The Real Possibilities – Reaching Beyond a Diagnosis

I’d like to preface this with one thing.  I don’t usually post to Sunny about things in my life that are just developing or things that I would consider to be “in limbo”.  This is me, Lulu, reaching out into the community in search of some informed opinions and suggestions.  I want to hear from you to learn about your personal experiences and gain from the reader’s pool of knowledge.  Not every answer is clear cut, and most of the best answers can’t be found in a book somewhere.

The New Doc on the Block

I went into my psychiatrist’s office for my regular med check last Friday.  Except, there was nothing about this that was regular.  My psychiatrist Dr. K. wasn’t in, and another doctor I was meeting for the first time was filling in.  I figured it would be more of the same, you know, “How’s it going?”  “Fine, except a couple of things.”  “Okay, well go off into the world, be good, and take your medication.”

I was dead wrong.

He asked me a few typical questions, like “What’s your diagnosis?”  and “What medications have you been on?”  and things of that sort.  He asked me how I’ve been feeling recently, and I answered honestly.  Mostly, I’m alright.  My moods are pretty stable, and I’m in a pretty good place most days.  I’m still pretty irritable and the anxiety I’m experiencing is just unmanageable anymore.  But, those are the constants.

I’m not fighting depression or mania at the moment, or living inside the confusing anguishing hell that is a mixed episode.  I’m alright.  Just alright.  Probably the best I could expect to be doing being someone with this condition.

This part shocked the hell out of me.

The doctor goes into a long explanation of why I’m still experiencing symptoms, being that I’m apparently not on medications that actually treat the disorder.  He tells me that Lamictal is not a mood stabilizer. Since I’m not on a mood stabilizer or and an antipsychotic, and since I have a lot of options, I should be on both.  In his medical opinion, I should not be on Wellbutrin or even really any antidepressant at all.  And Xanax and Halcion are not supposed to be for long term use to manage anxiety.

I fought him on the antipsychotic, explaining that those types of medications and I don’t get along well.  He insisted it was because I’ve never been on an actual mood stabilizer.  He kindly smiles and promised that as soon as my meds were fixed, then my bipolar would be fixed, and I’d be right on track.

He advised me to take a look on the internet at my treatment option throughout the next month, and then discuss with Dr. K. when I came back.

It was like getting slapped by someone in a moving vehicle.

As quickly as I went in, I was back out again.  I was disoriented and confused.  For a minute, I actually considered his words might be the truth to the whole thing.  Then I remembered what being on antipsychotics was like.  That created a whole host of problems that were unlike any I had ever experienced before.  And I don’t care to EVER go there again.

So, Xan and I got in the car, and I laid the whole thing out for him.  He was completely on my side.  He said, “I don’t see why they are trying to fix something that isn’t broken?   Why are they trying to dope you up like this?  What did you tell him?”

I replied, “Nothing out of the ordinary!  I told him that I’m having difficulty keeping a job, but I have no idea what that’s all about.  I’m struggling socially and have been, well, pretty much my entire life.  And that irritability, insomnia, and anxiety have been a constant for me.  I mean, for my ENTIRE life, before all the mood stuff started.”

And we both agreed.  Whatever throws down, that cocktail is not happening.

To Be Bipolar, Or Maybe Not Bipolar?

I’ve been thinking about this for quite awhile now.  My moods have been pretty stable for about a year now.  I mean, that is cause for celebration here.  I’ve had some minor snags here and there, but all in all, I’ve been pretty level.  The episodes I do have are not nearly as deep as they once were, even if the duration might be seemingly longer.  So, why am I still seeing significant dysfunction in certain respects?

Is it possible that I might not even have Bipolar Disorder in the first place?  Could it be something else?  Borderline Personality Disorder and Bipolar share some diagnostic traits.  Could there have been a mixup?

Or, perhaps, the mood episodes were actually solved, as I suspected, and we’re now uncovering something underneath the mood shifts?  I have long suspected that the anxiety that I’m reporting hasn’t had anything to do with my mood shifts, although I did describe them as having the ability to spark depression or mania, depending on the context.

Xan and I sat down later, and I said, “You know, if Dr. K. is going to cause trouble and shift medications around, I’m going to request that we do a complete reevaluation.  I’m talking about starting from scratch, covering it all from A – Z.”

