# Questions people want answered about DP - some answers



## Joan Smith (May 28, 2013)

Hi,

Some of you will remember when I first posted my recovery story and how I went on to become a therapist. I've been working with DP sufferers for a while now and I thought it's time to do a post since a lot of the questions asked I think will be of interest to people here.

*1) Are anxiety and DP the same thing?*

NO. In my experience the DP can be more persistent and harder to shift than the anxiety component. These two can be so closely linked that it feels like the same thing. However it is possible to fully recover from an anxiety disorder and still be experiencing DP. It is also possible to have DP and not feel anxiety (particularly if anti-anxiety or anti-depressant medication is numbing your anxiety).

*2) Is DP as a result of trauma?*

A lot of the time YES. Trauma is not just related to the instant where the DP set in or the experience of panic before the onset of DP. The trauma being activated often goes back a long way into your childhood or earlier memories. Even if you don't remember having a difficult childhood do not dismiss the importance of excavating your personal history.

*3) Is DP as a result of early childhood sexual abuse*

It can be but not always. Statistics are showing that emotional abuse is a big contributor to experiencing DP. Physical and sexual abuse are also significant indicators.

*4) is DP psychosis? Or am I schizophrenic?*

No. Psychosis is a split from reality not just feeling detached from reality. Schizophrenia has its own symptoms which may include dissociation and anxiety, but usually people suffering from anxiety and DP are afraid of the thought that they may have a mental illness such as schizophrenia or are afraid of the thought of going insane.

*5) is DP curable?*

Yes. The most successful results happen in psychotherapy and parts work is particularly effective at unearthing the root trauma and causes of the DP. If you are seeing a therapist ask them if they do parts work related to trauma.

*Other FAQ*

DP cannot hurt you. It is trying to protect you.

Do not engage in any 'retraumatizing' behaviour. This may include taking drugs such a psychedelics to try and find recovery. Or being around people who are not supportive or nuturing. These may have the effect of traumatising you even more therefore setting back recovery. Look after yourself in terms of your health and diet and find a therapist who does not dismiss dp as its own disorder.

Do not be fooled by your anxiety and/or DP symptoms. These can have you on a treadmill for years, leading you down the wrong path. DP is not a physical problem it is a psychological one. And I repeat the DP is trying to protect you.

Go well

Joan


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## missjess (Jun 1, 2012)

Very nice post Joan, I really liked the first post that dp can be it's own disorder seperate from anxiety because that is what I've been experiencing for years.


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## Joan Smith (May 28, 2013)

If anyone wants any other questions answered please don't hesitate to email me

kind regards,

Joan


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## Guest (Jan 13, 2014)

Selig said:


> Can you elaborate on this?
> 
> I have always been under the impression that anxiety was fuel for depersonalization, particularly in those who are suffering a transient episode unrelated to trauma etc. For example, if someone did not feel bothered or anxious by their depersonalization, how would it remain? Would the body not return to a 'resting state' and no longer perpetuate feelings of depersonalization?


Sorry to butt in&#8230; depersonalisation and anxiety disorders are separate, You can have one without the other. Just b/c you're not anxious, doesn't mean mean you will no longer have depersonalisation. I agree anxiety IS fuel for dp, but it's not essential to experience dp. Dp is a learned thing. Our minds have learnt to use this to protect itself. Every human being experiences anxiety and even overwhelming anxiety at times. It's also a natural human response. Though it's in response to different things than dp.

I'm not sure if I'm on the same track as you here. Just let me know if I'm not.. and I'll shut up 

M


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## Guest (Jan 13, 2014)

Selig said:


> I suppose my view was always that depersonalization was tied in with the fight or flight response and anxiety in general. I figured if someone did not experience any discomfort with their depersonalization, it would dissipate.


Same here. I actually find it more discouraging when people say that DP and anxiety aren't related. If it's not stress and anxiety, what the hell is DP protecting us from anyway?


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## node71 (Jan 12, 2014)

Thanks so much for posting this list. I'm curious to know what the recovery process feels like, however.

