Wednesday, 20 January 2010

Depression or Personality Disorder?

I've never really been told/given a diagnosis. The closest i came was when i asked Dr L as to what i should put on a form when i had to reapply for my driving licence after the 'accident' - She told me to say "recurrent depressive disorder" but that was 3 years ago. I know things have changed as i've matured.

I no longer get attached & latch on to the most inappropriate relationships such as tutors, receptionists & nurses etc. I may struggle mentally but i think before i act and don't do silly things like hand deliver letters to their houses....... (i was about 15 at that time!). I no longer OD or harm just because i'm distressed and then go and get someone to patch me up, unless i've totally lost control or i don't have the specialist equipment needed to treat myself (or it may need surgery, as with the burn - which may finally be healed over by the end of january). I'm no longer the manipulative naive desperate teenager but i still feel very confused about myself & life.

I'm not sure having a diagnosis would solve things (i'm sure it wouldn't) and i'm not even sure it would help in the slightest but it does feel like yet another thing playing on my mind. Perhaps i've been reading too many other mental health blogs, but i feel i'm becoming slightly obsessed that i will be labelled with BPD or some other no descript. Maybe i think that it would mean that the depression i feel so strongly would be overlooked. K always puts 'severe depression' in the diagnosis box on her computer (plus previously anorexia) and although personally i would pay more attention & trust wwhat she says, i know that a GP's opinion is not sufficient for some.

I find myself doing those (possibly pointless) online tests and quizzes for personality disorders. This mornings results are as follows for a personality disorder quiz:

Paranoid Disorder:Moderate
Schizoid Disorder:Moderate
Schizotypal Disorder:Low
Antisocial Disorder:Low
Borderline Disorder:Moderate
Histrionic Disorder:High
Narcissistic Disorder:Moderate
Avoidant Disorder:High
Dependent Disorder:High
Obsessive-Compulsive Disorder:Moderate

-- Personality Disorder Test - Take It! --
-- Personality Disorders --

Do i pay any attention? or do i try a depression test instead?

I suppose what i want to know is, is it simply depression? depression that is worth trying to treat or where treatment is futile & ongoing for the rest on my life? Or is it a personality disorder where i was simply born screwed up & am destined to be forever?

The major, more important point thought - Would a diagnosis/label be of any help/use?

6 people had something to say about this:

chaosandcontrol said...

What does a label achieve? Labels can be helpful if they open doors to treatment. Very simplistically, a diagnosis of depression could lead to a prescription for antidepressants and counselling. A diagnosis of a personality disorder could lead to a referral to a complex needs service and if appropriate, say, attendance at a therapeutic community.

I can only speak from my experience and I believe that in my area, to be diagnosed with a personality disorder the disordered behaviour needs to have been present and observed by the mental health services for a minimum of 5 years. The psychiatrist would take a life history from the client/patient/service user etc. Ideally a close relative would provide an equally comprehensive history of the patient too.

A diagnosis/label can be a source of relief and frustration. e.g. a patient is diagnosed with irritable bowel syndrome. “Excellent” thinks the patient.. “My illness has a name; it must be curable, right?” No, not necessarily. The diagnosis of IBS simply means there’s no underlying organic illness and the patient meets the criteria for a particular collection of symptoms. Treatment varies and the vast number of IBS support groups out there shows that prolonged remission of symptoms isn’t always achievable.

It's the way we respond to the labels that matters. Writing in the margins of my mind put better than I could when they said “a personality disorder doesn’t have to be a life sentence.”

cbtish said...

I agree with LittleFeet (chaosandcontrol) — a diagnostic label is only useful if it opens a door to effective treatment. There certainly are effective treatments for personality disorders (though it can be difficult to get referred for effective treatment). I don't know where the 5 years comes from, though. An experienced professional will be able to identify a personality disorder in a few sessions, just one session if it's severe.

Online quizzes certainly cannot identify personality disorders, which are essentially disorders of interpersonal relationships.

Susie said...

Thank you both.

Littlefeet - well i've had the antidepressants, counselling, referal to a theraptic community..... not sure about the complex needs service, never heard of one in this area.

I'm not sure i necessarilly want a diagnosis, it just seems to be playing on my mind and i know it won't provide a cure or an answer to everything.

CBTish - i know those quizzes are ridiculous, i expect if i went through as many as i could find online, they would all provide me with different results!

Bippidee said...

I agree with the other comments that diagnoses have limited value. However, if you were to be diagnosed with a PD it would not mean that you are destined to be screwed up forever. BPD is now considered to be a treatable mental illness, and the NICE guidelines state that a BPD diagnosis cannot be used as an exclusion for treatment in any way. It is also possible to have co-morbid BPD and Clinical Depression - one does not rule out the other. But to be honest I wouldn't worry too much about diagnosis. I was given the BPD diagnosis after asking for a reassessment following some evil bitch psychologist who hated me labelling me as Narcissistic, which everyone else thought was ridiculously off the mark, but unless you have some reason for particularly wanting a diagnosis, such as applying for benefits, or feeling your current diagnosis is inaccurate or something, I don't think it is worth it. It wouldn't change the treatment you are being offered. Oh, and I did that quiz out of curiosity and got Very High for Borderline, High for Avoidant and Dependent, Moderate for Paranoid, Histrionic and Obsessive Compulsive, and Low for all the rest. Given that my diagnosis is BPD, and I know I have issues with dependency and anxiety etc, and that they are the 3 my results were Very High and High for, it seems relatively accurate, but obviously none of these tests are a diagnosis.

Lola Snow said...

*grins* I got:

Paranoid: Moderate
Schizoid: High
Schizotypal: Moderate
Antisocial: High
Borderline: Moderate
Histrionic: High
Narcissistic: High
Avoidant: High
Dependent: Moderate
Obsessive-Compulsive: High

But due to my crackingly low self-esteem and conviction that I am the epitome of every last undesirable or complicated trait in the universe and totally incapable of getting on with anyone, I tend to percieve my behaviour as a bit extreme. According to most of the world I am actually quite nice to get on with, if not a little troubled.

I don't think labels help, unless they get you treatment and support, which in the case of PD's doesn't seem to always be the case, unless you are very lucky or very tenacious. Susie, I think you are lovely, and if anything makes someone feel lacking in something and searching for something, it's too much searching. I don't have the answers, but don't think they are findable in the ICD-10

Lola x

Lola x

Susie said...

Oh dear. Have i put bad ideas into people's heads? Please tell me you know that these tests are a load of crap. In fact sometimes i think, with the range of diagnoses and variations from shrink to shrink, that the whole mental health system is a load of crap.

Thank you for your kind comments, which i think confirm your statement regarding how you percieve your own actions and behaviour.

Much love to you all.

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