He answered, “I think that’s a good plan.”

My Homework Assignment

So, I’m doing my homework assignment right now.  I’m doing my research on the internet.

BUT!

I’m going beyond all of the articles, medical websites, and online assessments.  Sure, I’ll have those tucked under my belt, but I’m not a person who half-asses anything.

I’m taking it to the people.

Tell me about your experiences.  I’m open to all suggestions, ideas, theories, and everything and anything all open minds would like to add.

Thanks ahead of time readers.  I’m counting on you!

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BPD and Me

A post by Angel, concerning Avoidant Personality Disorder, had me thinking again about the possibility of me having Borderline Personality Disorder.  This is a suspicion that has plagued me throughout the course of my treatment within the last year or so.  Instead of going straight to the Borderline Screenings, I went to a personality disorder screening to see the possibilities of what I may be dealing with.

Disorder Rating
Paranoid Personality Disorder: High
Schizoid Personality Disorder: Low
Schizotypal Personality Disorder: Moderate
Antisocial Personality Disorder: Low
Borderline Personality Disorder: Very High
Histrionic Personality Disorder: High
Narcissistic Personality Disorder: High
Avoidant Personality Disorder: High
Dependent Personality Disorder: High
Obsessive-Compulsive Disorder: High
Take the Personality Disorder Test
Personality Disorder Info

I really never imagined that I would be symptomatic of multiple disorders in Axis II.  Since BPD still remained the highest, I decided to take a specific screening.

Results of Your
Borderline Personality Test

You scored a total of 43.
Severe Borderline Personality Disorder Likely
You answered this self-report test in a way that’s consistent with people who have been diagnosed with severe Borderline Personality Disorder. This suggests that these concerns may be an issue for you as well, and something that you should seek out further assistance with this issue from a trained mental health professional immediately. Borderline Personality Disorder is characterized by a pattern of unstable and intense relationships, as well as frantic efforts to avoid abandonment — even if it’s not real.

I thought about the entire year and the instability of my own marriage – the most solid thing I can think of.  I had all of these paranoid delusions that my husband was cheating on me, although in the back of my mind, I knew it was not a possibility.  I sabotaged myself at work with the line of thinking that everyone was against me.  I started severing ties with coworkers and hiding in my classroom.  I had always thought that was characteristic of bipolar psychosis, but now, I’m not so sure.

Using the same site that Angel used, I discovered something kind of shocking:

You may be at risk for developing BPD if:

  • you have a family member who has BPD
  • you felt emotionally unstable or emotionally vulnerable as a child
  • people in your household were impulsive when you were a child
  • you were emotionally abused as a child

And all of those were true.  My mother does not have a confirmed case of Borderline Personality Disorder, but it seems she is symptomatic.  When she was a very young child, she was put into foster care.  She has absolutely no memory of this, and none of her family members will detail what happened.  My mother married her first husband on a whim, because his draft number came up to go to Vietnam.  She had an extremely turbulent relationships with him, and he mostly left her alone all of the time.  That’s how she met and fell in love with my father.

Their marriage isn’t much better.  In private, she has gone on and on about my father’s faults.  They have had a rocky relationships, where I recall them throwing around the word “divorce” probably far more often than they should have.  She binge drinks and sometimes takes too much medication.  Medication that isn’t even hers to begin with.  She is as impulsive as she can be in her restrictive environment and goes through so much emotional turbulence.  But, she will never leave my father, no matter what.

I was an emotionally unstable child, and I wasn’t the one to immediately notice.  My preschool teacher had mentioned to my mother that I needed to “toughen up”.  That one little phrase was enough to spark years of tough love and general emotional abuse and neglect.  It gave them a free pass to call it “good parenting”.  As a result, I developed this need for achievement as a means of recognition.  I was designed to people please.  Regardless, another comment came from a teacher stating, “Doesn’t take constructive criticism”.  And the idea that criticism was encouraged compounded what I was already going through.

Impulsiveness!  My father used to just go drive off in his car without telling my mother where he was going.  He’d be gone for hours, and she’d be a wreck.  One time, he went through the house waving a gun, terrorizing us with suicidal gestures.  Honestly, I can never get that scene out of my head as hard as I could ever try.  My parents have both run their credit into the dirt over impulsive shopping sprees.

