Chapter 2: Seeking Help

Deciding to Seek Help for C-PTSD

Here’s another thing, You need to tell your therapist everything, you do not need to tell the prescriber everything and you really shouldn’t tell them anything that isn’t prescription based. If they want to know anything about your issues, tell them to talk to your therapist.

From my experience the public healthcare system is stocked with prescribers that have no idea how to deal with the therapy aspects of the care. They are also the ones that are pressured about getting you back to work, healthy or not. They have incentives to slapdash your care and you should not allow them too close to your case, beyond the medications they provide.

I’m going to share an experience wherein one of these “prescribers” sabotaged my disability case. First, whether they are or not, they are likely going to eat it up if you call them a doctor and they won’t correct you, it’s a power trip and a bright red warning sign to get away. Most of them are nurse practitioners, which isn’t at all a minor achievement, but they aren’t doctors the majority of the time.

What happened?

I had a practitioner that decided to throw my therapist's assessment of my case in the bin. My therapist made it clear, I am disabled for a year. I had been disabled for three years around this time and when I sat on a call with him he decided to say this;

“Well it seems you are having a hard time. I will sign your medical-1 form. I’ll sign for six months and we can reassess at that point.”

It was jarring. I didn’t exactly know what to say. My life was already hard enough and this dude wanted to cut my general assistance in half on a whim and against my therapist's trained opinion after that therapist had been working with me weekly for months. This dude didn’t know my case, my issues, my struggles, etc. I politely explained that, were he to give me six months, my general assistance and EBT, what I use to survive on and is only about $250 each, would be halved if he gave me six months.

You want to know what this asshole said in reply?

“I could just not sign it and force you back into the workforce.”

Yeah. I am already extremely insecure with only meager financial support and living on a classmate's couch. Cut my support system in half, that’ll help. Fucking dickhead. I essentially begged him for the one year and once he gave it, I made a formal complaint to my therapist and the management. That dude outright threatened to cut me off for daring to tell him the ramifications of his flippant suggestion to damage my support system. After the complaint, nothing was done. He was still my monthly prescriber.

I had four of these events before I outright told my therapist that I was looking into lawyers to file a malpractice suit against the company.

First, he tried to kick me off my temp disability. He eventually gave me the year, but it took more work than it should have.

Second, he kept telling me how smart I am. I don’t like that. I made it clear I don’t like that. Here’s the reason and it’s the same one I gave him, “Please don’t compliment my intelligence because it makes me feel like an even bigger loser when I see people who are less intelligent than I am, succeeding in life in ways I can’t. It upsets me.” Seems reasonable, right? He couldn’t get that reasonable request into his head. I made another complaint.

Third, he thought it was a good idea to tell me how much he wanted to see what I looked like, that I am a fascinating individual and that he really wishes he could see me. Does that sound like flirting to you? Because it did to me. We were on a telehealth visit and had always been, so maybe he wanted to check a box on the list, or maybe he wanted to get me in the sack, either way, it made me feel extremely uncomfortable.

Fourth and the last. Nearing the end of a session this dude tells me, “I think you should watch some videos from this fellow. He might be able to really help you find some support you have overlooked and give you some constructive ways to handle your condition.” Man, does that sound reasonable. Seems like he is trying to help me heal. Seems like he is taking a personal interest in my healing, maybe he has figured out what I actually need and how to constructively work on my problems.

The person he is praising to me and telling me he can turn my life around? Joel Osteen, The prosperity gospel cultist who won’t use his mega-church to help a community in distress. Now, don’t get me wrong, it was beyond unacceptable that my prescriber of my mental health medications was trying to recruit me into this fringe offshoot cult of christianity, but I would have told anyone to go screw themselves if they pitched that as an aid for my condition by my medical prescriber? No, fucking, way.

After I was off the phone with him, I digested exactly what happened and how I felt about it. Then I called my therapist's office and asked that a supervisor talk to me. I demanded this man be removed from my case. I am now at four complaints and they have only kept escalating.

The aftermath.

Upon the fourth complaint he was finally removed from my case, but they didn’t have anyone else to assign to me. I had to go to my general practitioner and ask that he prescribe my mental health meds, I explained what had happened, why I was asking, and if they could fill the need until my therapist's office hired someone else. My GP agreed, and I had him prescribing for about six months. That was when my med-1 form came due.

