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Old 10-08-2019, 02:25 AM   #1
lillib
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Unhappy Comorbidity Sucks

Comorbidity - having two or more diagnoses.

It sucks.

Treatment for one can sometimes worsen the other(s), or interfere with the treatment(s) for the other(s) - and I'm not talking about pills per se, but more so about talk therapy. I'm sure pills also complicate things when you have comborbidity.

Treatment for DID seemed to help dissociation, but it made my PTSD symptoms worse for some reason. Constantly focusing on mental illnesses while negating my physiological illnesses (I have two diseases, two or more conditions, and a lot of other diagnosed physiological problems, also), makes it hard for me to cope with anything for a substantial amount of time to receive the benefits of coping. Now my physical health is waning while my mental health is somewhat okay, but the two interact in such a way that as my physical health wanes, my mental health inevitably follows.

It's a never-ending battle to maintain.

Anyone else struggle?
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Old 10-08-2019, 04:35 AM   #2
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Default Re: Comorbidity Sucks

I'm sorry. I hope today will be better.
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Old 10-08-2019, 08:40 AM   #3
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Default Re: Comorbidity Sucks

I am sorry you have so much on your plate. It is very tough. Mine is probably pretty minor compared to what you are dealing with, but I do have a fairly significant peripheral neuropathy. It causes me to stumble and lose my balance and occasionally fall. It's hard for me to tell where my feet are in space. I have to be careful in the shower and when changing directions, otherwise, I can def fall. Being clipped into my pedals on the bike is sometimes interesting at stop lights. Interestingly, I had to stop my Abilify for an unrelated reason. My neuropathy symptoms have gotten a whole lot better. It's weird. I had all this testing done and I def do have a peripheral neuropathy. Somehow, though, the Abilify was making it worse. Is there some relationship between Abilify, bipolar type 1, and the nerves in my legs? I have no idea. But I am sure glad I stopped that Abilify.
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Old 10-08-2019, 11:01 AM   #4
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Default Re: Comorbidity Sucks

Quote:
Originally Posted by lillib View Post
Comorbidity - having two or more diagnoses.

It sucks.

Treatment for one can sometimes worsen the other(s), or interfere with the treatment(s) for the other(s) - and I'm not talking about pills per se, but more so about talk therapy. I'm sure pills also complicate things when you have comborbidity.

Treatment for DID seemed to help dissociation, but it made my PTSD symptoms worse for some reason. Constantly focusing on mental illnesses while negating my physiological illnesses (I have two diseases, two or more conditions, and a lot of other diagnosed physiological problems, also), makes it hard for me to cope with anything for a substantial amount of time to receive the benefits of coping. Now my physical health is waning while my mental health is somewhat okay, but the two interact in such a way that as my physical health wanes, my mental health inevitably follows.

It's a never-ending battle to maintain.

Anyone else struggle?
I have many mental and physical health problems too. for me the treatments for each did not make others worse...

example.....

my treatment for DID.... grounding, breathing exercises, relaxation/ CNS meditations , CBT DBT.. therapy, educating my self on my disorder, medications for anxiety (one or some of my triggers that would cause my brain to have its flight or fight response causing me to have my dissociative symptoms, the anti depressant/ anti anxiety meds made it so that I would not have anxiety in turn would not have my dissociative symptoms in turn my brain would not have its physical flight or fight response switching over to the dissociative stored information called alters)

my treatment for PTSD (long term trauma, panic/ anxiety/ attacks, flashbacks / psychosis, suicidal and intrusive thoughts) grounding, breathing relaxation/ meditation, CBT, DBT therapies, educating myself on my disorder, CNS medication for anxiety / depression / psychosis (otherwise known as antidepressants/ anti anxiety/ anti psychotic meds..

my treatment for Bipolar disorder...CNS medications (otherwise called anti depressants, anti anxiety, anti psychotic meds), grounding, breathing exercises, meditation, CBT, DBT... therapies...

