Have worked out a script and stuck it in a notebook to take with me.

[worlds_of_smoke]

Good luck with the appointment. FWIW, having a PTSD diagnosis is not the end of the world - it just means that you have a more specific way to attack the symptoms. ♥

[kaberett]

Thank you. <3

[kaberett]

staranise is relevant, as ever.

[pretty_panther]

Good luck :3 Glad your increase in citalopram has worked :)

[kaberett]

Cheers!

[elialshadowpine]

Honestly, it was actually my psych who suggested that I have PTSD. I was talking about some of my abuse history, and it wasn't until later that I found out that she noted down in my chart the PTSD diagnosis. (Former psych, not current.)

I believe that you have talked about an abuse history, so, I would actually suggest being straightforward about it. It's not quite the same thing, but how I asked my psych regarding my ASD diagnosis was that I told her, in a somewhat clinical fashion, some examples of behavior that fit with ASD, and I asked if in her opinion as a psychiatrist, if this was enough for a diagnosis of ASD. Which ended up with a discussion of why I was looking for the diagnosis, because I had also mentioned as a sidenote the possibility of seeing a specialist. IE, if I were looking for school accomodations, she'd have recommended a specialist, but as it was, she felt comfortable making the diagnosis.

So, in your case, I think it would be safe to basically bring up the things that are relevant to your PTSD, tell the doctor that you are wondering if you have PTSD, and ask for her professional opinion. It depends, I think, on how triggery talking about all this will be. You can also tell the doctor about your abuse history and that you think you have PTSD and mention that the benzodiazepines help when you are having a flashback/anxiety attack/whichever term applies.

TW Rape, child abuse

In my case, I did use in a way my PTSD to argue for more benzos. I talked to my new psych, established my past abuse history with my family, and that I have to have contact with my family because I rent from them. (This is not normally a huge issue, since I don't generally directly deal with my Dad, and I have 0 issues with Mom, but it does cause some background anxiety.) I also brought up that I was raped last October, and that I have had significantly more anxiety since then. In my case, I also have the history that I have been on lorazepam 2x a day in the past for... about two years? and then was able to back down to an incidental dose. So, the doctor knows I have a history of non-abuse. I also described my anxiety, my reactions, and the effect that my PTSD and abuse has on me on a daily basis, and used that to argue for a more regular dose. (FWIW, it worked, I am now on clonazepam 2x/day with 12 pills a month for emergency as needed. Some days, I don't need any, some days I need extra, this averages out well.)

Is this helpful? I found, also, that what I built up in my head was actually a LOT more difficult than dealing with the actual doctor, who was very kind and gentle and more than willing to help me.

[kaberett]

Thanks lots for the detailed comment & other discussion. <3

[hairyears]

I keep my peace, on this: some things are better left off the web, and a great many are better after sufficient reflection to 'know thyself' and understand what has been done.