ptsd Ptsd & C&p

[usmarine0311]

I have been diagnosed with PSTD and MDD. I have talked to several Vietnam Era vets who have told me to write a stressor letter and to get buddy letters. I find this very difficult to write, because I have a tough time just trying not to think of the past. Honestly, my life has been a living hell the last 3-4 years. I remember how I used to be, and I look at myself now. I did a complete 180, and now I'm very much a recluse. I don't go see anyone, and I don't want anyone to come and see me. I have pretty much gotten rid of everyone I associated with. I don't go anywhere hardly without carying my weapon. I just literallyfeel vulnerable and naked without it. My mom says I just need to "snap out of it". She constantly tells me there is nothing wrong wth me, an that lots of men have been to Iraq and they seem fine. I don't discuss the past with her or anyone else. I can't. My marriage is constantly teetering on the rocks and I just had to quit working 3 years ago. It got so bad I got to where I could'nt think anymore. I have a c&p physical and psyc exam next month and I have never had the psyc exam before. I am worried to death about saying the wrong thing as I have been told the examiner is looking for a reason to blame it on something else. I don't drink anymore, never used street drugs, never abused. Do I need to take all these letters in there and describe what paticular trauma caused this? There were so many different things I dont think I can pin point it exactly. I know this is alot to write, but I kinda wanted to throw it all out there so you'd have a better idea of whats going on. Yes, there is the sleep deprivation, sever anxiety, startled response, and I have a very short fuse. My gaf scoresthe last couple of years have been in the mid 30's to upper 40's. Nothing over 50. In 2007 and 2007 I was in and out of the hospital withall this, and one doc from Waco said I was bipolar. I disagree because I was not like this before. Any ideas?

[MikeR]

Bill:

Don't lie. If you are an alcoholic tell them but you can also self medicate or be a heavy drinker. It always sort of tickled me that many believe that you are not an alcoholic till you admit that you are. Drugs prescription and street are also signs.

If the VA catches you in a lie you may never recover.

Just be honest, and focus on the stressors. My exam was last October and I have been medicated since, and life has improved a lot. Is it perfect, well no, but much better.

[usmarine0311]

I don't drink much anymore, but I did so pretty heavy after I got back. I don't think I was addicted to it but I did drink to sleep. I drank to kinda numb everything, I guess thats how to describe it. Temporary fix. I mean when these ptsd symptoms cycle at times thats what I really want to do. I still get 2-3 hours a night if I am lucky. At times the pills don't even help, I mean when things are really bad. I'll have a good 2-3 weeks and then I'll wake up and I mean I think I'm loosing my mind for a week or so. I'm ALWAYS on edge but when things are bad it's completly debilitating. But I have notice that it cycles in and out for no apparent reason.

[Guest Ryan]

Starts with anxiety......then goes to feeling like just got ran through the ringer, and then depression sets in.

Any number of things can start this cycle (triggers) or it just initiates from the everyday mundane stresses that are expected from trying to function.

This is how it is for me anyway.

Anxiety should not be mistaken for mania.....but it's an easier way to rubberstamp if a shrink hasn't got much experience with PTSD. Seen this with my own two eyes, and then later the last VA shrink I saw admitted in my med record that it in fact wasn't mania, but anxiety.

[billy2]

Bill:

Don't lie. If you are an alcoholic tell them but you can also self medicate or be a heavy drinker. It always sort of tickled me that many believe that you are not an alcoholic till you admit that you are. Drugs prescription and street are also signs.

If the VA catches you in a lie you may never recover.

Pete,

I was told not to drink because of the drugs I got at the Mental Health unit. You may not wake up.

I'm diabetic and have other issues and the booze doesn't mix.

Drinking is over rated anyway. Never got arrested when I was sober.

Bill

[Commander Bob]

... I have a c&p physical and psyc exam next month and I have never had the psyc exam before.

DSM-IV-TR criteria for PTSD

In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The diagnostic criteria (Criterion A-F) are specified below.

Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning.

Criterion A: stressor

The person has been exposed to a traumatic event in which both of the following have been present:

1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.

2. The person's response involved intense fear, helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.

Criterion B: intrusive recollection

The traumatic event is persistently re-experienced in at least one of the following ways:

1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

2. Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content

3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.

4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

Criterion C: avoidant/numbing

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma

2. Efforts to avoid activities, places, or people that arouse recollections of the trauma

3. Inability to recall an important aspect of the trauma

4. Markedly diminished interest or participation in significant activities

5. Feeling of detachment or estrangement from others

6. Restricted range of affect (e.g., unable to have loving feelings)

7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Criterion D: hyper-arousal

Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:

1. Difficulty falling or staying asleep

2. Irritability or outbursts of anger

3. Difficulty concentrating

4. Hyper-vigilance

5. Exaggerated startle response

Criterion E: duration

Duration of the disturbance (symptoms in B, C, and D) is more than one month.

Criterion F: functional significance

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:

Acute: if duration of symptoms is less than three months

Chronic: if duration of symptoms is three months or more

Specify if:

With or Without delay onset: Onset of symptoms at least six months after the stressor

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders DSM-IV-TR ( Fourth ed.). Washington D.C.: American Psychiatric Association.

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TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF

CHAPTER I--DEPARTMENT OF VETERANS AFFAIRSPART 4--SCHEDULE FOR RATING DISABILITIES

Subpart B--Disability Ratings

4.129 Mental disorders due to traumatic stress.

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name............. 100%

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships............... 70%

Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships....... 50%

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events)...................................... 30%

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication............ 10% A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication................... 0%

[LarryJ]

"I have been diagnosed with PSTD and MDD."

You have?

Who, What, When and Where?