Analyse This

I realised that I haven't reported back from my Psychiatrist appointment the week before last. What with the most important day of the year (Halloween) following in quick succesion my mind was obviously taken up with higher matters!

 

The appointment went as well as an appointment discussing someone's broken mind can go. Helen came with me which was good as she can provide outside insight into behaviours I exhibit or things I saw that seem normal to me but are actually not!

 

We discussed how the OCD element of my problems has been ruling my life over the last few months. Helen pointed out that it all got really bad after the Shoreham disaster, I guess it completely threw me when something so important to me is affected in that way. I also mentioned the retirement of the Vulcan, expecting to be laughed at but as he pointed out it's a passion of mine so the OCD would 'go for' it. Ditto with my music OCDs and also my worrying about the bunnies.

 

My mood is still quite up and down - not helped by the OCD attacks so my mood stabiliser Lamotrigine has been increased to 300MG. I also need to go to my GP to get some Propranolol for the anxiety that then spills into OCD *adds to to do list*. He asked about my general behaviours and it turns out that I'm not very good at picking up or working within social queues and situations. As well as quickly flipping into being angry (shame I don't go giant and green, although I don't think purple shorts would suit me!) Which apparently is classic Borderline behaviour.

 

Me being me I completely forgot to ask about any of the therapies I researched and whether they're availble here, which I highly doubt to be honest. And also what the 'prognosis' is for getting myself under control and if it's at all possible. So I'm going to construct a letter and whizz it off to them in the next few days.

 

Here's hoping that the meds increase starts to have a positive effect, obviously aside from my weird night time hallucinations of a 'prescence' standing over me, it's lucky it's not a real ghost/alien/shadow person as it would seriously not want to face the wrath of Jen when her (already poor) sleep is distrubed!.

 

Love Jen

XxxX

To BPD, Or Not To BPD

Next Tuesday I have my 6 month follow-up with 'my' psychiatrist - sounds terribly important to claim to have a medical professional allocated to you no? I've had two previous appointments, one right at the end of last year and another back in April.

 

When I had my first appointment I went in assuming that I had either Bipolar II or Cyclothymia (the more rapid cycling less severe younger sibling to Bipolar if you will) and the associated anxieties with it. Firstly it was nice to have a psychiatrist who actually listened to me this time rather than the one two years previously who'd basically told me I was over-anxious, didn't fit into society and was unsure which medication to prescribe me because I was 'heavy' (I was a size 14 at the time - not sure what he'd make of my 16/18 self now!).

 

At the end of the appointment the Dr told me that he believed that I had a mixture of Obssessive Compulsive Disorder (OCD), Cyclothymia (as explained above) and Emotionally Unstable Personality Disorder (otherwise known as Borderline Personality Disorder or BPD). I was a little staggered as I guess I'd gone in with a set idea of what was wrong with me in my mind and had done plenty of reading up on Bipolar and it's symptoms and treatments. To my credit I fully took on board what the Dr had to say which for me is pretty good as I do have a habit of selectively remembering information and accidentally discarding things that don't seem relevant (luckily I did take Mum and Helen - especially when I managed to forget what I was supposed to do with my upped medication!).

 

I immediately mentally (no pun intended) disputed the OCD, I'm the messiest person known to man, rabbit or unicorn (the only thing I'm anal about are my CD shelves which are strictly arranged according to genre, with artists grouped together and a seperate stack of my most listened to albums - the Nirvana, 30STM, Lady GaGa albums along with MCR's greatest hits and the Top Gun soundtrack since you ask). But apparently some of my biggest anxious thoughts come under OCD in the way that I constantly ruminate on them, the thoughts spiral and I try to find ways to 'check' on them. So yes I have accepted the OCD 'thing' and maybe one day it'll even make me tidy and stop Helen wincing every time she comes in my room and sees the mess.

 

With the BPD I didn't want to accept it, I guess because it has nasty words like "emotionally unstable" and "personality" with it, it makes you feel like there's something really badly wrong with you as a person. In a way I've been disagreeing with it and fighting with it so to speak ever since. The books I've read use examples that don't seem to relate to me, the websites I've looked at just seem to paint a picture of horrible out of control people. There was even a website that I found when I was trying to research whether women with BPD should attempt to conceive or have children, just out of curiosity I hasten to add, 'supporting' men with ex-wives/girlfriends with BPD who have 'trapped' them into relationships by being pregnant or who are generally 'evil psychos'. Incidentally it would appear that pregnancy & BPD are not happy bedfellows going by various accounts I've read including one where the mother to be threatened to cut the baby out of her stomach!