Now, here’s where things get tricky.  Friends and family in the past have suggested that I may be suffering from Borderline Personality Disorder.  An ex used those weaknesses against me.  So the presentation is convoluted because my actions are purposefully deceiving.

frantic efforts to avoid real or perceived abandonment

I self-sabotage in this area.  When I perceive abandonment, I start to shut that person out of my life.  I have this funny idealization that person will perceive my own emotional abandonment and come running back.  It’s what my parents and my ex did to me, and I seemed to have picked it up.

I’ll also become more sexual and start having defensive sex or performing certain sexual acts to peak someone’s interest and entice them into staying with me.

I also have this habit of changing everything about myself to appease my partner.  This is an effort to avoid abandonment.  And it’s one that’s been preyed on before.

pattern of unstable and intense interpersonal relationships, characterized by alternating between idealization and devaluation (“love-hate” relationships)

People that are close to me are also subjected to this regularly.  Honestly, this is a major reason why I don’t let people get too close to me.  At first, I idealize someone and pick out the best of their characteristics.  Then, I start to idealize how the relationship with them will go.  Soon, I will become disillusioned at the first sign of trouble.  And it is at that point that I begin to demonize someone.  Everything about them is bad, and I have ever right to be suspicious at their deceptive behavior.  Except, it wasn’t deceptive.  I perceived them to be something that they weren’t and assigned them to the task of living up to my unrealistic expectations.

extreme, persistently unstable self-image and sense of self

I’d like to paraphrase the way I perceive myself.  I have lived a dozen lives, and each time, with every death, I’ve risen like the phoenix out of the ashes.  In my life, I have been a dozen different people and will be dozens more, each with their own birth, life, and death, only to start once more.

I take one aspect of my life and characterize myself through it.  I’ve been a baker, a mother, a wild child, a caretaker, a housewife, a teacher, a crazy woman, a bipolar woman, etc.  And for some reason, I can’t seem to integrate all of those periods of my life into the same entity.  They are just all separate from one another, as if I were living so many different characters in the same skin.

impulsive behavior in at least two areas (such as spending, sex, substance abuse, reckless driving, binge eating)

It is well known that I have a substance abuse problem with alcohol. But, here are a few facts that are the most difficult things for me to admit. I am guilty of day drinking every now and again. It is never when I’m alone with my child, for the record.  I am also guilty of taking too many benzodiazepines to escape reality from time to time.  Yes, I abuse my medication every now and again.  But, it’s not a dependence kind of thing.  I don’t find that it’s necessary, until I get into a frenzy of hysteria that produces so much distress that it’s unbearable.  The drugs quiet my mind.

And the other one is very difficult to admit as well, and I’m not sure if I can spell it out in detail.  I have a difficult relationship with food, dieting, and exercise.  I am guilty of binge eating.  I am also guilty of purging if I am distressed.  Especially if it’s about my weight.

And lastly, I recently made a confession of my sexual exploits in my youth in Promiscuously Yours, in the series The Friday Confessional.  I had multiple reasons for cheating on my ex, which is something I wouldn’t normally do.  I have a better moral compass than that.  Sometimes, I was so distressed that I just wanted to feel some kind of love.  Sometimes, I was trying to prove to myself that I was something special.  And other times, I did it out of spite.  Any which way you look at it, I did it in highly emotional moments.  And I always regretted it later.

recurrent suicidal behavior, gestures, or threats, or recurring acts of self-mutilation (such as cutting or burning oneself)

My cutting has been well documented in the past.  Unless I make a mindful effort not to self-harm, I will engage in the behavior.  I’ve written posts about the whys and wherefores in Why Self-Injurious Behavior?.  It’s complicated.

unstable mood caused by brief but intense episodes of depression, irritability, or anxiety

The mood episodes aren’t brief, so it leads me to believe that I may have a co-morbid diagnosis instead of a misdiagnosis.  However, I’ve always said this, and people have disagreed with me.  The only two constants for me and my disorder are reactivity and irritability.  I was under the impression that everyone with bipolar disorder is reactive and generally irritable most of the time.  Apparently, I was wrong.

