[MuddyBoots]

It’s common for someone with “Developmental Trauma Disorder” or “CPTSD” (neither consistently recognized as “real” conditions) to have 4, 5,6+ different diagnoses.

I supposedly have a significant trauma and neglect background, and have collected “BPD, bipolar, PTSD, ADHD, (right now anorexia but at sometimes better is described as bulimia or an unspecified eating disorder), and substance use disorder.” They’ve tried in the past going with a more schizo dx than bipolar, but dropped that, and once tried to pin me with DID. (Also was arrested once and told AsPD, but I feel and attach too much for that shyt to possibly he true. Maybe traits, but no, man, my cluster B is 100% BPD)

Read any book on trauma or the complex trauma center of Boston’s website and you can easily see someone who wasn’t loved or protected properly as a child meeting any of those “label criteria” in the 15 minutes they talk to their psychiatrist years down the line every so often after trying to hold things together forever.

If someone like myself has such “muddy waters” as my pdoc in the hospital put it, where do they begin with treatment? I was just inpatient, and it seems like unless you travel thousands of miles to some trauma treatment resort and spend the rest of your life in debt from it, they don’t like to touch anything PTSD-ish. Unless you have a BMI of 15 and a resting heart rate of 45 or are medically 100% fine (or go in debt doing residential in between IP and PHP) there’s no outside help (I’ve ever found anyway) for eating disorders. If you have both and manage to get treatment, there really isnt a place that truly addresses both (even if they’re very much connected). I consider my BPD a kind of trauma/stressor related disorder (even if DSM doesnt) because it 100% comes from an inconsistent and chaotic upbringing, so say I manage to find somewhere to help me eat AND manage flashbacks, are they at all likely to help with splitting, chronic feelings of emptiness, extreme dissociation/ psychosis under stressor or develop a stable sense of self? No. And if I get “manic” they’d likely see me at an early stage if hypomania where its fun and games and say I’m cured only for me to spend the next week’s nights wandering the city yelling at the caterpillars trying to infiltrate Market Basket’s upper management and then crying in a cop car about how a sea turtle wouldn’t stay an alligator or some random bizarre shyt like that. And if the ADHD symptoms aren’t addressed it’s not like I’ll let groups be productive for anyone, at least not the way the counselors intended anyway.

But it’s “Cambridge eating disorders clinic” to force you to eat, “so and so trauma center” that pri a ly has a bunch if EMDR therapists, or trying to find a DBT group to manage “BPD,” and if your pdoc catches you at the wrong moment they’ll try to add some heavy meds you MAY or MAY NOT truly need.

when they all probably are just signs you never learned to be a proper human when most people do instead of all these separate”disorders.”

The system is deeply flawed when it comes to people who COULD be diagnosed with (and treated for!) DTD or CPTSD instead of having 5 diagnoses and your doc saying “which needs work most now?”

I dont fking know doc! I hallucinate because I don’t sleep because I have nightmares and I’m depressed because I’m alone because I’m distrustful and angry all the time. But then someone says something sweet and I am over the moon for three hours until the tone in one text they sent doesn’t match the rest and then I’m researching best OTC meds to die quickest with, swearing to never eat again while hours later purging half a box of Lucky Charms, and I feel like the dumbest genius on this planet, and the most empathetic psychopath, and the most authentic actor and the loneliest life of the party. Someone says they love me ina most authentic fashion and I’m trained that they’re going to set me up for something not up my alley later, someone says “I’m gonna kill you” and I hear wedding bells. Tell me, doc, which diagnonsense is ruling me right now????! What treatment do YOU suggest?

Fk traditional treatment, just put me in a medical coma for a few years and wake me up when YOU get grandiose enough yourself to think you have an an answer. Depending on how far gone you go, you might be on to something by then. Until then, shove the Zyprexa where the sun don’t shine and sprinkle legos all along the path between your bed and the bathroom every night you have too much to drink before bedtime.

[Crazy Hitch]

Wow well written. I can’t imagine what you have to deal with. I know it’s gotta be so tough and it’s a damn shame you can’t get the treatment you deserve.

[MuddyBoots]

Honestly probably should’ve taken as much valium as they’d let me before I was discharged today. The weather is screaming at me
From this storm to the one in my head
I’ll never escape the way that I’m feeling
Until the day that I’m dead

Except Colourblind got it wrong. Today the storm’s a tornado, that’ll pass in twi hoyrs, then a blizzard’s coming in and gonna drop 4’ then a tropical storm’s coming behind it and theres gonna be major flooding, then we wont have a drop of rain for 7 weeks and its gonna hit the 90s and 100s every day, then I bet a microburst is gonna tear shyt up, and then an earthquake is just gonna scare rhe dogs and break some d-bag’s expensive vase, and then quarter inch hail will fall from the heavens while winds rip shingles and siding off of housing.