MS (Multiple Sclerosis) CNS meds (other wise called anti depressants/ anti psychotics, ) muscle relaxers, immune suppressants....and other meds.

the key to my treatments not affecting each of my problems is team work of my treatment providers and I. we literally have team meetings where we all get together in the same room and talk about me and all my physical and mental health problems. each of my treatment providers all have signed release of information forms so that they can all be in contact with each other co ordinating treatment options and plans.

maybe since you have so many issues going on you can do this too. all it takes is telling your treatment providers you would like to sign a release of information form so that they can be in contact with all your other treatment providers, it takes a while to get everyone on the same page with forms and all, but once every thing is set its well worth it.
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Old 10-08-2019, 05:46 PM   #5
lillib
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Default Re: Comorbidity Sucks

Quote:
Originally Posted by amandalouise View Post
I have many mental and physical health problems too. for me the treatments for each did not make others worse...

example.....

my treatment for DID.... grounding, breathing exercises, relaxation/ CNS meditations , CBT DBT.. therapy, educating my self on my disorder, medications for anxiety (one or some of my triggers that would cause my brain to have its flight or fight response causing me to have my dissociative symptoms, the anti depressant/ anti anxiety meds made it so that I would not have anxiety in turn would not have my dissociative symptoms in turn my brain would not have its physical flight or fight response switching over to the dissociative stored information called alters)

my treatment for PTSD (long term trauma, panic/ anxiety/ attacks, flashbacks / psychosis, suicidal and intrusive thoughts) grounding, breathing relaxation/ meditation, CBT, DBT therapies, educating myself on my disorder, CNS medication for anxiety / depression / psychosis (otherwise known as antidepressants/ anti anxiety/ anti psychotic meds..

my treatment for Bipolar disorder...CNS medications (otherwise called anti depressants, anti anxiety, anti psychotic meds), grounding, breathing exercises, meditation, CBT, DBT... therapies...

MS (Multiple Sclerosis) CNS meds (other wise called anti depressants/ anti psychotics, ) muscle relaxers, immune suppressants....and other meds.

the key to my treatments not affecting each of my problems is team work of my treatment providers and I. we literally have team meetings where we all get together in the same room and talk about me and all my physical and mental health problems. each of my treatment providers all have signed release of information forms so that they can all be in contact with each other co ordinating treatment options and plans.

maybe since you have so many issues going on you can do this too. all it takes is telling your treatment providers you would like to sign a release of information form so that they can be in contact with all your other treatment providers, it takes a while to get everyone on the same page with forms and all, but once every thing is set its well worth it.
@amandalouise - thank you!

I wasn't able to have a team approach in civilian life, but at the VA, that's all they believe in. They may not treat dissociative disorders, but for all the others, I'm hoping my new treatment team will work out (I moved out of state recently, so I barely meet with them next week, beginning with a nurse in women's health and moving on to specialized treatments after she refers me). The VA has notes that all the other doctors can see, so they know immediately if what they are prescribing is beneficial or potentially harmful due to the interactions. That said, therapists are often outside of the VA network and their notes are hidden, unlike regular physicians and psychiatrists at the VA. At the Vet Center, they take more of a holistic approach, though I can always sign a form that allows them to see my records at the VA, which helps.

I'm hoping to sign up with the Vet Center soon, but I need to get my regular doctors set up first.

What's hard is when they don't know what to do with chronic fatigue syndrome - my most debilitating condition apart from the nodule they found on my thyroid, which the last doctor wanted to refer me to an endocrynologist for further eval since the PDoc only can suggest waiting another year to see if it grows. The blood tests still showed normal functioning with my thyroid, so no disorder, but my neck was swollen and the xrays proved there was a nodule there. I just hope it's not thyroid cancer. Can you imagine emotion regulation for that?!

I also have issues with my reproductive system. Although I had endometriosis in the past, which caused me to have a four-day 104-degree fever that required laparoscopy surgery years ago, I have a new condition that can be treated with surgery or simply left alone. It has something to do with my pelvic region, as do many of my trauma- and non-trauma-related conditions.

TRIGGER WARNING FOR THIS SENTENCE: After my sexual assault(s), I later found out that I contracted genital herpes and human papilloma (not the visible kind, and not one of the two cancerous ones, but one of the five high-risk ones for cancer). That definitely added insult to injury, or injury to injury on top of the abuses I've had. I remain abstinent and single (asexual) for this reason, as it would be too much for me or for any potential partner to have to deal with. Besides, I don't want to risk contracting yet another disease if I were with a partner, even if the partner had the same diagnoses but different strains. I just want to be asexual, and I've been asexual for almost a decade. I didn't have human pap until 2013, and they found it on my cervical oz. The herpes I got sometime after I was raped, which was detected in the rape kit. Still, it's circumstantial since I didn't know if it was a latent thing from a past abuse or recent. When I asked my past partners, which were very few in my 45-year-old life, they never had any of those, even after I asked them to get re-tested. My ex from 2013 really wanted to be with me, but I told him that I have too many issues and feel more comfortable just being friends. We remain friends, and I seriously want him to find someone who is disease-free. Besides, I'm really okay being single and simply having friends. I feel safer that way.

