![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 31. This is the beginning of the thread.
Posted by alabamaauthor on December 21, 2012, at 19:57:49
First time post, I am a writer, a published author, and I just gained the courage to join my first ever forum dealing with my disease(s). I have been ill with what I refer to as Melancholia since I can remember, perhaps as young as 5. I think I have drug resistant depression, know I have CPSTD, from childhood abuse, know I have Borderline P Disorder from my childhood abuse, know I am the scapegoat in a very dysfunctional family, oldest of four girls, grew up in a very strict southern uber-religious family, was literally beat with belts, whips, you name it, all through my Jr. Sr. years, (nude) per my father, my Mom knew of the abuse and would stand outside the door and scream for him to stop that he was going to kill me, he kept beating, as he was in every major bloody fight in WW2, a paratrooper, he was deeply and profoundly abused as a child and I deal with that most of the time, and he died and never said a kind word to me in all my years of living. My sister was my best friend, she had a double lung/heart transplant over 23 years ago and died in May, I was her caretaker by choice, as my other sisters and my Mom did not want this job, I chose it because she was everything to me, my hero, my ONLY validator, and yes she listened to me, encouraged me and helped me seek the best care for my illnesses, and she had a son with Scz-Affective Disorder, and we have two other first cousins with same. So, I need help. I have had the same therapist for 10 years, I have tried everything, been hospitalized once, and withdrew after one night because I knew I wasn't so ill to b there, it was just after my sister's death, and I drank too much and took too many Xanax. I have tried everything med wise except MOAI's(spelling) because I fear the cheese/wine allergy, I have allergies to lots of things, and asthma and lupus and have had thyroid cancer, now need hip surgery, just really blue and really need some insight into what would "you" recommend for me. I have tried many, many "talk" therapists and they seem really stupid to me, I am very spiritually connected I think, then I think maybe that is my problem. I am mostly combative in conversations when I feel I am being judged by my dysfunctional family, basically when my sister died I lost reality for several weeks and sent nasty letters to her horrible husband who she knew was cheating on her, she died in my arms, we were alone in the hospital her husband never stayed with her, it was always me with her, and I spent the last two nights alone with her. I feel guilty because I gave her a Xanax to calm her because her Drs. had her on Klonipin and she begged me for a Xanax, and now I worry it was too strong for her, I am full of sadness, and such misery, I am currently on 4 mg of alprozalam a day, when i need it, Tramadol 100 mg, which for me is the best anti-depressant I have tried. I am allergic to the "epileptic" ones, I get very puffy, I am not an addictive person, I know my limits with alcohol, and have basically stopped drinking because I know how bad it is for me, it has been the worst drug of choice for me, and it makes me "psychotic" and I say and do horrible things to those I love. I am taking 10 mg of Ambien to sleep although it doesn't help at all, the only thing I have found which helps me is Seroquel, but I am so afraid of it, and the issues with diabetes and stuff, (I tried Lithium and was allergic to it, and suffered greatly from the few weeks I was on it) Seroquel is the only thing which levels me out, even on a low dose of 25-50 Mg. it helps more than anything, with my Xanax and Tramadol, so I suppose I just needed to ask what would "you" do if you were me, I feel most days like I need to be dead, I spend most of my time in prayer asking God to let me die, I have four children and five grands and most of my children have my illness of depression and anxiety and most have had lots of breakdowns, and it is hard trying to "mother" them when I am so ill myself. My bright spot is my wonderful supportive, loving husband, who believes in me and sees the best in me, I can never see. I try to be a good person, I feel I am bad because of the abuse and the narcisstic Mother, and two evil sisters. I am in the midst of "divorcing" my Mother and two sisters as I have always been the scapegoat, the seeker of truth, the only one to tell the truth. I think I need more help than I am getting, no one can help me I think. Thank you for reading this, and any suggestions will be appreciated.