“And all the people will move here for mild summers.” Yeah, hard to notice the heat when you’re passed out in a bathroom at a McDonald’s

[splitimage]

I've been Dx different things over the years too - with significant childhood trauma. I was just lucky when I started seeing my 2nd psychiatrist that she was a trauma specialist (total luck of the draw) and she Dx'd me with PTSD instead of BPD, although I do have a lot of BPD traits. And so it's been the PTSD dx that's followed me around which is not bad because at least there's no bad stigma for it. Current diagnoses MDD with psychotic features, and PTSD. Was diagnosed with a SUD, but I've been sober long enough that my Dr's have dropped it from current and it's just listed as a past Dx.

The things that helped me the most were treating the symptoms, real trauma therapy, and some solid sober time - like I'm talking 2 years min.


Feel free to read the rest or ignore. I'm going to share what worked for me, in the hopes that it will give you ideas.

Treating the symptoms. My biggest problem was wild emotional dis-regulation, I could swing from rage to despair to giddyness within minutes. What helped me the most was DBT and mindfullness. Yes DBT can be a bit of a pain in the butt, but for me when I put in the work and actually practised and tried to use the skills eventually I saw payoffs. But this wasn't a quick fix, it was 6 months of weekly groups plus time on my own on homework. I was also lucky enough to do a Mindfulness Based Cognitive Therapy group that's supposed to help with preventing depression episodes. I still can't meditate very well, but some of the techniques for short like a couple of minutes of intense focusing and the concepts were really helpful to me.

Real trauma therapy. I was able to find a trauma therapy program that was outpatient at a hospital in my hometown that was specifically for women with a history of childhood trauma. Their wait list was stupid long, like 6 months to get an assessment then 18 months to get into the first group, then at least 18 months to get into the next group. I just kept getting on the wait list and doing different groups. In those groups I met women like me all of whom had been in the psychiatric system for years and hadn't been fully treated by it. The program wasn't about dissecting or "processing" your trauma, the focus was more on looking at how the trauma was impacting your life in the here and now and figuring out how to better manage it. This therapy was a game changer for me. Keep looking for programs, you might find something in unexpected places.

Sober time. You may not want to hear this, but in my experience I needed some serious sober time for my brain to adjust to life without alcohol, and to learn to regulate my emotions. It literally took me 9 months when I first quit drinking to get to a point where I could function in anything resembling normal cognitive levels for me. I'm not saying I wasn't functioning when I was drunk - the problem was I was too well. I'd been operating for over 20 years with heavy daily drinking and my brain had adapted. I built a successful career in corporate finance. Then I quit drinking and I literally got stupid - couldn't function at work. I spent that first 9 months basically sitting on my couch staring out the window wondering what the F had happened. But I didn't stay sober long term, I went into a 13 year cycle of sobriety for a few months, then relapsing which never gave my brain a chance to heal and wasn't enough time for me to really learn how to cope. When I finally quit the last time, I spent the first year just focusing on not drinking and trying to stay housed. At about a year, I was ready to start volunteering, at about 18 months I was able to start thinking about working and got a part time job. At about 2 years I started to feel really good and it's been an upward trajectory since then.

Now I'm over 6 years sober, employed, going back to school and my life is kind of boring with its lack of self created drama, but it's continued to get better

[MuddyBoots]

How do you find these groups and special trauma therapy? We sometimes have a DBT group that starts and stops sporadically that I guess I’m on a waitlist for now. I was in it before (after being on the waitlist probably a year)and got kicked out after three weeks (don’t really regret it though because those three weeks were torture and I got nothing out of any group because it was 50 minutes of people explaining their specific homework (everyone go around and explain their DEARMAN script and the context of the situation) then 5 minutes of starting to read the packet for that week’s lesson but then “oh time’s up.”) so I’m not super hopeful on that.

My therapist said they have a group for substance abuse, but it’s not really for dual diagnosis, but she could try and ask if I could get in if I wanted to in a few months.

There’s an overall support group somewhere in town on Thursdays but it’s from like 8-9pm and I am a far cry from a night owl. I tried calling the people that run it to see if you have to sign up or register ahead of time but could never get a hold of anyone.

I was told Boston had a complex trauma center and got referred therefor Zoom therapy from the hospital I was just at. The social worker said she’d call me when she hears back, never got that call. I got referred to an eating disorder PHP (that I wouldn’t have transport to) and got denied for being “too acute” and got referred to inpatient eating disorder treatment and got denied for “not being critical enough to meet criteria.”

I tried looking up EMDR therapists that take my insurance and there are none around here.

I’ve done decent at not using substances I’m not prescribed. I smoked a lot of weed in February (which was encouraged by my therapist because at the time it was that or end up in jail for violent crime), and had a couple drinks in December. No binge drinking since the summer. I did drink rubbing alcohol with klonopin in it a few weeks ago but that wasn’t with a recreational purpose, but still, I guess that means it’s gonna be another whole year before bipolar meds have a chance of doing anything, or so I keep hearing.

I keep looking online and there’s like nothing accessible.

[splitimage]

I'm sorry you're having such a tough time accessing treatment, that must be frustrating as hell.


For me, the trauma program I don't remember if I found it by googling or if a therapist told me about it.

The DBT program I did was 6 months, private, and I hear you on the frustration of spending most of the session reviewing homework. the group I went to had 90 min sessions so we could take up the homework and discuss the new stuff. But I'd really encourage you to try to stick with it, despite the frustration, honestly it was a game changer for me in terms of learning to handle emotional disregulation.