My GP couldn’t sign the med-1 because he was not a specialist in my condition and really didn’t have the authority. I had to scramble or be left to twist in the wind. They were threatening to take away the shit support I was getting and I needed a solution. Thankfully I had blinding migraines too. I made a neurologist appointment and he agreed to give me a one month med-1 form. Good news right?

Guess again.

Mental Health Treatment During the Plague of 2019

I went to the neurologist in January of 2020. He gave me a month of disabled clearance. This reduced my assistance to about $200. Oh no. That wasn’t the reduction of cash aid. No. That was everything they gave me. I was receiving $100 cash aid and $100 of EBT. That was it. That didn’t seem all that bad, as long as I got a new form turned in ASAP. Then the first Covid-19 lockdown happened.

Suddenly I couldn’t get to my therapist's office, but that didn’t matter, none of them were in the office. That one month form giving me $200 of fuck you asshole? They decided to just grandfather that over. For the next year. The entire year of 2020 I had to beg my friends to meet the needs that I had. This was the most humiliating thing I had ever had to do… to this point.

I am really blessed to have the friends that I do. Each month I made it to the mark. I had someone giving me a regular drop of money without my asking. I had another that was helping me with my medication costs that aren’t covered by MediCal. I had someone periodically sending me gift packages. I had a friend sending me Girl Scout cookies. This was hard to accept. This was also when my childhood friend, that I have known since I was four years old, sent me an Xbox One to help me with my stir crazy mind that couldn’t really go outside and had problems staying in the moment, rather than constantly thinking about the horror of my life and the world around me falling apart because someone once teased an orange, spoiled, man-child, idiot, crybaby during the 2011 Correspondents' Dinner.

I’m looking at you Seth Meyers.

That was bad right? I mean, that seems like enough vengeance from the highly inappropriate prescriber, right? We’ll get back to this later.

Here is the point of this section. Deciding to seek help for C-PTSD is necessary, but do not assume everyone who is helping you is a good actor. There are a lot of shit people in the industry and you need to be prepared for that fact.

Finding a Therapist Who Specializes in Trauma

If you are poor, good luck. Seriously. When you are poor you are lucky to get a therapist at all, most of the people you are going to deal with are going to tell you a lot of the following:

* You don’t look sick

* You aren’t really doing anything, you should be able to do; X, Y, Z

* I had someone in here earlier with X. Y, Z

* Do you have the form X, Y, Z? I can’t help you until you do. Next

* Oh they didn’t mean you have to work, but you do have to go to the career center this often

* You’re just sad, get over it

* I can’t help you with that you need to see X, Y, Z

* Well it is the only appointment day we have so

* We don’t do that here, you will need to find someone else

* Your prescription was increase, but we have to wait until next month, because your insurance won’t just give you the increased numbers

* You need a reference from your doctor for us to do that

* Thank you for holding, your call is important to us. ∞🎶

* You’re buying that with food stamps? I really don’t think you should be able to

* What do you mean you can’t do

* You really should have taken notes

If you spot this story on Amazon, know that it has been stolen. Report the violation.

The only one that I will tell you to listen to is the last. Take a mountain of notes. All the notes. Seriously. You want a papertrail of everything you are dealing with. I know it’s going to be hard, but something you have to be prepared for is proving your case all by yourself. You are not likely going to get good records from your therapist, your prescribers will likely downplay your condition to improve their numbers and look as though they are “getting a slacker back to work.”

You need to see everyone as doing a half-assed job because it will prepare you for the worst if that is exactly what they did. In the years that I have had therapists helping me with my condition, I have had more therapists than I can name. Seriously. There is the added problem with my memory going to shit during this struggle. Things that I used to be able to file away for later were simply gone. I don’t remember moving out of the house when the dickhead threw me out. None of it. I lost about ninety percent of everything that I owned. I lost my birth certificate and my social security card. You need records. You need as many records as you can get.