Posted by jono_in_adelaide on December 21, 2012, at 20:31:15
In reply to Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 21, 2012, at 19:57:49
A few points -
100mg tramadol is a low dose, for pain it is commonly given in doses of upto 400mg a day, so you certainly have room to increase there
25-50mg of Seroquel at bedtime is unlikely to produce any major metabolic side effects, if it is the only thing that works, use it
Have you tried tranylcypromine (Parante) either alone or in combination with nortriptyline - it is certainly worth a try if you havent trialed it at maximum doses for 8 weeks or so - try it alone first, and also in combination
Posted by schleprock on December 21, 2012, at 21:09:16
In reply to Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 21, 2012, at 19:57:49
> First time post, I am a writer, a published author, and I just gained the courage to join my first ever forum dealing with my disease(s). I have been ill with what I refer to as Melancholia since I can remember, perhaps as young as 5. I think I have drug resistant depression, know I have CPSTD, from childhood abuse, know I have Borderline P Disorder from my childhood abuse, know I am the scapegoat in a very dysfunctional family, oldest of four girls, grew up in a very strict southern uber-religious family, was literally beat with belts, whips, you name it, all through my Jr. Sr. years, (nude) per my father, my Mom knew of the abuse and would stand outside the door and scream for him to stop that he was going to kill me, he kept beating, as he was in every major bloody fight in WW2, a paratrooper, he was deeply and profoundly abused as a child and I deal with that most of the time, and he died and never said a kind word to me in all my years of living. My sister was my best friend, she had a double lung/heart transplant over 23 years ago and died in May, I was her caretaker by choice, as my other sisters and my Mom did not want this job, I chose it because she was everything to me, my hero, my ONLY validator, and yes she listened to me, encouraged me and helped me seek the best care for my illnesses, and she had a son with Scz-Affective Disorder, and we have two other first cousins with same. So, I need help. I have had the same therapist for 10 years, I have tried everything, been hospitalized once, and withdrew after one night because I knew I wasn't so ill to b there, it was just after my sister's death, and I drank too much and took too many Xanax. I have tried everything med wise except MOAI's(spelling) because I fear the cheese/wine allergy, I have allergies to lots of things, and asthma and lupus and have had thyroid cancer, now need hip surgery, just really blue and really need some insight into what would "you" recommend for me. I have tried many, many "talk" therapists and they seem really stupid to me, I am very spiritually connected I think, then I think maybe that is my problem. I am mostly combative in conversations when I feel I am being judged by my dysfunctional family, basically when my sister died I lost reality for several weeks and sent nasty letters to her horrible husband who she knew was cheating on her, she died in my arms, we were alone in the hospital her husband never stayed with her, it was always me with her, and I spent the last two nights alone with her. I feel guilty because I gave her a Xanax to calm her because her Drs. had her on Klonipin and she begged me for a Xanax, and now I worry it was too strong for her, I am full of sadness, and such misery, I am currently on 4 mg of alprozalam a day, when i need it, Tramadol 100 mg, which for me is the best anti-depressant I have tried. I am allergic to the "epileptic" ones, I get very puffy, I am not an addictive person, I know my limits with alcohol, and have basically stopped drinking because I know how bad it is for me, it has been the worst drug of choice for me, and it makes me "psychotic" and I say and do horrible things to those I love. I am taking 10 mg of Ambien to sleep although it doesn't help at all, the only thing I have found which helps me is Seroquel, but I am so afraid of it, and the issues with diabetes and stuff, (I tried Lithium and was allergic to it, and suffered greatly from the few weeks I was on it) Seroquel is the only thing which levels me out, even on a low dose of 25-50 Mg. it helps more than anything, with my Xanax and Tramadol, so I suppose I just needed to ask what would "you" do if you were me, I feel most days like I need to be dead, I spend most of my time in prayer asking God to let me die, I have four children and five grands and most of my children have my illness of depression and anxiety and most have had lots of breakdowns, and it is hard trying to "mother" them when I am so ill myself. My bright spot is my wonderful supportive, loving husband, who believes in me and sees the best in me, I can never see. I try to be a good person, I feel I am bad because of the abuse and the narcisstic Mother, and two evil sisters. I am in the midst of "divorcing" my Mother and two sisters as I have always been the scapegoat, the seeker of truth, the only one to tell the truth. I think I need more help than I am getting, no one can help me I think. Thank you for reading this, and any suggestions will be appreciated.
You might want to hire an editor.