 

So I've been almost trying to 'prove' that I don't have BPD so I don't have to face up to it in a way, I'm more than happy to tackle friends and families' problems head on and with great energy but when it comes to me I'm more of a head in the sand kinda gal. So this morning I've been taking advantage of having an office to myself and taking loads of online BPD tests to prove that I don't have it, irritatingly they've all come up that I have a definite BPD type mentality *damn* and that I should seek confirmation from a trained professional *double damn*.

 

This is a 'sample' one that I took on an American site (the Americans really do seem to have a far better handle on psychiatric diagnosis and treatments than we do) - it does seem to have been lifted from a foreign site (the sentence structures make me think it must be German - 6 years of study didn't go to waste!) so I'll keep it worded as it was - especially as some of it is quite comically written!

 

Basically you select from 0-3 to agree or disagree with the statements (0 is strongly disagree and 3 is strongly agree).

 

1. In my family there was substance abuse (alcohol, prescription drugs, narcotics,..) 
AND/OR
I'm a habitual or compulsive user of narcotic drugs / alcohol / prescription drugs /..

My selection - 0

 

2. It doesn't take much for me to fall into anger.

My selecton - 3

 

3. I still have the same goals and priorities for my life as I had 2-3 year ago, and I also have relatively clear objectives for the upcoming 3 years.

My selection - 2 - I've never really had any goal or priorities so this one was a little hard to answer

 

4. Sometimes I am falling into deep emotional holes (with feelings of anxiety or depression).

My selection - 3

 

5. With some people, I have a quite extreme relationship: I deeply love them, but they can also burn me up.

My selection - 1, I figure that 'burn me up' means annoy or upset me but then that's surely normal of any relationship between family or friends? Everyone winds other people up from time to time. Is human nature!

 

6. Sometimes I feel very lost and lonely, and this can be very hard to bear.

My score - 3

 

7. It is difficult for me to maintain stable and lasting friendships.

My score - 0

 

8.
I occasionally hurt myself on purpose 
AND/OR
I am prone for smaller or bigger accidents.

My score - 3 but I'm not sure if I should score myself extra for being clumsy??

 

9. Sometimes, I find myself in feelings of extreme, paralyzing boredom - although there would actually be enough for me to do.

My score - 2

 

10. "I know who I am." - This statement applies to me

My score -1

 

11. Sometimes I'm not sure about my sexual preferences or what direction it really takes me.

My score - 2

 

12. Mostly I find ways and means to achieve my goals. If necessary, I will help for a little.

My score - 1 - also possibly my favourite worded section of the test!

 

13. Due to psychological problems, I already had contacts with psychiatry (hospitalization, psychological or psychiatri assessment(s) etc.), or it has been recommended to me to see a psychiatrist or psychotherapist.

My score - 3

 

14. In my life, I occasionally had the feeling to to lose control over myself, to "lose it" or to "go ballistic".

My score - 2

 

15.
I have memories of sexual abuse or violence (very harsh punishments also count), eg by parents, relatives or other people) 
AND/OR
I was left in the lurch by my parents in early ages (eg, separation, given away for adoption, to child and youth homes, nonparental supervision, ...)

My score - an obvious 0! It does annoy me when people assume you must have been abused!

 

16. I'm often spending much more than I planned.

My score - 1 - I am shockingly well behaved! Especially now that my job pays far less than before.

 

17. I often get in intense anger, which in some cases can lead to brawls or fights.

My score -2 - it is closer to a 3 but I am able to control it and haven't actually punched anyone, even those irritating people that walk SO SLOWLY in a crowd and slow everyone down! I do often see myself decking them!

 

18. If I feel very bad, it can lead to such an extent that I am hurting myself (or at least announce to do it).

My score - 2

 

19. Sometimes I use actions or make decisions without thinking enough about the consequences.

My score -1

 

20. I am a person with severe mood swings.

My score - 3

 

21. I tend to "black and white painting", to statements as "that's so.."/"that isn't.." or "You/they always..."/"You/they never..." with no gray area - without closer considerations.

My score -3

 

22. When I talk to other people, it often happens that they find it difficult to follow my train of thought.

My score 3 - sorry guys! It all seems logical in my head! Perhaps my brain just works too fast for ya'll :P

 

23. I quickly lose my equilibrium when things go awry / different to what I expected.

My score - 2

 

24. I have already taken significantly more on a drug than prescribed.

My score - 0 - I bloody hate taking tablets so the thought of taking more than I need to actually makes me gag!

