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deus ex machina
Member Since Jul 2014
Location: Ticket-taking at the cartesian theater.
Posts: 2,379
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#1
I have complex PTSD, and had considered it to be comorbid with a couple of other things, including a current, follow-on episode of major depressive disorder which would be considered treatment-resistant based on the clinical definition or any other definition for that matter. I no longer consider this to be the case though.
I would suggest that there must be some portion of people whose "treatment-resistant depression" is actually representative of the depressive symptoms of PTSD/CPTSD, and would be better regarded as such. Myself among them. From what I read last night in this most recent PC article, Brain Scan Study Aims to One Day Personalize PTSD Treatment, I am now thinking it is counter-productive, for me or anyone trying to treat me, to look at my depressive symptoms as being related to MDD or any other depressive disorder, when the better part of them are likely and rather the result of what is ultimately physical injury, but is termed psychiatric injury and is part and parcel of PTSD. Mainly I think it's counter-productive because of the nature of many psych professionals, in being so sure that the "right" anti-depressant or anti-depressant combination just has to be found, can result in a lot of lost time and in my case, a lot of lost hope where I had no sense of hope to begin with. Perhaps this belief on their part is understandable being that they have found it to be true in many cases of depression; but I've been aware for some time (and I've endured serious trauma since I was a young child) that anti-depressants simply do not work for me, based both on trial and error, and on my complete lack of response to them outside of a little tingling the first couple of times I try a new one. I was struck by the article's description of kappa opioid receptors becoming retracted and largely inaccessible in PTSD, causing what is ultimately a physically induced dysphoria. While it's my belief that my earlier experiences with dysphoria, when I was a kid, may indeed have been related to major depressive episodes I'd had at the time, and they were overwhelming indeed, they were not so definite as the experience I'm having now. I feel shut down in a way that is very different now, and I haven't been able to quantify how that is but I've been overtly aware of it for some time. Perhaps at this point the number of receptors still exposed in my brain has lessened to an unfortunate tipping point. I don't know how they're going to coax them lil things back out of hiding, but I hope a solution is forthcoming soon, and is nothing too invasive. (sigh) Quote:
My former practitioner was also of the opinion that we needed to "treat the depression first" before trying to deal with anything else; but if what is presenting as depression in a case like mine needs to be treated as PTSD, the folly of that thinking is fairly obvious. Wheels spinning ad infinitum. While I wouldn't go so far as asserting that PTSD and depressive disorders could not be comorbid, I think what has been found in this study makes it clear that screening for PTSD up front is essential, and that treating depressive symptoms in the traditional manner when PTSD is present should be a more carefully considered option. Certainly not insisting on repeated rounds of anti-depressants, and having an attitude towards a patient that they must be resisting, or non-compliant, or drawing some other such unhelpful conclusion. After all, riddle me this, in cases where a treatment is neither applicable nor indicated, how can its ineffectiveness then describe a condition as being treatment-resistant? __________________ “We use our minds not to discover facts but to hide them. One of things the screen hides most effectively is the body, our own body, by which I mean, the ins and outs of it, its interiors. Like a veil thrown over the skin to secure its modesty, the screen partially removes from the mind the inner states of the body, those that constitute the flow of life as it wanders in the journey of each day.” — Antonio R. Damasio, “The Feeling of What Happens: Body and Emotion in the Making of Consciousness” (p.28) Last edited by vonmoxie; Sep 22, 2014 at 11:56 AM.. Reason: grammatical |
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