Elliott, LPCC, NCC : Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.
Elliott, LPCC, NCC : Dear friend,
Elliott, LPCC, NCC : I believe that I can help.
Elliott, LPCC, NCC : What do you think precipitate this anxiety? What changed or occurred recently?
Elliott, LPCC, NCC : Were your grades OK?
Elliott, LPCC, NCC : Did you have a breakup?
Elliott, LPCC, NCC : A disappointment?
Customer: I don't feel like my work has been up to par, but my grades have been okay. The biggest change has been transitioning out of the semester - I've gone from 40 hours a week doing required work to a 15 hour a week part time job.
Customer: I'm in a supportive relationship with nothing to be horribly disappointed about
Elliott, LPCC, NCC : That sounds like "damned with faint praise"!
Elliott, LPCC, NCC : Tell me more about this relationship that is not horribly disappointing.
Customer: The relationship is complicated for most people. My boyfriend is having his own problems he's trying to deal with. He's told me vague things, like that he's anxious (at least as much as I am) and his head feels funny all the time. He's also actively trying to get help, currently going through the process of getting insurance to do so, and we don't see each other that often. But we talk 24/7, he's there for me when I have a crisis and vice versa.
Elliott, LPCC, NCC : You are both helping each other but neither of you is completely on top of your game at the moment.
Elliott, LPCC, NCC : Why are you so easily frustrated to the point of anger (like when the key gets stuck)?
Elliott, LPCC, NCC : Being irritable like that is a sign of depression. Are you feeling depressed?
Elliott, LPCC, NCC : It includes low self esteem, lack of energy and drive.
Customer: Sorry, mistype
Customer: I've been depressed before, but this feels different. It's not the void of demotivation and nothing I've experienced. It's more like I'm being bombarded by everything. I can't stop thinking about stressful things long enough to concentrate on doing something I enjoy. I think the anger may be tied in with that. Little things that go wrong just add to an already stressful situation.
Elliott, LPCC, NCC : Do you feel that you are having racing thoughts, flights of ideas?
Customer: I'd go with racing thoughts. It's mostly thinking the same things over and over, though. Anything new I try to add, like if I try to read a book, tends to just go out the window, though. It's hard to remember other things I should be concentrating on. On the other hand, I can't forget things that bug me.
Elliott, LPCC, NCC : So you are easily distracted?
Elliott, LPCC, NCC : To you also get more talkative at these moments?
Customer: I'm always distracted. I'm either distracted by the anxiety, or trying to distract myself from it. Makes it hard to get every day life things taken care of.
Customer: I wouldn't say I get more talkative. I don't like to talk about the things I'm thinking, because they're either trivial or horrible, so I clam up.
Elliott, LPCC, NCC : Are you involved in any kind of reckless behavior: spending, driving, gambling, sex?
Customer: Nope. My life is very dull. I don't go out because I get anxious and I just want to go home again. But then I hate being there too.
Elliott, LPCC, NCC : Do you ever get panic attacks: rapid heartbeat, difficulty catching breath, sweating, fear?
Customer: Yes. I've had them since my early teens. I've been fine with them for months, then this weekend I had several.
Elliott, LPCC, NCC : What do you think is triggering them?
Customer: I'm not sure. They seem to come out of the blue. It's like I'm constantly primed for one, and the tiniest thing can set me off.
Elliott, LPCC, NCC : Have you ever had medication for them or for depression?
Customer: Oh yes. I've been through many. I'm not fond of them, though. Most end up having side effects that start to seriously interfere with my life. I was most recently on Prozac, but I had to stop because I could not stop falling asleep all the time, everywhere, generally regardless of what I was doing. I don't take benzos anymore because I've become addicted before.
Elliott, LPCC, NCC : I thought we might be going in this direction. Why do you think you have suffered from both depression and anxiety for so long? Were you mistreated or neglected or abandoned?
Elliott, LPCC, NCC : Have you suffered or witnessed something very traumatic?
Customer: There are several factors. For one, depression runs in my mom's family. Every female for the past two generations has been diagnosed at some point. Then you have environmental factors: my dad was emotionally abusive when I was a small child, my mom became progressively more depressed and detached from the world, and I grew up thinking some of the things she did were normal. I've been sexually assaulted, been in emotionally abusive relationships, and once upon a time I tried to kill myself.
Elliott, LPCC, NCC : Do you ever get flashbacks? Hallucinations?
Customer: No. Lots of ruminating thoughts, but nothing so bad as that.
Elliott, LPCC, NCC : Are you easily startled?
Elliott, LPCC, NCC : Are you very apprehensive about possible threatening events: in other words are you hyper-vigilant?
Customer: In general, yes
Elliott, LPCC, NCC : I believe that you have Posttraumatic Stress Disorder (PTSD).
Customer: Why would you say that?
Elliott, LPCC, NCC : Because you have the symptoms.
Elliott, LPCC, NCC : Let me give you the official symptoms.
Elliott, LPCC, NCC : Unfortunately, the JustAnswer sight it not coping line breaks so it will look a bit compressed. YOu can still read it and I will give you link. These are the official diagnostic criteria from the Psychiatric Diagnostic Manual known as the DSM-IV.
