Tuesday, August 18, 2009

Denial or just wishful thinking?

As I was typing this up for a post on a BPD message board I belong to, I couldn't help thinking that it would make a great blog post instead, especially since all the questions I was asking turned out to be rhetorical....

One of the most prominent symptoms of BPD is the unstable and intense interpersonal relationships. But of all the symptoms, this is the one I don't have much of a problem with. I read what others with borderline write in their blogs and on the message boards I belong to with respect to their relationships (be it family, friends, therapist, etc.) and most of the time, I really can't relate to any of it.

It's not that I don't have relationships with people, though I do have very few. The ones I do have, by all accounts, are amazingly healthy. I'm extremely close with my daughter, but it's a healthy closeness, not a smothering one. We don't yell, scream or fight with each other and never have. Sure we get angry at each other from time to time, but it's rare & usually it's when one of us is PMS'ing. We don't dwell on the negative or hold grudges, we address what we're angry about like adults (she is nearly 18) and then move on.

I'm extremely close to my younger sister and we both help each other a great deal, from helping take care of each other's daughters to being the person to call when we're feeling down. I'm not close to my parents, but it's because they were abusive when I was younger and have been emotionally unavailable my entire life. However, I've come to accept the limitations my relationship with them has to have. I am civil, even friendly & engaging sometimes, and normally don't mind having them around. I also get along with my other sister, though she isolates herself, and my brothers. I don't have many friends, but I get along with them just fine too.

The only relationship that was ever a true problem for me was the one with my exhubby. There was a lot of the "I hate you, don't leave me" towards the end of our marriage, but isn't that a normal response to fighting with someone you love? Someone you promised to spend the rest of your life with? Isn't it normal to feel abandoned when they cheat on you? The rest of our marriage was full of love and friendship. We rarely fought and our arguments centered around what most couples usually fight over...money. Even when I found out he was cheating, the highest level of betrayal and abandonment I can think of, I responded in the most logical and normal of ways, I threw the bastard out (albeit I did it calmly, whereas most are so angry they throw the person's belongings in the front yard or something).

Even when it comes to my therapists and pdocs, I don't see the intense idolization/devaluation that's supposedly a common pattern of those with BPD. I have never once idolized any of my therapists or pdocs, though after awhile, I will devalue them based on my interactions and perceptions about how well I feel they are performing their jobs.

I've read that having those intense unstable relationships is so central to BPD that those well educated in the treatment of borderline hesitate to diagnose a patient as BPD without this particular symptom being present. Since that doesn't apply to me, do I really have BPD?

The more I think about this, the more I begin to doubt the BPD diagnosis I was given. Is it denial or just wishful thinking? I don't know. Sure I meet the criteria, but I think most people reading the list of symptoms can relate to several of them. But when does relating cross over into being able to be clinically diagnosed with BPD or any other mental illness? The guidelines say if you have 5 of the 9 traits, you have BPD. Does it matter which 5? Does it matter how deeply they impact your life? I can relate all 9 to my life in some way, but what if they aren't very pervasive? What if some of them come and go with a decade or more in between, like the self injury that disappeared on its own when I was 24, only to return when I was 34?

I hate to even say it, but maybe the therapist from hell was right when she said that maybe I was misdiagnosed. But if it's not BPD, what the hell is wrong with my brain? The next logical answer is Bipolar II, since that is another diagnosis I've been given. But I don't ever get manic (except when it was drug-induced). I don't even get hypomanic, at least not by the definitions I've read. I don't respond well to the meds most often used to treat Bipolar, in fact, they are some of the ones I have the worst reactions to.

I've given this a lot of thought and here are the symptoms I experience most often. If I come up with more, I'll add them, but this is what I've been able to compile from thinking back over my past and through reading my journals.

  1. Rage and/or extreme irritability that lasts for long periods of time, days or even weeks at a time
  2. Severe depression that extends back to early childhood
  3. Severe anxiety and panic attacks that started out of the blue when I was about 19
  4. Psychotic symptoms including visual & auditory hallucinations and paranoia, particularly in times of high stress or extremely severe depression
  5. Self injury, usually in the form of cutting, but I have used binge drinking as a means to self injure (occasionally medication abuse is added to the alcohol to intensify the level of self injury)
  6. Intense self hatred
  7. History of multiple complete mental breakdowns, the first one being at the age of 11, where I lose all grasp of reality
  8. Chronic feelings of emptiness
  9. Obsessive thoughts/rituals that for the most part tend to be on the mild side, but at times can interfere with my ability to function in the world
  10. Chronic hopelessness
  11. Chronic suicidal ideation with multiple suicide attempts
  12. Past history of postpartum psychosis (this may or may not have any relevance so I'm including it just in case)
Guess I'll pass this list on to my therapist and pdoc and see what they have to say.


Blogger Wandering Coyote said...

I have this issue, too, because I also don't have a pattern of intense/unstable relationships, they way so many with BPD do. I also don't have impulse issues, and I don't idealize/devalue. I think of myself as more of an atyptical Borderline. I have all the other stuff, though, and therefore meet the criteria. I used to doubt it too, but taking DBT really helped me to identify better with how the illness manifests itself. Everyone is so different.

5:37 PM, August 18, 2009  
Anonymous Anonymous said...

It could be ADHD, with co-morbid anxiety and depression. (which is fairly common) Although that doesn't explain the chronic emptyness. IIRC the only thing that chronic emptyness is a trait for is BPD. Which is probably why you were diagnosed with it in the first place.

2:01 AM, August 19, 2009  
Anonymous lili said...

I'm a card carrying full on bp'er but when you were talking about your relationships I noticed something. If you're protective and in familial (or family) mode your relationships are strong but you said with your ex-husband.

You went out on a limb and out of your regular life pattern (by marrying him)to be with a stranger(him as non loved or protected family) and he acted abusively maybe like or not like your parents but he did represent betrayal.

So maybe there is a part of you that already knows not to seek out too many relationships because there's a possibility of intensity/instability?

I only say this because I had so many relationships it was insane then I took out my lighter and began burning bridges until I have very few close friends left and have an immediate feeling of upset at the thought of meeting people more than once or starting relationships.

9:20 AM, August 19, 2009  
Blogger Handsome B. Wonderful said...

Sid, I'm soooo sorry for forgetting to reply to your on my blog when you questioned your diagnosis. You needed my advice and I wasn't there and I am sorry.

I feel so ashamed and guilty that I didn't respond to your comment until now!!! I meant to but it got lost in the shuffle of comments between all my blogs--I need to pair one back. Anyway and then I forgot until now.

Ugh, please forgive me.

I think you could very easily have bipolar II or schizoaffective disorder. Especially with the paranoia and psychotic tendancies/episodes and hallucinations. Those are the big indicators of SA.

Rage, irritability, severe anxiety and any level of psychosis (paranoia, hallucinations) are actually all types of mania. I always thought mania was just running naked through the streets and while I had moments like that (not the naked part) most of the day to day mania is the stuff you mentioned.

You should see a new psychiatrist if you can and tell him/her that you don't think you were diagnosed correctly and then give him the exact symptoms you mentioned here. I had doctor after doctor tell me I had just bipolar but I knew there was more to it.

I don't want you to have to be Schizoaffective if your not because it would mean more meds. However, if you haven't been treated for the right diagnosis all these years it would be a relief to finally know what is what.

Let me know how it goes.

5:51 PM, August 20, 2009  

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