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 Post subject: ptsd
PostPosted: Sun Oct 27, 2013 11:26 am 
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Joined: Thu Nov 01, 2012 10:52 pm
Posts: 50
Location: maryland
Does anyone know if post tramadic stress disorder can cause incontinence


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 Post subject: Re: ptsd
PostPosted: Sun Oct 27, 2013 1:52 pm 
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Joined: Wed Jan 06, 2010 4:59 am
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Location: Scotland
It certainly seems to be linked in women. I can't find anything on men though.


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 Post subject: Re: ptsd
PostPosted: Mon Aug 11, 2014 7:23 am 
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Joined: Mon Jul 28, 2014 7:49 am
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Location: MA
PTSD is most commonly associated with combat experience, but the term can apply to stress caused by any mental or physical trauma, as I understand it. I have been diagnosed with PTSD due to severe teenage sexual abuse by a priest, and I am mostly incontinent as well. It appears that the physical nature of the abuse and its damage to my urinary tract "caused" my daily incontinence, but the PTSD-induced flashbacks/nightmares result in sudden, total flooding, most often at night. Abena M4s, a booster pad, with Gary Active wear pants, bed pad and mattress protector are necessary every night. I know that many of the members here require similar protection so I am in good company.

I have been dealing with this for decades and the incontinence has worsened, especially after a prostate procedure. The flashbacks and nightmares are as vivid as ever, in spite of lots of "talk" with various professionals.


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 Post subject: Re: ptsd
PostPosted: Mon Aug 11, 2014 3:16 pm 
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PTSD (Posttraumatic Stress Disorder) was originally developed as a diagnosis by the American Psychiatric Association to assist in the treatment of soldiers who were returning home from active duty and presenting with a specific cluster of symptoms (extreme anxiety, re-experiencing of the original trauma in dreams, intrusive thoughts and flashbacks, feelings of hyper-arousal out in public and open spaces, etc., etc.). In WWII it was called "shell shock", then in Korea it was called "combat fatigue" and it was the Vietnam Veterans who led to the PTSD moniker for the same cluster of symptoms. However, this diagnosis is also regularly applied to any individual who experiences a significant trauma where they experienced the fear of death or dying, witnessed others who may be vulnerable to death/dying and where the above symptoms are clearly present. As a Psychologist, I see people from all walks of life who present with PTSD from things such as childhood physical, sexual, emotional abuse, rape survivors, accident survivors, natural disaster survivors and so on.

As far as incontinence and PTSD together are concerned, I don't know that there is much good literature out there linking the two. What I do know is that some of the medications used in the treatment of PTSD, anxiety disorders and depressive disorders often list incontinence as a potential side effect of the medications. I've had a few clients tell me that that they stopped taking medication because of this side effect and once it was out of their system, the incontinence went away. I also would have no trouble believing that an episode of re-experiencing a trauma (either through a dream, intrusive thought or a flashback) could be so intense that a person could lose continence unexpectedly during the re-experiencing episode, and especially at night when not fully awake. I also believe that many other mental health problems besides PTSD can be significant enough to lead to incontinence issues regardless of the medications that may or may not being prescribed.

CJ


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 Post subject: Re: ptsd
PostPosted: Mon Aug 11, 2014 7:34 pm 
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Joined: Sat Mar 29, 2014 11:45 am
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CJ,

Your expertise makes you an invaluable asset to our community.

Thank you.


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 Post subject: Re: ptsd
PostPosted: Mon Aug 11, 2014 11:41 pm 
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CJ, what are your thoughts on incontinence as a focal symptom of a conversion disorder.

Not to get too far off topic, but I'm curious, and it would seem the likely mechanism for PTSD induced incontinence.


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 Post subject: Re: ptsd
PostPosted: Tue Aug 12, 2014 12:57 pm 
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Patrick, thank you for the compliment. I view you and the other posters on this forum an asset as well. You all certainly have been helpful to me. I'm happy to pay it back or pay it forward when I can.

MSUSpartan, that's a great question. For folks reading this thread, a conversion disorder occurs any time the brain doesn't quite know how to handle an emotional or psychological stressor and winds up producing a very real physical response or symptom(s) as a result. Please note that these are REAL, non-manufactured symptoms that the person has no actual or intentional control over. This makes a conversion disorder different from something like malingering where the person is intentionally producing physical symptoms for some sort of secondary gain (i.e. disability claim, get out of something unpleasant, etc.). Incontinence could in my mind easily be a conversion related symptom/disorder secondary to the onset of PTSD in any individual. If you think about it, we see it in healthy typically developing children all the time. When a young person encounters some sort of emotional trauma, they may "regress" (I hate that word) or lose developmental ground for a bit and have continence issues during the night and even during the day. In kids, it might take the birth of a sibling, changing schools or some other emotional trauma that the child lacks the full comprehension to deal with (which is why these things are traumatic to kids but less so for adults). In an adult, a significant emotional trauma could easily produce any number of physical symptoms (i.e. blindness, deafness, mutism, paralysis, incontinence, etc., etc.) that would be an indication that the mind is having trouble assimilating this new experience into the person's consciousness, awareness, identity and so on.

For me to think I was working with someone who had a conversion disorder, I would still want to rule out any other possible physical causes which better account for the symptom(s) that are present. In the absence of a clear physical cause, a conversion disorder diagnosis may begin to make sense and I would likely suspect some sort of traumatic incident to be the trigger for the new symptoms. If the symptom clears up in the course of our therapy, that's also a good indication that the symptom was conversion-related rather than a pure physical change or abnormality. These are touchy subjects for many people because I would never want to come close to sounding like I was accusing the person of "faking" or being a hypochondriac. My worry is that some doctors, certainly not all, may not look hard enough initially for a cause and then tell the patient "It's all in your head". If it's a conversion disorder, it's not all in your head and it doesn't mean you don't look for possible physical connections.

CJ


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 Post subject: Re: ptsd
PostPosted: Tue Aug 12, 2014 1:16 pm 
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Location: Scotland
That's a very interesting post, CJinNM. You have a very good point about diagnosis here. Doctors are often unwilling to have all the tests done to rule physical causes out as some aren't even very pleasant. There was someone else on the forum the other week who had been told he had secondary enuresis but without and investigations. The doctor could be right but no one will ever know if tests are carried out.

Have you any tips for people to push for proper investigations to be carried out? (In my case I had a whole week of tests in hospital before my MS really got going but that was more the 390 years ago - before MRI scans.)


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 Post subject: Re: ptsd
PostPosted: Tue Aug 12, 2014 5:12 pm 
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CJ, that was my thought exactly. In children they refer to it as regression, probably because they are temporally close to the age of first continence. But why should it be any different in adults? Adults generally have better coping mechanisms, bit given a sufficiently bad trauma the result could be the same.

Wheels, that recent user that described the building fire, and losing his cats, as precipitating his secondary enuresis was the most recent example that brought this back to the forefront of my mind. The lack of an obvious organic cause made me wonder about a conversion type issue.


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 Post subject: Re: ptsd
PostPosted: Wed Aug 13, 2014 9:48 am 
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Location: MA
CJ
Thanks for your explanation of PTSD and your insights. It's great to have you jumping in here from time to time.


Fran


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