Any suggestions on PTSD & C-PTSD assessments

[Simon]

Numb.

So I speak to this Dr last night. Summary follows, paraphrasing:

I have to explain why I think I have PTSD, go through symptoms, etc, which I didn't want to do more than once, but ok, this guy is giving me some advice for free so I share the mimimum without getting into any specific trauma.


1. 'You should go through Bupa, if you call X number and say Y then they will give you an auth code and you won't need to get a referral or explain this to multiple people'

2. 'Your prior sensitivity to SSRIs,. SNRIs, ADHD medication and others is in your head and you need to be willing to put up with the side effects to get the benefits, treatment for PTSD must be pharmaceuticals plus therapy, so don't bother if you are not going to be willing to take the pharmaceuticals again'

3. 'I don't know anything about cannabis, that is a different specialism', followed soon after by 'cannabis is crap compared to this drug I am used to prescribing because canna only relaxes and does nothing else useful, it won't help you with anything else' and then followed by 'cannabis is very expensive right? So I am trying to save you money'


So I call the Bupa number and say what I was told to say. Can you guess what Bupa said?? Yeah, same as first time, 'you need a referral', you need to speak to a GP, either you own or one of ours first explain everything and they will confirm if you need an assessment / treatment.

I am struggling so much, it's taken so long to realise / accept I need help, longer to ask for it. Well this caused a meltdown last night and I am double exhausted today and feel further back rather than forward

Sending big hugs to you. We all love you!!

 

[Fiddlesticks]

Numb.

So I speak to this Dr last night. Summary follows, paraphrasing:

I have to explain why I think I have PTSD, go through symptoms, etc, which I didn't want to do more than once, but ok, this guy is giving me some advice for free so I share the mimimum without getting into any specific trauma.


1. 'You should go through Bupa, if you call X number and say Y then they will give you an auth code and you won't need to get a referral or explain this to multiple people'

2. 'Your prior sensitivity to SSRIs,. SNRIs, ADHD medication and others is in your head and you need to be willing to put up with the side effects to get the benefits, treatment for PTSD must be pharmaceuticals plus therapy, so don't bother if you are not going to be willing to take the pharmaceuticals again'

3. 'I don't know anything about cannabis, that is a different specialism', followed soon after by 'cannabis is crap compared to this drug I am used to prescribing because canna only relaxes and does nothing else useful, it won't help you with anything else' and then followed by 'cannabis is very expensive right? So I am trying to save you money'


So I call the Bupa number and say what I was told to say. Can you guess what Bupa said?? Yeah, same as first time, 'you need a referral', you need to speak to a GP, either you own or one of ours first explain everything and they will confirm if you need an assessment / treatment.

I am struggling so much, it's taken so long to realise / accept I need help, longer to ask for it. Well this caused a meltdown last night and I am double exhausted today and feel further back rather than forward

Hi Lank

1) Ok sounds good

2) Total bullshit. If this is BUPA's policy I am unaware

3) CPTSD nightmares are typically the hardest symptom to deal with. The avoidance of going to sleep as well as the discombulatedness when you wake up
Cannabis is the only treatment that can address the sleeping side of CPTSD. Unless the doctor fancies prescribing Xanax.
This is why you see veterans discounts being offered everywhere as Cannabis is highly effective at combating PTSD night terrors and there is no known alternative.

I have 3 pages of medication prescribed to me over the course of 5 years. I dont want to colour other peoples impressions of SSRI's as they may well provide them with the stability they need.
Personally I found SSRI's to be the most evil drug I have taken and gave me the equivalent of a illegal drug comedown every day without any of the fun!

To try and be some practical help I would look into the local mental health service trauma provision and try and get a "referral" that way rather than your GP.
So the process might be GP refers to local service with some actual level of understanding of the condition
Local service writes back to GP with confirmation of issues
GP can then write to BUPA?

You really want what the person was offering you at stage one. A simple conscise summary of issues that you can present to each health authority/service so that you dont have to re-live your issues every single time you try and access treatment they can refer to the summary.

 

[Lank72]

Yeah not having a great day as a result, but you clearly get it so I don't need to go into detail I'm sure

Thank you. I've made myself fill in the GP form for a call-back. My symptoms are getting worse over time (months and months now) so I don't feel like I can wait until I feel better.

Even though it is very detrimental to my health jumping through their hoops I just don't feel like I have any choice. Hopefully enough of me will make it through the cheesegrater to engage with any assessment / treatment without a full burnout.

I am going to all but beg my GP to just give me a piece of paper with some words on it without grilling me further so I can progress this.