Posted by SLS on December 22, 2012, at 0:07:38
In reply to Re: Melancholia is my existence, my life. Please read., posted by jono_in_adelaide on December 21, 2012, at 20:31:15
> 25-50mg of Seroquel at bedtime is unlikely to produce any major metabolic side effects, if it is the only thing that works, use it
I agree.
If you need to allay your fears, you could have periodic blood tests to ascertain your metabolic status.
When taking a MAOI, the food interactions do not involve allergy.
It would be easier to provide suggestions were you to provide some information regarding your treatment history.
Did a psychiatrist tell you that you had the "melancholic" subtype of depression? Not all cases of depression are melancholic. Ironically, the more common depression is called "atypical". Actually, melancholic depression can be divided further into subtypes according to psychomotor status: "agitated" versus "retarded" types. Yours would appear to be agitated. Do you feel significantly worse in the morning? Which tricyclic antidepressants (TCA) have you tried?
Although a biological treatment could help tremendously, it appears to me that you would still have unresolved psychosocial issues that need to be addressed despite feeling better. However, this would be a much easier task were the depression to be treated successfully.
- Scott
Posted by SLS on December 22, 2012, at 0:10:52
In reply to Re: Melancholia is my existence, my life. Please read., posted by schleprock on December 21, 2012, at 21:09:16
> You might want to hire an editor.
Was this meant to be helpful?
Even on my best days, I would feel hurt by this, particularly if I were a writer.
- Scott
Posted by 10derheart on December 22, 2012, at 1:27:53
In reply to Re: Melancholia is my existence, my life. Please read. » schleprock, posted by SLS on December 22, 2012, at 0:10:52
yikes! I agree with Scott. I winced when I read that. Attempt at humor but didn't work out quite right??
I know you are a kind poster schleprock, maybe you can rethink that one? -- 10der
Posted by alabamaauthor on December 22, 2012, at 9:56:36
In reply to Re: Melancholia is my existence, my life. Please read., posted by 10derheart on December 22, 2012, at 1:27:53
The Comment "you might hire an editor" has caused me pain and set me back three steps from the courage it took to open myself up to seek help from other people who I thought could help or offer suggestions. Thank you to all the people who offered help and suggestions. To the person who suggested I "might hire an editor", I can only assume you are in a much darker place than I, that you should make such a hurtful comment to someone on this forum. Sorry now I posted, I KNOW I am an accomplished author. I KNOW I suffer from probably the same thing that did in Virgina Woolf, and each day I empty my pockets of stones.
Posted by SLS on December 22, 2012, at 10:17:37
In reply to Re: Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 22, 2012, at 9:56:36
Please don't go away...
- Scott> The Comment "you might hire an editor" has caused me pain and set me back three steps from the courage it took to open myself up to seek help from other people who I thought could help or offer suggestions. Thank you to all the people who offered help and suggestions. To the person who suggested I "might hire an editor", I can only assume you are in a much darker place than I, that you should make such a hurtful comment to someone on this forum. Sorry now I posted, I KNOW I am an accomplished author. I KNOW I suffer from probably the same thing that did in Virgina Woolf, and each day I empty my pockets of stones.
>
>
Posted by Phillipa on December 22, 2012, at 10:19:57
In reply to Re: Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 22, 2012, at 9:56:36
Late to the thread but seriously a proper welcome to this site is in order. So welcome and at times read between the lines. Phillipa
Posted by alabamaauthor on December 22, 2012, at 18:08:06
In reply to Re: Melancholia is my existence, my life. Please read. » alabamaauthor, posted by Phillipa on December 22, 2012, at 10:19:57
INSIDE YOUR FIRST BREAKDOWN
Alabama Jane Brown
(First published on webdelsol)
When they ask you about this moment, it is only because you have forgotten
What it felt like to be living outside the song of the nightingale.
There will be darkness and fear.In this room there is light. Unknown to you. Deprived to you. Only you.
The light has escaped the wooden shutters, which have become frail and brittle over the years.
The letting in of light and the closing out of light.
The obsessions of many and the bane existence of the phobic. Do not worry.
The light can be your friend. You will learn this with time.
The light will become your only friend as you try and determine the depth of this Situation.
You can rely on the innocent light which has escaped the shutters.
Even they can not take that hope away from you.There is no sense and order in this.
There never is and never has been, since the beginning of time.
