Quote:
Originally Posted by June_Bug
One of the foremost authorities in DID is at the Sheppard Pratt Institute in Baltimore, Maryland. His name is Richard Lowenstein, he's the Medical Director for this trauma center and developed one of the models used today for grounding techniques throughout the United States in all the better know trauma hospitals. The clinicians that worked and studied under him have published several books which can be found at Sidran.org.
Dr. Lowenstein was my attending physician while I stayed as inpatient at Sheppard Pratt. He informed me that under PTSD is a sub-category for dissociative disorder, which is where he classified me. As well, my psychiatrist, who works with the researchers at National Institute of Mental Health in Bethesda, Maryland, has diagnosed me with PTSD/ dissociative disorder not otherwise specified (DDNOS). There is no DSM for chronic PTSD under the DSM-IV. To go further, the head of Neurology at Georgetown Hospital also classified me as having a dissociative disorder under PTSD. These are three well known doctors/researchers with proven published research over the past 30+ years.
I want to say here that there is a broad range of what dissociative disorders are. To say here in this forum that "I (and the mental health community here) believe....." is making a statement that is very misleading. It's taking the members down a very confusing path and DID/DDNOS is very confusing to begin with. I have decided to copy from three sources and print them here for anyone to discern for themselves. It's great we have this forum to learn from. But we all have to make decisions for ourselves and consult with our prescribing doctors and not rely exclusively what is said in forums in general.
This is from Sidran.org, as this was adapted from DSM-IV, p. 427-429 which states that dissociative disorders are classified under PTSD:
posttraumatic stress disorder (PTSD) An anxiety disorder based on how an individual responds to a traumatic event. According to DSM-IV, the following criteria must be met, see the last bulleted item:
• The person has experienced a traumatic event that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others, and the person's response involved intense fear, helplessness, or horror
• The traumatic event is re-experienced in specific ways such as recurrent and intrusive distressing recollections or dreams of the event
• Persistent avoidance of stimuli associated with the trauma or numbing of general responsiveness
• Persistent symptoms of increased arousal, such as hypervigilance or irritability
• Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month
• The disturbance causes clinically significant distress or impairment in functioning.
PTSD may be acute, chronic, or with delayed onset. Many individuals with DID (MPD) also have PTSD. The literature sometimes describes DID(MPD) as complex and/or chronic PTSD. Adapted from DSM-IV, p. 427-429.
http://www.sidran.org/sub.cfm?contentID=38§ionid=4
Under the DSM-IV for PTSD 309.81 B(3) as classified under Anxiety Disorders:
(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes.
Under the DSM-IV for DID 300.14:
A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
B. At least two of these identities or personality states recurrently take control of the person's behavior.
C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.
I find this all very interesting. For me, I wonder if DID or DDNOS is very different, just my experience. I live with DDNOS but at times when I dissociate I have to wish I was able to observe what I am like and what I have to say during this process. I recognize afterwords that I did dissociate and I have to live with the damage or wreckage of what I said or did.
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within this long post you stated the doctor told you "There is no DSM for chronic PTSD under the DSM-IV"
I wanted to let you know yes there is. the term "chronic" in psych terms means the problem is persistant and recurring. the DSM IV TR criterion includes in criterion E and F which states
"Criterion E: duration
Duration of the disturbance (symptoms in B, C, and D) is more than one month.
Criterion F: functional significance
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if:
Acute: if duration of symptoms is less than three months
Chronic: if duration of symptoms is three months or more
Specify if:
With or Without delay onset: Onset of symptoms at least six months after the stressor"
http://www.ptsd.va.gov/professional/...iv-tr-ptsd.asp
I also wanted to clarify why I use the wording "the mental health community here believe" which you state in your post is misleading.
I would use other wording but this site does not allow for any other wording other than speaking in "I statements" meaning only speak for yourself and your location and your own mental health community beliefs.
I cannot speak for everyone around the world and every members mental health agencies and every locations rules.
Psych central moderators have told me this is a support website where we dont tell other members how things are "for everyone" so my postings must reflect only what I go through, only what I have been Taught, only what the mental health community in - my - location believes.
so when I post that kind of wording in my posts its at the direction and rules of the moderators, administrators and psych central rules for posting here by keeping things specifically related to only me, those I work for and those that I am governed under as a mental health provider for NY state.
Im sorry its upsetting to some that I keep wording my posts the way I do, Im just trying to follow the rules here.
Got to say it - I get asked a lot why I am still moderated and this is exactly why.
I remain under moderation for this exact reason that some may find the wording of my posts upsetting and frankly its online and world wide so theres no way I can please every member, theres no way I can avoid every members triggers,and because of the stereotypical /generalized reactions to a mental health provider being in online support groups. by remaining under moderation I and the administrating team of moderators and administrators can be assured my postings are worded correctly - before - they are placed on the boards.
Im sorry to anyone my posts are offending, seems to be misleading and upsetting, Theres nothing I can do about it unless this site decides to get rid of the requirement that we only speak for ourselves and our own work places and our own locations. should they decide to do that I will be more than willing to have my postings reflect what the sheppard pratt institute of baltamore maryland, or any other agency, state country where I dont live or work for believes.