 

25. If I fall into anger, it takes some time, until I calm (or let someone calm myself).

My score -1

 

26. Some people say/said about me that I was manipulative and sneaky.

My score 0 - well I bloomin hope not!

 

27. Within the last 2 years, I had recurrent thoughts of suicide.

My score - 2

 

28.
When I'm alone, 
AND/OR
When I have nothing to do,
I easily get 'cabin fever' / start climbing the walls - boredom or the feeling of emptiness burden me above average.

My score - 2

 

29. Occasionally, I'm stealing something from stores.

My score - 0

 

30. There are periods when I tend to binge eating.

My score 3 - CHOC.O.LATE but I just thought that was being female!

 

31. I'm scared of being alone.

My score 1 - as it depends what mood I'm in

 

32. When I ought to write a three-page essay on what really matters to me in life, I would not think twice, and could immediately start to write.

My score - 2

 

33. I'm very afraid of being abandoned by the people I love.

My score - 2

 

34. If I am under extreme stress, I sometimes have an ominous feeling that I could 'crack up', to be swept off my feet, or to completely lose control of myself.

My score - 2

 

35.
I have broken many a time trainings, psychotherapy, medical treatment, school, etc., changed or lost my job more than average 
AND/OR
I have more broken relationships behind me than other people my age

My score -1 - purely 'cos I've had to leave 3 jobs due to them aggravating my condition/s

 

36.
Some of my friends, I sometimes wonder whether they really are the right ones for me 
AND/OR I often wonder whether my relationship partner is the right one for me.

My score - 0

 

37. Sometimes I'm extremely bored.

My score - 3

 

38. I find it not easy to empathize with other people.

My score - 0

 

39.
Sometimes I can't avoid the feeling that someone pursues me 
AND/OR Sometimes I have the feeling that certain parts of my body don't belong to me 
AND/OR Sometimes, I perceive things (visually or acoustically) of which I doubt that they are real.

My score - 0

 

40. I have fears (eg. of blushing, public speaking, of certain animals, from storms, fear of heights, from dirt, from spreading) that I just can't get rid of.

My score - 2 - as I figure this covers my OCDs

 

So let's assume that I'll finally take my diagnosis on board, I looked up the various treatments availible to help me cope with my problems and there are actually quite a few according to the Royal College Of Psychiatrists (so no weird quack remedies there).

 

We have -

 

Mentalisation Based Therapy (MBT) - combines group and individual therapy. It aims to help you better understand yourself and others by being more aware of what’s going on in your own head and in the minds of others. It is helpful in borderline personality disorder.

 

Dialectical Behaviour Therapy (DBT) – this uses a combination of cognitive and behavioural therapies, with some techniques from Zen Buddhism. It involves individual therapy and group therapy, and is helpful in borderline personality disorder.

 

Cognitive Behavioural Therapy (CBT) - a way to change unhelpful patterns of thinking. Been there, had about10000 sessions of it and didn't help one jot!

 

Schema Focused Therapy - a cognitive therapy that explores and changes collections of deep unhelpful beliefs. Again, it seems to be effective in borderline personality disorder. (Is that not CBT in disguise?)

 

Transference Focused Therapy - a structured treatment in which the therapist explores and changes unconscious processes. It seems to be effective in borderline personality disorder.

 

Dynamic Psychotherapy - looks at how past experiences affect present behaviour. It is similar to Transference Focused Therapy, but less structured.

 

Treatment in a therapeutic community – this is a place where people with long-standing emotional problems can go to (or sometimes stay) for several weeks or months. Most of the work is done in groups. People learn from getting on – or not getting on - with other people in the treatment group. It differs from 'real life' in that any disagreements or upsets happen in a safe place. People in treatment often have a lot of say over how the community runs. In the UK, it is more common now for this intensive treatment to be offered as a day programme, 5 days a week.

 

I've had a quick flick around google for any of these services in and around Eastbourne, I've found loads of Psychotherapists and Counsellors but none that seem to specialise in anything for BPD. So it's all very well accepting this diagnosis but what am I supposed to do about it when there are no services availible?

 

Did I say dammit?

 

Love Jen

XxxxX

Make That A OCD, Cyclothymia, Borderline Personality Disorder Cocktail Please!

Today I finally had my long awaited appointment with the Community Mental Health team and gained an insight into how the system should work. My previous experience with the team back in 2012 was a disaster as detailed here. What a world of difference today was. I immediately felt at ease with the Psychiatrist I saw. He listened to me, didn't interrupt and took his time gathering all the information I had to give. Mum and Helen came with me for support (thanks guys) and he included them in his questions and actively sought their input. He also had a very prettily patterned tea cup which always scores bonus points from me!