That if anything will be your consolation. You are not the first.
And you will not be the last.
The darkness is the primary symptom they speak of.
You will come to question they.They will become your conscious.
There have been many ones before you.
Fat ones, famous ones, fastidious ones.
They all have one thing in common.
They never meant to be here, just as you.
This is not page 300 of the biography on Virginia Woolf.
This is your life, dear one.
This is your new life.I have been there inside this house with closed shutters focusing on that one
Ray of sunshine that escaped the wooden shutters and rested on the dust of a forgotten corner
Always
Emptying my pockets of stones.
Emptying my pockets of stones.
Posted by johnLA on December 22, 2012, at 19:10:19
In reply to Re: Melancholia is my existence, my life. Please read., posted by schleprock on December 21, 2012, at 21:09:16
i rarely post anymore.
but, your post on this thread i found highly hurtful and rude. and, very stupid to boot.
i can't help myself...
what on earth were you thinking when you posted what you did to a first time poster who is in severe pain?
do the right thing...
Posted by johnLA on December 22, 2012, at 19:17:47
In reply to Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 21, 2012, at 19:57:49
dear alabama-
please stick around. there are some good people here who will be able to offer some good advice.
one thing i can tell you; replacing my hip was one of the best things i did for my arthritic pain. as for your emotional pain, again, i hope you come back and get some advice/help here.
john
Posted by schleprock on December 22, 2012, at 20:16:25
In reply to Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 21, 2012, at 19:57:49
http://uncyclopedia.wikia.com/wiki/Wall_of_Text
Hi, my name is schleprock, and I'm an unemployed loser, and will probably remain so for the foreseeable future due to an unfortunate chain of events that began when a so-called psychiatrist decided on a whim that I was bi-polar and became determined to disrupt what was until then very successful antidepressant regimen. At least until I kill myself. But in the indeterminate amount of time I have left, I'm not sure if it can be justified spent looking at overwhelming amounts of text with no clear and concise separation of thoughts arranged in a structure that would provide a comfortable and courteous degree of pacing for the reader. There is a limit to how much disorganization I can tolerate, due to the delirium I currently suffer as the result of mind-altering drugs. As one who has had recent experience with melancholia, I would have been interested in reading the above post, which makes the aforementioned circumstances all the worse. I already have enough trouble with Lou Pilder's posts, which I must admit I have no choice but to briefly skim.
Due to the disproportionate amount of anger and hostility directed against me by all in this thread, and the case that I have a very Jewish-sounding name, I must echo Lou Pilder's sentiments that flagrant anti-Semitism is permitted to run loose across this network.
I have no doubt that most of you are already plotting against me, and plan to make every thread consist of nothing but posts of walls of text in an effort to drive me off of the forum for good. I am sorry that Dr. Hsuing has let it come to this.
Posted by Phillipa on December 22, 2012, at 21:04:46
In reply to Re: Melancholia is my existence, my life. Please read., posted by schleprock on December 22, 2012, at 20:16:25
I feel badly for both of you. I think others were only asking for a clarification of what you meant. To the person reading for first time it did sound harsh. But now you have posted what I feel is a post that explains why you posted what you did. I understand. But also there is no anti-semetism here. I hope you are angry and not being sarcastic. As I find you a lovely poster. Phillipa
Posted by SLS on December 22, 2012, at 21:34:42
In reply to Re: Melancholia is my existence, my life. Please read., posted by schleprock on December 22, 2012, at 20:16:25
This is clever and funny, but I think a simple apology would have been more productive.
Don't worry about the loser thing. It happens to the best of us.
- Scott
> http://uncyclopedia.wikia.com/wiki/Wall_of_Text
>
> Hi, my name is schleprock, and I'm an unemployed loser, and will probably remain so for the foreseeable future due to an unfortunate chain of events that began when a so-called psychiatrist decided on a whim that I was bi-polar and became determined to disrupt what was until then very successful antidepressant regimen. At least until I kill myself. But in the indeterminate amount of time I have left, I'm not sure if it can be justified spent looking at overwhelming amounts of text with no clear and concise separation of thoughts arranged in a structure that would provide a comfortable and courteous degree of pacing for the reader. There is a limit to how much disorganization I can tolerate, due to the delirium I currently suffer as the result of mind-altering drugs. As one who has had recent experience with melancholia, I would have been interested in reading the above post, which makes the aforementioned circumstances all the worse. I already have enough trouble with Lou Pilder's posts, which I must admit I have no choice but to briefly skim.