I always have this underlying anxiety.  It’s made worse by social interaction, certain phobias I’ve developed, and worst of all, having to make decisions on my own.  It’s difficult for me to take care of my personal affairs, because I am always waiting on another person’s approval.  I get anxious when I make a decision by myself, because I often second guess myself.  I am constantly seeking reassurance about my decisions and guidance from others.

chronic feelings of emptiness

This one is complicated.  I don’t often feel empty.  I often feel lonely or distant.  Sometimes, I feel invisible, rejected, or ignored.  Most of the time, I actually feel too full.  I’m too full of emotion, noise, and stimuli.  I often have several voices and personas that follow me and make commentary on my life.  It’s too much.  But when medicine gets rid of them, though I am relieved by the lack of conflict, I am lonelier.  It feels like a piece of me is absent.

inappropriate and intense anger, or difficulty controlling anger displayed through temper outbursts, physical fights, and/or sarcasm

I recently wrote a post called, “I Want My Yellow Dress” using the analogy of a little girl in a movie in the most epic temper tantrum ever known to describe my own inner child.  My anger is often out of proportion for a given situation.  I have a bad temper, and I know it.  It’s something I’ve tried to deny for a long time.

In Love the Way You Lie, I described a mutually abusive relationship.  It was the only time in my life I have ever lashed out physically, but the point is that I did.  Whether a person could classify that as self-defense is questionable.  There were times I did it because I wanted to inflict pain on him.  I felt like he needed to know my own pain.

stress-related paranoia that passes fairly quickly and/or severe dissociative symptoms— feeling disconnected from one’s self, as if one is an observer of one’s own actions

I’ve written scores of blog posts and theories about this.  I am prone to paranoia, and I experience it rather frequently.  With my recent medication change, I can say that I usually only go through it once weekly.  Prior to the medication change, it was much more frequent than that.

The dissociative symptoms have been documented in Conscious, Subconscious, and Extraconscious, where I described a theory of multiple personas rather than full blown personalities residing in a place between the conscious and subconscious mind.  It’s complicated to get into, but it’s worth a read honestly.  It would give you a better idea of what I’m talking about in terms of dissociative symptoms.

When I’m doing something out of character, I often feel like I’m not the one who is doing it.  I feel like I’m trapped inside myself, or even completely outside of my own body, as a helpless observer.  When everything is said and done, sometimes I don’t quite remember the details of what happened.

It’s something I’m going to have to talk to my doctor about, because as I get older, it seems to get worse, rather than better.  Sure, I am not self-injuring in the sense that I’m not cutting.  But, I am still engaging in impulsive behaviors, and I can’t tolerate distress or disappointment.  My anger is out of control most of the time.  And that’s not when I feel too doped up to do anything.  Sometimes, I have symptoms regardless of the medication.  When I relapse, it’s usually very bad, and feels like it’s worse than the one prior.  I don’t just have a blip of an episode, but a full blown, complicated one.

The Seeds of Doubt

Amnesiac.

That might be a painfully accurate depiction of a large part of me. My memories prior to eleven are largely fragmented, save for a few vague impressions, recurring themes, and a traumatic experience that has recently resurfaced to rear it’s ugly head at me. Regardless of how often I attempted recalls, those calls went unanswered. A flicker, like a spark, would come alive, but leave existence as quickly as it came.

I often find myself in a unfocused world of disjointed memories and alternate realities. The vast fields of fog are sewn with seeds of doubt, spouting fears and obsessions. In those fields and shadows, monsters have plentiful cover to prowl for their prey – me.

They often say that when a lie is repeated so many times, it starts to embed itself as a portion of factual memory. Basically, if a person believes in something strongly enough, it becomes real. It becomes enough to rewrite someone’s entire history. The lines between reality and fantasy start to blur in a place where fiction and fact can coexist, even potentially peacefully.

Unfortunately, I have not once before been a person who can successfully smudge the details of my own personal past. Not to myself, anyway. I can report being guilty of deception by omission. But, something distressful stirs and blinks with any instance I even remotely consider telling a blatant lie.

