And no, it's not that I want another disorder. It's that I believe there is more going on and I feel like that's being ignored. I constantly feel like I'm screaming, screaming for help as the darkness creeps around me and light recedes. Screaming, even though it's hard to speak, or even to breathe. People hear me but they turn away. They hear me, but they don't have time to help. That leaves me feeling hopeless.
I wanted my GP to check for other disorders months ago, but there just arent enough community psychiatrists to see me based on what I think are possible conditions. I wanted to discuss it with the CMHT nurse who initially assessed me, but again, discussing it is really a no go until I'm assigned my CPN and my treatment really starts. That's why I'm attempting to inform myself about the possibilities.
I know self-diagnosis is not advised, but after 22 years of asking for help it's inevitable that I've done my own reading, so I have ideas, but I'll discuss them after I've gone over a few other comments in the psychiatrist's report which left me feeling deflated.
"Crisis team to monitor for 7 to 10 days", I'm already on day 8 and I now feel I'm running out of time for help when I haven't yet been given my community psychiatric nurse. Will I be abandoned again in two days time? I know the Crisis Team is as its name suggests, it's for crisis not long term treatment, however, if they discharge me before other help is in place I know I'll end up back at crisis point. I've thought about it so many times this week. And I'm not sure how many times I can go through the cycle before I lose faith in there being help again.
If I'm discharged from the crisis team before I have a CPN, I think I'll give up. I won't phone next time I feel like killing myself. What would be the point if the help I need never comes? That though leads to my next extract from the psychiatrists letter.
"No further medical input required". What does that mean? I need medical input. I need to know for sure if there is something else. I need the depression and anxiety to be treated so I remember how to live.
Last night I had a panic attack, when it east I ended up wandering the house looking for a way to kill myself as I no longer have access to car keys or pills. I had a plan to get an extension cable and hang myself from the banister. Matt had to phone the crisis team for me again. Talking to them helped, but it's a new method of coping. It's novel. Sooner or later I'll need more.
What do I need to do to get continued help from people who'll listen to me? Do I have to make another suicide attempt? Because if it comes to that, it won't be an attempt. It won't be cry for help, it'll be a determined attempt to die. And that's the head space I was in last night.
Here's the thing... My brain tells me I should be dead all of the time, constantly, and I want it to stop. I would die just to make it, and my self-loathing and self-doubt, stop. That means I need help, right? But help is hard to get. I'm in a cycle and it feels like the only way to get off the ride is by dying.
That's everyday life for me, however, so lets ignore the nagging suicidal thoughts for a moment and focus on "not enough evidence to formulate a disagnosis of co-morbid personality disorders." That's what I want to discuss.
There is a disorder I suggested to my GP, Borderline Personality Disorder, although she didn't seem overly interested in investigating. Here's why I think it's worth taking a look at...
Borderline Personality Disorder (this list of indicative/diagnostic questions is from the NHS website):
- Do you have an intense fear of being left alone, which causes you to act in ways that, on reflection, seem out of the ordinary or extreme, such as constantly phoning somebody (but not including self-harming or suicidal behaviour)?
Yes, I do this. I'm terrified of being abandoned. There are days when I'm irrationally furious with my husband and I'll scream at bim to leave. Then stand in the door so he can't, because I'm afraid he won't come back. I'll promise friends more than I can manage because I'm afraid of losing them if I say I can only manage less.
I'm a self published author, but in the past year but at times I've barely written because I've been rewriting somone elses chapters for them because I felt obliged to keep her happy and keep her friendship. As it is, that friendhip has now ended so I'm no longer rewriting her book for her, but I did get drawn into that trap for the better part of a year.
Even two weeks ago, when we were barely speaking as I'd learned how manipulative the person was, she messaged asking me to read over a short story. She hadn't spoken to me in weeks but she wanted a favour. There was no 'hello, how are you doing', just 'can you read this and give me feedback?' I spent three or four hours going through that story for her. I rewrote example paragraphs and made detailed suggestions. Then she went back to barely speaking again. Because my fear of being hated is so great I'll do things I'm not really up to, until I'm at breaking point and become angry, and push people away.
I also feel obliged to answer messages even when I'm in a situation where my phone should be off because I fear people will come to hate me if I don't reply. That's so stressful that I can only interact with a few people at a time. I barely write now because I'm afraid that if I take time for myself and stop messaging my few friends, I'll lose them.
And if I try to get in touch with someone and get no answer? I panic and keep ringing. If i upset someone I keep messaging, trying to explain, even though the flood of messages often make things worse rather than better. Sometimes I must look crazy (by that I mean out of control). I certainly feel it.
- Do you have a pattern of intense and unstable relationships with other people that switch between thinking you love that person and they're wonderful to hating that person and thinking they're terrible?