Is it a noticeable, gradual improvement that takes time? Or can the person immediately notice the difference after performing said therapy in a matter of days/weeks?


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## Joan Smith (May 28, 2013)

I will explain the difference between dissociation and anxiety using 'parts' which is the method I use with my clients to untangle this issue. When we look at the part of us that is 'anxious' you will find it belongs to an earlier time for example when you were a child. The 'dissociator' is the protector of this part. It is not the same part. It uses disconnection and dissociation to protect the anxious part - to keep the anxious parts fears/pain numbed and under control.

When we ask the dissociator to step aside in therapy work it usually reveals a very traumatised person who needed the protection.

Using these metaphors and analogies is particularly useful in subconscious work because the subconscious does not understand our science. It works in symbols and emotion.

kind regards,
Joan


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## Joan Smith (May 28, 2013)

node71 said:


> Thanks so much for posting this list. I'm curious to know what the recovery process feels like, however.
> 
> Is it a noticeable, gradual improvement that takes time? Or can the person immediately notice the difference after performing said therapy in a matter of days/weeks?


The recovery process is gradual. You will know you are on track when you get the right therapy/ist. A good therapist who understands dissociation and trauma can do some good work over about 6 months with your regular participation.


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## Guest (Jan 13, 2014)

...


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## Joan Smith (May 28, 2013)

Selig said:


> Thank you. What about those who don't necessarily have depersonalization due to trauma, but rather a genetic predisposition for anxiety triggering a depersonalized state from stressors?


When you say a genetic predisposition to anxiety it raises a lot of questions for me. I don't necessarily believe that anxiety is about genetics... moreso environment. Yes transient dissociation due to stress is what is happening daily to a lot of DP sufferers. However finding the root of the anxiety is important and this is usually where we stop using the word anxiety and switch it to trauma.


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## eddy1886 (Oct 11, 2012)

Joan as regards Trauma..is it possible for a person to block out traumas experienced in childhood to the extent that they can't be remembered or recalled..and if this is the case can therapy bring this stuff to the surface so it can be dealt with..I often look back at my childhood thinking I never suffered any traumas..is it possible that they are buried in my subconscious..I mean is it possible that I never believed that certain traumas in my childhood were significant enough to be damaging..I mean I don't look back at my childhood and think it was particularly traumatic..is it possible I blocked out the bad stuff..the biggest thing a dp sufferer wants to know are the underlying causes of their condition..in my case this is why I've never even had a so called starting point to recover from..I simply don't know what brought it on..ok weed triggered it but what was there before the weed..by the way it's terrific to see somebody who works in therapy and understands dp..it's a breath of fresh air..hopefully many will follow in your footsteps..thanks for your post..it's truly encouraging


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## Joan Smith (May 28, 2013)

Selig said:


> So any trigger could be considered trauma if it causes depersonalization?
> 
> When I say a predisposition, I'm referring to studies conducted where some children appeared to be inherently anxious as opposed to anxious as a result of their environment. If I recall correctly, it was then environmental factors that would influence whether they developed any psychological issues.
> 
> ...


I see where you are coming from Selig. With regard to the nature vs nuture debate on predisposition I stand on the nuture side. Even before birth the developing foetus is aware of negative or hostile conditions. I believe children can be more sensitive yes definitely however anxiety is always a response to something. The anxious self is fearing something - whether it is a rational fear or not is irrelevant - this is the anxious parts reality.

The word trauma has been ill defined and understood. When people hear the word trauma they think it means something terrible like a near death accident and yes this can cause trauma absolutely. However a sensitive child can be traumatised by less dramatic events as well. For example if your mother screamed at you and for a minute you thought she might go insane - this is enough to cause trauma.

