[Wanderlust90]

So here I am STILL trying to figure out what the hell is actually wrong with me if anything at all.

Pdocs don't agree, first said bipolar 2, second says anxiety, psych nurses say bipolar 2 & anxiety, & my GP has wiped his hands of me, I assume I'm in the too hard basket for now. I want answers, I understand that it's just a label but it directs my care & they seem to be selecting opposite routes of attack. Those that say bipolar say SSRI/SNRIs shouldn't be used as I had a significant worsening of agitated symptoms when taking them (regardless of the literature saying the rate of switching on SSRI/SNRIs is negligible so maybe I'm just having an adverse reaction not necessarily "switching.") Their argument was that SSRI/SNRIs actually increased my suicide risk & impulsivity, I have to say I agree. After having been given this information however, my current pdoc decided to put me up to a 40mg dose of Prozac to try to combat anxiety with no mood stabiliser when I did respond to 20mg Prozac for a depressive episode ( I had taken myself off my original pdocs rx of lithium due to physical side effects prior to this.) Then came all the reactive moods & impulsivity with an eventual return to depression. I have real concerns that my current pdoc is worsening my condition by ignoring the potential bipolar aspect to the obvious anxiety I have.

I tried stelazine for the anxiety & it seemed to reduce some of the undirected drive/restless energy I have but little else so I stopped that & now I'm not really taking anything but stelazine prn. Zyprexa helped during a period of heightened anger/agitation but I don't have any left, fairly sure it helped simply by making me sleep through it.

I haven't found that wonder drug for me yet, I doubt I will, I need a change of perspective that is lasting instead. I doubt all their dx, I wonder if it's all made up in my head, that everyone feels like I do they just deal with it better & Im simply a whiny ***** who can't deal with the world using mental health issues as an excuse.

I'm sure I've written this all before but have made minimal progress in 18months of treatment. Talk therapy is a waste of my time & makes me feel worse without dealing with any of the actual problems.

I asked my therapist/psych nurse about this being more a personality/temperament thing. He said he believes I have an illness (likely bipolar 2 & anxiety) & that he absolutely doesn't believe I have a personality disorder. I don't know, I question borderline traits, not the actual disorder. I have the typical unstable sense of identity, mood reactivity & lability, rapid mood changes that last shorter periods of time (probably closer to cyclothymia than borderline though, they usually last at least a few days.) I maintain perfectly good relationships though, (this may not have been true when I was using meth.) So add substance abuse, periods of self harm & disordered eating to the whole situation (appetite fluctuations relating to mood are probably more likely than an actual disorder.) I'm not looking for a PD dx, I'm just scared were treating this all the wrong way when I infact need therapy (DBT/CBT) as a primary treatment.

[Skeezyks]

Hello Wanderlust90: I have pretty-much always felt that what little bit of mental health treatment I received was basically worthless. The antidepressants either don't help or, in some cases, made matters worse. What passes for "therapy" is shallow at best. As a result, I'm no longer on med's nor do I see a therapist... just toughing it out one day after another. It's not great... but it seems to work as well as anything else. I hope you find something that works for you...

[BeyondtheRainbow]

Originally Posted by Wanderlust90

I haven't found that wonder drug for me yet, I doubt I will, I need a change of perspective that is lasting instead. I doubt all their dx, I wonder if it's all made up in my head, that everyone feels like I do they just deal with it better & Im simply a whiny ***** who can't deal with the world using mental health issues as an excuse.

I have questioned my own diagnosis and symptoms to the point that my therapist questioned whether I might be delusional as I was so obviously in a very bad place and insisting that I wasn't that badly off and I was making it all up. It took 2 hours of him going through my symptoms and what I did and didn't have to start to believe him. Until then I had (in this episode) convinced myself that I could hide my symptoms from my doctors. I've known both of them so long that they can read me very well and I don't have to tell them I'm symptomatic. But that can be so hard. I think though, at least for me, it is a way of blaming myself and beating up on myself.

Don't give up on meds yet. You haven't been on that many and honestly you've had some weird meds (ie Prozac is quite stimulating; I call it the drug from hell). Stelazine is an unusual option before trying more AAPs.And there are lots of AAPs that might help, some without even too many side effects.

