Do you think you might have PTSD? Well, you might.

PTSD or post-traumatic stress disorder has been given a lot of attention in recent years. The massive influx of military personnel returning from the Middle East who have endured one or multiple turn(s) of duty has forced us to admit that this is a real problem.

Oddly, even though we are now ready to admit the condition exists, there is still a lot of work to be done. First – there is no central thought on how to treat victims of PTSD – particularly in the government. Traditionally, men returned from war were told “Now you are home, get a job”….a little bit better than “now you are home, but we need you back”, but not near good enough. But probably the message that they hear in their mind is “Get back out there and fight you sissies”.

Even the VA or Veteran’s Administration has little to offer in the way of actual PTSD treatment. Compound that with the fact that most veterans who have PTSD have a little-recognized type kinown as Complex PTSD or CPTSD which is a series of traumatic events experienced over a period of time, where each occurrence may in itself not qualify as a traumatic event (but may) but occurred over an extended length of time in which the victim was stressed, experienced a threat to life, and felt trapped in the situation. Now, it doesn’t say that any of these situations had to be “REAL”, the definition is based on the perception – the victim had to feel or see that an event was traumatic, the victim had to feel that life or physical well-being was threatened, and they had to feel trapped.

C-PTSD did not make it into the latest version of the DSM (Diagnostic Statical Manual) which is basically the Bible for psychiatric conditions. But more and more cases of chronic PTSD are occurring.

Unfortunately, though most of the attention has been given to returning veterans – there are also several other groups who have a similar experience leading to chronic or complex. These groups are little recognized and rarely treated.

Consider the military experience – You got shipped around the world, people are shooting at you, bombs are going off around you, you have lost several friends, you may have lost a body part, you thought you would never leave alive, the food was awful, there was sand everywhere and little water, it was blazing hot all the time, you were isolated and learned to trust no one. You thought it would never end. You got out, can’t get a job, can’t have the same relationships as before, can’t feel, are angry and irritable and can’t sleep – you have nightmares or flashbacks all the time. Everyone says like you should get back “out there” but you can’t

Consider a different experience – you are a child, you think you will always be a child, people yell all the time for no apparent reason, this hurts your ears, you get spanked on an irregular basis, you may be locked in a dark place and not fed or spoken to for several days when you have done something “bad”, your uncle comes in and wakes you up and does things to you, he tells you never to tell anyone and if you do he will kill you or it will kill your mother. You don’t want your mother to be sad – or she doesn’t care. No one believes you or notices but they tell you that you have to do good in school. You don’t know if it will ever end. You feel like a bad kid that no one cares about because no one noticed or cared – or worse told you they would hurt someone.

You are a mom. You wanted to have children but when you got pregnant the first time, you lost the baby. The second pregnancy was very hard with constant gut wrenching vomiting, diabetes and an emergency C-section. After the surgery you can’t heal from the wound because you were in such bad shape. You can’t take care of the baby by yourself all the time but there is no one to help you so you feel bad. You have no money and are stuck at home sick, with a baby and cannot work. Just when you think there is a light through your fog – you get pregnant again – the first time you have had sex in a year. With a toddler in tow, you have another baby – through a C-section and healing difficulties again. Now you have a toddler and a new baby. The postpartum depression has not gone away. No one is trying to help anymore. You get only a few hours of sleep every night. There is always someone screaming or wanting you and it never ends. You feel trapped, have been ill for years and are being shouted at on a regular basis by both adults and children, you cannot go anywhere, you feel little real connection to children or even the world and you feel like a bad mom who deserves it.

In fact all three of these cases could actually be considered long term or chronic/complex PTSD. None are treated adequately or at all.

In all three cases – the person experienced traumatic stress both physical and mental over a long period of time with multiple or several acute episodes and felt trapped and helpless under those conditions. In all cases some symptoms have manifested themselves over time and the victims have become withdrawn, untrusting, disconnected and feel guilty about a lack of appropriate feelings. All three victims experience insomnia, anxiety, depression, hyper vigilance and a lack of appropriate interpersonal interaction. In all three cases there may appear to be functional behavior but may devolve. All three victims are suffering.

In the case of both the military returnee and the child abuse victim – a problem with a traumatic event may be recognized (or not) but will be treated as a single event (if at all). The military victim may receive some counseling and be put on a “no gun allowed list”. The child abuse victim may be given some counseling.

In the case of the pregnancy, it is likely that the trauma will not be recognized as such, particularly not as a disorder. The female may be treated for post-partum depression (or not) for a short period of time and likely the trauma of both physical (birth difficulties, sleep deprivation etc.) and/or emotional trauma of long term impossible constant demands will be seen as a single event or not noticed at all. This patient may receive some parenting classes and antidepressants (maybe).

The point being – we are supposedly the most advanced civilization in the world – but we fail to recognize some problems, serious problems which can be deduced with a little common sense. We should be able to see that these types of chronic conditions should be recognized and should be treated as chronic conditions and not as acute experiences.

I am a big proponent of pull yourself up by your bootstraps – but in some case, you need a little understanding and help

You can read more about Traumatic Stress Disorders at: the National Institute of Health PTSD at the VA PTSD or PTSD after pregnancy.