This is not say I am immune to deception and coercion into accepting an outright lie. My psyche is malleable in the way where I am susceptible to manipulation. Why? Because it’s been the very basis of which I have been raised.  My father once told me, “Believe none of what you hear, and only half of what you see.”  Then, was it his intent to distort my world in such a way that I will one day have difficulty trusting myself?

There are so many clinical words for this.  DissociationDepersonalizationDerealization.  Psychosis.  Delusion.  HallucinationDissociative Fugue.  Splitting.  Repression.  Coping.  So many clinical terms that overlap in their definitions, and yet, not one quite captures the true essence of being within it’s grip.

For me, my repression has a proximity sensor.  Clinically, it’s called Dissociative Amnesia or Dissociative Fugue.  In the past, I have always called it throwing a block or throwing up a wall.  I am figuratively walking along in my own mind, through wild, overgrown fields and forests of my own memories to suddenly smash into a concrete wall.  Suddenly, the whole landscape shifts, and I am boxed in this nondescript, blank white room.  White walls, white floors, no windows.  It is me and a dining room chair.  This is my mental waiting room, where I am being isolated until the memory of the memory passes.

I call it, “The Eraser”.  When it’s all said and done, I come back to consciousness in my own familiar surroundings, in my own waking life.  But, is it?

This is the direct result of the seeds of doubt being sewn into a person so carelessly in the impressionable youthful brain.  The concept of an active consciousness is disturbed, and the development is stunted and contorted.  It must be so easy to manipulate someone with such a frail sense of reality, a blank canvas of self, and stunted emotional maturity.  And that’s why abusers do it.

I slip in and out of streams of consciousness, alternate, yet simultaneous realities, and find skips and pauses that disarrange an incomplete chronology of life.  I start to get the belief that I am, in fact, a time traveler, as my external self as my own ship, however I have no use of my own controls.  Somehow, somewhere along the way, I have been damaged.  It mimics human ailments.

But I know none of that is true.  I am just as human as the next person, with cognitive dysfunctions resulting from mental illness and latent trauma.

Or faulty wiring.

I doubt everything.  My experiences often seem surreal.  My memories, unless attached to a particularly powerful moment, are vague.  My short term memory is shot, so it becomes unreliable.  I doubt everything I feel, all of the conclusions that I come to, and some of what is right in front of my face.  I doubt right down to self.  Is this me?  Am I me?  Am I here?
How did I get to such a place where I have to question everything?

 

Not Your Usual Serving Of Canvas

As some of you might not be well aware, and you’d probably be correct at this point at any point in confusion, I am a co-founder with Ruby Tuesday and a writer for A Canvas of the Minds. The following is a post on Canvas that request every mental health bloggers help for Mental Health Awareness.

via Not Your Usual Serving Of Canvas.

Thank you for your support in advance.  I would guess that everyone who is involved with Blog for Mental Health 2012 would be interested in joining Canvas and participating with us in our time of need of your support!!!

The Family Furnace

Brofenbrenner was completely correct in his ecological systems. The microsystem is the core for each and every one of us. In early development, it is the only system that exists. The people that system is composed of represent an entire world. And as we grow, it is those impressions that we take with us. Every person in our microsystem becomes an archetype for others we encounter in other systems that build as we grow beyond the microsystem.

As we are living beings, there is no end to our growth and development. There is only an early learning window where we build our foundations of understanding about the way the world functions around us, and the social rules and norms of our society. That is why children are prone to generalization. On our way to becoming adults, we sculpt the fine detail from our experience and observation.  Brofenbrenner did not take into consideration that mental development does not cease simply because physical development has come to a close.

Microsystems. Family and caretakers.  The core to each and every one of our worlds.  “Mother is the name for God on the lips and hearts of of all children.”The Crow.  But, what is a mother?  What is a family?  Does a mother represent our ideas of maternal figures who nurture, love, and protect?  Is a family a clan to which we pledge our allegiance, find recognition of ourselves, and find camaraderie within?  Are these people in our primary microsystem truly representative of ourselves and our families?

I have been limiting conversations with my parents to a few times a week.  In truth, there is not much in the way of substance to talk about.  It is more of a touchstone to alleviate the fear of abandonment.  On their side.  I have never been in the business of burning bridges, no matter what troubled places and people they are filled with.