It sounds like your mind is in overdrive trying to figure things out and honestly I have never managed to handle that kind of thing without treatment because it spirals out of control.

Keep writing if it helps. I know I usually need to talk when I feel that way.

[Icare dixit]

Why did you choose the avatar you chose?

I think purely from reading about the issues you describe that you probably have some borderline traits (indeed). It seems you don't find healthy expression of your emotions/problems. Everyone has that, but some know it and express their unease which aggravates the situation, in a cyclic way. Relationships, if strong enough, are not a problem (initial problems might've actually made them stronger than those of most).

But it doesn't require a diagnosis to deal with that.

As you said an antipsychotic helped you, you might try that again just to figure out whether any anxiety is caused by some "background" delusional thinking.

I'd suggest not taking any anxiolytics or antidepressants as long as you don't know the exact cause of your anxiety. You might need their full efficacy (the eventually and gradually lose efficacy) when you actually have a plan to eradicate your anxiety (which is possible).

Don't care too much about labels: BP-2, borderline and anxiety are all aspects of the same. Borderline may be more pronounced in your case than in most (some may have none of it), maybe not, but I'd suggest you just go for the "full" treatment and see what helps and what doesn't (takes at least months!).

Edit:
Days of emotions of depression or elation is not uncommon. I very much relate (also with the good relationships/friendships with others that are not or no longer toxic).

However, more intense borderline traits may be somewhat more common in BP-I or SZ (and related disorders/disorganisation). It may just mean you put a brake on so early you don't have longer and more psychotic mania, so you are always just a bit in a mixed state (which is what I suspect based on many of your posts, though I could be wrong).

Been there, done that, bought T-shirt: "Beware of reactivity!".

[Wanderlust90]

Originally Posted by Icare dixit

Why did you choose the avatar you chose?

I think purely from reading about the issues you describe that you probably have some borderline traits (indeed). It seems you don't find healthy expression of your emotions/problems. Everyone has that, but some know it and express their unease which aggravates the situation, in a cyclic way. Relationships, if strong enough, are not a problem (initial problems might've actually made them stronger than those of most).

But it doesn't require a diagnosis to deal with that.

As you said an antipsychotic helped you, you might try that again just to figure out whether any anxiety is caused by some "background" delusional thinking.

I'd suggest not taking any anxiolytics or antidepressants as long as you don't know the exact cause of your anxiety. You might need their full efficacy (the eventually and gradually lose efficacy) when you actually have a plan to eradicate your anxiety (which is possible).

Don't care too much about labels: BP-2, borderline and anxiety are all aspects of the same. Borderline may be more pronounced in your case than in most (some may have none of it), maybe not, but I'd suggest you just go for the "full" treatment and see what helps and what doesn't (takes at least months!).

Edit:
Days of emotions of depression or elation is not uncommon. I very much relate (also with the good relationships/friendships with others that are not or no longer toxic).

However, more intense borderline traits may be somewhat more common in BP-I or SZ (and related disorders/disorganisation). It may just mean you put a brake on so early you don't have longer and more psychotic mania, so you are always just a bit in a mixed state (which is what I suspect based on many of your posts, though I could be wrong).

Been there, done that, bought T-shirt: "Beware of reactivity!".

I chose it because the character Lisa Rowe is a good representation of a part of my personality, a side of me that only comes out at certain times. I'm not sure that's a good explanation. It's like a wave that comes over me at times, when I feel powerful. Magnetic, cold, wild, reckless, impulsive and violent (thoughts). That & I love Angelina Jolie.

I would agree that I'm so often in this conflicted state it's like I'm perpetually mixed. Always kind of agitated & dysphoric at a baseline.

[raspberrytorte]

I understand wanting to know what your actual diagnosis is because it determines the treatment you'll receive. The wrong treatment is damaging. If I'd followed my last pdocs advice (had let her bully me into it!) I'd be in rough shape right now!

Honestly, I think I just have depression with severe anxiety, and the anxiety is what caused my psychotic episode last year.

I wish I could find a pdoc who would take my anxiety more seriously. Maybe this next one will.

Anyway, I hope you can find the right diagnosis and start feeling better.

[Nammu]

Why not do both meds like AP, mood stabilizers plus CBT or and DBT. The best outcome is often a combo of both. Even if you don't have a personality disorder therapy can be invaluable in helping you find ways to recognize moods and give you the skills to manage them.