Yes. Not my marriage. Well, I have days where I can be loving and then believing I hate my husband. We've been together for twelve years and there have been some pretty unstable periods when our 'issues' clash, but he loves me, and I love him. He's one of the few people who can make me laugh.
The real unstable relationships are with friends and other family members. The friends I have, I idolise, but psst experience tells me that I can go from idolising to hating very quickly. There are a few I hope this would never happen with, and I hope they forgive me if it does. I'm really trying not to be the sort of person I seem to be. As for family members...
I supposed I must have idolised my dad at some point. We had a complicated relationship and there were a lot of times I hated him. It took until the last year, when he was dying, to be able to say 'I love you' again and mean it. It was the last thing I said to him.
Whereas the last thing I said to my brother was the he was an arsehole. That was the day after dad died and I was struggling. My anger was rearing up to protect me from breaking down and when we fell out it exploded. I apologised, but he wouldn't accept an apology. He then went on to tell me I only self harm to hold man hostage, which isn't at all true as mam often doesnt know when I'm self harming. We fell out. I fell out with my other brother too.
I hate them both.
I did love both of them. Despite our competitive streaks I idolised the older of the two and I adored the youngest. But now I hate them both, and they might as well have evaporated. And I decided that in a moment. I spent a while being heartbroken over the falling out, then one night I thought 'no, I hate them. I don't care what happens to them now', and the switch was flicked.
That's an unhealthy skill I have, the ability to flick from love to hate, I guess I learned it during the times when my dad walked away and wouldn't speak to me for six months at a time. Or maybe I learned it when friends left me because, I assume, they were fightened of being targetted by the bullies who were targetting me. I don't know. I just know I can press that switch.
- Do you ever feel you don't have a strong sense of your own self and are unclear about your self-image?
Goodness yes. At almost 31 I still don't know what I want to be. The best option is an author because I enjoy writing and it allows me to explore different facets of my character, of experience, and even work out how to be a better person. But as far of myself goes... I switched university course three times because my goals kept changing. What I aspire to keeps changing. A lot of the time I just don't know what I want.
- Do you engage in impulsive activities in two areas that are potentially damaging, such as unsafe sex, drug abuse or reckless spending (but not including self-harming or suicidal behaviour)?
I do spend recklessly. My husband is terrible with fiances so I have to control them, but that involves a battle with myself because I do impulse by a lot. Even when I 'plan' a big purchase, our version of planning is to discuss it without making plans other than 'we'll save up', and then one day I'll be in need of a pick-me-up and I'll say 'fuck it, lets get that'.
I also binge eat. My depression currently means I don't really have an appetite driving me to eat. I eat because my husband makes food. However, I do have a habit of going through stages when I'll go through every sweet thing in the house. My brother has shown his disgust before because I ate a whole Golden Syrup cake for breakfast. I can do that. Eat a whole cake. A family size bar of chocolate. A box of donuts. It's not a daily thing, but I go through periods of binge eating. I just don't admit it because I'm ashamed of it. I know it's tied up with my mental illness but I'm ashamed of it.
That comes back to stigma, though, doesn't it. There's a lot of media coverage on anorexia and bulimia, on how the media encourage those conditions and how people suffering symptoms of those conditions need help. But if the media shows an overweight person devour a whole cake, scorn follows. They're seen as greedy pigs. As a strain on the NHS. As people who don't deserve help because they're causing their own suffering. No one ever says 'this person has a mental illness and they need help'.
So I don't admit my dark, disgusting secrets about refusing dinner but then hiding alone eating a full family size packet of marshmallows. That's just stupid and disgusting, right? More so than vomitting after meals, which is part of an illness.
The media still sees eating disorders as starving because of distorted self-image or mental illness. They don't show that over-eating or over-eating junk food is also a reaction to distorted self image and mental health conditions. The person in the street often expresses the same bias. How can anyone admit binge eating is a problem for them when they expect to be met with disgust?
- Have you made repeated suicide threats or attempts in your past and engaged in self-harming?
Yes. Repeated threats, I've made one recorded attempt, family intervention has stopped several others, and in the last week crisis team involvement has stoped several. Ive self harmed for years. My left leg is scars from ankle to knee. I have scars on my other leg and my arms too.
- Do you have severe mood swings, such as feeling intensely depressed, anxious or irritable, which last from a few hours to a few days?
Yes. I'm in a severe depressive epidode at the moment with severe anxiety. An extended episode happens every few years, but between my them I'd consider myself to be emotionally unstable. I have severe mood swings that cause shorter term depression, anxiety, and anger. I can be ok, then at seemingly nothing I'll be suicidal, or anxious, or easily angered. Then I'll be ok again.
