Case Study on PTSD

Mick, 41 years old, currently MEC3 on sick leave from ADF, 20 years in the infantry

Most of my life I thought people with mental problems were wimps or fakers who needed a good kick up the bum. I’m a soldier, that’s what I’m good at. As a warrant officer, I've had a lot of younger blokes look up to me, expecting me to be a strong leader. And I was. I was bloody good.
Until about a year ago.
I’d seen some pretty horrible things in my time but it was all part of the job. I coped by blocking it all out. Job done, put it behind you, have a few beers. And that worked well for me until we went into a little village in Afghanistan a few hours after the militia had left.
They thought the villagers were collaborators and wanted to set an example. I won’t go into details but I’ve never seen so much destruction.
Anyway, we did what we had to do there. We called in the medics and managed to track down some of the militia. Enough said.
But when I got home a few weeks later, I couldn’t get those images out of my mind. There were lots of them, but one in particular stuck in my head, a young child who’d been ... well, the point is that the image came back to me over and over again.
I kept having pictures jump into my mind during the day, and then there were nightmares.
I became short-tempered and I was forever on edge. I was shouting at my wife and losing my cool with the kids. I just couldn’t think straight. I just wanted to lock myself away and draw the curtains. I was losing my mind. I was one of those wimps I always looked down on.

I figured I was going 'round the bend

I’d heard about PTSD [posttraumatic stress] but even when I had all those problems it never entered my head that I might have it. I figured I was going 'round the bend and I was the only one who’d ever felt like this. Yes, I know that sounds stupid, but that’s what it felt like.
It was my wife who got me to ask for help. She saved my life.
Someone she knew at work had a husband who was a cop with the Feds. He was one of the first into the Solomons after the troubles there. Apparently he’d developed PTSD and, like me, refused to admit it. It took over his life until he did something about it and saw a shrink. Since then he's got tablets and some therapy and he's doing OK . Because of that, my wife dragged me along to see the psychiatrist.
I tried to tell him what I was going through, but I kept crying. I felt like a complete idiot but I managed to tell him enough. I'm on some tablets now. I'm not a fan because they've stuffed up my sex life something terrible (although to be honest I wasn’t feeling much like sex anyway since this whole thing started) but they're doing their job. I’ve been on them for four months now and I think they’re helping. The psychiatrist said we can look at a different type of medication down the track that won’t muck up my bedroom performance.
I’ve read a lot about PTSD, and spoken to a few people who’ve had and gotten on with their life, so I’m feeling optimistic. I’m also seeing a psychologist every week. He’s given me a whole lot of tips about how I can control the anxiety.
We’ve just started the really hard part – talking in detail about that day in the village. It is hard, but I also feel a great sense of achievement. I’m not blocking it out, I’m facing up to it (maybe that makes me a real man after all!) And we’ve been through it a few times now and it’s getting easier.
I’ve got a long way to go, I know that, but I hope to go up before the medical review people in about three months. I reckon I’ll be back with the boys by next year.
It will have been a long break, but we had a bloke who injured his back, he was off for a year and came back good as new. Mine’s not that different really. Just happens to be my head instead of my back.

For more information on PTSD,

Visit: https://mtlhealth.blogspot.com/2019/04/post-traumatic-stress-disorder.html

Dependent Personality Disorder

Dependent Personality Disorder

Dependent personality disorder is described as a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior as well as fears of separation. This pattern begins by early adulthood and is present in a variety of contexts. The dependent and submissive behaviors are designed to elicit caregiving and arise from a self-perception of being unable to function adequately without the help of others.

Symptoms

Signs and symptoms, as catalogued by the DSM-5:

·        A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

·        Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.

·        Needs others to assume responsibility for most major areas of his or her life.

·        Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Does not include realistic fears of retribution.)

·        Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).

·        Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.

·        Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.

·        Urgently seeks another relationship as a source of care and support when a close re­lationship ends.

·        Is unrealistically preoccupied with fears of being left to take care of himself or herself.

Features

1.     have great difficulty making everyday decisions (e.g., what color shirt to wear to work or whether to carry an umbrella) without an excessive amount of advice and reassurance from others

2.     tend to be passive and to allow other people (often a single other person) to take the initiative and assume responsibility for most major areas of their lives

3.     often have difficulty expressing disagreement with other individuals, especially those on 

       whom they are dependent

4.     have difficulty initiating projects or doing things independently

5.     may go to excessive lengths to obtain nurturance and support from others, even to the point of volunteering for unpleasant tasks if such behavior will bring the care they need

6.     feel uncomfortable or helpless when alone, because of their exaggerated fears of being unable to care for themselves

7.     preoccupied with fears of being left to care for themselves

Treatment

People with dependent personality disorder should consider psychotherapy for treatment. Cognitive-behavioral therapy focuses on maladaptive thinking patterns, the beliefs that underlie such thinking, and resolving symptoms or traits that are characteristic of the disorder—such as the inability to make important life decisions or the inability to initiate relationships. This disorder often requires long-term therapy or treatment.
There may be other underlying conditions, so medication may be helpful. Antidepressants, sedatives, and tranquilizers are often prescribed for patients with dependent personality disorder to treat co-occurring conditions.

Avoidant Personality Disorder

Avoidant Personality Disorder

Avoidant personality disorder is characterized by feelings of extreme social inhibition, inadequacy, and sensitivity to negative criticism and rejection. Yet the symptoms involve more than simply being shy or socially awkward. Avoidant personality disorder causes significant problems that affect the ability to interact with others and maintain relationships in day-to-day life.

Features

 

The essential feature of avoidant personality disorder is a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation that begins by early adulthood and is present in a variety of contexts.

1.     avoid work activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection

2.     avoid making new friends unless they are certain they will be liked and accepted without criticism

3.     act with restraint, have difficulty talking about themselves, and withhold intimate feelings for fear of being exposed, ridiculed, or shamed

4.     As they are preoccupied with being criticized or rejected in social situations, they may have a markedly low threshold for detecting such reactions

5.     are inhibited in new interpersonal situations because they feel inadequate and have low self-esteem

6.     believe themselves to be socially inept, personally unappealing, or inferior to others

7.     They are unusually reluctant to take personal risks or to engage in any new activities because these may prove embarrassing

Symptoms and Diagnosis

1.     Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.

2.     Is unwilling to get involved with people unless certain of being liked.

3.     Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.

4.     Is preoccupied with being criticized or rejected in social situations.

5.     Is inhibited in new interpersonal situations because of feelings of inadequacy.

6.     Views self as socially inept, personally unappealing, or inferior to others.

7.     Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Treatment

As with other personality disorders, a mental health professional will design a treatment plan that is appropriate for you. Avoidant personality disorder treatments vary, but they will likely include talk therapy. If a co-existing condition, such as depression or anxiety disorder, is also diagnosed, appropriate medications may also be used.