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. 

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.