[dia]gnostic faith

ptsd-wordmapA significant day for me, today.

The first time my PTSD got bad enough, for long enough, for someone to suggest that this is what it was, happened around this time three years ago. Somebody who really made me anxious to be around had just moved into the house I was sharing, and then I went to visit friends in Paris, and came to pieces while I was over there. I thought I was having a thyroid incident at first, as my pulse rate refused to drop below 100. For several weeks. But after having a load of blood tests, the doctor gently suggested that it wasn’t a biochemical problem I was dealing with, but perhaps PTSD.

I managed it down, over the course of a few months, with help from a good therapist. While all this was going on, I was also in the process of coming out to myself finally as transgender, and began my transition the following spring. When I finally went onto a proper dose of Estradiol, 15 months after that first PTSD incident, my symptoms became suddenly very acute, and have remained so since.

Over the last 20 months since that happened, I’ve been learning to manage my fears, my hypervigilance, my flashbacks, and so on, to some extent, and to treat myself with a necessary gentle love in the face of their relentless presence. I have also spent that last 20 months realising, in retrospect, that I have been dealing with this basically since I hit puberty (it was brought on in the first place by sexual abuse). I hadn’t known what to call it, and it generally erupted very sporadically, and I just thought of it as occasional panic attacks, or a sense of desperation.

But it’s been there all along, and somehow, when I released my true gender-self from her protective coma two years ago, this came to the surface with a whomp! and demanded to be acknowledged too. A heavy price to pay, but I’ve been willing to pay it, since actually what I’m buying for that price is a genuine experience of myself, finally. And so I can engage with that genuine me, and help her to heal, to be female in body to go along with the rest of her, and to face my fears and damage with some love, finally.

And over the last 20 months, I’ve been wrestling with the Official Psychiatric Regiment of the NHS to try and get a definitive diagnosis, and today that happened. It took them long enough. They wriggled and jiggled over all that time, and wanted to call it a non-specific anxiety disorder and suchlike, though the therapists who were working with me on a regular basis were all very confident that PTSD was what I was dealing with. Somewhere in the process of transitioning over the last two years, I’ve become more assertive (who’d have thought it? I found out I’m valid!) and I kept asking my GP to keep asking them to do something about all this, and today is the overdue outcome.

Why does it matter? Because without an Official Diagnosis of Post-Traumatic Stress Syndrome/Disorder (as opposed to some wishy-washy “shows symptoms related to…” diagnosis), it’s been absolutely impossible for me to get any direct help from the NHS with treatment or support for this. I’ve been incredibly fortunate to have regular therapy given to me by the gender clinic, who saw a need and responded to it. I’m so grateful to them. And I’m also incredibly grateful to the two (women) doctors at my local surgery who between them both looked after me when I was in a mess, and championed my cause in getting referred for a proper diagnosis.

So now that I’m officially declared to have this Primary Mental Health Care Issue (or whatever this week’s bargain jargon is), the NHS are actually going to come up with a plan to help me overcome some of this. Which really matters. But to be honest, another reason why this matters is a rather private one. Quite aside from me being tired of struggling to be taken seriously by the health service, I was all too aware over the last three years of a number of my friends (the more fundamentalist allopathy worshippers especially) quietly thinking to themselves “Eh, she just thinks that’s what she has…” – because particularly when it comes to mental health issues, people take a clinical diagnosis (or lack of same) with devout seriousness. And knowing that some of my friends were thinking at me askance like that has been painful, and unavoidable until now.

The thing is, though, I’m strongly motivated to get help and become more functional and therefore reliable than I am at the moment, because I’ve lately developed a sense of direction, concerning what I want to do with my life once all my surgeries are over next spring and I can start getting on with life a bit more normally. I want to get more involved in LGBT youth work, and especially in supporting and mentoring young trans* folk. I’m making moves towards doing this on a formal voluntary basis at the moment (I’ve sort of drifted into doing it informally over the last year anyway), and one thing that’s obvious is that as I get more into this, there are going to be times when I have to deal with other peoples’ conflict and contention, and at the moment, that’s very hard for me. So this is my main practical reason for wanting to become more robust and functional – though of course I’d more simply just love to live a more normal, less fear-constrained life than I do at the moment.

Our culture puts so much faith in Psychiatry – which really isn’t the science they’d like to think it is. It does feel like a religion, and I feel like today I was initiated by a priest (or in some weird way absolved of the sin of “having an undiagnosed ailment”).

lucy-psychiatristThere have been times in my life when I’ve given medical consultants the feedback that they need to put the “agnostic” back in “diagnostic”, when they’ve been too certain that I had something I knew I didn’t have, and so were not treating the thing I knew I had. But this is one of those situations where Unwavering Faith on the part of a Psychiatrist is a requirement for me, in order to get the appropriate help.

