New Psychiatrist & Potential New Diagnosis

Well this morning I saw my new Psychiatrist; and in a word she is AWESOME!

She spent nearly 45 minutes, talking through things and she really seemed to care and listen to me. She is however, questioning the diagnosis of bipolar disorder…. she feels I don’t quite fit the criteria. Which is something I’ve always questioned as well to be honest. There’s certain elements of the diagnosis that don’t fit me. Like for example, the mania side of it. In order to fit the criteria, I’d need to be manic for a prolonged period of time, rather than just a few hours or a couple of days. Plus, I don’t exhibit a full match for mania either, even hypermania.

She’s toying with the idea of Borderline Personality Disorder, which is something I’ve often felt I’m more like under the list of symptoms. I can easily tick off 8/11 on the list. Whereas Bipolar, it’s hardly any I can 100%, hand on heart, say yes to. So it does make me think. Here’s a bit about BPD and a list of symptoms and I’ll underline the parts that I relate to –

Borderline Personality Disorder is a serious mental disorder marked by a pattern of ongoing instability in moods, behaviour, self-image and functioning. These experiences often result in impulsive actions and unstable relationships.  A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days.

Some people with BPD also have high rates of co-occurring mental disorders, such as mood disorders, anxiety disorders, and eating disorders, along with substance abuse, self-harm, suicidal thinking and behaviours, and suicide attempts.

While mental health experts now generally agree that the label BPD is very misleading, a more accurate term does not exist yet.

People with BPD may experience extreme mood swings and can display uncertainty about who they are. As a result, their interests and values can change rapidly. Other symptoms include:

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation). 
  • Distorted and unstable self-image or sense of self.
  • Impulsive and often dangerous behaviours, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating.
  • Recurring suicidal behaviours or threats or self-harming behaviour, such as cutting
  • Intense and highly changeable moods, with each episode lasting from a few hours to a few days
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or problems controlling anger
  • Having stress-related paranoid thoughts.
  • Having severe dissociative symptoms, such as feel cut off from oneself, observing oneself from outside, or losing touch with reality.

Seemingly ordinary events may trigger symptoms. For example, people with BPD may feel angry or distressed over minor separations – such as vacations, business trips, or sudden changes of plans – from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative meanings than people who do not have the disorder.

(Quite honestly, I’m beginning to see myself as someone with BPD….)

So, as you can see, I identify with a lot of the traits of BPD. Now, lets look at Bipolar Disorder in the same way –

  • Bipolar Disorder is characterised by extreme mood swings. These can range from extreme highs (mania) and extreme lows (depression).
  • Episodes of mania and depression often last for several weeks or months

Depression:

  • feeling sad, hopeless or irritable most of the time
  • lacking energy
  • difficulty concentrating and remembering things
  • loss of interest in everyday activities
  • feelings of emptiness or worthlessness
  • feelings of guilt and despair
  • feeling pessimistic about everything
  • self-doubt
  • being delusional, having hallucinations and disturbed or illogical thinking
  • lack of appetite
  • difficulty sleeping
  • waking up early
  • suicidal thoughts

Mania:

  • feeling very happy, elated or overjoyed
  • talking very quickly
  • feeling full of energy
  • feeling self-important
  • feeling full of great new ideas and having important plans
  • being easily distracted
  • being easily irritated or agitated
  • being delusional, having hallucinations and disturbed or illogical thinking
  • not feeling like sleeping
  • not eating
  • doing things that often have disastrous consequences – such as spending large sums of money on expensive and sometimes unaffordable items
  • making decisions or saying things that are out of character and that others see as being risky or harmful

Patterns of depression and mania

If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa.

Between episodes of depression and mania, you may sometimes have periods where you have a “normal” mood.

The patterns aren’t always the same and some people may experience:

  • rapid cycling – where a person with bipolar disorder repeatedly swings from a high to low phase quickly without having a “normal” period in between
  • mixed state – where a person with bipolar disorder experiences symptoms of depression and mania together; for example, overactivity with a depressed mood

If your mood swings last a long time but aren’t severe enough to be classed as bipolar disorder, you may be diagnosed with cyclothymia (a mild form of bipolar disorder).

Whilst I do identify with a fair few of the symptoms, they don’t last as long as the textbook bipolar disorder says they should, in order to be bipolar. Perhaps I have cyclothymia? Maybe… I honestly don’t know. I’m leaning towards the BPD personally, as having spoken to a few people who have it, it does sound more like me. Along with the information above, it’s kinda like reading about myself! But, I guess we shall see. I’m due to start the Bipolar Psycho-education course on the 28th, for 6 weeks, so will pretty much have finished that when I next see her. In which case I’ll have learnt more about Bipolar and will be better able to judge whether it really applies to me or not.

Also, in looking at the amount of symptoms I get, I know now that when I’ve experienced elevated mood, I can’t really call it mania, as it’s not really like what’s described. So again, it’s looking more likely to be BPD…. watch this space!

In other news, I bought a baby carrier today! Picking it up from Tesco’s tomorrow. Bit excited about it, because it’ll make going out and about so much easier. I love, love my pushchair, but it can be a pain in the ass, especially on public transport! So, we shall see how we get on with the carrier. Hopefully my daughter and I will both love it. I love having her close to me, so in that respect it’ll be great. Fingers crossed.

Right, this has turned into a rather epic post, so I shall leave it there! TTFN.

 

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