I think my husband has PTSD

[cthorne111]

My husband has what was labeled on him for a long time as social phobia, also he has OCD. After doing some reading on it he realized that his problem isn't exactly social phobia, but avoidant personality disorder. Main difference being that he doesn't focus on himself in social situations, he is focused on analyzing everyone else's actions. Anyway, a couple of years ago he went through some extremely stressful social situations over a period of about 6 months (situations that would have been hard for a normal person, much less him) and to top it all off, he was already stressed to the max and suicidal due to his stress level, before it all started.

Now our life has stabilized somewhat but he completely avoids almost everyone he knows. He has occasional email contact with one person, and contact with his parents, and that's it. He doesn't leave the house hardly at all. He has flashbacks of the social situations he experienced and gets extremely angry, they play over and over in his head even though it's been nearly two years. He doesn't usually verbalize it because he thinks it tends to strengthen it to discuss it, he recognizes it as abnormal to be thinking about it, but when he is having these thoughts he gets really snappy at me and cranky in general about everything. He occasionally uses alcohol to cope when it gets unbearable (maybe 1x/week).

Also for the past year and a half (undoubtedly as a result of the stress) he has developed serious depression and talks about suicide on a fairly regular basis (lately, maybe once every couple of weeks, but it used to be every couple of days). To top it all off, one of his avoidances is doctors and ESPECIALLY psychiatrists. He doesn't trust them. I went to my family doctor about a year ago (when his depression was exceptionally bad) and convinced him to give me a prescription for Effexor for him since he wouldn't go to the doctor. He took it and it did help his depression a lot (didn't do a whole lot for anything else), but the side effects were too much for him so he went off it last fall. Now, he is being tested for autoimmune disorders since he has constant pain in most of his muscles (he is willing to try ONCE to get a diagnosis from a doctor...if the tests don't show anything, he has notified me that he won't be going back to a doctor again about this issue). I'm fairly sure that in the end the pain issue will end up being fibromyalgia, and interestingly I found out that it sometimes is triggered by PTSD.

Sorry for the longwindedness but this isn't a simple problem to tackle. My questions are:
1. Does this sound like PTSD?
2. If so, how should he deal with it? Getting 'help' (mental) is NOT an option. trust me I've tried. It always ends badly.
3. Is there anything over the counter that actually works for anxiety disorders and/or depression?

[brice1967]

Somebody above mentioned to stay off of prozac.  First off, this decision should be made by a qualified health care professional.  Secondly, my wife (diagnosed with PTSD) has had great success with prozac.

Sooner or later, your husband is going to have to start trusting someone.  Do your research and find health care professionals that specialize in treating PTSD,  Let your husband know that you would do nothing to harm him and assure him that his health is what youre concerned with.

PTSD and any number of social anxiety disorder issues are very treatable.  As with anything, there are good doctors and bad doctors, there are good psychiatrists and bad psychiatrists.  Do your homework, be supportive with your husband, and together you can seek help.

[Jaybay]

My husband is the poster-child for PTSD and only sought help for it less than two years ago.  I was already seeing a pain psychologist who also specializes in PTSD, so I kind of got the ball rolling for him by example.  Had I not established the relationship with the shrink first, he never would have done it on his own.  It was just a very lucky accident that we found her.

PTSD isn't something that can be fixed with a pill.  Yes, meds can help with many of the symptoms, but talk therapy including behavior modification is essential if the person is going to be able to function and live a happy (or happier) life.  At first, my husband was just like yours.  "Why do I have to relive all this crap?  I don't WANT to think about it!  What good does talking about it do other than to upset me?"  His therapy has focused on identifying the worst areas of flashbacks that cause him to dissociate, be aware that it's going to happen, and stop a dissociative or panic episode before is escalates.  He's doing SO much better now it's unbelievable.

I've copied the DSM IV guidelines for PTSD.  Have a look and see if you think your husband fits the profile. My husband met every single criterion for PTSD listed below.  Seeing it in black and white actually made him feel better.  He knew he was "messed up" as he put it, but having a name put on it helped him actually deal with it and keep up with his therapy.  
*************************************

DSM-IV-TR criteria for PTSD
  
In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)(1). The diagnostic criteria (A-F) are specified below.

Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning.

Criterion A: stressor
The person has been exposed to a traumatic event in which both of the following have been present:

1.The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
2.The person's response involved intense fear,helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.

Criterion B: intrusive recollection
The traumatic event is persistently re-experienced in at least one 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 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.Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

Criterion C: avoidant/numbing
Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three 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 foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Criterion D: hyper-arousal
Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:

1.Difficulty falling or staying asleep
2.Irritability or outbursts of anger
3.Difficulty concentrating
4.Hyper-vigilance
5.Exaggerated startle response

Criterion E: duration
Duration of the disturbance (symptoms in B, C, and D) is more than one month.

Criterion F: functional significance
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

[MZLAUREL]

i mean emdr and dnms are good.