I have irritable bowel - always had that, coupled with periodic ulcers that I've had since 24, a few years after an honorable discharge from the military.

TRIGGER WARNING: I still have issues with a pelvic stress fracture that never healed correctly from being in the military, which is still rated as service-connected. This happened sometime after I was sexually assaulted in the military, but I cannot remember the entire event. What is on record, which I never reported but some other woman in the military did, was that my compassing partner in the military was raped, and her attacker went to the brig. When I was questioned, I couldn't remember - honestly couldn't remember. What I didn't say was that I was groped on other occasions, and that I kept having nightmares about being pinned down with a gun to my head. I don't know if they were just nightmares or not. I've always wondered if my pelvic stress fracture stemmed from military sexual assault or if it stemmed from something else. I explained all this during my evaluation 20+ years later when I finally mustered the courage to go to the VA. The VA scared me for over two decades because I feared that I would get revictimized. The Vet Center and later the VA helped me to stay connected with female providers (for the most part) so that I felt safer. Thankfully, they now have a women's clinic - stationed furthest away from the general VA on their campus, or at a different location. What also proved my service-connected PTSD and other disabilities related to that was the fact that prior to enlistment, I was resilient enough from childhood abuses to still qualify and graduate from the police reserve academy (on my record) as well as security jobs that required psychological and polygraph testing (also on my record). I passed all of those with no diagnoses or issues. If I had dissociation, it was mild or undetectable to both me and to evaluation experts, though maybe they don't look for dissociation at all in their evaluations. Anyway, my issues with PTSD only occurred after I had undergone military trauma, and then worsened only after I had dealt with traumas in civilian life after discharge. All this is documented and recorded in various records throughout my lifetime. I've tried so hard to deal with all of this, and the losing of time was interpreted as "dissociative fugue states," instead of DID.

Thankfully, sometime after discharge and before visiting the VA, I received treatment for trauma at an in-patient center. I went there twice, as recommended, and got a haldol shot in the buttocks the first time when I think an alter came out. The trauma treatment center helped me learn how to manage my dissociation the first time, and the second time, they helped me learn how to be in trauma support groups. I never had a haldol shot since, since it was a one-time thing when I entered that hospital.

I've had nothing but medical/physical problems after that, coupled with managed dissociation and ongoing ("chronic") PTSD, which is what they call it in my VA records.

POSSIBLE TRIGGER: I've had a strange eating disorder where, at times, I would feel nauseous with everything I ate, but it wasn't really bulimia, though I think it was diagnosed as such. But It would be from eating anything, not necessarily from binging. There would be some trigger or some intrusive thought that made me feel grossed out and sick. This occurred periodically and was not a constant issue. It maybe happened once or twice a year, if that. I don't have that problem as much anymore, but I do have gastrointestinal issues related to IBS and possibly something else. I was slated to have an upper and lower endoscopy done at the same time, but I told the VA that I'd wait until I relocated and petition to be put under since I will react if awake, and not in a good way (I'd most likely try to fight someone back if I felt a tube in my mouth and my **** at the same time; it would be too triggering for me to be awake). They completely understood.

Anyway, those are just some of the things I'm dealing with.

My chronic fatigue was diagnosed by the VA, as was my mild sleep apnea, obesity, and some other conditions.

My eyesight has gotten worse (I cannot see up close or far away, so I will most likely need bifocals or trifocals soon). It comes with ageing.

Then there's the whole transition of middle-age thing. I am slated to have menopause soon (I'm 45 now), and I'm worried about emotion regulation (which I've been somewhat good at for decades, but it comes with the territory of PTSD, etc.) in terms of both menopause and thyroid problems. I'm also afraid of being misdiagnosed as some latent personality disorder when it really would be caused by two or more medical conditions coupled with untreated dissociation (I still need to integrate) and unresolved PTSD. I'm doing what I can to get a handle on PTSD and full DID integration before menopause and thyroid issues inevitably persist. My hope is that the thyroid will go away on its own, but due to my stupid smoking/nicotine addiction (the only true addiction I have), it makes all of these issues more likely.

