MDD and BPD and OCPD, OH MY!

The Blog for Mental Health Project is back! For those of you who don’t know, the purpose of this project is share your experiences with mental illness, to educate, to reduce stigma and most importantly let those suffering know that they aren’t alone.

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“I pledge my commitment to the Blog for Mental Health 2015 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.”

I have had a lot of labels thrown at me. I have Major Depressive Disorder (MDD). More recently, Borderline Personality Disorder (BPD) and Obsessive-compulsive Personality Disorder (OCPD) have been added to the mix. I’m not a fan of these labels. I don’t feel like I fit these cookie-cutter definitions. This is what makes mental health so complicated. Each case is unique and must be treated as such.

This is my story…

I started treatment in 2006, but it began long before that. I think I was born hating myself. Mental illness runs on both sides of my family. It must be in my genes. I was always a very serious child. People would say I was moody, which I suppose was true, but it was more than that. I had terrible stomach aches and threw up a lot when I was younger. I guess I didn’t understand how I was feeling so it manifested physically. As I got older, the physical symptoms waned, I developed body image issues, anxiety, perfectionist tendencies, anger issues and the moods got harder for me to handle. Eventually I stopped going out, I stopped sleeping, I stopped functioning and I prayed that I would just disappear. Since it was unlikely that my prayers would be answered, I did the next best thing. I got help.

Currently, I wear many different hats. I am a Ph.D. candidate, a wife, a lab manager, a wannabe artist, a daughter, a sister, mum to the cutest kitty ever AND I am climbing my way out of the worst depressive episode I’ve ever had. Thanks to my family and closest friends, I am still here. Mental illness, whatever labels they may give me, will be a battle I will fight for the rest of my life. It’s a battle no one should have to fight alone. Blogging has been a great help in coping. I get to sort my thoughts out in words or at least doodles and connect with a whole community of people that understand what I am trying to say. Not only has blogging been a comfort, I have met some wonderful people and learned so much about mental health. I plan to continue blogging about my own experiences with mental health along with some art journaling, doodles, Lego, blog challenges and adorable cat pictures thrown in a long the way.

Alphabet Soup

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MDD, GAD, SAD, OCPD, BPD, CBT, DBT…..Argh!! Sometimes when it comes to my mental health, I feel like I’m living in a bowl of alphabet soup. These letters are constantly floating around me and half the time I have no idea what is going on. Health professionals don’t always have the time to explain what these things mean. Sometimes I think they find it easier not to mention them at all and I’ll just get a referral slip with a bunch of letters on it. I know going on the internet to figure things out isn’t always the brightest idea, but I’m glad I starting reading blogs. I’ve learned so much about mental health and these letters are starting to feel less like alphabet soup and more like acronyms that have actual meaning.

When I was 21, I was persuaded to go to a youth clinic for depression. The general practitioner there, diagnosed me as having Major Depressive Disorder (MDD) with some Generalized Anxiety Disorder (GAD). That’s the diagnosis I’ve known for the last 8 years.

Not too long ago, I had an appointment with the local clinic to start up talk therapy again. At the beginning of my treatment, I thought there was just medication or talk therapy, but over the years I’ve learned that there are different types of talk therapy. Cognitive Behaviour Therapy (CBT) was what I was usually referred to. Anyway, this local clinic woman was offering therapy that was new to me (Dialectical Behaviour Therapy or DBT). She was kind, easy to talk to and didn’t seem to be in a hurry so, out of curiosity, I asked her what my formal diagnosis was. She said it was a primary diagnosis of major depressive disorder or MDD (old news) and a secondary diagnosis of Obsessive Compulsive Personality Disorder (OCPD) and Borderline Personality Disorder (BPD).

Wait, what?!

I had never heard of OCPD before. I am familiar with OCD or Obsessive Compulsive Disorder, but OCPD? She explained that OCPD is basically my need for approval and my being a perfectionist, beating myself up over everything. It’s a completely different condition from OCD. Ok, fine. That makes sense but, what about BPD? That doesn’t make sense. I don’t know much about BPD, but I do know they tend to get a bad reputation (clingy, unstable, impulsive, demanding, reactive, difficult relationships, etc..). This sounds like the polar opposite of me. Most of it is probably misunderstood, a stereotype created by so many referring to Glenn Close’s character in Fatal Attraction as an example of BPD. I was pretty sure that the emotionally reactive/unstable mood part was accurate though.

The woman I was with was nice, but she didn’t have the time to answer ALL my questions about this, so I turned to Google.

Here is the DSM IV diagnostic criteria for BPD. A diagnosis of BPD is determined by meeting five of more of these criteria.

  • frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. Maybe. I think this is the reason I’m such a perfectionist. I worry people wont like me if I don’t do a good job at things. I always feel guilty that I’m not doing enough.
  • a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This doesn’t sound like me at all.
  • identity disturbance: markedly and persistently unstable self-image or sense of self. This could be true. I can’t seem to figure out what I want, what is important to me. I just aim for what I think everyone else wants or expects of me or I choose the hardest route so I can’t be accused of being lazy.
  • impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. I am guilty of binge-eating, skin picking, isolation, over sleeping, ignoring emotions….
  • recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Yea, ok.
  • affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). My moods can change relatively quickly. An emotion will come on all of a sudden and I just wont understand it. For example, I’ll be fine in the morning and then, in the depths of despair in the afternoon. This is something I don’t show to people though. No one can tell that I’m dreading something and having a total panic attack on the inside unless I tell them. I think I taught myself to do this because people would feed off my reactions and make things worse for me.
  • chronic feelings of emptiness. Yes.
  • inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). I get very intense feelings of anger, but I am always in control. No displays of temper or fights…I’m more likely to wait until I get home and then just got to sleep for a day or turn on the TV and eat junk until I feel numb.
  • transient, stress-related paranoid ideation or severe dissociative symptoms. I don’t think so…

Oh….

So, maybe I do fit the criteria…

Google also told me there were different types of BPD (High-functioning, Low-functioning, Extroverted, Introverted and Transparent). You can read more about these different types here. Based on this, an Introverted Borderline with High-functioning tendencies sounded a lot like me. I asked psych about this when I saw him last week and he agreed. Funny that he never shared this with me before. I guess he doesn’t like labels. No one fits perfectly into a cookie-cutter diagnosis when it comes to mental health.

The mystery of why my brain works the way it does is a little less mysterious.

No more alphabet soup….for now.

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