Here's a hot topic in today's mental health discussions: medication.
After this article came out, several people have asked me what I think of medication for illnesses such as PTSD (post-traumatic stress disorder). Sometimes, therapists suggest clients see a psychiatrist to look at the possibility of medication. What's a client to do?
First, I want to stress that decisions surrounding medication are personal and individual. They need to be made case by case. No one can say that one drug is the right answer for everyone with a certain condition. Not even doctors.
Second, as I've stated many times before, I'm not a professional therapist, psychiatrist, or...pretty much anything. I really don't know much about drugs and how they work. However, I am a professional fighter. I'm not saying that I have the right answer for any one person...except myself. All I can share is my personal experience, and I hope you find that helpful if you are currently dealing with this issue.
I don't have a lot of faith in medication. I watched my instigator take drugs for years, and not a whole lot of good came from it. "Crap" still happened. It didn't matter how many grams of aripiprazole or guanfacine she consumed; her behavior was still nowhere near something I could accept. So I started my own journey toward recovery with a very negative view of medication.
There are a couple of reasons doctors may prescribe medication for someone with PTSD, such as for panic attacks and depression. One of the most common reasons is for sleep. A widespread symptom of PTSD (as we've discussed) is debilitating nightmares or refusal to sleep. This was the reason my therapist recommended I consider medication. I felt like I wasn't safe enough to sleep at night; even if I was in a safe place, I would relive the traumas every night in my dreams just as vividly if not more so as when I had lived them awake. Sleep was not safe, and sleep was not restful. So, sleep wasn't an option.
Medication became an option after I went fourteen days without sleeping (this was shortly before I decided to leave the instigator). However, when I considered the hassle that would be involved, I decided against it. Honestly, I was afraid to lose control of my body once again, but this time, to medication. That fear lasted a long time. Five months after that sleepless fortnight, things got bad once again even though I was not directly involved in the same situation. This time, when my therapist recommended I visit the psychiatrist, I agreed. He prescribed Prazosin, which is a blood pressure medication. I took it a few times. It worked beautifully, but it worked very well. The first night I took it, I woke up for work the next morning and had to crawl down the hallway from the bathroom. It knocked me out for at least ten hours. For an active employee, that was a problem. I tried taking half of the pill, but since it was the smallest dosage they could give and the pills were just capsules of powder, it was difficult. Also, I was nervous about using a drug that treated a problem I didn't have (high blood pressure) just to make use of its side effects (drowsiness). I resorted to using the Prazosin if I'd not slept in days and caffeine was no longer effective.
The psychiatrist understood my difficulty and switched me to Clonidine, another type of blood pressure medication which has been used for easing everything from insomnia to withdrawal symptoms from drugs or alcohol to menopause. Clonidine knocked me out faster than Prazosin did, but I woke up feeling fuzzy. After a few weeks of Clonidine, I gave up on nightly use again. I have not used medication regularly since then, but I have used both Prazosin and Clonidine as needed (after the psychiatrist assured me this would be okay).
My main problem with medications commonly prescribed for PTSD is that they affect my body. That may sound strange, but think about it. Trauma occurs when something happens to you that you can't control. Medication affects your body in ways you may know about but cannot control. That's why I have such a hard time taking medication. I don't like giving up control.
I think it's fantastic that people are searching for a better drug for people struggling with PTSD. And if manipulating CB1 receptors through marijuana helps that, I'm glad scientists are looking for a way to make it more helpful. However, I don't think there's a miracle drug. Prazosin may work for some people; Clonidine for others. There are countless other medications that can help as well. But, once again, the decisions about whether to take medication or what medication to take need to be made case by case.
Some fabulous resources for this are out there. Your doctor or therapist can refer you to a psychiatrist. Going to a few different psychiatrists to get several opinions can be very helpful as well. Talk to other fighters and find out what works for them and why. And, as always, if you have any questions, contact me and I will give you contact information for people who know more than I do.
So, yes. That's my opinion on medication.
I hope it helps you formulate your own.
Take care,
Shalight
Showing posts with label nightmares. Show all posts
Showing posts with label nightmares. Show all posts
Thursday, June 13, 2013
Wednesday, June 5, 2013
PTSD Awareness Month: Signs and Symptoms
At my most recent counseling center intake, I filled out a questionnaire that had over two hundred questions asking me about my self-image, my ideas about others, any tendencies I had that are "abnormal", and how much I ate/slept/exercised/etc. By the end, I felt like I had just run a marathon. And as the product of my time and effort, the computer spat out something I already knew very well: I had post-traumatic stress disorder.
My first really good psychologist asked me what was going on, heard me out, and then told me exactly the same thing. At one hundred ninety-nine questions fewer and more more personable, my psychologist's opinion was much easier to hear than that of the computer. However, either way, defining what criteria qualify someone as having PTSD is very difficult.
I say all this to apologize for this post. No writing on a blog (no matter who the source is or what experiences they have had) will ever replace a real-life excellent psychologist and his or her diagnosis. However, since certain reactions are normal after a trauma event, it can be very difficult to determine when you or someone you love has PTSD.
That's why I'm still writing. Maybe you're wondering about yourself. Maybe you're wondering about a loved one. Maybe you're just curious. No matter what your motivation, I can provide you some basic information about how PTSD can manifest itself.
About a fourth of the way down this web page, you will find an overview of the signs and symptoms of PTSD. While I do NOT agree with everything you will find on that page, the section entitled "Signs and symptoms of post-traumatic stress disorder (PTSD)" and the subsequent section entitled "Symptoms of PTSD in children and adults" are very consistent with my experience and research. The reason I chose this website is that it looks most similar to the questionnaire that I took (although don't worry; this site is much shorter).
