Semi-diagnosed: Discussing "Borderline Personality Traits" and "PTSD Symptoms"

Is being diagnosed with "Borderline Personality traits" and "PTSD-like symptoms" enough to entitle you to support for trauma-related mental health issues?  

And I mean, if these are actually your main mental health problems, along with depression?

Why is it that it still doesn't feel as though I have been properly diagnosed with anything in this area?

And why is my OCD not "OCD-like symptoms"? There are so many aspects of OCD that simply aren't relevant to me.

It's so confusing. Why is it made so ridiculously hard to get the help that you need?

My Mental Health Diagnosis: Personal "Non-Assessment Appointment" Story

Finally, I am going to attempt to write this blog post. If you are reading this and haven't read my previous post regarding my mental health diagnosis, you might be interested in checking that out, as it gives more background about the situation which I am describing here.

Anyway, basically I have been trying, for some time, to persuade the mental health professionals to review my diagnosis. 

I had been under the impression that this was going to happen, and that I was going to be assessed for Borderline Personality Disorder, but this did not occur. 

The appointment with my psychiatrist and Community Psychiatric Nurse did take place, but we barely touched on the subject of BPD, and only then because I mentioned it, as they appeared to have no intention of doing so. 

They were more interested in discussing my OCD, as per usual, and trying to "push" medication at me. 

One pill suggested would make me gain weight - been there with that particular side-effect - and the other would cause diarrhoea, which is also not helpful, when you suffer, as I do, from IBS. However, I do give more details about this appointment in my previous post, so I won't ramble about it too much here.

As mentioned in my previous post, I did put my concerns into writing. 

When I eventually managed to get through to my CPN by telephone, she was extremely unhelpful, and gave me to understand that I was diagnosed with nothing more than depression, anxiety, OCD and "PTSD-like symptoms".

She said that she was "not prepared to discuss the diagnosis further", but did tell me that the psychiatrist would write to me and enclose a copy of the letter which had been sent to my GP. 

I did specifically ask her whether my agoraphobia diagnosis had also been removed, and she told me that I did not have agoraphobia because "you do go out". 

I currently go out on as many days as I can, although I remain very close to my flat.  However, I don't feel that it's necessarily helpful to take away someone's agoraphobia diagnosis the moment that the person is just about able to leave his or her home. 

I will probably write another blog post about my agoraphobia, or agoraphobic tendencies, as I feel that this subject needs more "space", in order for me to discuss it fully. I must admit that it is a little complicated, as my not going out much relates to my physical, as well as mental, health.

I did actually have two telephone conversations with the nurse, on the same afternoon, and the second felt more positive and constructive than the first, but I still did not entirely know what to expect from the letters which the psychiatrist would be sending. I could only wait.

Well, the letters arrived and, to be honest, it was not as bad as I had thought, or would have expected based upon what I had been told by my CPN, particularly during that first conversation. 

The psychiatrist seemed to have understood most of the points made during our interview, although there were still a few misconceptions, about which I know that I should write another letter, just to make matters a little clearer. I have lacked the motivation, so far, to do this, although I know that it is in my own best interests to do so. 

My official diagnosis now is recurrent depressive disorder, anxiety, OCD, Borderline Personality traits, and Post Traumatic symptoms, with panic attacks and depersonalisation. 

Although this does not cover everything, it is an improvement, and at least I have it in black and white, so that a week, year or decade later, they cannot change the words around and deny that the original ones were ever said at all, as has so often happened in the past.

I would recommend that anyone who has queries about his or her mental health diagnosis, or any aspect of treatment, should put these concerns into writing. That way, your letter has to be both answered at the time, and added to your medical files for future reference.

Thank you for reading this post. Please also check out my poetry site or/and my Facebook poetry page.

Getting My Mental Health Diagnosis Reviewed on the NHS: Failed Attempt

I am as ready as I will ever be to discuss this subject on my blog. I have been trying, for some time, to have my mental health diagnosis adjusted, as I do not feel that my current diagnosis covers many of my major issues.

Unfortunately, when I finally had an interview with a psychiatrist, who is new to our local mental health centre, and my CPN (Community Psychiatric Nurse), they did not assess me for the criteria of BPD, as I had been expecting. 

I was asked more questions about OCD, with which I am already diagnosed, than BPD. They contradicted themselves more than once. My CPN talked one moment as if I had been diagnosed with PTSD all along. The next moment, I had "PTSD-like symptoms". 

The psychiatrist said that there had "never been any question of" BPD, and then changed this to "might have Borderline features". They were so inconsistent. 

Also, the nurse ridiculed me, with a dismissive one-liner: "I think Paula read something on the internet." 

I have been researching BPD for some time now, both online and offline, and through talking to others who have the diagnosis. To imply that I might have "self-diagnosed", as they like to call it, on the basis of some vague comment online, is patronising and totally inaccurate.

I meet almost all of the criteria for BPD, but I seem to be a "quiet Borderline" or "introverted subtype". I tend not to exhibit extreme behaviour, and am more likely to turn my pain and anger inwards. 

I am also older than most people would be when they are diagnosed with BPD, and it would probably be embarrassing for them to admit that I might have had the condition all along, and they didn't even notice. 

Yet, I have symptoms which are not covered by my existing diagnosis, and it is obvious to me that a diagnosis of BPD should at least be properly considered.

It's all very well for people to say that it's wrong to "self-diagnose", but what are we supposed to do, when they won't even take us seriously and go through the criteria with us - having promised to assess us for an illness, for which we meet the criteria? 