- Do you have long-term feelings of emptiness and loneliness?
Yes. All the time. It's one of the hardest parts of being me, the emptiness that just stays, stoping me from interacting or living like normal people. I can't remember not feeling lonely on some level.
- Do you have sudden and intense feelings of anger and aggression, and often find it difficult to control your anger?
Yes. This influenced my falling out with my brothers. It's affected my interaction with colleagues before too, and my husband.
- When you find yourself in stressful situations, do you have feelings of paranoia, or do you feel like you're disconnected from the world or from your own body, thoughts and behaviour?
I often feel paranoid that people are talking about me, laughing at me, or plotting against me, at othertimes I feel totally disconnected and yes, like my body is going through the act of living and interacting but I'm not really there.i also find it hard to remember things that go on while disconnected.
In the last week alone I've phone the crisis team because I've gone from managing to panicked nauseous or suicidal for no reason. I do have stressors at the moment, but this switch can happen for seemingly no reason too.
So, that's Borderline Personality Disorder, the indicators and my responses. I think that's my most likely disorder and would like that to be investigated, but I feel like having waited 16 years to help with depression (22 if you consider the years of migraines due tobstress before that diagnosis), that it'll be another 22 years before anyone listens to my suspicions that more is going on.
However, let's consider me as someone without BDP as the psychiatrist I saw didn't mention it at all. Let's consider Avoidant Personality Disorder instead, as an epansion of my anxious avoidant strategies which were noted.
Avoidant Personality Disorder (taken from this website):
The most common avoidant personality symptoms are:
- Avoidance of occupational activities.
I've been on the sick for 6 months and I really don't want to go back. Does that count?
- Easily hurt and offended by criticism or disapproval.
Yes. Definitely. And I'll spend days going over and over critisism feeling worthless.
- No close friends.
No. I have a select group of close friends.
- Strong reluctance to get involved with other people.
Yes and no. I'd like to be involved but I don't know how to be without extreme anxiety inhibiting me.
- Strong reluctance to take personal risks or engage in new activities.
Yes. Definitely. Risks and unfamiliar situations cause panic attacks.
- Very shy in social situations.
Yes. Very. I'm known for sticking to my husband's side and staying quiet.
- Preoccupied with criticism.
Yes. See point two.
- Exaggeration of potential difficulties.
I wouldn't say I exaggerate, others might.
- Holding back in intimate relationships.
No. As far as intimate relationships go I'm an all in kind of person.
- Perception that they are socially inept.
I AM socially inept.
- Constantly using 'always' and 'never' statements.
I sometimes use always and never statements.
- Blaming others for creating a problem rather than dealing with the problem.
No, I'll deal with it while seething at the person who is to blame. At least I did until my current depression hit.
- Catastrophizing - always assuming the worst case scenario.
Yes. I do that.
- Depression and mood swings.
Yes.
- Escaping to fantasy worlds and daydreaming about ideal relationships.
Yes, I guess. I'm an author and I write paranormal fantasy books so escaping to fantasy is kind of my thing...
- Fear of abandonment.
Yes. So much so that I avoid people so I don't upset the into leaving, but then they feel pushed away anyway.
- Hardly speaking when forced to participate in a social situation.
Yes. I do this whenever I'm forced into a social situation.
- Hypervigilant - having an unhealthy obsession with the actions, thoughts and interests of others.
I wouldn't say obsession, but I do have an unhealthy concern over the thoughts of others.
- Passive-aggressive behaviour.
Sometimes, when I'm trying to rein in the openly angry outburst which relate to what I discussed in the BPD section of this post.
- Self-loathing and self-victimisation.
All the time. I hate myself. I blame myself for everything. Often it's unbearable.
- Tunnel vision - can only focus on a single concern while ignoring priorities.
I want to say no, but recently it's a yes.
I've read up on other personality disorders too, but none fit as well as BPD followed by AvPD. And the indicators that I've answered yes to all severly impact my life, my ability to socialise, leave the house, maintain family relationships, maintain friendships. I really do think there's something else going on apart from recurrent depressive disorder, but I'm terrified of mentioning it again in case I'm ignored, or told I'm being a hypochondriac. I'm scared of being judged if I ask for a third time. So what do I do? That's a question I can't answer, because part of my brain say's I need help, but another part of my brain also says no one will help anyway so I may as well stay quiet. Or better yet, die.
This is what happens when mental illness goes untreated for too long. Vulnerable peole whose minds are already working against them become ever more entrenched in their doubts and symptoms. But a lot of the time, it seems the government and wider world don't care about that. Physical illness is worthy of being treated. Mental illness? Not so much.
Pseudonymous Zombie
xxx
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