I don't believe a panic attack later on in life which begins the onset of DP is the one defining traumatic event. Certainly it feels traumatic at the time and it may feel like a near death experience however I'm looking at what has been activated. If the panic attack passes and the DP remains, why does it remain? Is it because this part cannot see that you survived? Why cannot this part rationalise that you are alive that you are ok? Something else has been activated. This is what we need to go looking for. Why does this part no longer trust you?

kind regards,
Joan


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## Joan Smith (May 28, 2013)

eddy1886 said:


> Joan as regards Trauma..is it possible for a person to block out traumas experienced in childhood to the extent that they can't be remembered or recalled..and if this is the case can therapy bring this stuff to the surface so it can be dealt with..I often look back at my childhood thinking I never suffered any traumas..is it possible that they are buried in my subconscious..I mean is it possible that I never believed that certain traumas in my childhood were significant enough to be damaging..I mean I don't look back at my childhood and think it was particularly traumatic..is it possible I blocked out the bad stuff..the biggest thing a dp sufferer wants to know are the underlying causes of their condition..in my case this is why I've never even had a so called starting point to recover from..I simply don't know what brought it on..ok weed triggered it but what was there before the weed..by the way it's terrific to see somebody who works in therapy and understands dp..it's a breath of fresh air..hopefully many will follow in your footsteps..thanks for your post..it's truly encouraging


Yes eddy1886, I agree with what you are saying. When DP/anxiety first comes on it is so disorienting and terrifying all we can think of is escaping it and getting back to reality. It isn't possible to think about what predated the DP for a while because we are so frightened. Yes we do bury memories and therapy will unearth them. We often dismiss things that have happened in our past as insignificant or not important - this is because you are viewing them from who you are today not who you were back then. Perhaps now you understand that your mother was screaming at you because she had a bad day, but back then you felt like she was going insane and it was traumatic. Do you see? You have to revisit the child's eyes.


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## Guest (Jan 13, 2014)

Why don't people just call DP post-traumatic stress disorder?


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## Guest (Jan 13, 2014)

...


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## Joan Smith (May 28, 2013)

seafoam mellow said:


> Why don't people just call DP post-traumatic stress disorder?


Getting a diagnosis of PTSD is extremely difficult for some reason. PTSD suffers have symptoms DP sufferers don't such as flashbacks, nightmares, night sweats etc. but certainly yes I believe a percentage of people suffering DP also have PTSD.

Kind regards,
Joan


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## Joan Smith (May 28, 2013)

bill said:


> Hi Joan, some great info and advice there. I want to ask you, can DP/DR be cured without drugs/therapy?


Hi Bill,

Some people seem to 'spontaneously' recover from DP without medication or therapy, this usually happens by them looking after themselves in terms of diet/exercise/lifestyle and not re-exposing themselves to any stressful situations that might trigger DP again.

For those that don't recover this way, therapy is usually necessary and for those who are really struggling to cope at all then medication can be considered. Medication should be a last resort, not a first because its more a circuit breaker rather than a cure itself.

Joan


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## wise (Mar 29, 2012)

Trauma is supposedly the trigger for dp. I saw a video a while back on loveandtrauma.org that illustrated how and why.


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## livinginhell333 (Feb 19, 2005)

I notice that when i'm in public places that are crowded like malls I feel more dissociated and disconnected and feel like people are watching me. It makes me detach from the environment and reality, and i feel out of body in these instances.


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## Joan Smith (May 28, 2013)

livinginhell333 said:


> I notice that when i'm in public places that are crowded like malls I feel more dissociated and disconnected and feel like people are watching me. It makes me detach from the environment and reality, and i feel out of body in these instances.


yes livinginhell333, that is a common experience. Flourescent lighting in supermarkets can be awful as well. We're already in a state of overwhelm and the added stimulus just makes us dissociate even more.


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## Mar1982 (Feb 14, 2013)

I've been seeing a therapist for 4 years now (as long as I've had DP) I'm afraid she doesn't know enough about DP and Dissociation. She continuously tells me that my DP is a symptom of anxiety and that I have the lingering DP for a reason, but I have NO IDEA what that reason is. I can't understand why the damn thing lingers. It just doesn't make sense. Is my body supposed to still be reacting to something that happened to me years ago? Why can't my brain just let it go?