[MZLAUREL]

oh yes
Stay away from psychiatrists.
EMDR therapy
DNMS   "

[MZLAUREL]

Hi
Pills are not the answer, if he won't take them.
Was your husband ever in combat? The snappyness is similar to what my BF and I do when triggered.
If he was not in combat, then there would need to be some TRAUMA for it to be PTSD.
Some examples are:
Childhood beatings/abuse/neglect/sexual abuse. If any of these things were observed by him as a child may do it.
Car accident
Sexual Assuault
Witness to horror (not movie)
Assault
Bullying
Public Humiliation/Embarassment

Your description of these "social" occasions is cryptic. Was it a wake or funeral? Or ritualized pedophilia??? Was it a hazing? Bullying? Arrested??? Did he do a drunken striptease at a funeral????
There is a quite a spectrum of possibilities.
What I would say is he needs to see the event and its relativity to him and its relativity to appropriateness.
If the event was inappropriate, and he was a victim of it?
If the event was appropriate and he was not?
I was triggered to my PTSD some 30 years later, when my Mother in Law mentioned the name of the man that sodomized me. I remember the moment in perfect detail. Something my mind sought to forget, was now an issue.
So I am saying that the particular social event may not actually be the trauma. It may just have made him remember the trauma. (Like priest molestations)
Get him out and walk EVERY DAY. ( 1 mile) Tell him you want/need (lie and say the doc says to) to do it, but need him to keep you safe or something. (?engage his love of you, and his desire to protect... you know what I mean... it helps for him to take care of others.)
Some things, men have an almost impossible time talking about. They are trained as boys to deny certain feelings that might get them killed in the ARMY. You would be surprised at the differnce in the number of words women have for feelings compared to men.

[JAKA]

I cry reading your story.Believe me ,You've received great advise their, I suspect from a
professional.??.. After 11yrs suffering from PTSD, And being stuck on the Drug "Merry-go round"...Your Hubby, WILL ...WILL....WILL  Benefit greatly from communicating, In a group therapy situation..But only with OTHERS WHO HAVE HAD SIMILAR EXPERIENCE....
With my event, I found it impossible to talk to anyone, Including my 20 yr wife, Clinical
psych's, Specialists etc... But quickly opened up with fellow vet's, Who had gone through similar event's.
I really feel sorry for the spouse's in these situations...Very very difficult situation to deal with...Whole families are affected,
Just please...DONT allow him to make my mistake..STAY CLEAR OF EFFEXOR..
Dont simply believe what a DR tells him/you...EFFEXOR Is a mind altering drug..
With HUGE side affects.. I've "LOST" 11yrs of my life..On that CRAP..
Do what ever it takes, Get him out of the house, Make him answer the phone/front door
Get him communicating..He will eventually meet someone with a similar event
I know many who have passed by their own hand...Those who talk about it, Dont usually do it..     Hope he meets the right people soon.. We are out their...

[drifter0213]

i have PTSD and i suffer from anxiety nightmares and flashbacks of what happen to me in the service also causes substance abuse i also have schizophrenia :)

[lilpersianangel]

I have had PTSD for years now, it's a difficult condition to have and initially, to understand. I can imagine how you both are feeling. It does sound 'classic' because from what I have learned over the years (and through some therapy) is that avoidance behaviors are a hallmark signature of trauma. Most therapists claim to treat it, but have little practical methods that usually end up doing nothing beyond suggesting 'meditating' (laughable) and rehashing memories that just bring them all to the surface at once. I don't blame him for not trusting shrinks, honestly, even the ones with the best intentions usually do little or no good. However, depending on his body's biochemistry, some anti-anxiety (and perhaps anti-depressants) might help take the edge off. He would have to 'experiment' with various meds over time to see which ones he prefers. Don't use prozac. Ever.  With ptsd, people feel like their previous trust in the world and in people has been destroyed. They feel like people are unpredictable, even potentially dangerous, to their well-being (which depending on the other people, can indeed be true!) and ptsd survivors cannot handle being around those who have a tendency to be unpredictable or selfish, or who have tempers which appear as threats in the ptsd brain. Think about how an abused animal or pet behaves with people...it's the same effect on the nervous system. He probably has lots of stress hormones floating around inside which gives him a sensitivity to extra stress. It's not all in his 'head', a lot of becomes truly biochemical. There is also a vicious cycle of depression, as the person feels helpless and powerless, and then becomes angry to feel some sort of control in life. Try not to take it personally. It already sounds like you are trying to show him caring and that you are his ally, which is important. He needs a schedule to feel control over life, and he needs routine. The way he can also deal with it is to try over the counter herbal remedies such as St.John's Wort (for depression & moods) to help take the intensity away, but it's no cure. He also needs to talk about his feelings but only a little piece at a time, as talking about the whole picture all at once is overwhelming to the nervous system. The best thing for him in the short term is distraction. A movie, a new hobby, a new regular activity (i.e., church, sports), and something that will instantly put him into a 'zoning out' feeling to cope. It's one of the most complex conditions I suppose, but it can be 'controlled'. However, never 'force' him into treatment, that will forever harm your marriage as he will probably never trust you again. PTSD survivors need to feel things are their decision. I would also STRONGLY RECOMMEND finding some kind of support group where he can talk with other survivors about problems they encounter, so he doesn't feel alone and that in itself is the best therapy. If there isn't one, try going to meetup.com to look in your city area. If they don't have one, create a group on your own. If you can slowly find ways to rebuild his faith in people, to help mend his world view that was shattered, that will greatly reduce the intensity of the condition. But it rarely ever goes away 'completely', but it can get better. He's lucky to have you. If he gets angry and it hurts your feelings (I know that's got to be hard)...just softly tell him you love him and don't try to get him out of his shell. He will come out on his own. Hope that helps.