Thursday, August 18, 2005

Symptoms of PTSD, Part One

Case History – Part One

In “The Body Bears the Burden: Trauma, Dissociation, and Disease,” Dr. Robert Scaer begins with the case history of Beth. Beth was involved in a low-speed motor vehicle accident (5 to 10mph) prior to developing the symptoms that brought her to Dr. Scaer. There was no damage to either car, and the other driver was uninjured.

“Beth, on the other hand, continued to suffer from terrible neck and shoulder pain, numbness of her right arm, disabling headaches, and temporomandibular joint syndrome. Six months of chiropractic treatment and massage therapy brought her only temporary relief from pain, and a dental splint only slightly helped her morning headaches. Recently she developed severe pain in her right hip and buttock, with the pain radiating down the back of her leg. X-rays and MRIs failed to show any cause for her spinal or leg pain.

Since the accident, Beth had also experienced worsening problems of distraction and an inability to concentrate. Her memory was terrible, and she would constantly go somewhere and forget what she had intended to do. She had recently started to drive again, and would travel to some familiar place in town, and on arriving, realize she could not remember how she got there. She would stumble over words, say the wrong word for what she meant, and then feel stupid. She even had developed a stutter whenever she was stressed. She constantly made errors in her checkbook.

Worst of all, since the accident, she had become panicky when traveling in a car, especially as a passenger. Her heart would pound for no reason. She had become edgy and irritable, and jumped at every loud sound. Thoughts and images of the accident kept popping into her mind, producing distraction and anxiety. Although she was able to fall asleep without drugs, she kept waking fully aroused, sometimes with a racing heart, sometimes with dreams of the accident or of being threatened with no means of escape. During the day, she was exhausted by every physical and mental effort, and had dropped out of her master’s program in clinical social work. Her extreme sensitivity to almost any stimulus had resulted in her isolation from almost all of her prior social activities.

She admitted that at times she was worried that she might have a brain tumor. She experienced dizziness when she moved her head too quickly, kept losing her balance and bumping into things, and noticed that her vision blurred whenever she moved her focus from one object to another. Reading caused blurring of vision and a headache,” (Scaer, pp. xvii-xviii).



When Dr. Scaer questioned her about her past traumatic life experiences, he discovered that from the age of six to twelve, her brother, who was seven years older, would come into her room after bedtime at least twice a week, overpower and rape her. Beth entered counseling in college, and thought she had put it all behind her. Her motor vehicle accident was the event that precipitated her symptoms, but it was not what initially caused her nervous system dysfunction, the unresolved flight/fight/freeze response.

Do any of Beth’s problems sound familiar?

What about these?

Do you have frequent urinary tract infections? Painful urination or intercourse? Loss of bladder control or sphincter muscle tension?

Do you have unexplained pelvic pain?

Are you often fatigued or exhausted by comparatively minor activities that others seem to do with greater ease?

Have you designed your workspace, if you are able, so that no one can “sneak up behind you?” Are you easily startled by the “sudden” appearance of another person?

Do loud sounds “hurt,” or make you feel irritable, edgy, or angry?

Do you suffer more than others from the symptoms of premenstrual syndrome?

Do you get frequent headaches?

Do you have digestive problems – alternating constipation and diarrhea – frequent heartburn? Difficulty swallowing? Do you experience frequent dry-mouth?

Do you have problems with your memory (ever forget your own phone number)? Do you stutter, stammer, and search for the right words, especially in stressful situations (job interviews, doctor appointments)? Have you ever experienced, “word spaghetti,” when an archaic or little-used word pops out of your mouth instead of the word you intended to say? Do you often lose your train of thought in mid-sentence?

Does your heart race, or feel as if it’s going to jump out of your chest at times (ka-THUMP)?

Do you have sharp, shooting pain in your limbs that seems to have no source? Does the pain radiate? Do your arms and legs go numb or tingle?

