[Ubiquitous Maninlev]

I have read many of the previous posts on PsychCentral and these have helped enormously over the last few months. So thanks to all of you for your contributions and allowing me to feel less isolated.

I have suffered from depression and anxiety since childhood (I'm now 32). I'm currently a year into a bout of severe depression and have had 7 months or so away from work. I currently take 225mg Venlafaxine and 2mg Risperidone. My belief is that these are making the situation worse, not better.

I have learned to struggle through my defective thinking and function to a reasonably high level at home and at work by burying things and never expressing them. I alternate extremely between believing I am under-achieving or over-achieving. I live life in the shadow of the hidden truth, which I suspect is widely available amongst the collusive masses, that I am a fraud.

I believe that mankind is underachieving on a massive scale, and that the existence of a collection of individuals who grace the planet briefly stops any real development and resolution for the human race. I believe that I am being, rightly, punished for my failings and that this is a test of my strength and resolve, and that my failure in this test is right and proper.

Trying to look at the DSM and apply it myself I find the following -

Abandonment

I am not frantic in this, but I carefully keep everyone happy in order not to be judged negatively

Interpersonal relationships

Are stable, but my opinions on my worth and the other party's worth vary greatly. For example a month ago I was certain that I must leave my wife and that she was mistreating me. I currently think she is the most wonderful thing on the planet, and curse myself for putting her through such misery.

I am very secretive to the point that neither I nor my wife really know me. I am shy, but those relationships I cultivate are not strained - they are just not as warm, nor free-flowing as perhaps a normal relationship should be. I hide things and do not give away my feelings - often because I have no idea what I do feel. I am often described as being 'difficult to read'.

Identity disturbance

I vary from thinking I am undiscovered genius to thinking I am the worthless detritus of the human race. And this can be within five minutes. I shape my personality to the needs of others.

Impulsivity

I binge eat, I spend more money than I have on trivial items, I used to drink a lot to try and escape my problems, my driving varies from careful to absolutely bloody stupid.

Suicidal and self-harming behaviour

I have a history of self-harming and this has got considerably worse over the past year. I frequently, and obsessively, think about suicide, and this has led to a couple of frightening incidents. However, I have managed to stay out of hospital, and instead been under home treatment intermittently.

Affective instability

My default mood is one of discomfort. My moods vary very quickly and last between minutes and hours. Depression, anxiety, panic, irritability, anger, confusion, despair, complete absence of any feeling.

Feelings of emptiness

I absolutely feel devoid of meaning. My distractions seem trivial and self-serving.

Anger

I feel very angry a lot of the time. Often at myself for feeling angry with someone else for no reason. But I do not have outbursts.

Paranoid ideation and dissociative experiences

I frequently feel that I am not here, or alternatively, that I am here but the world is not real. I work under the assumption that others collude to my detriment and their favourable attentions are merely misplaced pity. I am having daily attacks of paranoia where my belief in this becomes heightened. This has led to some minor psychotic episodes.

The Psychiatric Nurse I see suggested Dialectical Behaviour Therapy (which is a very new thing here in the UK). This is likely to be denied me due to not being diagnosed BP. However, this encouraged me to research BPD and the more I read the more similarities I saw with myself. But the fundamental core of the diagnosis is missing - I have fairly stable relationships with people, I don't have outbursts of anger, and my impulses are only a little out of control.

I am getting desperate. All I know is that the medication doesn't work and I am getting worse with little prospect of getting better. This is why I'm trying to research this for myself. And why I ask for your help.

After all that waffle my questions are relatively simple - does anyone out there recognise this in themselves? Could this be BPD? Or am I completely barking up the wrong tree?

Thank you to anyone who has had the patience to read this, and many thanks to anyone who is kind enough to respond. I truly hope that you will all manage to tame the internal beasts which dominate our external lives.

Regards,

UM

[Zloppy]

I know exactly what you are saying. I have thought I have BPD too because most all the things apply to me except the outbursts of anger. I keep everything inside and don't show emotions well, and I don't get really angry, well I do sometimes, but no one will know i am. So I have been not sure if thats what I have or not too.

But to be considered to have a personality disorder, most the time, not EVERYTHING will apply to you. I have found that out. If the majority of the stuff is the same/similar, then it is most likely you have it. I would say you do have it. Even though unstable relationships is a major part of BPD, that is only a part of it. All the other stuff still counts towards it too, Just that the unstable relationships and stuff is the most common or most known for BPD.

[Ubiquitous Maninlev]

Many thanks for your help. It is really good to know you're not alone when dealing with this kind of stuff. I really appreciate your reply.

