I am a survivor of Compound Military Sexual Trauma, meaning more than one workplace attack. I was raped a number of times by my Navy work center supervisor while the ship was at sea. I was raped again while stationed at a shore installation, and the men that raped me appear to have known each other.
As a result of these rapes, I began to suffer from and still suffer from persistent, extreme hyper-vigilance that is compounded with profound nightmares of the military rape. I have dissociative flashbacks, but I am often able to talk myself out of disassociation and into real time. Most of these symptoms are well managed most of the time. I suffer from sleeplessness and bouts of depression that are sometimes manageable. I avoid settings that remind me of the military; in fact, I avoided any contact with other veterans until a couple of years ago.
While in the Navy, I was prescribed Zoloft to treat my upset from being raped at sea. While I was on Zoloft, the second rapist stalked me for a few weeks and eventually pushed into my barracks room and raped me. I dissociated into a nearly manic state during that rape. My heart was pounding, and I felt a number of hyper sensations that I have trouble describing but that I understand can come from Zoloft, from being raped, or from a combination of these two.
My Navy psychiatrist diagnosed me in 1999 with Bipolar II Disorder. She told me that my flat affect and the fact that I had not been in combat indicated that I was suffering from Bipolar II Disorder. This diagnosis was made after three meetings, and there is no specification in the DSM-IV or IV-TR that before applying a DSM label, the treating professional needs to spend a significant amount of time with the patient and to consider what is actually causing her upset. I think that the Navy doctor’s diagnosis was lazy and inaccurate. Unfortunately the Navy doctor’s diagnosis influenced the VA doctor’s diagnosis.
In April of 2011, I went to the Department of Veterans Affairs Trauma Clinic in Washington, DC for help with the above problems. During my intake interview, I told the interviewer that, while in the Navy, I had been given a Bipolar II diagnosis after being raped in the Navy. The VA psychiatrist then diagnosed me with Bipolar II, telling me that my reported “Manic” reaction to Zoloft, along with the previous diagnosis of Bipolar II, implied Bipolar II rather than or in conjunction with the upsetting consequences of the rapes. She appears to have interpreted my having failed to fight off the attacker during the second rape not to the trauma of the rape but rather to my alleged Bipolar II Disorder. This would not have happened if Bipolar Disorder did not carry the weight of supposedly being a scientifically-grounded, serious mental illness. The DSM-IV criteria for Bipolar II Disorder do not include any indication of the importance of ruling out the kinds of causes for the problems I was having because of experiencing actual trauma. This is especially problematic, given that being raped would understandably cause serious changes in mood that could be fully explained by the assaults. Thus, the therapist assigning me the Bipolar II Disorder label was actually following DSM-IV requirements for that category.
I was prescribed medication for anxiety and offered pills for anything that I reported. I stated on several occasions that I would take some medication for anxiety and sleeplessness but did not want to take a “pill for every ailment.” I feel that I was treated as if I were ”difficult” for not wanting “drug therapy” and that this would not have been the case if I had not been labeled mentally ill.
A VA therapist other than the VA psychiatrist mentioned above dismissed me from a Cognitive Processing Therapy group, because she decided that I was not suffering from anything traumatic from my military service but rather from a Borderline Personality Disorder which she referred to as a “Foundational personality disturbance due to childhood abuse.”
This “Borderline Personality Disorder” diagnosis can limit benefits that would be available to me at the VA if I had been described as having been traumatized by events during my military service, which I certainly was. While the VA has independent budgetary incentives for diagnosing preexisting mental illness rather than service-related injury, it is the Manual’s recognition of “bipolar disorder” and other dubious labels which enables the denial of benefits to traumatized veterans. Moreover, legal redress is often foreclosed because reviewing courts themselves regard the Manual’s diagnostic pigeonholes as “authoritative,” holding that “the inclusion of bipolar disorder and depression in the [DSM] lends further support” to “the characterization of these disorders as mental conditions.” Michaels v. Equitable Life Assur. Soc’y., 305 Fed.Appx. 896, 908 (3rd Cir. 2009).
After being dismissed from the Military Sexual Trauma Clinic, I was afraid to accept treatment at the VA, because I was afraid that I would be billed for services for problems that, because of the Bipolar II label, were not considered service-connected, and I cannot afford to pay cash for VA services.
This problematic Borderline diagnosis could also threaten my federal security clearance and therefore my job. I could lose custody of my kids if I were declared emotionally unstable as the Borderline Personality Disorder label indicates. I may have lost benefits at the VA, which may result in a pricey bill for services from the VA. This type of “re-diagnosis” can help the VA circumnavigate the congressional mandate of treating all claims of Military Sexual Trauma.
I am fighting both the Bipolar II and the Borderline Personality Disorder diagnoses, and I am in treatment in another VA clinic at this time.
If Bipolar II Disorder and Borderline Personality Disorder were not so seriously lacking in solid scientific underpinnings, and if there had been clear warnings in the diagnostic manual about the importance of not assigning these labels when there are other obvious explanations for the patient’s behavior or moods that might be among the criteria, I would not have been given these labels and would not have suffered the significant harm that has come to me as a result of being psychiatrically diagnosed.
-My understandable reactions (mood and behavior) about the repeated sexual assaults were discounted or minimized by the focusing on my allegedly having Bipolar Disorder, and this was dehumanizing and otherwise upsetting.
-I was denied treatment on the grounds of allegedly having Borderline Personality Disorder.
-My refusal to take psychiatric drugs was pathologized because of my having received these two psychiatric diagnoses, rather than being regarded as a reasonable request from a person who was not mentally disordered.
-I have steered away from seeking services at the VA to which I would be entitled had I not been diagnosed with these two labels, because both of them imply that my upset was not service-connected but instead due to abnormalities in my brain or to chemical imbalances within me. Problems not classified as service-connected do not carry treatment that is covered by my VA benefits, so I would have to pay out of pocket. While seeking services at a VA currently, I may therefore end up having to pay for those services.
-Being diagnosed with Borderline Personality Disorder could cost me my security clearance and therefore my job, and this causes me intense apprehensiveness.
-Being diagnosed with Borderline Personality Disorder could result in my losing custody of my children, and this causes me intense apprehensiveness.
-I am concerned that I might be denied treatment again because of the two unwarranted “pre-existing conditions” with which I have been diagnosed.