>
> Due to the disproportionate amount of anger and hostility directed against me by all in this thread, and the case that I have a very Jewish-sounding name, I must echo Lou Pilder's sentiments that flagrant anti-Semitism is permitted to run loose across this network.
>
> I have no doubt that most of you are already plotting against me, and plan to make every thread consist of nothing but posts of walls of text in an effort to drive me off of the forum for good. I am sorry that Dr. Hsuing has let it come to this.
Posted by Emme_V2 on December 22, 2012, at 21:49:28
In reply to Re: Melancholia is my existence, my life. Please read., posted by schleprock on December 21, 2012, at 21:09:16
> You might want to hire an editor.
Since Alabamaauhor makes his/her living as a writer, she or he may have been using the stream of consciousness narrative mode, a valid literary device used by the likes of James Joyce. This may have been the the most doable or natural way for her or him to express distress at that time.
That said, some of us here (like me) have some brain fog sometimes or get fatigued quickly, so long unbroken posts can be extremely difficult to concentrate on. If there are some paragraph breaks and more punctuation, it's easier for me to see what's going on and see if there's anything I can help with. (And every now and then there is...:)
Welcome Alabamaauthor, and I hope you find treatment that works for you.
Posted by alabamaauthor on December 22, 2012, at 22:23:30
In reply to Re: Melancholia is my existence, my life. Please read. » schleprock, posted by Emme_V2 on December 22, 2012, at 21:49:28
Dear all, I only speak in truth to my immediate feelings and write as I think in rambled nonsense and sometimes very, very, very dyslexic scribe, as I am dyslexic with all my my other problems in my brain. I offer one thing...I truly believe we are all of the same origin and some of us are over evolved and some of us are hyper-sensitive due to our issues with our brains being off kilter, "the normal" evolution. I simply seek to help myself, and others truly understand why we are so "sad", ",misunderstood", "melancholic" and "depressed". I love all mankind, and I am always open to a dialogue that will enhance the love of man between others in our situation. I read recently, (and that is why I started this post) that all people with a mental illness need to connect with a supportive group, and because everyone I know thinks I am well on my way to "hell" because I have a mental illness, I sought out this group to help me. I am always here for anyone, no matter how trivial the issue, no matter how you feel, I am here to offer at least advice of some king of help, never will I offer judgement, pain or any sort of meanness.
Posted by Phillipa on December 22, 2012, at 23:13:50
In reply to Re: Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 22, 2012, at 22:23:30
Thank you you are sweet:)))) Phillipa
Posted by jono_in_adelaide on December 23, 2012, at 16:52:39
In reply to Re: Melancholia is my existence, my life. Please read. » alabamaauthor, posted by Phillipa on December 22, 2012, at 23:13:50
Alabamaauthor - I cant encourage you enough to try Parnate (tranylcypromine) both by it self and in combination with nortriptyline if you havent yet done so.
There are several other "end of the road" options you could try as well, so please done lose hope, Remeron + high dose Effexor for example.
Also, keep looking for a therapist who is right for you, because you obviously have a lot of stuff to work through.
Posted by brynb on December 23, 2012, at 16:59:54
In reply to Re: Melancholia is my existence, my life. Please read., posted by johnLA on December 22, 2012, at 19:17:47
Posted by alabamaauthor on December 26, 2012, at 16:28:23
In reply to Re: Melancholia is my existence, my life. Please read., posted by jono_in_adelaide on December 23, 2012, at 16:52:39
Thanks all, hope we all made it through Christmas.
I have tried Pamelor three times and it seems to be the best for me, my therapist is out of town, and being very desparate, I pulled it out and have been taking 20 mg at bedtime with Ambien, no Seroquel, and 1 mg of Xanax. I believe it has immediate action, as my anxiety is way down, I can't remember why I stopped it. I am certain as the days go by I will be reminded by the side effects, Oh! I remember, I was told it had cardio effects??? Does it suppress anxiety? Does it cause weight gain too?