If you are poor, you are going to have a revolving door of people treating you. The public mental health sector pays peanuts and they are going to move on the second they can. You can’t blame them for that, but you need to be prepared for it. One of the poison pills you need to prepare for is that the rotating door is going to make it hard for any one person to understand the totality of your case. You are going to need to memorize a purse dump script. You need to fill in everything the new therapist doesn’t know in order for them to help you. They aren’t going to read the notes, or at least, assume they aren’t going to. Keep a record of your meds, the effects, what date you started, what the strength is, if you had side effects and those side effects you have. You are going to need a file that you can send in to your lawyer to work on your disability case, if you have to file for them it goes smoother. Assume your lawyer is going to be a student, over-stressed, and juggling cases. You are not going to be a priority if you have to go through a law center or any other free legal help. You are essentially going to have to spoon feed your case to your lawyer and hope they remember enough of it to defend you well.

The Challenges of Therapy for C-PTSD

Bad actors. Remember the douchebag that was pointing me to the prosperity gospel conman? That dude slipped a note into my case file saying that I never mentioned my anxiety or panic attacks to him, and that I was using heroin and cocaine. Every bit of that is a lie. Do not assume anyone is going to be on your side, do not think they are a good person because they are in the medical field, do not trust them to be honest, and know, there is likely very little you can do about calling them on their bullshit.

Records. I cannot stress this enough. Take notes. This is now your full time job. Yeah, I know you are disabled and going through a lot. I know you can barely get through the day without falling into a slump on the couch and just wishing to die, but our government is looking for every single reason to deny you. They are going to deny you a lot, and you are going to need to be prepared for that fight to be long. I am now in year six of being disabled and the fourth year of fighting for disability. The first two years using my savings to survive and try to “pull myself up by the bootstraps” means nothing to the judge at all. You are not going to get credit for it, do not wait. File.

I have to assume, had I still had private insurance when I started filing for my case, it would have gone differently, and it is simply not an experience that I am familiar enough with to go into, so I am going to continue with my experience of being poor in this shit system.

The biggest challenge is staying on top of your own case, while trying to heal, while stressing about money, while thinking death would be a better solution, while trying to be productive, while trying to keep your symptoms in check, while you watch family and friends distance themselves from you, while being told you need to snap out of it, while people demean you for needing help, while the system is slow walking your case and looking for any reason they can to discredit you.

Yes. You are going to have to work full-time, while being unable to work full-time. It isn’t fair. It isn’t right. It is cruel and unnecessary and it is the reality of being poor in the wealthiest nation to have ever existed on Earth.

Shit deal right? Yeah. Sorry to break it to you.

The challenges of therapy are many. The key aspects are going to be; maintain consistency in your mental work. You are going to have to remember the things you have covered and what the comments of your therapist were for those issues, because you aren’t likely to have the same therapist throughout the entirety of your case. I moved from California to New Jersey. I couldn’t keep my therapist. I moved facilities three times in NJ. I changed therapists too many times to count. I have had a bunch of prescribing psychologists and a lot of them were shitty.

In fact. I had one about two months ago that needed to be replaced the first time I met with him. The visit was telehealth so I got to see the walls of his office. When I saw that he was in the military I had hope that I had someone who might be able to understand the condition. I know I was never in a war, but spending over a decade constantly braced for an attack, walking on eggshells, doing everything just right or being attacked by a grown man, that fucks someone up. The beginning of our session, he spent filling out paperwork for someone else. I just sat there waiting. Eventually he started the questions about my meds. Don’t worry we are getting to meds next.

I tell the fellow what I am on, when I got on them, why I had a switch, why I was on the dosage, etc. Then came the question.

“So what is wrong with you?”

“I have C-PTSD from physical abuse that was random, systemic, and constant for over a decade. I had a mental breakdown about six years ago and I have been trying to crawl out of it the entire time with no real progress,”

We had a pleasant conversation about my meds and my symptoms. I want to get better, if this dude knows of a drug that might help, he needs to know my ongoing symptoms.

“Well, that is a lot, well these meds seem okay, but have you thought about increasing this medication to a higher dose?”

All boilerplate. Nothing new. Just the simple dance I have danced a dozen times now.

As we close he says this, “As far as the PTSD, that happened a long time ago, you need to get over it,”

I went slackjaw.

“Excuse me?” I asked.

“Well that abuse happened in your childhood. You are a grown man now. You shouldn’t let it impact you anymore,” He clarified.

