Post Traumatic Stress Disorder (PTSD) and the homeless

I first came across Post Traumatic Stress Disorder (PTSD) when my uncle who was in the Vietnam war told me that he had it.

More recently, I heard other people tell me they were given the same diagnosis. So I read over the dsm4 description and was totally spooked by how familiar it was to people I know who are or have been homeless.

Then I put a q-tip in my ear and dug around my case files that I keep locked away in my secure 'I forget your honour' filing draw of a brain and my head started nodding.

Post Traumatic Stress Disorder amongst homeless people was something that made a lot of sense to me.

So I read the Wikipedia entry on it (http://en.wikipedia.org/wiki/Post-traumatic_stress_disorder), then the DSM IV criteria (http://www.behavenet.com/capsules/disorders/ptsd.htm) for Post Traumatic Stress Disorder again and so this brought me to post this question...

1. Have you been diagnosed with Post Traumatic Stress Disorder and are currently or formerly homeless? If so was the trauma one:
a. related to an experience prior to living on the streets?
b. that prompted you to live on the streets?
c. you experienced on the streets?
d. you experienced moving off the streets?
e. you experienced after you moved off the streets?

2. Have you diagnosed current or formerly homeless people with Post Traumatic Stress Disorder? If so, from a to e above what was the timing of the crisis in relation to their experience of houselessness? and
a. Is there a particular study you would like to point out?
b. Findings of your own you would like to point out anecdotally?
c. Further comment you would like to make?

3. Can someone please outline the differential diagnosis for Post Traumatic Stress Disorder...? That would be helpful.

4. If you are current or formerly homeless, please mention if you will any prior mental health diagnosis you have recieved and any position you have or comment you want to make.

5. If you know why reading DSM IV prompts someone to post in an overly orderly manner using numbered lists and sub points while asking a question, please keep to yourself exactly what page in DSM IV my name is mentioned on.
a. But feel free to PM me the page number.

So what is the diagnosis regarding Post Traumatic Stress Disorder and Homelessness?

PS, I'd encourage responses from people with personal experience rather than doctors (for everyone's sanity).

Oh and don't forget the workers - if you have PTSD from working with homeless people shout out and comment from that perspective.

Dom, one thing I think you should add, is the subvariant C-PTSD.

http://en.wikipedia.org/wiki/Complex_Post_Traumatic_Stress_Disorder_%28C-PTSD%29
I think this would be more relevant to some homeless people (and others).

It's something that affects a lot of child carers of parents with a mental illness as well. The other category of people who have it in spades are refugees from torture regimes.

And because someone is sure to ask, yes you can have combination PTSD and C-PTSD. One derives from an acute stressor like someone trying to kill or rape you. The other derives from constant prolonged stress. Perhaps the better way to say it is there is a huge if not total overlap in PTSD and C-PTSD in terms of symptoms. It's the same disorder, but with a different cause and a different frequency of symptoms.

To illustrate, if 85% of people with PTSD have emotional outbursts and 15% have hyper-controlled emotions. Then 70% of people with C-PTSD might have hyper controlled emotions and 30% be prone to outbursts.
So you see the same spread of symptoms but a different pattern of frequency.

The common factor in both is that the trauma is suppresed in some way.
Either because you need to survive, or because noone believes you, or because you feel you are alone in this, or that no one else would understand, or you are physically isolated or any one of a number of reasons.

At least that's my personal understanding of it.

Cheers,
Konstantin

Can't really answer all your questions Dominic, but I can tell you my experience with PTSD. When I was with my ex, I was diagnosed with bipolar disorder. None of the meds they had me on worked, and I ended up on government assistance because I wasn't able to work. I left my ex, and after a few years of being homeless, ended up in a stable situation. I saw another psychiatrist, who informed me that I didn't have bipolar disorder at all. I have PTSD from the years of abuse I suffered. He helped me learn to cope with the disorder, and sent me through therepy. It didn't happen overnight, but I am now able to work full time, take care of a home and family, and have an active social life, none of which I would ever have been able to do before. I am not on meds, except when the emotions threaten to overwhelm me, and then I take a month or two of prozac to get me through. PTSD is never a good thing to have, but it is great to finally know what is wrong with me, and that I can deal with it.

What kind of therapy did you do?

Konstantin.

I don't know really what to call it. It mostly consisted of meeting with my therapist once a week (sometimes more) to talk about what happened, how to deal with my feelings, how to keep it from happening again, and appropriate ways of dealing with the stresses in my life. I tended to run from them or tune out completely. Now I have learned how to deal with them effectively. The therapy was very helpful in ways that the meds never were. Medicine could make the problems go away for a little while, but once off the meds they were still there. With therapy, I learned how to face them and cope with them. The problem is, I had to be willing to accept what the therapist was saying, and to take her advice. Not everyone is willing to accept help.

Yikes, normally the therapist would tell you what it's called.
Oh well, I'm glad it worked out for you, that's the important thing.

Regards,
Konstantin

3. Can someone please outline the differential diagnosis for Post Traumatic Stress Disorder...? That would be helpful.


Hi Dom, I Just noticed this.
There's lots of em.

Group 1 (Anxiety disorders-Non PTSD)

Acute Stress Disorder (ASD)
Generalized Anxiety Disorder (GAD)
Panic attacks.


Group 2 (Dissociative disorders)

Dissociative Amnesia,
Depersonalisation disorder.


Group 3 (Phobias)

Social Phobia,
Agoraphobia,


Is a (very) short list.

Regards,
Konstantin

I have had PTSD for 2yrs now due to a nasty MVA , I was getting treated with CBT therapy, and it wasnt working with me just making it worse I have stopped for now but without gov housing rent auto pay all that some days im not sure what id do its hard to even think about doing the dishes some days, and im sick of the dreaming which leaves me exhausted to some days, I need to get back in the car again sometimes soon and face this stuff, I could see PTSD being a huge huge issue i would hate to be in private rental suffering it s