I want to find a new therapist asap. After 11 years you would think I would be on a better path.
Thanks all for the time you took to post.
Posted by jono_in_adelaide on December 27, 2012, at 21:28:56
In reply to Re: Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 26, 2012, at 16:28:23
Pamalor releives depresssion and anxiety - effective dose between 50 and 150mg per day (usualy 75-100mg)
It can cuase some weight gain, but it isnt as bad as some of the tricyclics, and in your current condition, I think a few pounds weight gain would be a small price to pay for releif
You can get extra antidepressant effect by combining Pamelor with an SSRI (Zoloft, Lexapro or Celexa, NOT Paxil or Prozac)
20mg is a subtheraputic dose (like taking half an aspirin for a headache), i would enciurage you to push it to 75mg asap, then geta blood test after 2 weeks to see wether you need to go higher, go lower, or stay at that point.
Posted by hyperfocus on December 30, 2012, at 13:49:25
In reply to Melancholia is my existence, my life. Please read., posted by alabamaauthor on December 21, 2012, at 19:57:49
Complex PTSD has many ramifications; treatment-resistant depression is just one of them. Dissociation -- a fragmenting of your consciousness -- is the hallmark of Complex PTSD and while its surface symptoms satisfy every criteria for major depression and extreme anxiety and obssessive thinking and paranoia and several other psychiatric conditions, it's actually a completely separate disorder that requires unique targeted treatment. Somatization of psychic distress is universal and can manifest as chronic fatigue or any number of puzzling treatment-resistant physical conditions. Meds can play a large role but treating CPTSD, if that is what you have, primarily requires you to re-establish in your mind a sense of safety, stability, control, and relearn many things about your self that abuse and trauma have erased. The psychological consequences of abuse and trauma create in the victim a sense of helplessness and unworthiness that can pervade a person's life, from your inability to control your own thoughts and memories, to regulate your own emotions, maintain executive control of your attention, focus, physical and emotional energy, to handle disappointments and challenges, manage conflict maintain relationships, to set goals. It also unfortunately makes you more vulnerable to revictimization which can form a self-fulfilling cycle of abuse and dysfunction. Like I said all these things might be attributed to major depression and anxiety et.al but obviously it goes much deeper that.
Posted by SLS on December 30, 2012, at 14:31:13
In reply to Re: CPTSD » alabamaauthor, posted by hyperfocus on December 30, 2012, at 13:49:25
Brilliant explanation. Thanks.
Let me know what you think of this:
http://www.positivehumandevelopment.com/developmental-ptsd.html
How does this compare to C-PTSD?
http://www.traumacenter.org/products/pdf_files/JTS_Oct_09_Cloitre_et_al.pdf
I am looking at the possibility that prazosin would be an effective treatment for these conditions.
- Scott
> Complex PTSD has many ramifications; treatment-resistant depression is just one of them. Dissociation -- a fragmenting of your consciousness -- is the hallmark of Complex PTSD and while its surface symptoms satisfy every criteria for major depression and extreme anxiety and obssessive thinking and paranoia and several other psychiatric conditions, it's actually a completely separate disorder that requires unique targeted treatment. Somatization of psychic distress is universal and can manifest as chronic fatigue or any number of puzzling treatment-resistant physical conditions. Meds can play a large role but treating CPTSD, if that is what you have, primarily requires you to re-establish in your mind a sense of safety, stability, control, and relearn many things about your self that abuse and trauma have erased. The psychological consequences of abuse and trauma create in the victim a sense of helplessness and unworthiness that can pervade a person's life, from your inability to control your own thoughts and memories, to regulate your own emotions, maintain executive control of your attention, focus, physical and emotional energy, to handle disappointments and challenges, manage conflict maintain relationships, to set goals. It also unfortunately makes you more vulnerable to revictimization which can form a self-fulfilling cycle of abuse and dysfunction. Like I said all these things might be attributed to major depression and anxiety et.al but obviously it goes much deeper that.
Posted by hyperfocus on December 31, 2012, at 18:12:52
In reply to Re: CPTSD » hyperfocus, posted by SLS on December 30, 2012, at 14:31:13
> Brilliant explanation. Thanks.