Funny old world.

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6 comments on “[dia]gnostic faith

  1. Taka says:

    congrats!
    it shouldn’t have to be such a feat to get the right diagnosis, but knowing how hard it is through other people’s experiences, i feel genuinely happy for your having finally gotten it. a shame that some people actually believe more in the professionals who only saw you for a few moments, than the actual owner of the body and mind that suffered the trauma and consequences.

    • womandrogyne says:

      Thanks, and too true. Although I can also understand a certain reluctance to let people with mental health issues be the sole judge of their own conditions, it’s a terrible setup that has people who are very vulnerable having to fight the system that’s supposed to be supporting them in order to get recognised in the first place.
      In my case, it feels like as much as anything else, it was a matter of chance that the experts I got seen by in the past were unable to do what this psychiatrist did. It’s really pretty bizarre.

      • Taka says:

        pretty bizarre and not helpful at all. it reminds me of how i’ve tried to see therapists. probably happened three times in my life, and they found nothing to try treating. me wanting to see a therapist of any kind should be more than enough evidence that i need it, but after establishing the fact that i’m not likely to commit suicide, they simply decide to take their time. not considering the possibility that the person they’re talking to might be an alternate personality who has a slightly more realistic outlook on things than the shut-in who really wants to talk to someone, but doesn’t even dare asking for a few seconds of a professional’s time. i couldn’t find a good way to explain that despite not thinking i’m doing too bad, i also know i’m not doing good at all.

        i need to try again, but i still don’t know how. there aren’t too many to choose from this close to the middle of nowhere.

      • womandrogyne says:

        I hope you get lucky with the next one. It really is luck of the draw. I had a psychiatric assessment 15 months ago that should have had the outcome this last one did – but I was in more of a state then (oh, the irony), found myself stuck in a room on my own for 90 minutes with a man who kept on misunderstanding me, I felt very unsafe, and froze up and didn’t tell him the bits of very personal info that were vital to him diagnosing me correctly. I realised what had happened after the fact, and wrote him a letter (from a safe distance) to fill in the blanks, but he’d already made up his mind and written me off.
        It’s basically a goddamn stupid system that doesn’t allow for the possibility that the assessing psychiatrist could be perfect trigger material for the person being assessed. Oh, I can’t remember whether I mentioned this in my blog-thing, that this time I requested specifically to be seen by a woman psychiatrist – and they told me “Erm… we don’t have any.” Well. They had a female assistant come in and sit with us, and that helped. But seriously, Devon has no female consultant psychiatrists? So I looked it up, and there is only one in the entire county who doesn’t “specialise in children and adolescents”. The mental healthcare system clearly has an issue with valuing women.

      • Taka says:

        that sounds utterly ridiculous and extremely irresponsible. the patient has a right to feel safe when they’re with a psychiatrist, i’ve never been met with that level of irresponsibility in norway, the first thing they’ve asked is whether i prefer a specific gender for a psychiatrist or psychologist. and norway is small enough in population that you’d expect it to be difficult to find the right person.

        what i don’t like is that they spend only a very short time assessing the patient before making up their mind. they should see the patient at least two or three times before they’re able to tell anything about the patient’s mental health. the first time you can only try to establish some kind of trust between patient and doctor, i wouldn’t expect finding out anything of importance other than whether there’s an immediate risk of the patient harming themselves or others.

        in the end, the patient has to take responsibility for finding the right doctors and getting the right diagnosis. i don’t like that. my mom once needed sick leave because she was totally stressed out, mentally exhausted, and couldn’t function properly at all, but the doctor refused despite agreeing that she should be on sick leave, because he believed those at the other office wouldn’t accept it. she’s luckily more than strong minded enough, and chewed him out for not doing his job. then she went to the other doctor, got her sick leave, and the other doctor also had a talk with the less competent one. those at the other office also didn’t have any choice but to accept the doctor’s decision, because my mother would never let them do anything else (they would make trouble for weaker persons). that’s how “easy” it is…

      • womandrogyne says:

        I agree – part of the problem is that people who are trained to be clinicians are not at the same time trained to be good people – so unless they already are, they often have appalling interpersonal skills. And the further up the professional ladder they get, the more certain they are that they’re always right about everything. I have had to learn to be more assertive, flying in the face of an upbringing that conditioned me to think of consultants as The Metatron. It’s amazingly hard for me to stay adult in front of these people, but I’m getting better at it.

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