Do you have tender spots that hurt under pressure? Is it hard to find a comfortable position? Do you feel sore and achy when you haven’t changed position for some time? Have you ever experienced “referred pain” – pressure on one part of your back, for example, may feel like pain radiating from your chest?

Does your jaw ache?

Do you have pain in your teeth that is hard to localize, and your dentist can’t find any problems?

Does the surface of your skin go numb in odd, seemingly random places, such as a patch on your upper arm, or do you feel as if you are wearing gloves on your naked hands, or stockings on your bare feet?

Do your hands, especially the palms, redden? Have you ever noticed a red, lattice-work appearance under the skin, sometimes called a “strep rash?”

Do you have any tremors? Muscle spasms or “fluttering?”

Do your tendons hurt for no apparent reason? Do you have joint pain, but no sign of osteoarthritis or injury?

Do you suffer from back aches with no sign of spinal injury?

Are your muscles tired as though you’ve been working out?

Do you have burning sensations in your limbs? Sciatica, or pain that radiates from the buttock down the back of your leg?

Do you have sharp, shooting pain in your chest wall, especially on either side of the sternum?

Do you feel faint when you stand up?

Do you have difficulty breathing (especially exhalation) or symptoms of asthma but normal blood oxygen levels when tested?

Do you feel dizzy (vertigo), as if the world is moving around you while you stand still, or do you perceive that your body is moving as if on a merry-go-round?

Are you clumsy or accident-prone?

Do you miss a lot of work due to flu-like symptoms?

How well do you sleep? Do your dreams often involve falling? Dying? Being pursued? Do they wake you? Are you even able to remember your dreams?

Do any of these problems intensify during times of increased stress? Have you ever looked for a pattern of illness that occurs at about the same time every year, as in, “I get sick every spring – it must be allergies?”

Do you have difficulty telling others (or identifying for yourself) how you feel emotionally?

Do you have an eating disorder – anorexia or bulimia – or obesity?

Do you have a history of psychological or physical trauma, such as sexual abuse, abortion, motor vehicle accidents, surgery, serious illness, slip and fall accidents, physical abuse, assault, or have you been a witness to any traumatic events?

Have you been tested for, diagnosed with and/or treated for, or troubled by any of the following conditions:

Alzheimer’s Disease?
Anxiety disorders?
Alcoholism or other substance abuse?
Chronic Fatigue Syndrome?
Depression?
Diabetes or hypoglycemia?
Insomnia?
Anorexia Nervosa and/or Bulimia?
Hyperparathyroidism and hypothyroidism?
Seizure disorders?
Sleep apnea?
Systemic Lupus Erythematosus?
Migraine?
Multiple Sclerosis?
Meningitis?

These are a few of the conditions listed by the University of Maryland as having similar symptoms as Post Traumatic Stress Disorder, which gives us an idea of the systemic (fully-involved) range of physical symptoms that accompany this physioneurosis. It also helps explain why PTSD and many of the illnesses mentioned above are difficult to diagnose.

Dr. Scaer dedicates his book to a professional colleague and friend who taught him that “…the diagnostic truth lies more in the uninterrupted story told in its entirety by the patient than in a dozen diagnostic tests.”

In the next segments I will be discussing more symptoms, pick a few, and then go into an explanation of why and how PTSD causes them. Commentary here would be really helpful - there are so many to choose, that I would like to hear what others are most interested in discussing. After that, we will look at therapy for the disorder. I will warn you that the prognosis is not the greatest - and no, I am not going to sell you a book or a video, either, so read in peace. When I have covered everything I need to cover, I will condense this in a booklet format, and make it available to view, download, and print in .pdf format - free of charge. There isn't much that ticks me off more than buying a book that proposes to help me and finding an advertisement in each chapter for more junk I have to buy before they let me in on their secrets. I've linked to several of my sources at the sidebar. None of these professionals purports to sell you a cure, but they do help us understand what's going on - and that in itself is therapeutic.

When abortion hurts, it hurts permanently. As a medical solution to the temporary condition of unwanted pregnancy, we will discover it's like amputating the leg to relieve an ingrown toenail.


