Posted by BSBD on April 1, 2008, at 13:08:20
I have a history of longterm physical, emotional and childhood sexual abuse lasting approx 14 yrs. There have been many other stressors involved including the death of my first child, the suicide of a previous lover (although we had not been involved for many years before it happened), and a traumatic divorce. I've made five suicide attempts, starting at age 16. I'm currently 38 yrs old.
I have been diagnosed with bipolar 2 disorder, PTSD, and borderline personality disorder in the past. I also have a diagnosis of chemical dependency.
I spent over six years in weekly therapy attempting to work on the trauma issues, but was unable to resolve them. I can talk about my abuse issue intellectually with anyone, but the moment it starts to get emotionally involving for me, I shut down. You can imagine how frustrating this was after six years.
Every time that I've been admitted to the psych ward following a suicide attempt, I've tested positive for substances and was subsequently referred to addiction treatment. I'm currently again in IOP treatment for drug addiction to opiates. I am not currently on any medication and am not in therapy, other than the addiction treatment which has never been successful in the past (due to my "inability to understand that all my problems are caused by drug use and that if I just stop using, everything will be fine").
I've recently been researching studies done regarding the phenomenon of endorphin release caused by PTSD triggers (such as therapy sessions) often causing numbing and inability to resolve those issues (which is what always happened to me in therapy, I shut down) followed by an endorphin withdrawal afterwards leading to using drugs to increase the endorphin levels. The problem is with getting anyone to see that this is more than just an addiction problem.
I noticed a clear example of this in myself over the weekend. Saturday morning's therapy session had something very intense happen and when it did, I felt that first rush of emotions, then I blocked it out. I switched over into this calm rational person and by the time I left there, I was literally high. I would not have felt any higher if I had taken drugs right then. I was floating. Within hours, I crashed, felt that restlessness and irritability coming on. So, I went and hung out somewhere that had always given me a bit of a rush before (skydiving is an interest/hobby and I just went and watched people skydive for a few hours). I left there feeling good. By Sunday morning, I was rock bottom.
There are times that I have no problems staying sober. I walked out on my last therapist in November 2007, mainly out of just frustration during the last session, and never went back to him. Within the following weeks, I quit using all drugs, alcohol, even smoking. I was able to work on rebuilding a lot of things that I had thrown away during the previous six months which had been very traumatic months for me. I can honestly say that I was doing well.
Mid February, I went on vacation and during that vacation, experienced something that in retrospect triggered me hard on my PTSD. Immediately upon return, I went off onto a binge, even using much harder drugs than I ever had, such as heroin. I even started smoking again. Everything came back, the suicidal thoughts, sleep problems, irritability, everything.
Every study I've read (and I've researched this an incredible amount in the last week) has indicated very poor recovery rates for addicts who are not treated concurrently for their PTSD as for their addiction. However, of course, "the issue is that I just need to stop using drugs". Okay, I get that. I've been clean for ten days now. Guess what kicked in this Sunday after all that other stuff? The urge to cut...something I haven't even thought about in four years. When I brought it up today, the answer was "that's common for addicts that self-mutilate. You are looking for a release."
Okay, yeah, exactly, but if the PTSD isn't resolved or at least dealt with, I WILL use again. I've been through this too many times to have any different thoughts about it. Their issue is that as long as I have addiction issues, then the PTSD can't be dealt with. It's a maddening cycle.
This can't continue. I can stay sober for now, for a while. But eventually, the PTSD *will* trigger me again at some point and I know that I'll be using again. This last event took me from reasonably stable to suicidal within a matter of weeks.
There's been some studies into using naltrexone during PTSD treatment to prevent that endorphin release and enabling the patient to remain "in the emotions" during therapy, but I've not been able to find a therapist that seems to have even heard of that.
I guess I'm just looking for other opinions on this. I'm just tired of being treated like there is nothing wrong except that I use drugs and just need to stop that.
Thanks.
poster:BSBD
thread:821013
URL: http://www.dr-bob.org/babble/subs/20080104/msgs/821013.html