Psychiatric Injury vs. Mental Illness

Over the past decade, I’ve been amazed at how the conversation around mental health has evolved. I remember back in 2011 after a colleague assaulted me, another colleague-turned-friend called Jaymee was very supportive. Through conversations with her, I was able to call the encounter what it was: sexual assault. Jaymee also openly talked about her mental illness, and I remember feeling shocked when she first used the words “mental illness” to describe her experience. At the time, I was 41 years old and had struggled with periods of deep depression, suicidal ideation, self-injury, and for over two decades; yet, I never ever would’ve characterized myself having a “mental illness” for two reasons. First, “mental illness” was something “serious,” like schizophrenia or bipolar disorder or psychopathy, not depression. Certainly not! Second, people just didn’t talk about mental health at all.

Nada. Zip. Zilch.

The mentally ill were feared. They were violent or scary or dangerous. Sadly, this truly was the cultural script at the time and the way my generation, Gen X, and those before me were raised, were socialized. This was as true as the sky is blue. In fact, I suspect a good portion of Gen Y was socialized to believe this too. Thankfully, somewhere between younger Gen Y and Gen Z, the cultural script changed. Finally, it was okay to talk about mental illness, and I couldn’t be more thrilled about it.

Back to Jaymee, when she said her “mental illness” was Depression, I remember thinking “that’s not a mental illness,” for reasons stated above, and also because I struggled with depression. Certainly I wasn’t not mentally ill, which would’ve been a devastating thing to believe at the time for the aforementioned reasons. Thankfully, my self-awareness took over and I felt nothing but respect and empathy for her. I accepted that I, too, had a mental illness, namely depression with increasing instances of anxiety and panic attacks. When I still wrote under the name O. M. Grey, I did a panel on mental health with Jaymee and others at Aetherfest, a Steampunk convention in San Antonio. We spoke openly about our experiences, and it was liberating! I had already been quite vocal about the assault at the hands of that Steampunk colleague, so the audience knew I didn’t shy away from difficult subjects.

The following year I experienced another assault, and the perpetrator this time was someone I not only knew, but loved. Reeling, I desperately tried to find some footing, but my psyche had been shattered. Between this one, the Steampunk musician, and a third by my best friend the year before that, I barely functioned for years.

During that time, my husband recognized my symptoms as those of PTSD, so I read about PTSD and subsequently C-PTSD, which introduced me to the concept of a psychiatric injury.

Everything started to come together. I didn’t have a mental illness after all; I had a string of psychiatric injuries dating back to my first sexual assault when I was 19 in the Navy.

This made sense. This is why anti-depressants had never worked on me because depression wasn’t the cause. Depression was the symptom. Anxiety wasn’t the cause. Anxiety was the symptom. Those are both symptoms of PTSD, a type of psychiatric injury.

Whereas anti-depressants work wonders for people who are clinically depressed, I realized it’s because in their case Depression was the cause. In mine, it was the symptom. On the outside, the behaviors look the same. Even the experience of depressive episodes can be the same, but I learned the difference between the cause and the symptom. I didn’t want to treat the symptom; I wanted to treat the cause.

I devoured everything I could read about PTSD, C-PTSD, trauma, and trauma recovery. I read everything I could on Rape Trauma Syndrome (RTS), Sociopathy, and the effects of repeated abuse, and I began to understand my own experience and response to those experiences.

This was the beginning of my healing journey. For twenty-five years I had been misdiagnosed over and over. From clinical depression to personality disorder to bipolar not-otherwise-specified. My symptoms never fit into a clear-cut box, so professionals had a difficult time diagnosing me. Plus, the DSM-V didn’t yet characterize repeated abuse as a cause of PTSD. These misdiagnoses resulted in the wrong treatment—for decades—which caused further problems, both emotional and physical. Once I obtained that correct diagnosis of C-PTSD in 2015, I started treatment for that, and my life has gotten increasingly better over the past seven years. Without that proper treatment, I’m not sure I would’ve survived the break down of my marriage.

If you’re struggling with either a psychiatric injury or a mental illness (or both), you are not alone. There is help available. There is support, and I’ll tell you something now that I read during my rape recovery: there is no such thing as too much support.

Take it where you can find it.

Read about your symptoms and your experiences to help narrow down the cause of your struggles, then you will have a place to start when you see a psychiatrist. Then you can advocate for yourself. While doctors and psychiatrists and psychologists are experts in their fields, you are an expert on you. You know more about your experience than any of them will in the 15 – 60 minutes they spend with you.

When you talk with a psychiatrist or your PCP, you tell them your experience. If you know you have a psychiatric injury rather than clinical depression (meaning depression is the symptom, not the cause) or generalized anxiety disorder, tell them that. Be sure to use the words “affecting my quality of life.” The first thing they’re always going to try is an anti-depressant, and it might work for you, but if you know it won’t from previous experience, tell them that, too. There are many other meds to try with far fewer side effects, so tell them your experience and what you aren’t comfortable taking, the side-effects that are not acceptable.

This is your body. This is your brain.

There are also non-pharmaceutical treatments, although depending on the severity of your psychiatric injury, you might need treatment consisting of meds, behavioral therapy (like DBT or CBT), and psychotherapy with someone specializing in PTSD, like I do.

There is no such thing as too much support.

May you find peace.

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