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PTSD Diagnosis

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  1. rAVENSFAN99

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    Posted 6 years ago
    Fri Oct 19 2012 9:43:45
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    Many people have speculated on this forum that they believe they have PTSD (post traumatic stress disorder) after their encounter with bedbugs and wondered if it was a possibility.

    I just came back from my psychiatrist, who without my broaching the subject, formally diagnosed me with PTSD.

    Now, I'm not saying that everyone who's been through what so many of us have been through actually have PTSD. . . that's something to decide between you and your doctor. But I am saying that it's possible.

    I'll also add that I already have a diagnosis of OCD and major depression (and have for the past 16 years) which may have predisposed me to this.

    What next? My p-doc has given me the names of some cognitive behavioral therapists and I am reluctantly starting therapy again after nearly 2 years therapy-free. I haven't been to war; I still have my limbs. I need to try to treat this and move on.

    Good luck, all.

  2. studiopeg1

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    Posted 6 years ago
    Fri Oct 19 2012 9:51:10
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    Best wishes, and I totally understand. Many of us including myself wonder if our psychological state has been damaged by our BB experience. I for one know that my family's psychological history, my anxiety issues, and my nightmares about BBs every night have contributed to my weakning psychological state.

    Amazing how such tiny creatures can wreak so much havoc, both physically and mentally.

    Again, best wishes on a full recovery.

  3. Koebner

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    Posted 6 years ago
    Fri Oct 19 2012 10:29:30
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    It's not so surprising. BBs get to the disgust response which is particularly linked to OCD & other anxiety problems. Pre-existing mental health problems seem to make individuals more vulnerable to complex PTSD.

    PTSD itself is very poorly understood, not least because of its association in the popular consciousness with combat situations. It's worth remembering that there are, if anything, more diagnoses of complex PTSD among abuse survivors than among former combatants. I admit that this may be due to under-diagnosis in the veteran population - mental health care for veterans is still indefensibly poor, but it demonstrates that living longterm with anxiety & distress can lead to just as poor an outcome as surviving major trauma such as IED incidents.

    We really need psychologists & epidemiologists to start researching the mental health effects of BBs - to date, the health implications of BBs have only been investigated in terms of disease vectoring, something at which they are very poor. Public health officials have simply whistled a happy tune & looked the other way when it comes to the direct & deleterious effects of BBs on mental health.

  4. Nobugsonme

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    Posted 6 years ago
    Fri Oct 19 2012 13:49:25
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    Hi ravensfan,

    I am glad you got a diagnosis so you can get help with that.

    I started and run the site but am "not an expert."
  5. DougSummersMS

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    Posted 6 years ago
    Fri Oct 19 2012 14:12:46
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    Here are links for the latest proposed APA criteria for Acute Stress Disorder and PTSD diagnosis.

    Acute Stress Disorder
    http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=166

    PTSD
    http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=165

    Here is a wiki article about Complex PTSD
    https://www.ptsdforum.org/c/wiki/complex-posttraumatic-stress-disorder/

    Most readers will not qualify for a diagnosis of Acute Stress Disorder (ASD) or PTSD because they do not meet criterion A... Exposure to actual or threatened a) death, b) serious injury, or c) sexual violation.

    Patients with pre-existing conditions may qualify due to previous life experiences that do meet the criteria in the APA diagnostic handbook referred to as the DSM 5 which is scheduled to be published next year.

    Exposure to bed bugs would be characterized as severe stressor or trauma experience that can produce deleterious symptoms, but we would need to see something like a life threatening anaphylactic reaction to BB bites to qualify for the medical def of PTSD

    I believe that a well adjusted person can be seriously impacted by the experience, but the def of PTSD requires exposure to death, serious injury or sexual violation to meet the primary criterion.

    I don't want to minimize the problem... People with this type of trauma experience can experience symptoms that resemble PTSD in terms of avoidance, intrusive thoughts, nightmares, sleep disturbances, anxiety and severe stress, for example.

    It doesn't really matter what you call the effects of a traumatic experience with bed bugs, but for most people... it is not technically correct to call it PTSD.

  6. theyareoutthere

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    Posted 6 years ago
    Fri Oct 19 2012 15:05:24
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    Good points, Doug. We do have to remember that the reason the medical community is so strict is that it impacts treatment options.

    The sleep deprivation and financial impact alone will impact most people's stress levels, and it's easy to go beyond that.

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  7. Nobugsonme

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    Posted 6 years ago
    Fri Oct 19 2012 15:26:56
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    That said, we're not talking about people diagnosing themselves, but a diagnosis of PTSD that was made by a licensed psychiatrist. Likewise, someone here had previously been diagnosed with Acute Trauma Stress Disorder.

    If the DSM did not currently allow for this (in the other case I have in mind I am fairly certain anaphylactic shock was not an issue), how are people getting diagnosed as such?

    Doug, is the situation that the current DSM allows for this diagnosis, but the proposed revisions don't?