There are three major categories of symptoms of PTSD. The first is reliving the experience. This includes, as the website says, flashbacks and nightmares. Nightmares were the reason I finally went back to counseling at the age of seventeen. I could not and would not sleep because of the intensity of the nightmares I experienced. Often, this first category is the most noticeable. It's not difficult to see when a car accident survivor has a flashback and freezes up because a bus came just a bit too close. My friends know just by looking at my face whether I've been sleeping or not.
The second category is avoiding anything that connects to the incident. This may be avoidance of emotions, places, or people. These symptoms are very difficult to identify as PTSD because these are very natural normal trauma reactions. To return to my former example, someone who has been injured in a car accident will be very reticent to drive again. For me, I used to strongly avoid discussing topics such as family. Because of the subtlety of these signs, it can be very difficult to distinguish between normal reactions and PTSD (more on this in a few paragraphs).
The third category is called "emotional arousal". As far as I have seen, this section is the one most constant in the fighter and least noticed by his or her loved ones. Once again, a car accident survivor may be constantly aware of his or her surroundings when on the road or may react strongly or jumpily when startled while on the road. For me, hypervigilance is the one symptom that has not drastically improved since I got out of the situation. I still am constantly aware of where everyone in the room is. I still habitually look around me as I walk. I still pay attention to where people's hands are, especially if people are upset. These are examples of typical emotional arousal.
So, the first category is easiest to recognize from the outside. The second is difficult to distinguish between a normal reaction and a reaction magnified by PTSD. The third is often only noticed by the individual himself or herself. How does one actually determine whether someone may have PTSD or is recuperating normally from a trauma event?
The only answer we seem to have right now is time. The generally accepted rule is that if someone has been experiencing symptoms from these three categories for longer than three months, they have PTSD. This can be a very frustrating answer because many people just want to know right now. The key is to remember that for any problem, whether it be cancer or PTSD or Alzheimer's, getting a diagnosis takes time. The plan of action I recommend the most is to see a professional. A professional is probably familiar with PTSD, and familiarity fosters recognition. That is why going to a professional the best way I know to determine whether you or a loved one has PTSD.
Have questions about seeing a professional?
Hold on to that thought.
Take care,
Shalight
My first really good psychologist asked me what was going on, heard me out, and then told me exactly the same thing. At one hundred ninety-nine questions fewer and more more personable, my psychologist's opinion was much easier to hear than that of the computer. However, either way, defining what criteria qualify someone as having PTSD is very difficult.
I say all this to apologize for this post. No writing on a blog (no matter who the source is or what experiences they have had) will ever replace a real-life excellent psychologist and his or her diagnosis. However, since certain reactions are normal after a trauma event, it can be very difficult to determine when you or someone you love has PTSD.
That's why I'm still writing. Maybe you're wondering about yourself. Maybe you're wondering about a loved one. Maybe you're just curious. No matter what your motivation, I can provide you some basic information about how PTSD can manifest itself.
About a fourth of the way down this web page, you will find an overview of the signs and symptoms of PTSD. While I do NOT agree with everything you will find on that page, the section entitled "Signs and symptoms of post-traumatic stress disorder (PTSD)" and the subsequent section entitled "Symptoms of PTSD in children and adults" are very consistent with my experience and research. The reason I chose this website is that it looks most similar to the questionnaire that I took (although don't worry; this site is much shorter).
There are three major categories of symptoms of PTSD. The first is reliving the experience. This includes, as the website says, flashbacks and nightmares. Nightmares were the reason I finally went back to counseling at the age of seventeen. I could not and would not sleep because of the intensity of the nightmares I experienced. Often, this first category is the most noticeable. It's not difficult to see when a car accident survivor has a flashback and freezes up because a bus came just a bit too close. My friends know just by looking at my face whether I've been sleeping or not.
The second category is avoiding anything that connects to the incident. This may be avoidance of emotions, places, or people. These symptoms are very difficult to identify as PTSD because these are very natural normal trauma reactions. To return to my former example, someone who has been injured in a car accident will be very reticent to drive again. For me, I used to strongly avoid discussing topics such as family. Because of the subtlety of these signs, it can be very difficult to distinguish between normal reactions and PTSD (more on this in a few paragraphs).
The third category is called "emotional arousal". As far as I have seen, this section is the one most constant in the fighter and least noticed by his or her loved ones. Once again, a car accident survivor may be constantly aware of his or her surroundings when on the road or may react strongly or jumpily when startled while on the road. For me, hypervigilance is the one symptom that has not drastically improved since I got out of the situation. I still am constantly aware of where everyone in the room is. I still habitually look around me as I walk. I still pay attention to where people's hands are, especially if people are upset. These are examples of typical emotional arousal.
So, the first category is easiest to recognize from the outside. The second is difficult to distinguish between a normal reaction and a reaction magnified by PTSD. The third is often only noticed by the individual himself or herself. How does one actually determine whether someone may have PTSD or is recuperating normally from a trauma event?
The only answer we seem to have right now is time. The generally accepted rule is that if someone has been experiencing symptoms from these three categories for longer than three months, they have PTSD. This can be a very frustrating answer because many people just want to know right now. The key is to remember that for any problem, whether it be cancer or PTSD or Alzheimer's, getting a diagnosis takes time. The plan of action I recommend the most is to see a professional. A professional is probably familiar with PTSD, and familiarity fosters recognition. That is why going to a professional the best way I know to determine whether you or a loved one has PTSD.
Have questions about seeing a professional?
Hold on to that thought.
Take care,
Shalight
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