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Was diagnosed in past with BPD but revisiting psychiatrist


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Hi all,

 

I actually went to a psychiatrist some years ago (I think it could be 10+) and I have decided it is time to go and get a diagnosis again - last time I didn't agree with the shrink and stopped attending.  I am a little older and possibly wiser now and think it is time to get serious and try to gain some sort of control in my life, especially as I am all over the place emotionally/mood-wise lately!

 

I seem to recall diagnoses of anxiety, depression and borderline personality disorder, though I think there were others but I can't recall.  Somewhere along the line I told my then GP I thought I might have bipolar (non psychotic) and he agreed with me at the time.  Now that I am researching personality disorders, I think I could be wrong, not sure as yet. 

 

You see, when I heard the term "borderline personality disorder" all those years ago, I took offence.  I didn't understand what it meant and being the hot head that I am, I took it as an insult, sort of the psychiatrist's way of making fun of her patient or something.  Maybe there is an element of paranoid personality disorder with me too.  Of course, I realise my reaction and choices were not entirely correct back then and I need to "get real" and maybe consider what the psychiatric world has to say.  I guess I was arrogant in thinking that I could diagnose myself better because I had to live with myself - delusional, I know.

 

My only concerns about all this are:

a) I have been booked for a "special" one-off diagnostic appointment - an hour in total! Apparently that is enough time!

b) In an hour, is it possible to therefore misdiagnose or miss-a-diagnosis?

c) Is it possible I could give incorrect information (i.e. not enough info or go off on a tangent) and get the wrong results?

d) What the heck does borderline personality really mean anyway, it sounds pretty bad although I know there is more to it and I promise I have been reading about it. 

 

I feel really bad like I am some sort of f*ck up for having it - kind of buying into the old "you are bad, you are difficult, you are moody, you are aggro, you are just a terrible child/teenager/daughter" thing. 

 

The other thing I find hard to accept is that it is a supposed "learned" disorder.  Like, have you seen some of the people in my family?! There are people with intellectual disabilities, there are plain old weirdos, there is my mother, who has anxiety, OCD and other but refuses to accept anything is wrong/won't get treatment and lets my dad control every aspect of her/our lives and complains about it! My father is a narcissist and has epilepsy - has mother was the same, he has sisters with epilepsy, his father was a bastard but he was from Aberdeen in Scotland - presbyterian upbringing; my son even has Aspergers' & dyspraxia, we have only scratched the surface! So, how can there not be a genetic component - I refuse to believe I merely Learned this disordered way of functioning - or nonfunctioning!

 

I guess I am in for a rude shock.  The more I dig and read, the more upsetting it is for me because I guess the truth hurts. 

 

 

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Firstly, make sure that the sources you are reading are reputable - this is important for anyone but particularly with BPD because a lot of what is on the web is biased at best and downright hateful at worst. You have to not take some of it too seriously because much of what is out there is very very wrong, even things said by doctors/therapists.

The understanding of BPD currently is that there are both biological and learned/social contributions - a biopsychosocial model. I think that the term "learned" is also not amazing because it implies that it is your fault that you got it. I really feel like it is more "induced" than "learned".

For books, I would recommend Lost in the Mirror for a more complex book or The BPD Survival Guide for something more basic. For memoirs, I read Get Me Out Of Here, but it is very old and the treatment she gets is not what we would consider appropriate. The Buddha and the Borderline is more modern, but I have not read it myself. If you are up to something complex/academic, I really recommend reading Linehan's Cognitive Behavioral Treatment of Borderline Personality Disorder. It is not intended for patients but it really helped me understand diagnosis as well as what good treatment would look like.

There is also a great article in the New York Times from a couple years ago about Marsha Linehan, who pioneered the treatment of BPD. She talks about her own BPD and how she overcame it and it is very positive and encouraging.

I guess what I am trying to say is that BPD is very misunderstood. I will say more about that later (question d) but I am dashing off a quick reply.

As to your other questions, the best way to diagnose BPD is for a doctor to know and follow you for a while. But a 1 hour assessment is a reasonable start, especially because you can get a recommendation for treatment. A good psychiatrist will ask questions and steer you to the information they need to know. Certainly you could get a misdiagnosis but that is always a danger with medicine and this assessment is your best way to start. The most common misdiagnosis I think is bipolar disorder.

Also just wanted to say good for you for arranging to be assessed again. It's tough for sure but hopefully this is a step towards getting you feeling better.

Edited by tryp
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I can relate to a lot of what you said in terms of the buttons a BPD diagnosis can push, throughout my life I have been labelled 'moody' 'irrational' 'dramatic' 'morbid' 'imaginary' etc, all of which implied that what was happening was my fault.

 

For me, BPD is a result of trauma, partly my own personality tendencies (sensitivity etc) a lack of support as a teen, some chemical stuff linked to bipolar/rapid mood shifts and it did take years with a clinician for us to sort through how to treat it. I find that BPD in someone who is really stressed and lacks any support can make life so chaotic that it takes a period of time to stabilize and then make long term decisions re: therapy and meds, someone who is self harming or suicidal or taking risky impulsive actions needs some safety to recover before they can see how BPD affects them long term. It has certainly been the case that some of the nine criteria have been more a problem in certain phases of my life, even now some of those symptoms persist at different times.

 

If you are in the UK, MIND, Time to Change and Emergence are good charities to contact re: accurate info.

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Thanks Tryp and Titania.

 

I guess I just have to wait and see at this point but I am anxious/impatient to get this show on the road! I just hate the idea of more wasted years.  Hard to get into a pdoc's surgery here too - some only work a few days a week, so appointments are limited.  I don't know what a good psych even "looks" like.

 

Tryp - Thanks for the book info and reassurance that I probably shouldn't feel guilty - my parents always made me feel guilty and I would have made an awesome Catholic if I had become or been raised one!

 

Titania - It is nice to know that one is not alone in these things, though when times are tough, it is difficult to feel any other way, especially when family don't believe you have a mental illness.  I hate that people think that psychology and psychiatry is a crock and usually they are not the most educated or informed people.  Ignorance is not always bliss.

 

Thank you once again to both of you for your replies, it is very much appreciated.

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I understand that when you are suffering, you want out as quickly as possible and treatment can take time that feels like it is wasted. I remember those days keenly. But any effort you make to communicate and get treatment is taking you close to stability, this is a long game, take the long view.

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