[MuddyBoots]

Is going to a group really that much superior to doing it with an individual therapist? I did it with my last T and still have most of the handouts and printed out more of the worksheets I found more helpful than others.(We didn’t do the interpersonal relationships module because she left (without my knowledge at that) so I haven’t gone over most of those skills with someone in person, but that was the module they were in when I was in those three groups so I do know DEARMAN and the 10cent “how much is this fight worrh?” chart thing, and when I’m IP at my regular place, I got sick of doing the same groups on “anger is a secondary emotion” and “why boundaries are important/signs of poor boundaries,” so they let me borrow their copy of the actual DBT workbook to go through in my room instead of getting my 40th copy of the anger iceberg.

I am not going to refuse it whenever they say I can start, but I’m just wondering you know if it’s another 10+ month long wait or if they say I’m not welcome back or I find I don’t really understand the way they “teach” the skills (AKA read the title of the packet and say “you can read the rest of the packet on your own and figure it out before you start the homework”), can going over what I have myself and looking up any questions or curiosities I have about it be an equal or even super substitute?

I hope it’s okay if I ask something more personal: If you were “successful” while you were drinking, what was your motivation to stop? What was your motivation to improve your overall mental health and what kept you working at it during times it seemed you were getting nowhere or if hopelessness kicked in and nothing seemed worth it?

[splitimage]

In general, I like group therapy because it lets me hear other people's experiences and thoughts and I find I often relate to things that other's share or hear things that I hadn't thought of. Also the group and the relationships between group members are a pretty good model for interpersonal relationships, which is a pretty big component of DBT. Basically learning to navigate in group, despite your frustrations, is a good place to practice skills that you'll use in other relationships.

As for your question, I'll try to explain. I started drinking when I was around 11 or 12 but not heavily until I left home at 18 and it was always pretty heavy from that point on. By my mid 30's I was drinking a 26 oz bottle of hard liquor a day, hated myself, was self injuring, was dealing with depression, dissociation (as well as blacking out) and just my life outside of work was just pure chaos. I was holding it together at work, I was a finance director by that point, but I knew I was killing myself. It was work, come home drink til I passed out, repeat. I guess for me it was ultimately fear that got to me, I knew I couldn't continue doing what I was doing, and so went to my first rehab. There were many things wrong with that rehab - I hadn't really picked it, it was where my company sent me, and while they dried me out I didn't pick up any tools on how to live sober. I got out was 21 days sober and made the mistake of attempting to go back to work right away. Big mistake because, as I've said before, without the alcohol my brain was stupid. they even told me at work that I'd been faster when I was drinking. So no shock here, I didn't stay sober and my drinking really escalated. Finally after 4 months of me screwing up at work and missing a lot of days to stay home and drink my company gave me a choice get my **** together now or take a package and leave. I took the package, and promptly went on one of the worst binges of my life and landed me in an ER on Christmas day 2006. I was in the hospital for a week. they hooked me up with a really good rehab and my addictions Dr. who I still see today. But that was the start of the worst period in my life, 12 years of staying sober for a while then relapsing and binge drinking for up to a couple of weeks. Between 2007 and 2018 I attempted suicide 3 times, had 3 inpatient psych stays, did rehab a bunch of times, and did the DBT group and a bunch of other therapy. I'm not really sure what motivated me to keep trying therapy, and sobriety except maybe a self preservation instinct and the ongoing encouragement of my addictions Dr. I still can't figure out why she didn't cut me loose, I was such a messed up patient, but she kept encouraging me to keep trying so I did making tons of mistakes along the way. In this period I also lost my apartment and wound up in transitional housing for 18 months before I was able to reenter the housing market. Then in Oct. 2018 I had what was my last relapse. The binge was so bad but the withdrawal was hellish - 4 days of throwing up, the DT's etc. When I came out of it, I just knew I couldn't go through that again and that if I picked up a drink again I'd probably die. With that something in my mind shifted and I decided that I would do whatever it took to not drink today, and started to throw all my energy at just staying sober. As I said before it took time, but eventually I was able to start volunteering, did the trauma therapy, and was then able to start working again. I won't say my life is perfect now, my housing is less than optimal, I'm currently living in a boarding house for people living with psych diagnoses that's run by a Catholic charity, but it's clean and it's very affordable. I'd like to get my own apartment again someday, but I figure I'll stay where I am until I get through school which I'm starting in the fall.


Hope that made sense.

[Victoria'smom]

Have you looked into Restore it's a LONG waiting list. I have several diagnosis. They treat my eating disorder as a symptom of my other disorders. If I'm really active with ED than it's likely I'm in psychosis. They don't treat my ADHD or my anxiety medically. I'm in therapy 2x a week. I'm on heavy medication for SZA, my PTSD isn't really addressed. Right now we're working on safety when alone and taking meds nightly. I'm hoping to get off doxpin. My team isn't perfect but my meds are much better. I'm more stable ( no homicidal thoughts) now I'm in the middle of weirdness that's not being addressed yet but will be later this week. find a good therapist. Mine is not willing to work with me unmedicated because of liability.