PTSD and misdiagnosed?

by
Chaplain Kathie

Schizophrenia, bipolar, personality disorder, drug and alcohol addictions, depression, look up any of these mental illnesses and see how easy it would be to have PTSD misdiagnosed. The key to getting the right diagnosis is PTSD come after a traumatic event.

What are the symptoms of schizophrenia


The symptoms of schizophrenia fall into three broad categories:

Positive symptomsare unusual thoughts or perceptions, including hallucinations, delusions, thought disorder, and disorders of movement.
Negative symptomsrepresent a loss or a decrease in the ability to initiate plans, speak, express emotion, or find pleasure in everyday life. These symptoms are harder to recognize as part of the disorder and can be mistaken for laziness or depression.
Cognitive symptoms(or cognitive deficits) are problems with attention, certain types of memory, and the executive functions that allow us to plan and organize. Cognitive deficits can also be difficult to recognize as part of the disorder but are the most disabling in terms of leading a normal life.

Depression: A Treatable Illness (Fact Sheet)
Depression is a serious medical condition that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things.Date: 2004

Borderline Personality Disorder
What is Borderline Personality Disorder?
Borderline personality disorder (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. More about borderline personality disorder >>

Last year I was asked to explain what PTSD was to hospital chaplains in training. They asked what they needed to look for to know if it was PTSD or something else. I told them the simple answer is, to listen. Listen to the families, listen to the patient. Hear what they say. The clue is found usually in the words, "suddenly changed."

If you hear those words, the next question is, "when" did they change. Most of the time it's after an accident, death, crime, natural disaster, fire, or any other life threatening event where they were either a victim or witness.

When it comes to the veterans or National Guards, police, firefighters or emergency responders, that answer is no as easy to track down. It's more of an occupational hazard. Anyone treating people in this category needs to actually read their chart or ask what they do for a living, ask if they were in the military or a veteran of any of these occupations.

I am on the NAMI Veterans Council and taking Family to Family training for people living with mental illness. The Veteran's family to family was not available in my area. In the process of reviewing the training I became more aware than ever before how easy it is to have PTSD misdiagnosed as something else.

In the case of a flashback, they can hear voices, along with see the event repeated so vividly they have the same physical responses as when the event happened. They have increased heart rates, sweat, muscles tense up and they are hyper-aroused. This can be confused with hallucinations or hearing voices.



Mood swings, short term memory loss, decreased level of personal hygiene, detachment, paranoia, rage, obsessive compulsion constantly checking doors and windows or patrolling the "perimeter" of the home, constant worry, easy to confuse, inability to focus, easily distracted, diminished ability to think rationally and process information. All of this is a part of PTSD. Usually there are also physical signs like twitches, talking to themselves, inappropriate outbursts and lashing out.

Nightmares are common and waking them up the wrong way can produce a physical response with a fist, often confused with battery and has resulted in the arrest of many sleeping veterans with no clue what happened or why they did it. Stunned wives trying to figure out why their loving husband of years suddenly became a "wife beater" just because she woke him up from a nightmare.

Decreased sexual interest or unusually increased obsession. Lack of emotional connection.

Detachment from family members, unable to feel anything for them or take an interest in them, becoming oblivious to family members. Wives have reported husbands no longer notice changes in weight or color changes of their hair for months, then suddenly notice something is different.

There are so many ways PTSD can be misdiagnosed and until the last few years, many mental health professionals have been only doing what they know instead of learning about PTSD. The problem is there are still many clueless psychologists as well as family doctors, usually first consulted when family members are clearly in need of help.

There are things that happen inside of us that change us, the way we act and relate to others, but there are also things that happen outside of us, out of our control and we respond to those events, sometimes in "unusual ways" after an abnormal event. If the person we look to for help gets it wrong, then time is lost, the wrong medication is given and therapy is focused on the wrong thing.

If you experienced, or someone you love, has been through a traumatic event, it is important your doctor knows about this so they can look to see if it is PTSD and not something else. Many people have also been treated for addiction to alcohol or drugs, when they were not addicted to the chemical itself but were seeking relief from feeling. This is called "self-medicating" and is usually confused with addiction. There are also many with addictions and PTSD, which makes things even more complicated for doctors to diagnose. Again, full disclosure from a family member or patient is vital in treating this properly. Your doctor cannot know what you do not tell them. When you look up the signs and symptoms of mental health illnesses, you can see how easily it is for them to get it wrong.

Be proactive in your healthcare and remember that your doctor only knows what you tell him/her.