>
> Let me know what you think of this:
>
> http://www.positivehumandevelopment.com/developmental-ptsd.html
>
> How does this compare to C-PTSD?
>
> http://www.traumacenter.org/products/pdf_files/JTS_Oct_09_Cloitre_et_al.pdfThanks for the articles. I was unaware of the differences between what's called Developmental PTSD and Complex PTSD. Although they are very similar I suppose their development and root causes warrants a distinction. Developmental PTSD can be an extraordinarily powerful diagnostic tool for abused and disadvantaged children to mend their lives.
>
> I am looking at the possibility that prazosin would be an effective treatment for these conditions.
>
>
Honestly I've become skeptical of the ability of meds to treat conditions like C-PTSD rooted in psychological trauma. Our emotions, thoughts, behaviors, memories, and perceptions are locked in very complex relationships.....I think that changing just one thing isn't sufficient to get a mind healthy. Also it is critical for people recovering from trauma to re-establish in themselves the belief that their will, however you wish to define this, controls these emotions and thoughts and behaviours et.al . Meds like prazosin and atenolol can reduce the overexcitability of adrenoreceptors in the nervous system and reduce anxiety and the occurrence of intrusive memories and flashbacks and nightmares. These things can help somebody tremendously with dissociation and depression and the sense of helplessness CPTSD and all MI sufferers feel, and give them back some semblance of control over their inner experience. But to me switching the locus of control of inner experience to medications, with all the expectations of recovery, isn't a long-term viable or safe strategy.To me knowledge and understanding are powerful tools, just as powerful or even moreso than meds. I think a lot of people with MI simply are unaware of what they are suffering from, and the piecemeal diagnostic strategy psychiatrists have employed so far doesn't help at all. This is why I do not understand the decisions to remove conditions like Asperger's and Complex PTSD from the DSM. I find the ability for a patient to see what are a vast and often confusing array of conditions as having a single root cause to be incredibly useful, independent of whether one can define a 'cure' for these things. For many people just having knowledge of what actually is wrong with them is like 50% of the battle.
Just a personal example: today I did some work in our front-yard. Usually I can't do anything like this because it seems I get fatigued and depressed very easily and a huge amount of poison just seems to bubble up from the depths of my mind and I just have to stop after like five minutes. Like a lot of people on PB I find physically demanding activities like yardwork or routine activities like housework to be beyond me most of the time. But as I started working, just the knowledge that the initial physical fatigue I felt in my muscles was actually part of my Asperger's and that I was just different from other people and not lazy or weak gave me the will to carry on. Just the knowledge that the bad things people would say about me as a kid whenever I attempted sustained physical effort were no way my fault or under my control made me able to put them aside and keep working. When I started getting the familiar feelings of depression and worthlessness and all the accusing voices and memories of being called stupid and lazy and careless et.al, just the knowledge these intrusive thoughts and feelings actually had a psychological cause and were just how my brain worked presently was enough for me to continue with what I was doing. Somehow just the ability to recognize and understand the emotional distress as just a bunch of thoughts and memories and feelings and perceptions that had nothing to do with my actual abilities, and had nothing to do with the present moment; that were completely separate from what my present day reality was, allowed me to carry on much longer than I thought possible. Afterwards, the feeling that I had that for the first time in a long time our house would be semi-presentable for the New Year was quite encouraging and liberating. I actually look forward to what I can accomplish tomorrow. I honestly believe that this is the kind of progress I can make independent of whatever meds I am on.
Part of the principles of mindfulness and I suppose Buddhism is that our pain and suffering and desires are not who we are in the least. For me personally, this knowledge and knowledge of my condition and tools and exercises and strategies I've learned to re-establish a sense of control over my inner experience have been extraordinarily powerful weapons that have gone far beyond what I hoped for from medication. I think that this sense of control is what CPTSD victims may crave the most and meds are not sufficient to establish this permanently. All of us who had a response to medication at some point dreaded the day poop-out would occur. To me it is much better to try to find a sense of control by using adversity and illness and all the things that have broken us down as a way to rebuild ourselves into people who are more aware of who they really are and what their real place in life is -- people who can become better and stronger and smarter than we were before.
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Dr. Bob is Robert Hsiung, MD,
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