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## rowey12 (Jan 7, 2015)

Hi John

Your understanding and articulation of the underlying causes of DP are brilliant.

I think I'm a classic example. Drugs also triggered my DP but if I'm being honest with myself, I think the issue goes deeper than that.

I have always struggled to understand myself in some ways. I was definitely affected from my mothers mental illness when growing up but luckily we were raised by my grandparents which ensured a very stable and loving environment. At the same time, I realise I have always internalised my own feelings.

The strange thing then is why I am the kind of person I am? Everyone that knows me would be gobsmacked if they were reading this. I am a very confident, outgoing and social guy. I have lots of hobbies such as sport and cooking, i don't do drugs, drink very little, keep myself fit etc. I also have a successful career as a commercial property agent and have a lot of confidence in my ability.

But here I am as a DP sufferer feeling like I'm too weak to get myself together.

Maybe this confusion I have about myself explains the DP?

Keep em coming Joan. Really enjoying your posts.

cheers

Craig


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## *Dreamer* (Feb 18, 2014)

Joan Smith said:


> Getting a diagnosis of PTSD is extremely difficult for some reason. PTSD suffers have symptoms DP sufferers don't such as flashbacks, nightmares, night sweats etc. but certainly yes I believe a percentage of people suffering DP also have PTSD.
> 
> Kind regards,
> Joan


I see this thread was started a year ago, however I saw this and had to respond

PTSD is regularly diagnosed in veterans, and in those who have experienced a LIFE THREATENING experience. That is the clinical definition. It is a very specific diagnosis, resulting from a very specific type of trauma. PTSD has also existed since the beginning of time in soldiers ... called "battle fatigue" "nostalgia" "homesickness" "shell shock" ... I could post an article on research done into this recurring phenomenon since time began.

PTSD is a very specific diagnosis. I have met individuals with PTSD and many do not know what DP/DR is.

PTSD is also categorized as an anxiety disorder. (Along with acute stress disorder -- "milder" on a spectrum).

DP/DR are DISSOCIATIVE DISORDERS ... a completely different category with very different symptoms.

I would still put DP/DR in the anxiety disorders category or one of its own. But from knowing individuals with PTSD, working/studying mental health for years, talking even with a doctor at the VA hospital here ... PTSD is NOT DP/DR.

I will post for the bazillionth time the criteria for PTSD.

There is however a new diagnostic criteria that is still being debated and is not official which is "Complex PTSD." It has not been recognized as a clearly defined disorder. It is based on a concept of long term abuse.

I came from a crazy abusivee family, but was diagnosed in 1975 with DP, clinical depression, and a bazillion anxiety disorders. My Dx has never changed, and no one has ever seen symptoms of PTSD in me.

I CAN say, that it makes perfect sense that someone with PTSD could have symptoms of DP/DR as well. However, I would say someone with DP/DR on its own does NOT have PTSD ....


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## *Dreamer* (Feb 18, 2014)

Well, I guess I posted in RTF without knowing it. This is directly from the Merck Manual ....

To meet the criteria for diagnosis, patients must have been exposed directly or indirectly to a traumatic event and have symptoms from each of the following categories for a period ≥ 1 mo.

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*Intrusion symptoms (≥ 1 of the following):*



Having recurrent, involuntary, intrusive, disturbing memories


Having recurrent disturbing dreams (eg, nightmares) of the event


Acting or feeling as if the event were happening again, ranging from having flashbacks to completely losing awareness of the present surroundings)


Feeling intense psychologic or physiologic distress when reminded of the event (eg, by its anniversary, by sounds similar to those heard during the event)


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*Avoidance symptoms (≥ 1 of the following):*



Avoiding thoughts, feelings, or memories associated with the event


Avoiding activities, places, conversations, or people that trigger memories of the event


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*Negative effects on cognition and mood (≥ 2 of the following):*



Memory loss for significant parts of the event (dissociative amnesia)


Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world


Persistent distorted thoughts about the cause or consequences of the trauma that lead to blaming self or others


Persistent negative emotional state (eg, fear, horror, anger, guilt, shame)


Markedly diminished interest or participation in significant activities


A feeling of detachment or estrangement from others


Persistent inability to experience positive emotions (eg, happiness, satisfaction, loving feelings)


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*Altered arousal and reactivity (≥ 2 of the following):*



Difficulty sleeping


Irritability or angry outbursts


Reckless or self-destructive behavior


Problems with concentration


Increased startle response


Hypervigilance


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In addition, manifestations must cause significant distress or significantly impair social or occupational functioning and not be attributable to the physiologic effects of a substance or another medical disorder.