[Icare dixit]

Originally Posted by Wanderlust90

I chose it because the character Lisa Rowe is a good representation of a part of my personality, a side of me that only comes out at certain times. I'm not sure that's a good explanation. It's like a wave that comes over me at times, when I feel powerful. Magnetic, cold, wild, reckless, impulsive and violent (thoughts). That & I love Angelina Jolie.

I would agree that I'm so often in this conflicted state it's like I'm perpetually mixed. Always kind of agitated & dysphoric at a baseline.

I'd say that could very well describe borderline traits (only just sometimes distancing oneself from emotions, self-sabotage for example, by "pushing someone's buttons" because you will get emotionally hurt by inflicting pain, and generally sometimes losing control without really (mania-like) losing control). She has more a borderline personality than the main character (she is far too timid and generally stable).

I hurt people (most) when stable (that problems with "boredom"). I think we talk about more or less the same thing (not sure of course).

Meds and therapy, maybe it works. Just try them all!

Edit:
Of course the big difference with Lisa is that there is no emotional blow after (maybe just mildly) expressing those tendencies, since she always is distanced from her feelings (mostly), but the tendencies and even the reasons are quite similar.

Being overwhelmed by "boredom", sabotaging that, is more giving reason to ambivalence (was also talked about in the film: the true meaning) and other problems.

Not to sound as a psychopath/APD: I also curb say 99% of my tendencies and I certainly don't have them all the time (more an impulsive wave (indeed) like short mania, but at the moment more controlled and rational, feels very deliberate and the blow is rather immediate). Just a personality to match your BP. Maybe you have it. Sublimation should do it: find the subconscious reasons (sabotage to explain emotions, feelings) and find other ways to deal with that need to "feel". Some (fixed time of total) freedom of expression, feeling free, might help.

Have you tried boxing (you said you might)?

Another edit:
When I was about 6 I curbed 50% or less for a few years, having developed that/a personality. I am sure it kickstarted the long, severe depression that followed and the mania after that.

It's a nice mix of some SZ (the disorganised and emotionally distanced bits) and some BP (to not really become SZ: a way of expression, quite reactive, which is healthy in itself). I see it as more pure psychotically disordered: be proud! Again, if you have some of that.

It used to be called borderline schizophrenic and has really some bits of that but you (might have: if you have it) moved away to BP, which is commendable!

If you know of anything that's helpful, let me know (I don't do therapy: am not good at following my own advice, call it setting myself up for disaster, self-sabotage really).

[piano97]

Hi. It does sound like you have some mixed features. I have some of that too. And cycle frequently. If I'm not particularly stable, I can have hypomanic, mild manic, and depressive symptoms all within a week. I've gotten to the point I can predict when it's coming on. And it sounds messed up but I look forward to the 'peak day' when I feel like I'm made of gold and my body has a different vibration. I can't think straight and within a day am thinking my phones probably tapped and the cia, might, be plotting against me, but some of that can be headed off with extra anti-psychotic PRNs and benzo PRNs. But anyway, if I could bottle and patent what that peak day feels like, I could be a millionaire. But I have learned that when I know I'm headed that way, I have to tell friends "in a couple days I'm totally going to stop meds and probably think they might be poison, so pretty much I need you to reality check me, until I say I'm taking them." I did that last time and only missed a couple doses, and had taken PRNs the couple days before so I didn't get as out of whack as I could have.

Anyhow, I did not get a borderline flair from your posts, at all. I know you mean by that, for awhile I kept telling the doctor I thought I might just be axis 2, therefore didn't need meds. He told me, at least 5 times lol, that 'everyone has a little bit of axis2, but I don't see that as being part of what's going on". Then another time he read the dsm to me, in full, on BP2. "If that's not you I really must have missed something, and please tell me".

I'm not really in the most stable place right now, I think it's a seasonal./time change induced thing, but I'm relatively functional compared to some other times in the last year and half. I take a mood stabilizer and antipsychotic (though I'm trying to get off that). I think that is the standard treatment and in general gets good results. Keep working with MD to find the right mix.