  8. rAVENSFAN99

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    Posted 6 years ago
    Fri Oct 19 2012 15:34:51
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    No offense; I'm going to go with my doctor's assessment of my mental health. As for what constitutes a serious injury, I'm glad to have all my limbs, but my psychiatrist saw my arms covered in welts, and he saw me not really sleep for 5+ months, so I guess that qualifies as serious injury.

    I will give you a few examples of my personal experiences and how I'm being affected:

    I have a hard time saying the word "bed bug" or typing it.

    I have been avoiding going above 180th street (the infested apartment was about 30 blocks north of there) for several months.

    I do not take the A train, which is the train line I used to take to get to that apartment.

    I do not like to hear the name of the street where the apartment was. A friend was mentioning the name of a dog she knew, and I knew it was the same as the name of the street, and I interrupted her and asked her not to say the name.

    My computer has been in a Ziploc bag for more than 18 months (it's been taken out a few times for a few minutes) and despite the time that has passed, the fact that it was Vikane gassed, and the fact that there's been a passive monitor in there since February, I can't bring myself to use it. Now I don't even like opening the Rubbermaid container it was in.

    Last week a pillow fell on the floor. Since I couldn't be sure nothing got into the inner part of the pillow, I threw it out. Then I had a meltdown in two different stores, complete with tears, because none of the pillows were completely sealed in plastic. When I finally did find one, I decided not to buy it because it would be welcoming trouble.

    I spend much of my day saying, "You don't have bedbugs; you have carpet beetles" in my head.

    18 months after infestation, I still have almost no furniture. In fact, I'm afraid of it.

    I'm not trying to play "my pain is worse that yours," but I am pointing out that different people experience stress in different ways.

  9. DougSummersMS

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    Posted 6 years ago
    Sat Oct 20 2012 1:02:12
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    No offense taken... I don't disagree with your doctor opinion... The DSM definitions have changed over time and professional judgement is critical to formulate an accurate multiple axis diagnosis.

    The APA definitions of PTSD & ASD are a matter of intense debate... Many clinicians believe that the definitions should be expanded to include trauma clients that do not meet all of the criteria, but still exhibit the same cluster of symptoms.

    The definitions are quite arbitrary and often imprecise... I posted the proposed definitions as a reference for the discussion... I didn't mean to imply that your diagnosis was inaccurate.

    The APA manual is a cookie cutter approach... These are just guidelines... Diagnostic codes are useful for assigning nomenclature, gathering statistics or filling out an insurance form, but shouldn't be taken too seriously.

    I apologize if my comment came across as unsupportive... As I stated earlier... a traumatic experience that does not strictly meet the APA definition can still produce the same cluster symptoms and will respond to the same therapeutic interventions that are utilized for treating PTSD.

  10. Nobugsonme

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    Posted 6 years ago
    Sat Oct 20 2012 1:18:40
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    Thanks for clarifying, Doug!

  11. rAVENSFAN99

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    Posted 6 years ago
    Sat Oct 20 2012 13:57:21
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    Thanks, Doug.
    I'm aware that a different p-doc might give me a different diagnosis--they might say I don't actually have PTSD, but that this is all a part of my already existing OCD. But since I haven't read of anyone getting an actual PTSD diagnosis on this forum, I wanted to share.

    The fact is, the treatment is the same no matter what you call it.

  12. DougSummersMS

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    Posted 6 years ago
    Sat Oct 20 2012 14:30:05
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    The APA manual states in the opening chapter that the diagnostic codes are just guidelines and that professional judgement should be utilized to determine the most appropriate diagnosis.

    The manual defines each disorder in isolation, but in the real world we need to take into consideration the synergistic effects of multiple conditions.

  13. Koebner

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    Posted 6 years ago
    Sun Oct 21 2012 12:10:41
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    Doug - One of the problems with DSMs is that they tend to be seen by the public as inerrant (they really, really aren't). As you suggest, the definition given above may be fair enough when the patient began without pre-existing psychological problems, but inadequate when dealing with people already in psychological difficulty.

    There are plenty of dissenting professional voices when it comes to the APA's regular frolic into definition & the WHO's ICD is not without critics either. It's difficult because psychiatrists want to put a biomedical gloss on their project but their only basis for diagnosis remains psychological.

    On Bedbugger, we hear from a lot of people who are already suffering from depression, anxiety disorders, OCD, or other mental health difficulties when they discover BBs. For someone with severe psychological problems, the experience of threat & distress associated with BBs may be far greater than for someone who begins from a less difficult position & thus the consequences may be far more severe. DSM has always been poor at dealing with overlapping groups of symptoms or with people who begin with one diagnosis & go on to display symptoms of other defined conditions.

  14. Nobugsonme

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    Posted 6 years ago
    Sun Oct 21 2012 12:53:43
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    Did some trolling around to find links for a possible FAQ.

    It sounds like bedbuggerry may have gotten a diagnosis of PTSD also.

    "S" was diagnosed with Acute Trauma Stress Disorder, as she described in this post.

    Jerome Goddard actually did a study (PDF here) of bed bug discussion boards including this one and found many users exhibited signs of PTSD (which isn't, of course, the same as full-on PTSD).


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