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Treatment


Exposure therapy or other psychotherapy, including supportive psychotherapy


SSRI or other drug therapy


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If untreated, chronic PTSD often diminishes in severity without disappearing, but some people remain severely impaired.

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The primary form of psychotherapy used, exposure therapy (see Exposure therapy), involves exposure to situations that the person avoids because they may trigger recollections of the trauma. Repeated exposure in fantasy to the traumatic experience itself usually lessens distress after some initial increase in discomfort.

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Eye movement desensitization and reprocessing (EMDR) is a form of exposure therapy. For this therapy, patients are asked to follow the therapist's moving finger while they imagine being exposed to the trauma.

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Stopping certain ritual behaviors, such as excessive washing to feel clean after a sexual assault, also helps.

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Drug therapy, particularly with SSRIs (see Selective serotonin reuptake inhibitors (SSRIs)), is effective. Prazosin

appears helpful in reducing nightmares. Mood stabilizers and atypical antipsychotics are sometimes prescribed, but support for their use is scant.

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Because the anxiety is often intense, supportive psychotherapy plays an important role. Therapists must be openly empathic and sympathetic, recognizing and acknowledging patients' mental pain and the reality of the traumatic events. Therapists must also encourage patients to face the memories through desensitizing exposure and learning techniques to control anxiety. For survivor guilt, psychotherapy aimed at helping patients understand and modify their self-critical and punitive attitudes may be helpful.

Last full review/revision May 2014 by John H. Greist, MD​Content last modified May 2014​​http://www.merckmanuals.com/professional/psychiatric_disorders/anxiety_and_stressor-related_disorders/posttraumatic_stress_disorder.html?qt=Post%20Traumatic%20Stress%20Disorder&alt=sh​​


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## *Dreamer* (Feb 18, 2014)

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Posttraumatic stress disorder (PTSD) is recurring, intrusive recollections of an overwhelming traumatic event; recollections last > 1 mo and begin within 6 mo of the event. The pathophysiology of the disorder is incompletely understood. Symptoms also include avoidance of stimuli associated with the traumatic event, nightmares, and flashbacks. Diagnosis is based on history. Treatment consists of exposure therapy and drug therapy.

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When terrible things happen, many people are lastingly affected; in some, the effects are so persistent and severe that they are debilitating and constitute a disorder. *Generally, events likely to evoke PTSD are those that invoke feelings of fear, helplessness, or horror. These events may be experienced directly (eg, as a serious injury or the threat of death) or indirectly (eg, witnessing others being seriously injured, killed, or threatened with death; learning of events that occurred to close family members or friends). Combat, sexual assault, and natural or man-made disasters are common causes of PTSD.*

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Lifetime prevalence approaches 9%, with a 12-mo prevalence of about 4%.
----------------------------
Note that child abuse is not included in PTSD. (That would be the debate over Complex PTSD). *One has to have SURVIVED an incident DURING WHICH ONE WAS CERTAIN ONE WOULD DIE, AND ESSENTIALLY SHOULD HAVE DIED. War, plane crash, survivng a violent rape/attack, etc.*


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## *Dreamer* (Feb 18, 2014)

Found the article!