TRIGGER: I've been psychotropic med FREE (no meds) for over a decade because all the other meds had an adverse effect. The anti-psychotics (Lamictal, Depakote, Resperidol, etc.) only made me more aggressive, dissociative, and suicidal. The ambien and ativan (2 mg, I think) were enough to cause me to lose more time and hallucinate more than I did without them. The Neurontin, Paxil, and other meds they gave me (in addition to the others mentioned above) made my hair fall out, my body feel sick, my mind feel numb, and my wanting to crawl out of my skin. I dissociated and self-injured. I'm NOT a cutter, but that only occurred while on these medications. When I changed psychiatrists at a County Mental Health clinic back in the early 2000s, the female psychiatrist weaned me off of all the medications and suggested that dissociation, as opposed to possible schizophrenia or other conditions, was a more viable diagnosis, though still undetermined and therefore undiagnosed, and that PTSD with Major Depressive Disorder were more of what could be detected. She suggested that she monitor what I am like without any medications, and after a bunch of puking and about 30 days of readjustment, and about 2 years of seeing her monthly, she stated that I did way better without the medications and that my diagnosis of bipolar or psychosis/schizophrenia were wrong.

Finally, after a pastoral counselor tried to help me for free, since I had enough of the year-long DBT they had offered at the County, and since DBT wasn't really helping me cope with being homeless, having given my daughter up for adoption just a couple years prior (willfully, no system involvement, with the help of my pastor and a lawyer), having lost time (not remembering while NOT on any substances and then not remembering while on the psychotropic meds and then NOT remembering when off of the psychotropic meds for the following two years), and many "mood swings" or "personality changes," I FINALLY was referred by the pastoral counselor (who understood trauma and dissociation) to find a dissociation-based therapist.

I found a therapist outside the church who helped for almost a year before she suggested I come to her home and bedroom, and before her roommate threatened my life out of jealousy. That ended treatment there, but I pursued other treatments - both in a trauma treatment facility and outside, with the confirmed diagnosis of DID (polyfragmented). DID, PTSD, MDD, IBS, panic disorder, insomnia, and possibly EDDNOS were on the list of diagnoses. No personality disorders detected, which I thought was weird because I always thought of DID as a personality disorder until someone explained to me why it wasn't.

I no longer qualify for the MDD diagnosis or the EDDNOS diagnosis, and DID probably has changed to the dissociative features of PTSD or perhaps the new dissociative symptoms without a disorder, which is fine by me. But the PTSD has been a constant in my life, as were IBS, insomnia, and panic disorder.

Periodically, I would have heart palpitations - not connected with any panic - and sometimes connected with my CFS, which I later was diagnosed with by the VA after ruling out so many other things. Sometimes my heart palpitations would occur because of a low potassium level. Sometimes they would occur daily (typically in the evening). I would also hear my heartbeat in my ear sometimes, mostly daily at night. I once had an ambulance called on me and was given nitroglycerine under the tongue. I'm worried about my heart health, though it's hard for me to quit smoking.

I began smoking after I gave my daughter up for adoption. I learned how to smoke from a person in a psych ward who worked there and handed out free patient cigarettes. They thought they were helping; after three weeks of in-patient, I was hooked. I blamed them for giving me that addiction, as I hated cigarettes before that. However, I also was very depressed after giving my daughter up for adoption, and I thought that the threat of being committed for a year if I didn't come out of my room was enough for me to try smoking, since I "punished myself" for giving my daughter up for adoption through smoking cigs. I didn't want to be committed for a year, but it was hard for me to come out of my room because I was so tired and depressed and sad and crying all the time.

Still, the addiction is my fault because I chose it. So I have that to worry about. I will get treatment for that soon, so wish me luck on that first step toward health and recovery.

Anyway, this is all I can think of for now. I won't list all the misdiagnoses and other medical conditions I've had, since they are no longer existent. But my days of exercise and physical agility as I knew them were over the moment I was sexually assaulted in the military. My careers as I knew them were over. The losses of everything that occurred after that meant many other goals I had were over. Family - gone. Reputation - over. Friends - gone, except for a few whom I speak with from a distance and have maintained for over 20 years. Jobs/careers requiring physical fitness - gone. Perfect record - gone. Beauty - gone. Being a mother - gone. Moral fitness - hindered. Emotional stability - gone, but now managed. Identity - perhaps was always fractured, but got completely shattered during the military, which probably wiped away any and all resilience I had prior to that time.

So, yeah, comorbidity for me means medical trauma, grief trauma, moral injury trauma, and the recollection of past traumas that caused all of these subsequent post-traumatic physiological and mental-emotional effects. It's a double-whammy.
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