Of course you are spot on with what you say about canna and their pills. I still wake in the night with this, but I can get back to sleep, and I can usually get to sleep easily enough in the first place (T30 Indicas are my weapon of choice for bedtime). Canna has and still does provide such support and relief. I wouldn't be getting to sleep or getting out of my bed in the day without it at the moment, can't really say it simpler than that I don't think. I did not feel it worth my spoons trying to go through all that in this case.

Suffice to say, I will not be choosing that doctor if I get through all this bullshit

 

[Fiddlesticks]

Yeah not having a great day as a result, but you clearly get it so I don't need to go into detail I'm sure

Thank you. I've made myself fill in the GP form for a call-back. My symptoms are getting worse over time (months and months now) so I don't feel like I can wait until I feel better.

Even though it is very detrimental to my health jumping through their hoops I just don't feel like I have any choice. Hopefully enough of me will make it through the cheesegrater to engage with any assessment / treatment without a full burnout.

I am going to all but beg my GP to just give me a piece of paper with some words on it without grilling me further so I can progress this.

Of course you are spot on with what you say about canna and their pills. I still wake in the night with this, but I can get back to sleep, and I can get to sleep easily enough in the first place (T30 Indicas are my weapon of choice for bedtime). Canna has and still does provide such support and relief. I wouldn't be getting to sleep or getting out of my bed in the day without it at the moment, can't really say it simpler than that I don't think. I did not feel it worth my spoons trying to go through all that in this case.

Suffice to say, I will not be choosing that doctor if I get through all this bullshit

You hit the nail on the head
Zopiclone
Amitryptiline
Mitrazapine
Setraline
The list goes on. These medications are certainly impactful on mood and feeling but they do NOTHING to address the experiencing of nightmares and in some instances lock you into those nightmares.
Yes Cannabis is abusing your REM cycle and you simply "dont remember" the dreams. However when you are not disturbed so much by the dreams themselves but the fear of terrors prior to sleep and the dissasociation when you wake up.
I am not doing a full blown Jungian dream analysis which no modern doctor can touch but I will make toast of any health care proffessional that tries to tell me what is what when I have experienced it most my life!

 

[Lank72]

I'm really glad you said that, I have had so many mornings where I KNOW I had a nightmare, woken up, sweating, panicked, etc but fucked if I know what it was exactly.

In 6 months I only vaguely remember one of them and that was recently when things have been getting worse

Yeah canna gives me all the benefits and none of the side effects, but it's like armour for me so can only take so much of the sting out of stuff for me, I guess it's just reaching a point over the last few months where I can't ignore it anymore

 

[Al.]

All meds aside.

I have just recently been exactly where you are Lank, the frustration of an Ins. company saying no drove me deeper into the depression side, almost too much.
Many times I should have called crisis, in a way I did my own. I have a great GP surgery however one particular GP had some psychiatric exp., she understood when I told her my symptoms were not depression alone and I asked her advice. With what the NHS CBT assessor had said and a personal referral I just called up one of our local private hospitals (the Psychiatric consultant referral there) and he saw me a week later. He diagnosed after a second visit and wrote a stiff letter to my (negative and dismissive) Insurance company. (It must be a Psyciatrist. NOT a GP, Psychologist or anyone else)
Two days later they call me and I am covered.


Six months pain and hell with C-PTSD, MDD and PD. I did not need to go through.

Lank, If I could go back 40 years and tell a 20 year old me....(I have been through that one a couple times). But if I could go back to me, were you are now and give myself advice it would be. Divi up the cost of a couple of appointments against your sanity/life etc., you may well get the same good result and quicker help than I restricted myself to.

Likely you will get the initial costs back too.
People do care and love em they really do want to help (fills me up every time)

Best
Al

 

[Lank72]

GP to the rescue.

I am not sure how, perhaps this GP is a psychiatrist too and I got lucky possibly. They said it was quite clear from the written submission I shared in advance, and what I said on the call.

I now have a written PTSD diagnosis, which has been entered on to my health records already as a diagnosis (I checked separately).

And I also have a completely unambiguous referral letter that basically says shut up Bupa, this patient has PTSD, give them the therapy they need ASAP and stop stalling

If I wasn't so numb at the moment I'd be relieved, hopefully that will kick in at some point

On to the next stage, I suppose that is when I will find out if it's PTSD only or C-PTSD?

 

[Lank72]

The Bupa gates are battered down, following a laborious interaction I can pick a therapist. Now for the real fun to begin

Thanks to everyone who commented

 

[Fiddlesticks]

All meds aside.