8 Comments:

At 2:52 PM, Blogger Josephine said...

Answers:

Yes
no
yes
yes
yes(in fact I sit in the doorway no getting in or out)
yes( I cant stand the TV above 3 notches on my reciever)
yes
no
yes to all
yes to word spagetti
yes(hubby says its panic attacks)
yes
yes to the chest pain
yes
no my teeth really are a mess
yes I get numb circles for no reason
no
yes under my eyes and mucle twitches
mmm wouldnt know wont go for diagnosis
no
yes
yes
yes
no
yes
being pursued or trapped. Or dreams about my twins
yes
sometimes
no
yes(abuse and a witness to things)
I have been tested for nothing to get me to the doctor I would have to be near death.

 
At 7:24 PM, Blogger achromic said...

I want to know more. But I'm not sure about what. I want an answer. I want to know if what is wrong with me is this stuff that you are talking about or it is something else... and I don't know how to tell. I don't know how to get the doctors to tell. I'm ok if it is a mental problem.... I mean it blows and I hate that but ok I will deal with it. But how do I make sure that it isn't something else? It all seems so confusing. I feel overwhelmed, if I wasn't feeling the stress of my past (ie trapped,scared, out of control) I'm sure begining to with all the stuff with the doctors. I need answers, even if I don't like them.

 
At 9:23 AM, Blogger Josephine said...

I think its more than just mental. I think the imprint on the memory causes genuine physical damage. ITs in your head but its also in your mucles and blood and all that other stuff it takes to run the human body. Kinda like a alchoholics damage to the body. I think it is possible that the adrenaline and other naturally occuring hormones and body chemicals can cause harm after repeated exposure. And I say that because of the trouble adrenaline junkies have with arthritus and metobolic disturbances. They dont have ptsd but they have symptoms similar to ours.

 
At 1:37 PM, Blogger achromic said...

Well I don't think that your mental state can cause MS or that having tragity and resulting from that you get Lupus. I think there is MS and there is Lupus and then there is mental stress that causes symptom that mimic MS and Lupus.

 
At 1:45 PM, Blogger Josephine said...

Ohh Im not saying that these things dont exist by themselves Im just saying our symptoms arent made up they are real and physical. People like to think its all in our heads but the pain and effects are very much a physical occurance and not purly psycological.

 
At 6:24 PM, Blogger Silent Rain Drops said...

These are great comments. There is a section in Dr. Scaer's book, Achro, that talks specifically about lupus and MS as a result of chronic stress. They are both autoimmune disorders. During the stress response, leuokocytes don't work - this will be in my next segment, which is about done and should be posted tomorrow, where I'll tie these symptoms into the stress response and PTSD.

Anyway, I've learned that autoimmune disorders are the body's normal system going nuts and attacking healthy cells - the signals to the leukocytes get scrambled, maybe? There's a complex explanation in Dr. Scaer's book about how it relates to the damaged hippocampus (damaged in PTSD patients) that I need to study. There is also more evidence completely unrelated to PTSD that is developing the same relationship between chronic stress and autoimmune dysfunction.

As you said once, we are living longer, so maybe this is the beginning of our understanding about the long-term consequences.

 
At 8:04 PM, Blogger Jo Ann Fore said...

I found this old post. Do you by chance have a link to the pdf booklet you made reference to completing?

I would love the information.

 
At 7:13 AM, Blogger Silent Rain Drops said...

Hello, Jo Ann -

Thank you for reading! I have not yet completed the .pdf. I have the revisions complete on paper, but have been lazy about making these online, and completing the last chapter (abortion, trauma, and social attachment disorders such as autism). I have resolved to finish after the holidays.

In the interim, all of the articles that will be edited for inclusion can be found at the sidebar so you don't have to scroll through historical writings that are irrelevant. I will keep your email handy so I can let you know as soon as I have it finished and converted to .pdf.

Thank you again for reading here, and Merry Christmas - Happy New Year.

 

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