Elliott, LPCC, NCC : PTSD DSM-IV309.81 DSM-IV Criteria for Posttraumatic Stress DisorderA. The person has been exposed to a traumatic event in which both of the following have been present: (1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.B. The traumatic event is persistently reexperienced in one (or more) 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 young 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) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) 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 a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following: (1) difficulty falling or staying asleep (2) irritability or outbursts of anger (3) difficulty concentrating (4) hypervigilance (5) exaggerated startle responseE. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.F. 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 3 months Chronic: if duration of symptoms is 3 months or moreSpecify if: With Delayed Onset: if onset of symptoms is at least 6 months after the stressor
Elliott, LPCC, NCC : http://www.ptsd.va.gov/professional/pages/dsm-iv-tr-ptsd.asp
Elliott, LPCC, NCC : This is a response to trauma including abuse.
Customer: While I agree that I fit some of the symptoms, I disagree with the diagnosis in general. Nothing has been overly traumatic for me. I've been through a lot, yes, but I lived through it, I've moved on, and I've literally moved away. I'm not focused on any sort of past traumatic event. The worst was the possibly abusive relationship, but I'm working through that crap too. More importantly, it doesn't answer my biggest question: Why now? By all accounts, I should be fine. I'm in a graduate program, not living up to my crazy high standards, but doing better than at least some of my class. I'm in a relationship that, while sometimes stressful, I definitely want to be a part of. I'm a little financially stressed out, but I have safety nets in friends and family if it comes down to that. All I have is free time now - but I can't do anything with it. I literally can't even read a book. I'm so focused on tiny things, whether I can find a second job, closing a bank account I don't need, finding a way to pay for transportation to my sister's wedding... it's utterly stupid
Customer: but not centered in trauma
Elliott, LPCC, NCC : You do not have to have all of the symptoms but you do have a significant number of them..
Elliott, LPCC, NCC : You were abused and sexually molested?
Elliott, LPCC, NCC : It is called POST traumatic because it occurs after the precipitating events, sometimes years after.
Customer: It's all a grey area. When I was younger, I was coerced into doing things I didn't want to do, but I always managed to end the situation before penetration. I may have been date raped, but I don't know if it counts because I tried my hardest to roll with it. The emotional abuse, I can't tell. My last therapist called it such, so does my mom. But again, I have no scale by which to judge these things. Did the man manipulate me horribly? Sure. Does it count as abuse? maybe.
Elliott, LPCC, NCC : Big clues are that you are easily startled, vigilant, have panic attacks, easily distracted, suffer some depression, and are very affected.
Elliott, LPCC, NCC : I have worked with many people with PTSD and I see the symptoms. You can be helped but not really with drugs, as before. You don't want drugs anyhow. You can be helped and cured.
Elliott, LPCC, NCC : I can give you a wonderful self-help workbook to start you off.
Elliott, LPCC, NCC : If you can get free counseling at school, it is worth the trip back and forth; if the counselor is experienced, she will see what is going on and will also be able to give you guidance.
Elliott, LPCC, NCC : Let me get the books that I want to recommend to you.
Elliott, LPCC, NCC : Don't accept what I say, but please investigate this further. You are a very sweet young woman but you are suffering now and having trouble focusing your life. You can get better and even help yourself.
Elliott, LPCC, NCC : Let me get the book links for you.
Customer: Please do
Elliott, LPCC, NCC : This is a book just re-released and updated from 2002 edition. This one came out 6 weeks ago.
Elliott, LPCC, NCC : The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms by Mary Beth Williams PhD LCSW CTS and Soili Poijula PhD
Elliott, LPCC, NCC : http://www.amazon.com/PTSD-Workbook-Effective-Techniques-Overcoming/dp/1608827038/ref=sr_1_2?s=books&ie=UTF8&qid=1369280008&sr=1-2&keywords=ptsd+workbook
Customer: Thank you. I think you might be right about it being worth the trip to see someone at school. I'd like to feel some sort of normal again
Elliott, LPCC, NCC : Once more alternative workbook
Elliott, LPCC, NCC : Overcoming Trauma and PTSD: A Workbook Integrating Skills from ACT, DBT, and CBT by Sheela Raja PhD and Susan M. Orsillo PhD
Elliott, LPCC, NCC : http://www.amazon.com/Overcoming-Trauma-PTSD-Workbook-Integrating/dp/1608822869/ref=sr_1_4?s=books&ie=UTF8&qid=1369280125&sr=1-4&keywords=ptsd+workbook
Elliott, LPCC, NCC : I am so glad that you are going to investigate this. It is important to get to the bottom of this and get your life back on track.
Elliott, LPCC, NCC : I shall keep you in my prayers for success and healing.
Elliott, LPCC, NCC : You are very welcome. I am so glad to help you.
Elliott, LPCC, NCC : Warm regards,
Elliott, LPCC, NCC : Elliott, MAE, LPCC, NCC, CCMHC
Customer: Thank you! You've been quite helpful
Elliott, LPCC, NCC : I am so glad to help you.:)