I have just recently been exactly where you are Lank, the frustration of an Ins. company saying no drove me deeper into the depression side, almost too much.
Many times I should have called crisis, in a way I did my own. I have a great GP surgery however one particular GP had some psychiatric exp., she understood when I told her my symptoms were not depression alone and I asked her advice. With what the NHS CBT assessor had said and a personal referral I just called up one of our local private hospitals (the Psychiatric consultant referral there) and he saw me a week later. He diagnosed after a second visit and wrote a stiff letter to my (negative and dismissive) Insurance company. (It must be a Psyciatrist. NOT a GP, Psychologist or anyone else)
Two days later they call me and I am covered.


Six months pain and hell with C-PTSD, MDD and PD. I did not need to go through.

Lank, If I could go back 40 years and tell a 20 year old me....(I have been through that one a couple times). But if I could go back to me, were you are now and give myself advice it would be. Divi up the cost of a couple of appointments against your sanity/life etc., you may well get the same good result and quicker help than I restricted myself to.

Likely you will get the initial costs back too.
People do care and love em they really do want to help (fills me up every time)

Best
Al

Hi Al
Its upsetting to read the problems someone has in getting a correct diagnosis especially around CPTSD.
Its also telling how quickly the private consultant diagnosed and the stiff letter that your symptoms were clear.
You are also right to make a clear distinction between a psychiatrist and psychologist. I forgot that.
Accessing them in the NHS is like hens teeth unless you are causing a real problem to the state.
Not good

Your advice is really sound and I am glad you are covered going forward.
Thanks for sharing top lads Xxx

 

[Al.]

Thanks Fiddlesticks.

The process is set up for folk that are 'stable' to negotiate, to be frank the things I have seen the couple of years explain the morbidity data for neurodiversity (it is an eyeopener, I am not dissing the NHS this is the general attitude of the system).

Lank, I am very pleased you have some therapy, let's hope it gets you better, what have they offered you?

 

[Lank72]

Thanks Fiddlesticks.

The process is set up for folk that are 'stable' to negotiate, to be frank the things I have seen the couple of years explain the morbidity data for neurodiversity (it is an eyeopener, I am not dissing the NHS this is the general attitude of the system).

Lank, I am very pleased you have some therapy, let's hope it gets you better, what have they offered you?

My pick of some Clinical Psychologists who each have a range of specific therapies they offer.

I've been reading up about it, and apparently the 'Clinical' bit is very important as that is the distinction making them a specialist doctor, who can diagnose and determine which therapy(ies) might be suitable.

I'm kind of spent after the last few days though and don't really feel up to reading though loads of stuff about it today. Possibly going to give it a few days and try and recover a bit before pushing on

 

[Al.]

Good call, don't deplete your energy stocks (not joking).

 

[Fiddlesticks]

Thanks Fiddlesticks.

The process is set up for folk that are 'stable' to negotiate, to be frank the things I have seen the couple of years explain the morbidity data for neurodiversity (it is an eyeopener, I am not dissing the NHS this is the general attitude of the system).

Lank, I am very pleased you have some therapy, let's hope it gets you better, what have they offered you?

I dont think I would want to look at the data. I only need think of those I know that were lost along the way.
Just to add my tuppence on therapies. I let the proffessionals decide what they think I need as it was they who diagnosed me however CBT and EMDR are less effective for me as I have a pathological issue in relaxing.. lets put it that way.
Everyone has a different formulation that a knowledgeable psychiatrist should make.
I have been told and agree that I need Schema therapy to overcome what is blocking me.

 

[Lank72]

I am glad I waited to recharge a little bit after this week.

I've now been through the bumph and contacted my favourite (on paper/screen) therapist so see what the craic is.

Feels good to have done it, fingers crossed...

 

[Fiddlesticks]

Really glad to hear Lank.

I would like to reccomend a book that helped me on my journey.
It was originally written as a book for therapists however it is one of the best I have encountered and I bought, it is widely used and thought of still.
Different strokes for different folks of course, but if you want to try and understand a lot of different aspects you cant go wrong.
Hope this helps someone.

Free pdf: https://notability.com/g/download/pdf/Q6bWJMpd4NPNACpEsRa3K/Complex PTSD: From Surviving to Thriving.pdf
To purchase: https://www.amazon.co.uk/Complex-PTSD-Surviving-RECOVERING-CHILDHOOD-ebook/dp/B00HJBMDXK

 

[Bluewaffle1878]

Swear i had to jump through hoops to get the diagnosis man multiple talk therapys n failed edmr then mentel health teams in the GP referred to a mentel health team
And gave me my diagnosis but it took over a year for me

I turned down goin bk to them after a disgnosis as i dont like talkin to people like that, i was diagnosed with asd and ADHD last year as well meself

 

[Al.]