 
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Mental Health Issues: It might be you and not “them”

Since last week was Mental Health Week – I know this not because I am self-aware but only because I have seen several postings from Nikki et al at “Moms Who Drink and Swear” – which is a nationally recognized phenomenon now – (a blog, a book and a facebook page – probably soon a cable TV show – since there is so much swearing it has to go on cable), occasionally quite nasty blog, offensive to some but always funny and true –  had several blog postings on the subject of Mental Health. Anyway it made me think – about my own journey – and that of my friends and relatives – and those small-ish and irritating people who suddenly developed an opinion about the age of two.  Also – lets not forget my husband – he has issues too.

According to the National Institutes of Health, about 1 in 4 adults are at any one time suffering from some sort of mental health issue.  As with many government statistics – this is certainly vastly under reported as this is likely based on those who are actually diagnosed – or who answered a survey.  In fact there are certainly thousands and thousands more with issues that they either will not see a doctor about – or refuse to admit it even to themselves – even if family and friends already know.

Unfortunately in today’s judgmental society, admitting that you have a mental disorder can disrupt many facets of your life.  First, it will likely affect your friendships – once your friends know that you have a mental disorder, they can hold it against you – be patronizing – disregard what you say, etc.  It may also affect your family relationships – “if you disagree with me, it must be because you aren’t taking your meds” – “are drunk or high” or “are just plain crazy which is “bull$hit” – or “I must make sure you are limited in your exposure to the outside world and therefore you are not allowed to drive or go anywhere by yourself” – or all of the above.

The worst thing that can likely happen, unlike Kay Jamison’s experience, Carrie Fisher’s experience, and all the other celebrities who “come out” with their mental and emotional issues, supposedly receiving worldwide support – social media will let others know just how sick you are (or not in the case of Anna Nicole) – even if you are getting treatment.  It can affect what college you get into, what job you get or destroy a job you already have.  It can also cause you to be suspect in the world arena – “What if he is about to ‘go off’…does he have a gun, a bomb, a knife? – maybe he will be the next mass murderer….”  Just admit it – all the recent news stories involving people doing weird, dangerous and violent stuff were either later claimed to be suffering from a mental disorder – or they are something much worse.  People “going off” because they are “fed up” must be classified – one way or another.

I am clearly not saying it is ok to “go off” – but I am saying that if you have sought treatment or acknowledge any kind of mental aberration, you are now suspect to being ridiculed, argued with, disregarded , or put on a list if you do so much as disagree with someone – it must be your illness.

The fact is that people disagree, people get angry at other people, people are insecure AND you can’t step outside your door without running into 10 people who have a mental disorder – just most of them haven’t admitted it yet.  EVERYONE and I mean EVERYONE has several relatives and several friends who have mental health issues.  You might also have one yourself – maybe you would know about it if you would just be a little bit introspective.  If you can’t look at yourself and see anything wrong, then you definitely have Narcissistic Personality Disorder – which means you also lean toward Borderline Personality disorder, Antisocial Personality Disorder and possibly are Bipolar or a Sociopath – or maybe just have ADHD.

See there – you are just a hair away from being a Psychopath – all because you can’t see yourself, because you are perfect and everyone around you are the crazy ones.

Truthfully, mental health disorders are vastly underdiagnosed – because they are overstigmatized.  They are also misdiagnosed and overmedicated – particularly in children.  If this irritates you – bear with me a bit.

How many boys (and girls) are diagnosed with ADHD, really just because they can’t go outside and play?  Schools have cut back on PE programs and in some places have outlawed recess or in the case of one public school in New England – have outlawed physical activities on the playground?  A recent issue of new stamps has been recalled because some of the activities were considered “too dangerous”.  These included normal kid activities like skate boarding and riding a bicycle.  How many kids have been diagnosed with an Autism Spectrum Disorder because they have never been taught to behave.

So now – we put our kids in pillows, never let them eat dirt or bugs – -let them pick their meals (usually chicken nuggets, french fries and soda are the choice), give them more than a hundred vaccines, making their immunity into crap, give them medication for ADHD or ignore their aberrant behavior – then call them names –  but never treat them during teen or early adult years – and we certainly don’t treat their parents because someone might think they are “off”.

For a lot of mental disorders – medication is not the answer.  In many cases, some good common sense – for example – postpartum depression could be handled a lot better if a woman had more help after giving birth – she would get more sleep and benefit from the advice and assistance with new-baby and normal household issues – creating a lot less anxiety.  Our society says – get off your a$$ and get back to work – NO MORE SOUP FOR YOU.

In many cases of ADHD – send them outside – stop tellling them to “be quiet”.  In cases of Narcissism – a swift kick in the butt – you are not the center of the world.  In a lot of cases of chronic depression – set the alarm, open the curtains, get some coffee and get dressed – even if you don’t feel like it – moving will help stimulate the chemicals in your brain.

This is not to disregard the people who need medication or treatment because there are many real cases of AHDH, Autism, depression, bipolar disorder, addiction, schizophrenia etc.and as a pharmacist, I know the medications work, for some – but really my point is to destigmatize the existence of mental health disorders, because nearly everyone has at least one (probably 2 or 3 according to the DSM – if you don’t know what that is, google it since you are probably glued to the internet – this is known as internet addiction and can likely be treated with either an antidepressant or an amphetamine).

Just because someone disagrees with you, gets therapy, takes medication or just plain trips while walking doesn’t mean they are off their meds, crazy, high, drunk, developing medication side effects or are otherwise deranged.

Maybe the problem is that you should be diagnosed or maybe you either get them some help if they need it OR should just shut the fu(k up and mind your own beeswax – the probably weren’t talking to you anyway.