Post assessment report

[Boatsetsailrose]

Hi
So i received the report following the assessment i had with the community mh team.
Within the report it referred to my  mood and past treatment from m. however it didn't mention the psychological symptoms i had described, getting triggered or that i i have a diagnosis of complex trauma.  I am awaiting to speak to the nurse assessor re the content and omissions of information.
Also and which shocked me was the  pointing  to the possibility that i could have dysthmia (which ive researched and seems to be a diagnosis of depression but given another name ? I could be wrong and missing something here.
Also possible bi polar type 2 which I'm not discounting completely but im wondering as I've read others on our forum describe how after being in ef there can be an experience of having a high which may just be the sheer relief of being out of ef ... ?
I've just been in EF for several days came out and then did experience a high and not needing as much sleep (6 hrs a nite) lots of energy and feeling really good and positive . Im now on a more middle to slight low ...

Any experience on these matters much appreciated

[Three Roses]

Ugh. It seems like they either weren't listening to you, or are discounting the things you've said as irrelevant. Sounds to me like they are trying to get your symptoms to fit in their neat little mold. 

[Kizzie]

I hate to say it but I agree with TR that they may be trying to fit you into what they know. This is not to discount potentially being bipolar but really they need to look at all you have told them versus pieces to make an accurate diagnosis and develop an effective treatment plan.

I'm glad to hear you have a meeting with the nurse assessor to discuss the omission of what you believe to be be relevant info.  There are some downloads about CPTSD for health practitioners in "Resources" you might want to take if you didn't already. For example, Blue Knot Foundation Fact Sheet for Health Professionals Working with Complex Trauma."

They were written by a medical doctor who founded Blue Knot for adult survivors of childhood abuse in Australia so may be more credible for the assessor than your own lived experience.

When do you go again?

[Boatsetsailrose]

Thanks both, yes that my background feeling on it ...mood disorders are well known to professional s and so its easily the frame of reference ..
I got the sense that the nurse specialist didn't really get what cptsd is and i guess why would she if she isn't fully trained in the content of its complexity.
Its interesting as when i did really believe i was bi polar 2 years ago (had not long been clean and sober the psych said it wasn't diagnosed in the UK.
I really do not want this to become a ' me and them' scenario and am taking the view that this is a good chance to  open up conversations and partnership work. Its easy to get into fear but no one has the key to lock me up and i feel empowered enough with the support here and the good experience i had with the trauma charity to advocate . I'm also really conscious of having an advocate with me at any big meetings (although unfortunately one couldn't be with me for this assessment.
Thank u kizzie for the blue knot profs sheet reminder i read that before and thought it was v good something i will use .
Im awaiting a phone call from the nurse assessor and also have my first meeting with the nurse who is overseeing my care on the 3rd Jan.

I am v grateful (i think ) that the team have taken me in ...its v hard to get this unless psychotic or just out of hospital.

[Kizzie]

I hear you about a you versus them scenario, a gentle approach may be the ticket. 

Will the trauma group be able to send an advocate with you to this next meeting?  

[Boatsetsailrose]

Thanks kizzie
It is a mental health charity that provide advocates i wouldn't ask for one to meet the nurse just for any assessments etc.
The trauma charity gave me 10 months of free therapy ..was v good and im grateful but a short term spot in the grand scheme of things ....i feel reluctant to engage in anything else short term but i keep hearing people having good results from emdr

[Three Roses]

... this is a good chance to  open up conversations and partnership work...

[Rainagain]

I wouldn't rely on the disthymia or bipolar diagnoses too much.

I had a disthymia diagnosis that was revised to become major depressive disorder.....

Our symptoms are compared to the manuals to see if they fit various diagnoses, it seems to be more art than science and the better the psych the better the diagnosis.

Our history is vital to the process, that needs to be recorded properly and evaluated correctly.

I've had psych evaluations that differed greatly so don't rely on them to be accurate.

Its an exercise in trying to fit a complex situation into categories, not easy to do properly and I'm not really sure how helpful that exercise is anyway.

The most helpful part of my last evaluation was the statement that I had symptoms that didn't fit the diagnoses given, I had ticked all the boxes for my diagnoses but had plenty of ticks left over with no obvious boxes to use them against.

Told me everything I needed to know about the evaluation process, if I had a physical disease the Dr wouldn't leave symptoms lying around 'spare', they would have meaning.

A psych evaluation is the opposite of a medical evaluation, instead of finding out why the symptoms are present and what underlying illness is causative of the symptoms the psych starts with possible diagnoses and  tries to make them fit us.

For physical illness that is the equivalent of noticing a high temperature and diagnosing it according to how high the thermometer reading is, so a fever of 104 is treated as an illness separate from a fever of 102 or 103 and not as a symptom of an illness.

[Kizzie]

I have to say despite the anxiety I felt after my latest EMDR it did what it was supposed to and that was to gain back the objectivity & a sense of control/power around people with NPD I had lost. It was only about 7 sessions and specifically focused on that issue so I believe the anxiety I felt afterward was residual trauma stirred up by the sessions.  I know several people here have said they are getting good results with EMDR but have some anxiety too. It likely is 'normal' for EMDR or any approach for that matter given we have an accumulation of trauma.

EMDR was developed specifically to help with trauma (i.e., it is focused on engaging more of the brain to shift us out of the trauma loops we're stuck in), so ten months worth of EMDR may be much more impactful than other types of therapy.

Rooting for you 

[Boatsetsailrose]

Thank you kizzie it is so helpful to hear others experiences and how that has helped give you back some control /power that was lost..
The consultant last year said emdr is not evidenced as effective for cptsd but I keep hearing of others experinence which tells me otherwise which I'm grateful for..
If I'm to be offered some shorter term work better it's effective hey

[LilyITV]

Richard Grannon on Youtube speaks highly of EMDR.  He believes that some find it not effective because some people are going into skeptical and not really putting the work in.  You are very motivated and doing a lot of hard work already so I think you'd get a lot out of it.

[Boatsetsailrose]

Thank u lily for your recommendation and kind words

[Kizzie]

Lily, I was somewhat skeptical but it did work for me thankfully.     What I am still reserved about though is some EMDR practitioners who don't know about CPTSD think its the same as PTSD and can tap into too many layers too quickly. CPTSD is not like PTSD where there is one event or shorter term trauma of some kind to remember, it's an accumulation so treatment has to be tempered or titrated and learning safety and grounding are really important.

This is not meant to discourage you at all Boats, just suggesting you might want to talk about this with whomever you work with if you do go ahead with EMDR.  I do think with most approaches anxiety will be stirred up so it's important to learn how to manage it and work out a plan with the T.

[Boatsetsailrose]

Thank you kizzie ..
It is something i have thought about and wouldn't enter into.unless the t had background with cptsd
Best wishes and peaceful new year to all

[Kizzie]