I am sure that, if I went to a GP and asked to be assessed for diabetes, he or she would ask about my symptoms and then do the relevant blood tests, as opposed to simply demanding whether I had read about the condition online. At the end of the day, is the source of my information that important? Surely it is more important to ensure that patients receive an accurate diagnosis?  

(2018 inserted update: Things got much worse than any of this indicates, with the CPN in question, and my life was put at risk when I was actively suicidal, and also self-harming.  I no longer even try to get help from the mental health "services".  But I now have serious physical health and dental problems that did not exist then, as well as the same ones health issues I had before.  The NHS is a mess, and the treatment many of us receive is completely unacceptable.  They don't care whether most of us live or die, as we are only "stats" to them.  Original post to resume...)

I have put my concerns in writing, so I shall have to wait and see what comes of this. Thank you for reading this post. Please also check out my Facebook poetry page and poetry website. 

Maladaptive Daydreaming and Dissociation

I have just discovered the term "maladaptive daydreaming", and I feel overwhelmed. I cannot believe that I have never heard of it before, as this is something to which I totally relate. 

I first heard the term in relation to Dissociative Identity Disorder, which I don't have, although I do experience dissociation, and many aspects of DID overlap with my own mental health issues. I have now done a search on Google, and there are people discussing "Maladaptive Daydreaming Disorder" or "MDD", although it appears that this is probably not yet an official diagnostic category.
 

I have been trying to piece together my own jigsaw, due to the lack of interest and support from the mental health team, none of whom will even seriously discuss my depression with me, since changing my "primary diagnosis" to OCD. I know that they often resent my attempts to investigate my own mental health, and to learn about mental health disorders in general, but I only want some answers, and to find out what is going on with myself. 

I am also interested in finding out about different mental illnesses, so that I am in a better position to help and understand others. 

I am so fed-up with hearing that people shouldn't "self-diagnose", with either physical or mental health problems. I wouldn't even be diagnosed with dyspraxia had I not first "self-diagnosed", later having the diagnosis confirmed by professionals. Self-diagnosis can be dangerous, but so can just "going along with" what you know to be an inaccurate or incomplete diagnosis.

Anyway, I am going to research "maladaptive daydreaming" some more. I don't feel ready to explain it yet, as I am only just discovering about it myself, although believe me, it is nothing new that I am hearing about. The only aspect that has come as a shock to me is that there is actually a name for something which I have experienced since childhood.

Chronic Moderate to Severe Depression

I would like to discuss some questions and feelings that I have about depression - in general and also relating to my own experience of depression.

First of all, I would like to clarify that I have always suffered from depression - for as long as I can remember. I remember having these feelings as a small child of two or three years old. Often when I tell people this, they simply refuse to believe me. The next question is always whether or not it was diagnosed. No, I was not diagnosed with depression at two years old, but I know that I have always had the feelings of depression. 

When I was around eight years old, my mother told me that I mustn't pull the bed covers right over me, as I could suffocate and die. I had apparently done this unknowingly. After this, I deliberately tried to do the same, but it didn't work, because she always checked on me at night. I don't know if it could really have worked anyway, but it has always stayed in my memory, as this shows how young I was when I actually started to have suicidal thoughts and feelings.

In the process of researching the subject of this blog post online, I have come across more information, which is of interest, and may to some degree, be the answer to some of my questions. My concern has been that most information given about depression, in books and online, describes two specific types of depression: major depressive episodes, and dysthymia, with the latter term basically referring to chronic mild depression. To me, this simply fails to address the fact that depression can often be both chronic and moderate or severe. 

Even the fact that "double depression" is occasionally acknowledged - episodes of major depression, occurring in those already suffering from chronic depressive disorders - doesn't entirely cover what I am talking about, although it's a start, and I certainly wish that double depression was more frequently mentioned. However, I have to say that I have now come across the term "persistent depressive disorder", which does seem to make more allowances for longer-term cases of major depression. This term apparently came into use in May 2013, although this appears to be in the USA. I don't know if this term is current here in the UK and elsewhere, although I am hoping that it is.

I have to say that I don't find that the distinction between mild, moderate and severe depression is always appropriate. If you suffer from mood swings as I do, it is actually possible to make the transition rapidly from mild depression, which could easily be missed altogether, and which can often be "covered up", to being literally suicidal. Dramatic mood swings are a well-known feature of bipolar disorder, but they also occur in unipolar depression, particularly when someone has Borderline Personality Disorder, or BPD features. 

My own mood swings would be between my "normal" (for me) state, and severely depressed or/and angry or/and agitated or/and panicky. They occur more frequently just before, during, or just after my period, but happen enough at other times to mean that they can't be attributed entirely to my menstrual cycle. Sometimes, the mood changes are very sudden. Since I do not get "highs", I do not consider that my mood swings relate to bipolar disorder, although it's true that the distinction between unipolar depression and bipolar disorder is not always as clear as is often imagined, especially when considering forms of bipolar such as cyclothymia. 

By the way, with regard to BPD - I am not currently diagnosed with this, but I am trying to get my diagnosis reviewed. However, that subject would require a blog post of its own, which I may consider writing in the future.

I do get frustrated, to say the least, by talk of "serious mental illness", which somehow excludes depression. Severe depression can actually be classed as a serious mental illness, and it is a misconception that it is not. 

Also, I think that there should be more recognition for the specific struggles of people suffering from both depression and anxiety. It is not easy to live with either depression or anxiety, but to suffer from both can be much more disabling than people often realise. I will talk more about anxiety disorders in a future post, and possibly cover the specific difficulties that many of us have when we deal with both anxiety and depression.

Thank you for reading. I do have several ideas for possible future posts, so watch this space. If you are struggling with depression, know that you are not alone, and there is always hope.