*Warriors in ancient Iraq suffered Post-Traumatic Stress Disorder more than 3,000 years ago, say researchers*
The Independent
*"The risk of death and the witnessing of the death of fellow soldiers appears to have been a major source of psychological trauma"*

http://www.independent.co.uk/news/science/warriors-in-ancient-iraq-suffered-posttraumatic-stress-disorder-more-than-3000-years-ago-say-researchers-10000953.html


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## Guest (Mar 17, 2015)

Dreamer&#8230;. There is a link between child abuse and ptsd. Here's one article I found that includes ptsd as one of the effects CA can have.

http://www.asca.org.au/About/Resources/Abuse-related-conditions.aspx

And I don't think it's right to say ptsd can only happen if one faces a direct threat of death. Where you said, '*These events may be experienced directly (eg, as a serious injury or the threat of death) **or indirectly (eg, witnessing others being seriously injured, killed, or threatened with death; learning of events that occurred to close family members or friends).'* So even just 'witnessing' and not being threatened with death can cause it. At least that's how I read it.


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## *Dreamer* (Feb 18, 2014)

Zed said:


> Dreamer&#8230;. There is a link between child abuse and ptsd. Here's one article I found that includes ptsd as one of the effects CA can have.
> 
> http://www.asca.org.au/About/Resources/Abuse-related-conditions.aspx
> 
> And I don't think it's right to say ptsd can only happen if one faces a direct threat of death. Where you said, '*These events may be experienced directly (eg, as a serious injury or the threat of death) **or indirectly (eg, witnessing others being seriously injured, killed, or threatened with death; learning of events that occurred to close family members or friends).'* So even just 'witnessing' and not being threatened with death can cause it. At least that's how I read it.


Zed,
I am not PERSONALLY just saying the exact definition of PTSD is related to imminent death ... as it stands now, today, in medicine as a very specific diagnosis.. It is a great problem with the military these days -- because military personnel survive horrible trauma -- individuals who should be dead are saved, and this particular type of syndrome plays out.

Even in the late 1900 it was not fully understood why Veterans (only a certain percent) developed PTSD. With neurological research and a clarification of symptoms the official diagnosis (and a clear definition) of PTSD appeared in medical literature.

It was then more closely observed that say individuals who survived plane crashes or who have survived bombings, or who have survived situations where they nearly drowned, or were nearly shot to death by a criminal, etc. that the "imminent death theory" was attatched SPECIFICALLY to PTSD.
I am not making this up, it is a fact.

This site you presented is a more trauma related organization, much like the ISSD-T here in the US which focuses on Nurture, more than Nature. I have said many times, military service dogs -- not al, get PTSD -- symptoms identical to those of individuals in the miitary.

Being traumatized in childhood is REAL. It DOES affect the brain, but it is not PTSD. As I said, the concept is now being called "COMPLEX PTSD" and is being debated. These are two VERY separate diagnoses, like cancer from abestos vs. cancer from smoking cigarettes.

Also, in the article you posted -- which is interesting -- there are what I see as clear errors. You may not agree with me, but this again is from my own learning, research, interaction with mentally ill individuals, etc. And, my own abuse.

From your article
"Below is a list of a range of psychological conditions that are associated with child abuse. Please read on to find out more about them."
• Post-traumatic stress disorder
• Panic attacks
• *Depression*
• * Dissociation*
• *Dissociative Identity Disorder* (my note DID IS a dissociative disorder - don't know why it is separate)
• Bipolar
• Schizophrenia
• Eating disorders
• Personality disorders

---------------------
No one knows the amount of Nature and Nurture nvolved in any of these disorders -- and I have read about this and heard about it a million different times -- no one can agree. *I will agree that depression and anxiety are more clearly linked with abuse.* DID as well (which I don't know a lot about -- formerly MPD.) The name was changed as the concept of multiple alters was called into question). It could indeed be atrributed to abuse, but we really don't know. DID is one category of dissociation, so that category would include amnesia, DP/DR, and DDNOS. Abuse is only one possible factor.

The actual disagnois of DID is in debate. It could be a form of Borderline Personality Disorder.

However,
It is known that bipolar and schizoprhenia are neurological disorders. They can be inherited. Abuse is not known to cause these illnesses, any more than abuse is related to epilepsy. It is true one can have bipolar or schizoprhenia and grow up in abusive home, but the statistics do not prove that this disorders come from abuse. Neither does autism. And children are BORN with schizophrenia for one.