The upshot of the appointment is that I seem to cross into a few different diagnoses of different conditions, a mix and match if you will or a cocktail as I prefer to think of it (preferably with a large helping of gin or amaretto). So I've listed my 'conditions' below and highlighted the aspects I feel apply to me.

I've long-suspected (and it's been suggested to me on a number of occasions) that I have some form of OCD due to my weird anxieties.

It's symptoms are -

• obsession – where an unwanted, intrusive and often distressing thought, image or urge repeatedly enters your mind
• anxiety – the obsession provokes a feeling of intense anxiety or distress
• compulsion – repetitive behaviours or mental acts that you feel driven to perform as a result of the anxiety and distress caused by the obsession
• temporary relief – the compulsive behaviour brings temporary relief from anxiety, but the obsession and anxiety soon return, causing the cycle to begin again

Cyclothymia is a form of Bipolar but rather than more extended periods of 'highs' and 'lows' the cycles are much more rapid, from hour to hour even. It is also aggravated by stress (hi work) and can progress into more serious forms of Bipolar - such as proper mania which I have been lucky enough not to have experienced before. 

The final 'diagnosis' of Emotionally Unstable Personality Disorder (more commonly known as Borderline Personality Disorder) came as more of a surprise. I hadn't thought that my personality could be unstable rather than my brain chemicals. 

The symptom groups are - 

Emotional instability (a psychological term for this is affective dysregulation)

If you have BPD, you may experience a range of often intense negative emotions, such as:

• rage
• sorrow
• shame
• panic
• terror
• long-term feelings of emptiness and loneliness

Disturbed patterns of thinking or perception (psychological terms for these are cognitive or perceptual distortions)

• upsetting thoughts – such as thinking you are a terrible person or feeling you do not exist. You may not be sure of these thoughts and may seek reassurance that they are not true
• brief episodes of strange experiences – such as hearing voices outside your head for minutes at a time. These may often feel like instructions to harm yourself or others. You may or may not be certain whether these are real
• prolonged episodes of abnormal experiences – where you might experience both hallucinations (voices outside your head) or distressing beliefs that no one can talk you out of (such as believing your family are secretly trying to kill you). These types of beliefs may be psychotic (delusions), and a sign you are becoming more unwell; it is important to get help if you are struggling with delusions

Impulsive behaviour

• an impulse to self-harm – such as cutting your arms with razors or burning your skin with cigarettes; in severe cases, especially if you also feel intensely sad and depressed, this impulse can lead to feeling suicidal and you may attempt suicide
• a strong impulse to engage in reckless and irresponsible activities – such as binge drinking, drug abuse, going on a spending or gambling spree, or having unprotected sex with strangers; impulsive behaviours are especially dangerous when people are in brief psychotic states, because they may be more likely to act impulsively if their judgement is impaired.

Intense but unstable relationships with others

If you have BPD, you may feel that other people abandon you when you most need them or get too close and smother you.

When people fear abandonment, it can lead to feelings of intense anxiety and anger. They may make frantic efforts to prevent being left alone, such as:

• constantly texting or phoning a person
• suddenly calling that person in the middle of the night
• physically clinging on to that person and refusing to let go
• making threats to harm or kill themselves if that person ever leaves them

The only time I'd ever heard of BPD (as the cool kids call it) is in Susanna Kaysen's book Girl Interrupted and the film adapted from the book (one of my favorite films in fact). Starring Winona Ryder (apologies for an entirely superficial comment) and I love her cropped hair and striped top combination.

Angelina Jolie is amazing in it.

Admittedly if my condition ends up with me ccommitted like Susanna did I can think of worse people to be locked up with ...

And of course in the film Susanna's boyfriend who tries to break her out of the hospital is played by none other than Jared Leto ...

Being busted out of hospital by the lead singer of my favorite band is somewhat appealing and amusing I must admit. 

The film also has one of my favorite quotes -

The current treatment plan is for my Lamotringe to increase to 200mg over the next month which will hopefully pull my ups and downs back into check. I also explained my work issues to the Psych and in his own words he felt that I was being "set up to fail". So when he writes the report letter to myself and my GP he is going to add a paragraph about how negatively work is affecting my condition/s for me to wave at my next Occupational Health appointment and when I go back to the office. I will see him again in around a month for review. It feels really odd having a genuine and official treatment plan!

I'm really hoping that this will get me on the right track and also help with the work situation, they can't argue with a psychiatrist right?

Love Jen

XxxX