Friday, 29 January 2010

I've Been labelled.....

I saw it there in black and white:

"Borderline Personality Disorder"

So i'm not depressed then?

"According to DSM-IV, the diagnostic manual from American Psychiatric Association, criteria used by mental health professionals, you have Major Depressive Disorder if:

*You have had an episode of depression lasting at least two weeks with at least five of the following symptoms:
(1) You are depressed, sad, blue, tearful. yes
(2) You have lost interest or pleasure in things you previously liked to do. yes
(3) Your appetite is much less or much greater than usual and you have lost or gained weight. yes - my weight continues to rise
(4) You have a lot of trouble sleeping or sleep too much. i sleep 9-10 hours every night
(5) You are so agitated, restless, or slowed down that others have begun to notice.
(6) You are tired and have no energy. yes, i could go to up to bed to sleep right now (its 11.30am)
(7) You feel worthless or excessively guilty about things you have done or not done. does feeling this way about the last 10 years count?
(8) You have trouble concentrating, thinking clearly, or making decisions. yes, & i've offered to do the grocery shopping later, decision making hell! but thats because i feel guilty about being me etc etc
(9) You feel you would be better off dead or have thoughts about killing yourself.
if it wasn't going to destroy my family once and for all......
*These symptoms are severe enough to upset your daily routine, or to seriously impair your work, or to interfere with your relationships.

*The depression does not have a specific cause like alcohol, drugs, medication side effect, or physical illness.

*Your depression is not just a normal reaction to the death of a loved one."

I feel like no-one believes me. Just because no-one sees me all day, no-one sees the tears - what do i have to do for them to believe me? If i reacted by harming of ODing that would just cause them to adhere the BPD label even further. But i'm not, i may have thought about it but instead i'm sat on the sofa sobbing my heart out.

Theraputic Community was mentioned again and it seems ultimately that is the punishment for the last 10 years. Send me away to live among a group of people, stop me from seeing my family, probably feed me crap food that will cause me to get even fatter, especially as i won't have access to the gym. They want to have a meeting between me, mum, D, Dr L and this psychotherapist to discuss whatever.......i don't know, i've had enough of seeing them all. I'll go along to keep them happy, otherwise i will just be accussed of being obstanate.

I'm not saying BPD doesn't apply at all.

"The DSM-IV gives these nine criteria; a diagnosis requires that the subject present with at least five of these."

Traits involving emotions: Quite frequently people with BPD have a very hard time controlling their emotions.
1. Shifts in mood lasting only a few hours. My moods don't change that quickly

2. Anger that is inappropriate, intense or uncontrollable. I rarely get angry, and i generally think its justified - like going to see people that i really don't want to see!

Traits involving behavior:
3. Self-destructive acts, such as self-mutilation or suicidal threats and gestures that happen more than once yes, but certainly not as frequent as when i was younger.

4. Two potentially self-damaging impulsive behaviors. These could include alcohol and other drug abuse, compulsive spending, gambling, eating disorders, shoplifting, reckless driving, compulsive sexual behavior. Only one there was the eating disorder, and that started as more of a self harm/destructive act.

Traits involving identity
5. Marked, persistent identity disturbance shown by uncertainty in at least two areas. These areas can include self-image, sexual orientation, career choice or other long-term goals, friendships, values. People with BPD may not feel like they know who they are, or what they think, or what their opinions are, or what religion they should be. yes i have uncertainty as to long term career/goals but when you have few qualifications yet would like to do something more than work in Tescos, wouldn't you? (am i trying to justify my way out of this one?). But i know my opinions, who i am, what i think, and i KNOW i don't believe in religion - i'll respect others who do, but i know its not for me.

6. Chronic feelings of emptiness or boredom. Doesn't some of that emptiness refer back to depression? I don't have the energy to waste on feeling bored anyway.

Traits involving relationships
7. Unstable, chaotic intense relationships characterized by splitting (see below).
8. Frantic efforts to avoid real or imagined abandonment

*Splitting: the self and others are viewed as "all good" or "all bad." Someone with BPD said, "One day I would think my doctor was the best and I loved her, but if she challenged me in any way I hated her. There was no middle ground as in like. In my world, people were either the best or the worst. I couldn't understand the concept of middle ground."
*Alternating clinging and distancing behaviors (I Hate You, Don't Leave Me). Sometimes you want to be close to someone. But when you get close it feels TOO close and you feel like you have to get some space. This happens often. In my mind maybe but i keep it in my mind. Although i have been keeping away from K and J for reasons like this even if i haven't shared that with them.
*Great difficulty trusting people and themselves. Early trust may have been shattered by people who were close to you. If trust issues have been shattered early on then surely loads of people have trust issues?
*Sensitivity to criticism or rejection. You're not human if you don't feel this to some degree!
*Feeling of "needing" someone else to survive I wouldn't say i NEED anyone, like may be easier with some people though
*Heavy need for affection and reassurance Reassurance maybe but not affection anymore
*Some people with BPD may have an unusually high degree of interpersonal sensitivity, insight and empathy FFS! people think your fucked up if you can't empathise with people most of the time. I'm constantly told that insight is a good thing!!
9. Transient, stress-related paranoid ideation or severe dissociative symptoms

This means feeling "out of it," or not being able to remember what you said or did. This mostly happens in times of severe stress.
Only happens very very rarely, maybe a handful of occassions over the last 10 years.

And anyway, this is the second time Dr L has seen me after a 3 year gap - How the hell can she slap a label on me that quickly when i've changed so much in the last 3 and a half years!

Perhaps i should have entitled this post "How to make Susie angry and dislike you"

3 people had something to say about this:

Bippidee said...

Just for the record, you can have co-morbid Depression and BPD, I do. One doesn't rule out the other. Personally I am kind of jealous that you are being offered a Theraputic Community - I would genuinely jump at the opportunity for that kind of treatment. They really do help people, and that is the one thing left that I think could make a difference to me. I know being labelled is horrible, but it doesn't make your Depression any less valid. xxx

cbtish said...

Lists of symptoms or traits are not much better than online quizzes for making a diagnosis. However, an experienced professional can sometimes make an accurate diagnosis quite quickly. Even if Dr L has jumped to the wrong conclusion, assessing you at greater length might do nothing to change her mind.

As I've written before, the important thing is the treatment you receive, not the label. If you are willing to give a therapeutic community a try to keep them happy, it might be an interesting experiment. But it's possible you have other options, too. What kind of treatment do you think would be the most helpful, if it were entirely up to you?

Susie said...

Bippidee - i don't mean to sound ungrateful when i say i'm not keen on a TC, having now been offered this possibly for the 3rd time. But there just seen to be to many cons, compared to the pros of that option.

CBTish - i'm not even sure i could try that one to keep everyone else happy. It feels like i would be losing everything in my life if i had to leave for a year.

I will perhaps write more but once again, i can't even think about the subject with out geting very emotional & tearful - and with mum and D in the same room right now, i can't afford that to happen.

But thank you for your comments.

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