Just diagnosed

Hi, I was just diagnosed with DPD (and BPD traits) today. Before that, my diagnosis was BPD, which I fought, but I think I hate the DPD label even more. I also have a developmental disability (used to be autism but now they're saying developmental disorder NOS). Anyway I've been in a mental institution for nine years. Of course, that could create dependenc in itself, but I'm feeling the kind of dependence they think is disordered is my resistance to try tasks that in my opinion I do not have the executive functioning (organizational skills) and/or fine motor skills for (I also have a mild motor disability and am blind). In other words, they're labeling me dependent because I can't/won't do some activities of daily living. I mean I don't want people dictating my every move, in that sense I'm not dependent at all. However, I do have limitations due to my multiple disabilities (dev disorder, motor disability, blindness, etc.). I feel this DPD label is just there so that people can push me beyond my limits and exercise control over what sort of independence should be important and what shouldn't.

I have a question though: what is the normal approach of treatment to people with DPD? Is it to decide for us when we ned to do stuff for ourselves, ie. focused on practical independence, or is it more focused on empowerment (making our own decisions)? If it's the latter, I wonder how a therapist or support worker, who is essentially in an authority position over us, can help us with it. If it's the former, no thanks, I don't want people telling me I should cook my own food when my husband can do this faster, more efficiently and more effortlessly. As long as I know how to operate the microwave if he's in bed with the flu, I should be fine.

Hello Astridetal: I'm sorry I do not know the answer to your question really. But I saw no one had replied to your post so I thought I would. It's an interesting question. I guess what I can say is that I worked for many years with people who had developmental disabilities (as well as other types of disabilities.) So although I cannot speak with any authority to the question of what the normal approach is with regard to treatment for people with DPD, I believe I can speak to the question of teaching independent living skills & empowerment. (Of course, how these issues are viewed in the Netherlands may be different than they are in the U.S. where I am.)

It seems to me that the primary goal should be empowerment (making one's own decisions to the greatest extent possible.) And then secondarily the objective should be to teach the independent living skills needed in order to reach whatever goals one has decided upon... if that makes any sense. In other words, first you need to be empowered to establish the goals for the services you're going to receive. And once these goals have been set, then it can be decided what independent living skills need to be taught in order to make it possible for you to achieve your goals.

I do think it is possible for a therapist or support worker to help with this process. But it requires someone who has a "client-centered" approach. Someone who believes they know what you need better than you do will not be helpful, as you know. From my perspective, you're absolutely correct. Not everyone has to learn to cook. (There are lots of men in particular, who can't boil water!) As long as you can use the microwave, & you're comfortable with that, there's no reason for a therapist or support worker to try to force you to learn to cook. At least this is my perspective with regard to your post.

Thanks so much. I actually was in independence training for 1 1/2 years ten years ago. They focused on practical independence rather than empowerment. I learned to cook, clean etc. there, but as soon as I left the place and lived independently, I lost those skills. I lived on my own (with support) for three months before I fell apart and was hospitalized in a mental hospital. I've been in a mental hospital for nine years now and I badly want to leave but only wth the right supports. I mean i have a husband, with whom I want to be rather than with my fellow clients here. However, i"m very afria dthat I won't be able to get the home supports I (feel I) need based on the DPD diagnosis.

I have DPD (and some other things, so this may not apply) and I cook and have a part time job and am working on my doctorate. So I don't think the diagnosis is based on what a person can and can't do for themselves in the self-care or functioning in the world realm. For me, it seems to be based on having difficulties making decisions, looking to others for support, being needy, wanting others to be there 100% of the time.

What kind of supports do you think you need? Is there a way to get those on your own? I live in the US, so am not familiar with the way things work in the Netherlands.

I'm guessing they're going to go with the "empowerment" angle.

I don't have DPD, but I have ADHD (executive dysfunction), and I have actually tried to get therapy for the purpose of improving functionality and independent-living skills. However, it hasn't worked. From my experience, many mental health professionals just cannot wrap their brains around executive function problems. They act like they don't believe I have EF problems, even if they don't disagree with the ADHD diagnosis. If I say I have problems doing XYZ, or I haven't been able to do XYZ, or I'm doing a bad job at XYZ (because the whole reason I'm forking over money to this therapist is because I want to get better at stuff like XYZ!), they believe I'm perfectly capable of doing XYZ and I just mistakenly believe I can't do XYZ due to some kind of depression or self-esteem issue!

I actually have depression, but it's in remission due to meds. I'm pretty sure I'd be considered to have depression even if I didn't.


Now there have been some therapists that did believe and understand my issues... but they still couldn't help me gain better skills.