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Gift From Within - PTSD Questions & Answers with Frank Ochberg, M.D.

PTSD: Definition of PTSD How Common, Who Gets PTSD? Is PTSD a normal event? Does PTSD Affect The Brain? Duration Pregnancy Delayed Onset PTSD PTSD Tip Sheet for your Doctor Medications for PTSD Distinguishing PTSD from BPD Generalized Anxiety Disorder Can the Wounds of PTSD Heal? Complex/Chronic PTSD: CPTSD Explanation Long Term Prognosis & Complex PTSD PTSD vs. CPTSD Managing Past Intense Feelings Overcoming Complex PTSD PTSD Symptoms: Anger and Brain Injury Anger Flashbacks Loneliness Feelings Of Loss And Sense Of Self Anxiety Numbing Re-Traumatization Differences bet. Depression, Dysthemia, Major Depression Depression vs. Sadness and Grief Biological Depression Memory Loss Triggers and Body Sensations PTSD & Facial Tics Emotional & Physical Reactions Delayed Stress Response after Experiencing a Shock Can A False Memory Happen? Differences Between Hypervigilance and Hyperarousal Negativity & Pessismism after Trauma PTSD/PTSI Insomnia: Not Being Able To Sleep PTSD/PTSI & Psychosis Relationships: Peer Support Issues Explaining PTSD To Children False Memory Toxic Family Of Origin Protection From Unwanted Contact Preventing Intergenerational PTSD Numbing in Male Survivors of Domestic Violence How To Increase Social Support Caregivers/Partners with PTSD: Starting a Conversation about PTSD Both Partners with PTSD & its Complications Fiancé Doesn't Believe in Therapy Managing PTSD After Partner Pushes Too Hard Childhood Abuse: Emotional Abuse Childhood Trauma & Intrusive Images Revisiting The Scene Of Trauma And Abuse Gaslighting Stockholm Syndrome & Child Abuse Survivors Can a Child be Born Depressed Childhood Survivors and Being a Parent Work Issues: Disability Letter for Attorney-Sample Low Stress Jobs Doctor's letter for Employer Sample Dealing with Co-Workers Job Searching with PTSD Recovery: Frank Ochberg's Color Wheel of Positive Emotion Triggers Rebuilding Self Esteem Life After Trauma Coping During The Holidays Substance Abuse Improving A Damaged Self-Concept Explaining PTSD is a Responsibility Grief & Loss from a Tragic Death The Trauma Bond & Forgiveness Sudden Panic, Anxiety & Flashbacks Stockholm Syndrome, Trauma Bond and Undue Influence Therapy: Dialectical Behavior Therapy (DBT) Inadequate Therapy When to End Therapy Repeating Your Trauma Story PTSD Symptoms After The Therapy Hour Exposure Therapy Service/Therapy Dogs & PTSD ECT (Electro-Convulsive-Therapy) Bipolar & ECT Therapy: An Interview Telling Trauma Story to Therapist PTSD Client Expectations from Therapy Sessions Veterans & PTSD: PTSD A Disease Seasonal PTSD & Anniversary Reaction. Emotional Injury Therapy Sessions Active Listening for Moms and Friends Military Sexual Assault Professionals: Compassion Fatigue Consequences Of Emotional Numbing School Teachers And PTSD Using The Counting Method with Clients Helping Clients with PTSD Other Conditions: Borderline Personality Disorder Social Phobia Dissociation Obsessive-compulsive disorder (OCD) Cutting & Self Harm Link between PTSD, BPD and Bi-Polar Somatization Disorder or Briquet's Syndrome Stockholm Syndrome & Child Abuse Survivors Dealing with Psychopaths & Narcissists

PTSD Questions & Answers with Joyce Boaz & Dr. Frank Ochberg, M.D. Read "Survivor Psalm" by Frank Ochberg

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It is important to distinguish PTSD from BPD. Q: Dear Frank, Why do so many professionals still misdiagnose PTSD for BPD? A: Dear Joyce, PTSD includes feeling numb, having pent-up emotion, and, at times, being aloof or angry. BPD (borderline personality disorder) includes those feelings, too. But a person with BPD can also feel dead inside, and can have volatile, out of control emotion, and can be very difficult to live with --at times being extremely loving, and then, rather suddenly, becoming rejecting and insulting. This pattern does appear more frequently with women and when it occurs on an in-patient mental health unit, the diagnosis pf BPD serves as a warning to staff - "Be careful! Don't be too friendly!" I recall being told as a psychiatric resident, "These people have a knack for playing one staff person off against another and causing morale problems on the unit." BPD may be over-diagnosed on a psych unit. The label gets used for any difficult patient. The difficulty could stem from legitimate physical pain, and legitimate anger when pain medication is withheld. The difficulty could have to do with personality clashes (we can't all like one-another) but the staff gets to give the diagnoses and the patient ends up with a permanent record that may have some serious consequences. I don't know how often someone with PTSD is mis-diagnosed as having BPD. But I do know it happens. It has happened with a patient I see now. She has complex PTSD resulting from a childhood trauma (near strangulation by a psychotic mother). She gets angry. She gets overwhelmed. But she is NOT borderline. Previous therapists who, in my opinion, failed to understand and appreciate her condition and her true personality got angry with her and gave her that BPD label. I did help a friend, many years ago, get his wife's medical record amended to reverse a mis-diagnosis. It isn't easy. You can't pull a page out or erase an entry. You can have an evaluation placed in the record that notes a change in diagnosis or a "second opinion" about a previous diagnosis. Now that BPD has been well researched, particularly by Dr. Linehan (http://www.linehaninstitute.org), some of the stigma is reduced. BPD responds to a form of treatment that modulates emotion, appreciates "mindfulness," and attracts therapists who can work with a person who, sooner or later, subjects them to withering verbal abuse. PTSD and BPD may co-exist. This is most frequently seen when the trauma occurred during formative years in the family of origin. I've written about that before: http://www.giftfromwithin.org/html/FAQ-Link-Between-PTSD-BPD-Bi-Polar.html When the conditions do co-exist, it helps to have a therapist skilled in treating both patterns. I'm glad, Joyce, that a GFW correspondent raised these issues. It is important to distinguish PTSD from BPD, to know that both diagnoses may apply and, most of all, to realize that labels do not make the person. You are not a borderline. You are not a disordered person who has PTSD. You are you and you deserve respect, self-respect, and well-informed care. Frank Tweet Was this helpful to you? If so, please consider supporting our work.

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