Maybe PTSD?

By Kristina Randle, Ph.D., LCSW

Intense anxiety, mood swings associated with external stimuli, reliving past events; First of all, thank you for your time you may spend reading my post. Before you begin, I would like to note that I have been very thorough, and I wouldn’t want to waste your time, so please, read at your own discretion.

I have seen many doctors, and have had one after another change my diagnosis from BDP to bipolar mania to schizoaffective to whatnot. Recently, a doctor talked to me about PTSD. I would like an undessenting voice to help me Identify if this may be a good possibility.

The now.

Every day, I manage my day to try to avoid contact with others. I almost never sleep a full night, not even when assisted with medication; waking up 3 to 15 times a night (I counted 24 times once). I have terrible nightmares of my last relationship and my childhood, and when I’m awake, these memories feel so ingrained into my mind that I feel as if I am perpetually living through them, even when I’m trying to preform everyday tasks, just like now, as I’m writing this post. I had a period of moderate alcoholism, which had consumed the majority of my free budget for around 9 months, although I have been sober since November 2010. Before I could obtain alcohol, I used to self-mutilate in a large variety of ways.I used to hide this for years out of shame. Loud, spontaneous noises, especially, but not limited to, the breaking of glass or ceramics, spring me in to a sharp, painful, disassociated rage in which I fight with all my will to contain- and I have on several occurrences assaulted others and mutilated my fists and body during these breaks from reality. I do not lose perception of reality, just my lucidity and ability to rationalize right from wrong; in short, I literally consider ALL who are present a physical threat or otherwise hostile. My chest tightens, my mind burns with stimulation and many dull pains, and my body feels consumed with energy. I had one long term love relationship, in which my (female, and at that, relatively small female) partner ‘assaulted’ me, and although I was never hurt physically, I was hurt emotionally by the merit of her intentions. I eventually had a mental break after a period of intense relations with her, and I nearly threw her from a window after she had struck me. I have little memory of this, and I had fought suicidal thoughts after the event. I truly loved her, and I would have rather died then have hurt her, but at the moment, so I heard, I was almost alien to the people who knew me. One once said that my eyes looked like the coldest steel, and I know that in these periods I feel hatred so great that I lose myself in its wake.

At any given point of time, my (lucid) opinion of someone can shift from love to loathe. I used to maintain a mental checklist of those I hated, and what they had done. This included children and teachers from grade school, whom several I still feel a burning anger towards. I used to plan to kill them; Now I am trying to reprogram myself to think more positively. I my love life is unstable, as I had said, I have had one long term affair, although I have had many, many short ‘relationships’. Even the people I care for I hold in a state of contempt, mostly because everyone, sparing only friend, that I trusted has on many occurrences betrayed me (for granted, I am talking about a relatively small pool of people). I am always aware of my surroundings, and I sleep with a gun and a knife, for versatility in a potentially dangerous situation. I don’t believe that I will be attacked, but I hate being defenseless so much, that I feel it is too hard to bear. I also work out beyond my physical threshold, up to 6 hours a day, almost always at least 2, because I hate my body, even though I know it’s terrible for me. I used to wear a mask at home, so I wouldn’t have to see my face, but I stopped as soon as other people began to notice. Oddly enough, I’m generally good natured when I can calm myself down, and relax my fear and distrust, because I really don’t want to hurt these people, but anyone who gets close to me eventually sees me at my worst, and my worst is notoriously bad.

A little background on my childhood

My parents split when I was 8. I don’t remember much from before that age, but my mom says I was a very well behaved child, and that I was normal, although I was very shy, and I had had at several times been struck with terror, once trying to hide from her between the bathtub and the toilet at our old house after spilling dish detergent. With tears in her eyes, she said that she never trusted my dad awith me after that, and that I was so distressed, that if I could have fit in the crevice, in that bathroom, I would have. Through my later years, I had to endure a very abusive father, who led an eccentric life. My mother was too poor to have me around her house, so I spent the majority of my time with the Dad, until up to age 16, when i was homeless, and 17, when my mom could afford to take me in. I only recently told her my dad had kicked me out; it annoys me when she acts sorry; she isn’t. My father had drugs (and druggees) around my home like it was a jailhouse crack store. He was admittedly (and very proudly) bipolar, saying it was a characteristic, not a disorder. He used to talk to my about his sexual life, and his sadomasochistic promiscuity. He openly praised a serial killer whom murdered men “Not through blood loss, or traumatic stress, but from the very torture itself, gripping them for weeks in pain”. He’d often reenact movies, such as Pulp Fictions famous “Say what again” scene, after I had shown up late one night, after which he assaulted me, and which night marked a period of time where I was only allowed to sleep at home for 4 hours a night (he would record this time, and you probably know very well this is not a very attainable trait). I used to sleep in the lockers at high school rather than go to class, because I was too weak of a man to stay awake in class. The hours I was at home he had made me work at my Granddad’s shop, as he said that I wasn’t pulling in money at school……

And so on and so forth. I’m sure I have said enough to relate I had a bad relationship with my father, and several distressful situations that could be classified as semi-traumatic, and I fear that any more detail will be me simply reiterating my past rather than requesting serious advice from a professional source.

My question lies here, given my testimony on my ‘symptoms’ and my mental instabilities, should I disqualify PTSD as a possible answer, or do you feel I should investigate this more thoroughly? If you could make any suggestions, please, I really want every bit of help I can get. I’ve been told by a few (not all) that I’m a good looking, brilliant guy, but I can’t form relationships, and it’s hard to hold a job; which is why I usually feel a bit lonely. Again, Thank you so much for your time, and I apologize if I included too many details, but I’m getting desperate, and I’m truly afraid and those I love and those around me, so I don’t want to waste time on a bad diagnosis- I just want to learn to be normal again.

I know if I cant help myself, people may get hurt again. I don’t want to be responsible for that.

A. I appreciate the very detailed nature of your question. PTSD is a very realistic diagnosis. Maybe you do not match every symptom associated with PTSD but you seem to have enough symptoms for a therapist to consider the diagnosis. Also, keep in mind that individuals can have multiple diagnoses. You could have bipolar disorder, schizophrenia, or schizoaffective disorder, etc. and PTSD. Other mental illnesses and PTSD commonly co-occur.

You are concerned about which diagnosis best matches your symptoms. I would encourage you to research all of your diagnoses. It is always in an individual’s best interest to do their own research regarding their condition, no matter how great or well-respected their treatment provider may be.

To say that you endured a very difficult childhood would be an understatement. You have had and continue to have a very challenging life. Despite this you are willing to and continue to seek help. You want help and you’re making the effort to get it. I commend you for your efforts.

My biggest concern is your potential to harm others. You have harmed people in the past and you worry about it happening again. I’m encouraged by the fact that you are aware of your potential for violence but the problem has yet to be resolved.

Two additional concerns are that you actively carry a weapon and there are times when you admittedly misperceive reality. The obvious concern is that you will misinterpret a situation and accidentally harm someone. It is imperative that you be in treatment and are open and honest with your treatment provider about this potential problem. If you are having difficulty perceiving reality clearly, then there may be times when you’ll need to rely on an objective party to interpret a situation. Be proactive. Now is the time to develop a plan about how to handle potentially dangerous situations. Make it your main priority in treatment.

If you have any additional questions, please do not hesitate to write again. I wish you the best. Please take care.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 30 Mar 2011

APA Reference
Randle, K. (2011). Maybe PTSD?. Psych Central. Retrieved on November 28, 2014, from http://psychcentral.com/ask-the-therapist/2011/03/30/maybe-ptsd/