How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Mark Your Own Question

Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5109
Experience:  Dr. Mark is a PhD in psychology in private practice
50444359
Type Your Mental Health Question Here...
Dr. Mark is online now
A new question is answered every 9 seconds

After being released from active duty in 1998, I started experiencing

Customer Question

After being released from active duty in 1998, I started experiencing issues of anger and rage in emotional situations to the point where I punched a glass picture frame in one of the instances. Stressful situations would just set me off.

Fast Forward two years later when I started using psychotropics, ecstacy, and LSD to remove myself from the reality of guilt I was experiencing from being in the US military. I was studying international politics and was researching the money being made through war and international "diplomacy". Basically I was learning why 9/11 happened before it happened. I could sum up my college education as to everything I learned was for the most part in XXXXX XXXXX's Fahrenheit 9/11.

All these drugs, including some of that good old big pharma produced meth, AKA, adderall, caused a manic episode at a point, and I was suddenly diagnosed as bi-polar. The drugs they gave me were horrible, depakote, zyprexa, wellbutrin. Made me a f**king zombie who couldn't wake up from a nap.

I stopped taking these drugs and didn't have a violent reaction until I attended an anti-war protest in Washington DC in 2003. I had also learned of a friend who had overdosed on heroin. I had another manic episode. Hospitalized again, but at a better hospital. This time, I demanded lithium and have been using it successfully ever since.

I had one relapse in 2005 when I lost my medication while travelling. And was again experiencing stress from a job I was working that broke their contract and a living situation that was not conducive to a good sleep pattern.

In 2011 I had a mild panic attack after watching the unedited version of Collateral Murder for the first time. It set me off, I wanted to die. I was a gunner on a tank. In a room full of hundreds of people I wanted to cry and did my best to hold back the tears. I didn't know what was happening.

Late last year, I had two more panic attacks. They made me very scared until my girlfriend told me what was happening to me and that these were panic attacks.

I don't get depressed, I've used cannabis every day since I have been off of active duty, except when hospitalized. My mania only happens with intense triggers. I have survivors guilt as the guy who slept adjacent to my quarters was killed during his trip out of Bosnia. We talked every night, and he was a great mentor. His death was covered up to protect a 1st Lt career, as the vehicle he was in was deadlined (for non-military, means unsafe to drive). He had 7 children.

My first near death experience in 1995 was in Korea, as I was almost crushed by a S. Korean tank that was speeding through a blindspot at a maneuver range called MPRC. The HUM-V was demolished, and my passenger was injured. I was just lucky I broke the HUM-V and saved my own life by swerving into an embankment.

The 2nd experience, I was drunk and almost impaled myself falling off a balcony.

My arguement is that I have PTSD, not bi-polar, or the bi-polar is a symptom of the PTSD which I understand as rare from my limited research. The PTSD led me to the hard drugs which caused the mania. One drug induced manic episode doesn't make someone bi-polar.

What do you think?

I value your feedback and thank you for your time.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Mark replied 1 year ago.

Hi! I believe I can be of help with this issue.



First let me say that I can imagine how distressing and frustrating this situation must be for you. Your story is really rather amazing and I'm sorry you've gone through this. That you are seeking help is a very good thing. I will also at the end of the posting give you a technique you can use to help with your anxiety from the PTSD you are indeed suffering. It will help you find some temporary relief with your anxiety.

Your immediate question is whether your symptoms sound consistent with PTSD as opposed to Bipolar Disorder (BD). There are a number of factors we have to keep in mind at the same time as we discuss this. First off, we have to remember that PTSD and BD can be comorbid, meaning that a person can be suffering from both. They are not mutually exclusive. However, the manic symptoms as well as the depressive symptoms of BD can indeed be mimicked by PTSD episodes. That complicates things.

The way you and your psychiatrist and psychologist/therapist would determine what is the correct diagnosis or diagnoses will be based on how the manic episodes have their onset. You are indicating that the onset is based on an external trigger that causes an anxiety reaction based on your past war experiences. That would indeed imply a PTSD episode as opposed to a manic phase onset.

However, that only partially rules out the manic phase of BD. While most often in BD, manic phases are cyclical and respond to internal cycling, they can indeed be triggered by environmental factors. Therefore, you and the doctor and therapist need to determine if the behavior of the mania is more consistent with a BD manic episode (no need for sleep, grandiose behavior, etc.) or if it is more consistent with the panic/anger/excitable PTSD state.

It will take a serious effort at keeping mood charts and discussions with your doctor and therapist to really sort this out. You might consider making mood charts to get started on your own to see if you are correct that you are experiencing PTSD anxiety/panic episodes rather than BD manic states. It sounds very possible from what you report. Here are three resources: the first are computer programs for tracking moods:

http://mood-chart.com/

https://www.moodtracker.com/

They are both popular; Moodtracker is perhaps more well known, at least here in the US. Here, though, is a simple printout with charts that you can copy and fill in by hand and that may be enough:

http://www.cqaimh.org/pdf/tool_edu_moodchart.pdf


 

I'd like to state here, though, that whatever the decision will ultimately be on keeping the BD diagnosis or deleting it, one thing is clear: there is definitely PTSD and it has been present for a long time and not adequately addressed; the PTSD needs to be addressed directly. There are no medications for the direct treatment of PTSD, only the anxiety that comes with it. So that needs to be considered as well.

Psychotherapy that is helpful for PTSD is some form of Exposure Therapy. I have found EMDR can be very useful especially for one time traumas. It is a type of therapy specifically for PTSD originally. Here is the International Society's website:

http://www.emdria.org/

On the web you will find many opinions on EMDR both for and against. I am trained in it and have found it useful. Exposure therapy is also very helpful. I have found that you need to combine these types of therapy with a more introspective, humanistic or psychodynamic approach. If we actually look inside, we can find great relief and meaning. And we can feel whole in ourselves in ways that we haven't for decades. But many EMDR practitioners and therapist working with Exposure Therapy do not take the time to insure the emotional safety of the patient and so that's why you need someone who is more humanistic or psychodynamic in approach.

If you don't have a good referral source, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (you can see a photo of the therapist!) look at the listing and see if they list working with PTSD and EMDR and also some form of psychodynamic or humanistic therapy in their orientations. You will need this for the work on the self worth problems as well that you need to address. And make sure you are confident in them as a therapist and they share your values.


http://therapists.psychologytoday.com/rms/

I wish you the very best!

Finally, I am going to put here a protocol that is used for anxiety. You're experiencing a lot of it. So I want to give you this technique to help you!

Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum. And this is good also for just general anxiety without panic attacks as well.


I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety and negative thinking is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5109
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Thanks Dr. Mark. Being a serial entrepreneur on top of all this makes life interesting.


http://www.ithic.com


http://www.cannabis.pro


 


Appreciate the help.


 


Sincerely,


 


Mark J. Linkhorst

Expert:  Dr. Mark replied 1 year ago.
Mark,

I'm sorry I was away.

I enjoyed browsing Ithic.com. I had no idea Pandora is so big that there are these opportunities.

All the best to you!

Dr. Mark

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education