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Q. Kindly help me to manage PTSD.

Answered by
Dr. Guruvamsee Krishna Avvaru
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 28, 2020

Hi doctor,

I was diagnosed with PTSD but I believe it as complex PTSD. I am 25 years old female. I was taking Lamictal 100 mg and Abilify 10 mg for three months. I was fine mood-wise but still, I was not able to sleep, eat, or drink. I know that there is something wrong. Then I had anxiety, depression, a mood disorder, and PTSD.

A few days ago, I had a breakthrough where I got realized that I was in two back-to-back psychologically abusive relationships for the past seven years. Now, I am learning and realizing things. I am experiencing a lot of anxiety if I am triggered. For example, I was triggered and got anxious to the point where cannot calm myself down. My heart started beating fast, started to have sweating, unable to breathe, started to have racing thoughts, dry lips, dry mouth despite drinking water. I got irritation and I was not able to sleep. I need something to calm me down. I tried consulting my psychiatrist to know what is going on, and she did not listen to me.

She told me that it was due to a change of medication even though I was taking Abilify and Lamictal for three months. She advised me to take Lamictal 25 mg and Abilify 10 mg. I do not believe that I need it. I need something to help me with this anxiety and lack of sleep. She told me that she is unable to diagnose me over the phone and if the anxiety becomes bad, she advised me to go to the emergency and check into the mental hospital. I tried telling her that I am not in a danger to hurt myself but she did not listen to me.

I tried explaining to her that I was having a breakthrough and I was realizing about the abusive relationships had for seven years. I am experiencing a lot of anxiety. I even told this to the therapist who is a middle man and explained what was going on before consulting a psychiatrist. She had a better understanding of what I am going through.

This is the most levelheaded condition felt in years and I am working closely with another therapist through talkspace who is seeing my progress. He is helping me through it. My psychiatrist will refuse me for speaking with the therapist. So I have another therapist and I barely talk to as a middle man who does not even ask me questions about myself. Please give suggestions and say whether I need to take medicines for anxiety.

#

Hi,

Welcome to icliniq.com.

Please explain the duration of these symptoms. Please say about your mood, interaction with others, your future, and sleep habits. Please say whether you have any negative thoughts, hallucinations, worthless feelings, friends around you, and traumatic history in your life. Kindly send your psychological reports. Please say whether you have thyroid.


Investigations to be done:

complete blood count
thyroid function test
lipid profile
ECG (electrocardiography)

Treatment plan:

Take tablet Paroxetine 25 mg one tablet at night for fourteen days, tablet Clonazepam one tablet at night for two weeks. Please stop taking Aripiprazole. Please mention the exact dose of Lamictal. Continue Lamictal for the time being.

Thank you doctor,

I am having these symptoms for a week. I am levelheaded and I can think clearly. But I am easily triggered and I experience anxiety. I have lack of sleep during the night. I also feel like I am trying to process these events and emotions in all places. I am communicating a lot more with others about my trauma and I am trying to process a lot of things which is not stressful. I hide my abuse for over seven years. I am paralyzed and after being provoked and gaslighted so many times.

I did passive suicidal ideation and slipped off from the balcony during a fight. I am working with a therapist to talk space and she is been helping me for a few months. She saw progress in me and I decided to get off my Lamictal and Abilify. I am doing good and socializing more. However, still, I have problems with eating, drinking, sleeping, and racing thoughts at night. I can think clearly about the future. I want a positive life despite being in a wheelchair and my trauma.

My sleep is awful for two hours at night. I have a lot of self-guilt from being gaslighting. I often think that I am an abuser and it is my fault and so I contemplated suicide. I have a lot of self-hate. I blame myself for my ex abuser relapsing and using heroin. I feel worthless. I am often writing in my mind that I am truly crazy or I am thinking rationally because of all the psychological abuse had for the past seven years. I often forget about my trauma and have to remember what happened.

Sometimes I feel like I am living in a traumatic moment, or I feel dissociated. I have a good support group however and I hide all this abuse from my friends and family for years. I did not know that I was being abused. I always come clean to my friends and family who are closest to me as they wonder how can I be quadriplegic for so long.

#

Hi,

Welcome back to icliniq.com.

You are suffering from mixed anxiety and depressive symptoms with differential diagnosis of severe depressive episode with psychotic symptoms.


Treatment plan:

Please stop taking Aripiprazole. Start tablet Paroxetine 25 mg for two weeks, tablet Alprazolam 0.25 for two weeks. It gives relief to your anxiety temporarily. continue Lamotrigine. Practice sleep hygiene. We will see after two weeks after seeing the response with Paroxetine


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