The topic of the house came up in conversation.  Conversations with family members are tricky business, brimming with subtext, doublespeak, and hidden agenda.  Recall the old adage, “Honesty is the best policy”?  A proverb says, “Be careful what you say and protect your life. A careless talker destroys himself.”  My preference leans toward the proverb. I have taken myself down by revealing my hand too soon.

My mother’s overeagerness gave me a glimpse of her hand far before she anticipated. She asked when we’d be completely moved out. Bad choice of words. Rather than asking us when we’d be finished moving, she’s rushing us out the door. Why? She was vague. I asked if a few more weeks would be a problem. Not a problem, because it probably won’t happen until September, if at all.

Confirmed. There are plans. She refuses to tell me, because she knows she is going to backstab me. She wants to retain deniability and spousal blame. Why not? It has been a family custom longer than either of us has even been alive combined.

She slipped in her earlier lament about how my brother has to go on vacation and how it’s such a financial detriment. “I don’t know how I’m going to pay the mortgages.” More than one. Exposing a five year old lie. I offered to take over the mortgage, because I suspected they were misappropriating funds and not actually paying the mortgage. Not possible, the mortgage for the two deeds is singular. Guess not.

Originally, I had a sense of dread that the move would pull the puppet strings around my throat. When it ceased to do so, I felt liberated. I had never felt so free. It was not fleeing, not like when I was younger. It was moving on. No strings. I was a real woman after all.

Until that very moment, when the last nearly three decades came into perfect clarity.

This was the moment. I yanked those strings right back. “I hope you know we’re taking the furnace.”

There was never a tantrum in recorded history, short of a monarch, quite like that. She attempted every angle to envoke something in mem. Guilt. How could you do this to me? Shame. Where would you even put it? Fear. Your father would never let me speak to you again. Pity. What will we do in the winter?

What did I do in the winter of ’06? I was living there. It rose nothing but cold resentment. All questions to which I answered, “I never paid for it. My FIL did. It’s his, not mine.”

The realization of my own subtext hidden between the lines had yet to emerge.

Meanwhile, my husband had stayed up all night, exchanging emails with his aunt, and toning down her grandiose ideas for remodeling. I spent the morning anxious about his lack of sleep, and consumed with dread over the threat of another manic episode. I was actually angry with him for letting her keep him up on a work night, or maybe not being forthcoming with me.

Really, I was upset that we were even entertaining the idea of taking money from her. The anxieties that rose did not have roots surrounding my husband. They bubbled from a deep, dark insecure crevice. It was a place so primal, that it went almost completely unrecognized by my conscious mind.

Family had somehow become synonymous with pain.

I ended my conversation with my mother and plunged into writing. I could detail each wrong. I won’t. The ending comments were these: ” They took every opportunity to hold my head under the water. Out of jealousy. Out of greed. Out of fear that I’d leave them one day, and do better with my life and for myself.”

Anxiously facing another winter without heat, my FIL put a sizable dent in his credit card to purchase and ship a furnace. When we were almost to the point of starvation, my MIL purchased us food and brought it to our home. After the accident that totalled our completely purchased car, they lent us theirs. When that car died, they helped us get through the down payment. Everytime T.D. (my son) needed clothing, they helped us find a way. When I faced having to drop out of college due to financial constraints, his aunt bailed me out.

It wasn’t centric to money, as it seems. My mother refused the honor of standing at my side when I had T.D. My MIL took her place. When Zen (husband) had a complete breakdown, his mother tried to tend to him and help him get care. My FIL gives my husband career advice and instructions to repair things. My MIL has picked up the phone in the middle of the night, just because I didn’t know who else to call.

I sat outside of Zen’s aunt’s childhood home with a cigarette filled with emotion and confusion. Neither of us carry her blood or her family name. I am a damaged girl, with a limited career, from a bad neighborhood. I have no tangible value. Why would she and the rest of her family be so enthused to have have us here?

I couldn’t believe how simple the answer is. Out of love. Because, it doesn’t matter what lineage you originate from. All that really matters is the familial love that one person can feel for another, and the kind of relationships you want to have with each other. If you want love, all you have to do is open up to receive love. And the rest follows.