I know enough individuals personally with these disorders who have never come from abusive homes. I have friends who have one child with bipolar and 4 completely healthy other kids.

I also know that if bipolar runs in a family one's chances of developing it are far higher than the average individual. This is also true of alcoholism.

The Personality disorders are "hard-wired" so to speak. It would seem they are literally a part of a person's personality from birth. Not created in the environment. The environment could play a role in ANY of these disorders, as a stressor, but there are no direct correlations.

Panic attacks and eating disorders are also seen as medical disoders stemming from possible environmental triggers. Abuse specifically cannot be implicated.

---------------

*All of this does not mean there EDIT: can't be remission, or control of any of these disorders with a variety of treatments -- both therapy and meds, lifestyle changes, etc. But you cannot tie all of these disorders to child abuse.*

If you can prove me wrong, I will happily change my mind.

I however am coming from a point of interacting directly with patients and with their family members (caretakers). That experience alone illustrates that the correlation between serious mental disorders cannot be attributed directly to child abuse. Bipolar and schizophrenia particularly.

*And as noted, PTSD is not the same as COMPLEX PTSD.*

I can only repeat myself so many times. I don't with to fight, but to clarify what I see as misunderstandings.

Also, there are indeed two schools of thought on mental illness -- one more psychoanalytic and one more neurological. 
This does not mean that any mental disorder is "hopeless" and cannot be treated. However, again, in talking with people who themselves have schizoprhenia and bipolar in particular -- they would not attribute their illness to abuse. You would have to speak with them to be convinced. Or read any number of books by those who have been affected.


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## *Dreamer* (Feb 18, 2014)

Again, sorry for grammar, spelling, typing mistakes. I give up.

EDIT: I fixed some for the sake of clarity.


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## *Dreamer* (Feb 18, 2014)

> '*These events may be experienced directly (eg, as a serious injury or the threat of death) **or indirectly (eg, witnessing others being seriously injured, killed, or threatened with death; learning of events that occurred to close family members or friends).'* So even just 'witnessing' and not being threatened with death can cause it. At least that's how I read it.


You are correct and I wanted to clarify this.
Witnessing this type of event is witnessing* a violent evennt whrein someone* else's life is taken. It is experiencing near mortality or witnessing mortality.
- A soldier sees his fellow soldier being blown up by an IED. The soldier feels s/he failed to "save" his/her friend -- has survivor's guilt, and can have PTSD.

- A mother witnesses the drowning of her child

- An individual in a car crash sees his/her passenger dead in the seat next to him/her. The individual who survived could have the fear of ever getting in a car again.

- A survivor of the World Trade Center disaster witnesses burning bodies jumping from the Twin Towers. Someone with PTSD may have survivor's guilt and cannot get that image out of his/her head and has endless nightmares about this.

- A police officer shoots someone in self-defense and sees the victim die -- at his/her own hands

*Again, the "witness" is the witness to an event that involves loss of life.*

But there are other events such as BEING in an auto accident yourself and surviving. Surviving a rape when you are threatened with a knife.
--------------------------------
Witnessing one's mother being beaten by one's father is not the same. It is a different type of violence.
Now if a a child witnesses his/her mother being beaten to death by his/her father that would be closer to a PTSD diagnosis. Also, children have slightly different criteria for PTSD than adults as they cannot express their fears or process the experience in the same way. This is why there are counselors available at school shootings

So many children are abused themselves -- that would be addressed by the COMPLEX PTSD diagnosis. And so many children in this world are abused or subject to horrors -- living in war zones, adults as well -- you would think far more would have PTSD. Children have different forms of PTSD. In many countries they don't survive long enough, or there are no mental health services to follow up on thees disorders as well.

Also, there has been a question if the symptoms of Traumatic Brain Injury in veterans may contribute to some of the PTSD symptoms THEY have.

Just trying very hard to clarify.
Thanks for reading.


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