And keep talking to other people

[Icare dixit]

Originally Posted by piano97

Hi. It does sound like you have some mixed features. I have some of that too. And cycle frequently. If I'm not particularly stable, I can have hypomanic, mild manic, and depressive symptoms all within a week. I've gotten to the point I can predict when it's coming on. And it sounds messed up but I look forward to the 'peak day' when I feel like I'm made of gold and my body has a different vibration. I can't think straight and within a day am thinking my phones probably tapped and the cia, might, be plotting against me, but some of that can be headed off with extra anti-psychotic PRNs and benzo PRNs. But anyway, if I could bottle and patent what that peak day feels like, I could be a millionaire. But I have learned that when I know I'm headed that way, I have to tell friends "in a couple days I'm totally going to stop meds and probably think they might be poison, so pretty much I need you to reality check me, until I say I'm taking them." I did that last time and only missed a couple doses, and had taken PRNs the couple days before so I didn't get as out of whack as I could have.

Anyhow, I did not get a borderline flair from your posts, at all. I know you mean by that, for awhile I kept telling the doctor I thought I might just be axis 2, therefore didn't need meds. He told me, at least 5 times lol, that 'everyone has a little bit of axis2, but I don't see that as being part of what's going on". Then another time he read the dsm to me, in full, on BP2. "If that's not you I really must have missed something, and please tell me".

I'm not really in the most stable place right now, I think it's a seasonal./time change induced thing, but I'm relatively functional compared to some other times in the last year and half. I take a mood stabilizer and antipsychotic (though I'm trying to get off that). I think that is the standard treatment and in general gets good results. Keep working with MD to find the right mix.

And keep talking to other people

Everyone has a bit of axis 2 because everyone has a personality. Seriously, those axes are not mutually exclusive, quite the opposite: it is not at all unlikely that you have "something" on all axes. Any problems/challenges in functioning which aggravate your problems, for example, would have been on axis 4, your GAF score, also functioning, on axis 5, any purely somatic conditions on axis 3.

The DSM-5, however, has done away with these axes—because there is so much overlap between personality disorders and other mental disorders.

They keep the personality disorder categories, but they also provide a dimensional model. Basically, categories make even less sense for personality disorders than for other disorders.

That said, I have no idea whether the underlying causes for any possible personality problems (that's what counts) is like that of people that have mostly borderline traits. But the changes in demeanour (not being due to mania or depression), that wave, and confusion or ambivalence, boredom, might indicate some personality "problems" which could be described as borderline traits. Suppressing these can lead to instability.

But it could be something else altogether or indeed a very normal, very well-adjusted personality. It doesn't really matter much whether it is significant enough to diagnose, if it is a problem.

Having just BP doesn't mean that there are no other problems and if you take meds you're good. Might exist, but I think it's unlikely.

What counts is whether you can deal with it yourself or not.

I've read your posts, and from that limited information, I do not get the BPD vibe from you at all. I think that when drugs are involved in any situation BPD symptoms come out, especially when you have a pre existing BP diagnosis. Also, you are smart and probably overly introspective, so that might be part of the problem/thing that makes you interesting.
Like I said, I don't know you personally, but I have worked with many BPD individuals (I'm an LMSW), and I just don't see it.

[Icare dixit]

I could really see something that's not there. If others see nothing of the sort, they're probably right.

Edit:
Just wanted to note that drug use could very well be a "result" of a borderline personality. But again, it could be something else completely, nothing related to your personality or . It's just the confusion, irritability, impulsivity, reactivity and changes in demeanour.

It could also just be being introspective yes, causing anxiety when your mood changes, making it erratic, like a mixed state.

How you (seem) to continuously struggle and be confused about your emotional state: really hope you find the right help, ways to manage, soon! Hope I didn't add to the confusion.

At any rate, thinking you are exaggerating or anything like that is nonsensical: if you struggle, there is a problem that needs fixing/managing.

[Wanderlust90]

I am quite introspective, I'm not sure that it's a good thing haha. It can be maddening sometimes when I'm feeling negative, but I think it's been a little bit of a safety mechanism when I've been agitated or elevated, I think I recognise poor judgement earlier. I defiantly do have anxiety in relation to mood shifts. & I do feel the need to suppress certain affective states, hide how I'm actually feeling because I know it's inappropriate in some way, sometimes it becomes too much & I lose that control so to speak.

Thanks all for the replies & awesome insights.