Swear i had to jump through hoops to get the diagnosis man multiple talk therapys n failed edmr then mentel health teams in the GP referred to a mentel health team
And gave me my diagnosis but it took over a year for me

I turned down goin bk to them after a disgnosis as i dont like talkin to people like that, i was diagnosed with asd and ADHD last year as well meself

Six months of assessments by MH NHS Nurses and CPT to see the Psychiatrist for my diagnosis. A matter of understanding the triage process I now understand. Trouble is C-PTSD, MDD, PD (ADHD/ASD) is/are not really good tools to help you navigate this stuff.

40 chats into therapy and I might be stable enough for EMDR next week.

They use the term 'Watchfull Waiting'. Makes me giggle.

Be kind to yourselves

Al

 

[Fiddlesticks]

40 chats into therapy and I might be stable enough for EMDR next week.

Hi Al

Let us know how it goes. Triage is the word they use and it infuriates me greatly.
You do not triage mental health conditions.
You triage battlefield injuries. The fact the NHS uses it in conjunction with MH conditions is a massive insult to those on waiting lists. I was put into "triage" for the best part of two years.

Did the psych ask for you to cut out or reduce cannabis consumption before undergoing EMDR? I think its a good idea but that is personal to me.
Processing dreams is kinda impossible when you are trying to blot them out every night.
There are different types of EMDR so that is just my opinion to be clear.

Most people need to go through safety and stabilisation before moving to EMDR or schema therapy.
I have encountered the term Watchful waiting before mostly in the formulation stage . Everyone will have a different formulation made for them by the psych for treatment. I would be happy to share that part of mine, privately as it has confidential info in it. Sometimes it can help though for people to see what that looks like.

Thanks for sharing and all the best for the next few weeks.

 

[Al.]

Hi Al

Let us know how it goes. Triage is the word they use and it infuriates me greatly.
You do not triage mental health conditions.
You triage battlefield injuries. The fact the NHS uses it in conjunction with MH conditions is a massive insult to those on waiting lists. I was put into "triage" for the best part of two years.

Did the psych ask for you to cut out or reduce cannabis consumption before undergoing EMDR? I think its a good idea but that is personal to me.
Processing dreams is kinda impossible when you are trying to blot them out every night.
There are different types of EMDR so that is just my opinion to be clear.

Most people need to go through safety and stabilisation before moving to EMDR or schema therapy.
I have encountered the term Watchful waiting before mostly in the formulation stage . Everyone will have a different formulation made for them by the psych for treatment. I would be happy to share that part of mine, privately as it has confidential info in it. Sometimes it can help though for people to see what that looks like.

Thanks for sharing and all the best for the next few weeks.

Thank you friend. Yesterdays session was a 'prodding' one (he needed to know what the trigger was that set this off).

It's not often I have to go through this after the barrage of initial assessments (can be challenging..) so last night and today I am still coming down. It will be okay - thanks (I have no way of sending you my email, I would rather not post in a thread).

@Lank72 Having a PM/DM forum feature for the sort of thing Fiddle is kindly offering would be a terrific help for the MH guys in the MC community (?) I sat in my room alone for almost a year not knowing anything or anyone who knew about what I was going through first hand (not the background nec., more the symptoms). Having the support of others with similar issues (the same diagnosis at least) would have been a great help then.

 

[Fiddlesticks]

@Lank72 Having a PM/DM forum feature for the sort of thing Fiddle is kindly offering would be a terrific help for the MH guys in the MC community (?) I sat in my room alone for almost a year not knowing anything or anyone who knew about what I was going through first hand (not the background nec., more the symptoms). Having the support of others with similar issues (the same diagnosis at least) would have been a great help then.

Whilst I second the request, maybe this is just not the place for it.
I can only imagine the website and janitor issues that would arise from providing the feature.
Protecting vulnerable people, of which many users could be categorised, has to be priority when trying to run a ship like this. So if the DM feature is not possible then I understand.

If ever anyone has a question, or something that is really bothering you, then please I love to help. Its something that always makes me feel good. All I ever want is for people to have what I didnt.
I am considered reasonably capable by most that meet me and my battle with CPTSD defeated me. Everyone needs help.

I echo your message to be kind to oneselves.