“You know. I was a fully functioning person until my trigger took that from me six years ago. I had to move out of the house by sixteen, because after the divorce of my parents, my mom had to feed all of us on her pay alone. As a teen going through growth spurts, this made it hard for me to eat my fill in the house because I had three younger siblings. I was essentially chased off by my mom to favor the other children. They were younger and more vulnerable. It hurt, but it was something primal that I had to accept. I dropped out of high school to get a job to survive on my own as much as possible. I have been quickly given management roles my entire career. When I was thirty, I went back to school because my employers told me bluntly that my lack of a high school diploma was going to make it hard for me to leave and advance in another job. I passed the Ability to Benefit test, got into a junior college without a high school diploma, then achieved my associate arts. After that I went to university and achieved my bachelor of arts degree as well. I worked through pain. I hurt my back twice at work and I kept working as hard as I could. Every single step I have taken in my life has been a challenge and I really resent you telling me that I should just drop the illness that puts all of that progress at a stand still.”

I didn’t let him finish or explain, I walked out, took a day to digest if I was overreacting and then went to the head of the office and filed a complaint. I nipped that in the bud the second I had to. There is no reason for me to feel less than while I am struggling to survive, especially from one of those assigned to my mental health.

You can do that. You might not feel you can, but you can. Do not allow some bad actor to poison your case. Get that person away from you as soon as you can, act like they are carrying gasoline and a matchbook ready to set you on fire, because that is exactly what they are going to do to your case and your treatment. Protect yourself.

The Importance of Medication for C-PTSD

When I first got to my latest facility I lucked out getting a former military member with PTSD. At the time I was on the medications, gabapentin, amitriptyline, prazosin, and marijuana. While we were doing my intake I got to run down the meds and when he heard my current scripts he smiled.

“You know. That’s what I am on. PTSD?” He says.

“Yeah. I didn’t serve though,” I felt the need to mention.

“That doesn’t matter, you can get trauma for a lot of things, do not let anyone dismiss you for having a different reason for it, it’s none of their business. Those pills help a lot for PTSD, I know people I served with who are also on the same and the combination really helped their condition over time. It lets you get a handle on everything,”

*le me in tears feeling seen*

“Are you okay?”

“Yeah. It is just really nice to have someone who understands and actually knows what I am going through.”

He hugged me and it was something I had needed for months. We talked about the marijuana use, and he too as well as his fellows with PTSD all use from one degree to another. It helps with the dreams and it lets you sleep through the night.

I talked with him about how much I work to be predictive, but it isn’t immediately financially helpful so my family sees it as a waste of time.

“They don’t see your effort as work. Fuck ‘em. Don’t let them make you feel less. You are doing what you can and you need to be proud of yourself for that. I’m proud of you for that.”

You are likely going to have to experiment with your meds, I have not spoken to a single person that got a mental health medication that made everything better on the first try. Gabapetin was originally given to me in college for my anxiety. It works. It gave me a calm. It worked well, for a while.

My list goes:

Gabapentin: Gel capsules not tablets/Tablets take longer to metabolize, longtime use causes fogginess.

Buspirone: The jolts

Xanax: Rapid heart rate

Risperidone: Killed sex drive

Rexulti: Made anxiety worse and rapid heart rate

Fanapt: Tingling and jolts

Prazosin: Alone gives me heartburn / Fine with Amitriptyline

Amitriptyline: Alone gives me insomnia / Fine with Prazosin

Wellbutrin: Energy is a little better

We have talked about marijuana enough, you know what it does for me. Make a list. You are going to need it. The drug, the beginning of use, the effects, and the side-effects. You want to be able to tell your prescriber the whole gamut. You need to be able to tell them what you have used so you don’t cover the same ground. If you forget, as I did, you might have to try something a second time and with the jolts, that is not something you want to deal with twice. My prescriber had no idea what the jolts were, she just looked at me like she was terrified and told me not to continue the use. For clarification, the jolts felt like this; I would take the tiny little pill. Within about twenty minutes I would feel a charge of energy building up at the base of my skull and then it would begin surging through my body up and down my nerves in waves for about a half hour. This is one of those rare but serious side-effects. Now, that was supposed to be helping me with my anxiety. Nothing says “everything is fine” like feeling wave after wave of electrical charges flowing through your body.