Very best wishes

[Beth1957]

Hi UM,
I'm not a psychiatrist/psychologist/counsellor, but it sounds to me as if you have BPD. Mainly because that's my dx, along with major depressive disorder, and you sound similar to me...
I do have a history of volatile relationships, but on the other hand I'm not (I think!) manipulative, so I don't fit all of the DSM criteria either, as this is another of the "core" features. However, as Zloppy says, you don't have to fit all of them to "qualify"

As to treatment... I've read good reports of DBT, but like you I'm in the UK and it doesn't seem to be available where I live. I've been on venlafaxine; actually I've been on a lot of different antidepressants at one time or another - I keep breaking through on them. I'm currently on duloxetine & indeed have been for a couple of years now & it's still working, which is probably a record for me! It doesn't really help with the BPD side of things but does help with the associated depression. I'm also on Sodium Valporate as a mood stabiliser - now that has really helped me! I still get the mood swings but they aren't nearly as violent: in fact I've not felt the need to self harm for months. And I think I've curbed my overspending, though not my binge eating or my smoking, a bit.
I'm now in group therapy. It's going quite well, but it's early days yet and I've not raised a lot of my issues in the group.
I'm here if you want to talk; PM if you like.
In the meantime take care & stay safe.

I don't have BPD, but I do have a DBT workbook that I've worked through, as well as working through some DBT skills with my Teacher T (I have 2 T's) and I think they are great skills for ANYONE to have at their disposal.

Perhaps the DBT would give you some relief,whatever your diagnosis...

Good luck to you..

[Ubiquitous Maninlev]

Originally Posted by Beth1957

Hi UM,
I'm not a psychiatrist/psychologist/counsellor, but it sounds to me as if you have BPD. Mainly because that's my dx, along with major depressive disorder, and you sound similar to me...
I do have a history of volatile relationships, but on the other hand I'm not (I think!) manipulative, so I don't fit all of the DSM criteria either, as this is another of the "core" features. However, as Zloppy says, you don't have to fit all of them to "qualify"

As to treatment... I've read good reports of DBT, but like you I'm in the UK and it doesn't seem to be available where I live. I've been on venlafaxine; actually I've been on a lot of different antidepressants at one time or another - I keep breaking through on them. I'm currently on duloxetine & indeed have been for a couple of years now & it's still working, which is probably a record for me! It doesn't really help with the BPD side of things but does help with the associated depression. I'm also on Sodium Valporate as a mood stabiliser - now that has really helped me! I still get the mood swings but they aren't nearly as violent: in fact I've not felt the need to self harm for months. And I think I've curbed my overspending, though not my binge eating or my smoking, a bit.
I'm now in group therapy. It's going quite well, but it's early days yet and I've not raised a lot of my issues in the group.
I'm here if you want to talk; PM if you like.
In the meantime take care & stay safe.

Thanks very much - that is extremely helpful. Its really good to know that there are people out there going through this and have managed to find medication that works. It really sounds like things are going pretty well for you - good meds, going through therapy, curbing the self-destructive traits (which is bloody hard when one minute you say you'll never do it again, and the next minute you're doing the exact thing you swore against). That's really impressive.

I must say I've been offered group therapy and have my reservations - I'm really not sure I'd ever bring anything up.

I really really appreciate your response. Responses like these mean I can go and face the psychiatrist with a bit more confidence, and get him to seriously consider comorbid diagnoses rather than wait yet another month for the medication to not take effect.

Many many thanks. I wish you the very best of luck. I can't tell you how much your response has helped me.

UM

[Ubiquitous Maninlev]

Originally Posted by earthmama

I don't have BPD, but I do have a DBT workbook that I've worked through, as well as working through some DBT skills with my Teacher T (I have 2 T's) and I think they are great skills for ANYONE to have at their disposal.

Perhaps the DBT would give you some relief,whatever your diagnosis...

Good luck to you..

Many thanks. What little I know of DBT sounds really good, and I'd really like to try it if they will let me. I'm in one of those ludicrous situations where you can only be accepted onto the treatment regime if you've been diagnosed BPD - but the psychiatrist is not able to diagnose personality disorders, and there is a long waiting list to see a clinical psychologist who I'm reliably informed only deals with 'simple' cases and won't be able to diagnose anything beyond that.

I'm really pleased you have benefitted from DBT - it seems like such a practical approach. And what little I know of it I agree wholeheartedly with you - it seems like something everybody should do.

Very many thanks

UM

Hi UM,

Welcome to PC.

You might want to do some research on The Quiet Borderline, sometimes referred to as "Acting In" BPD.

Here's a link.

http://www.borderlinepersonality.ca/borderquietb.htm

[Zloppy]

Nice link Orange. Sure helped me out as well. Hope that link helps you too, UM.

[Ubiquitous Maninlev]

Orange Blossom - many thanks. That is me exactly. In fact, it is me to a scary degree. I'm going to print this out and take it to the psychiatrist.

I can't thank you enough. I really feel that with your response and all the others that I am finally getting somewhere. I know a diagnosis isn't a cure, but it is the first step to getting well-directed help.

Thank you

UM

[Fuzzybear]

Welcome to PC - keep posting!

[Beth1957]

Originally Posted by Ubiquitous Maninlev

Thanks very much - that is extremely helpful. Its really good to know that there are people out there going through this and have managed to find medication that works. It really sounds like things are going pretty well for you - good meds, going through therapy, curbing the self-destructive traits (which is bloody hard when one minute you say you'll never do it again, and the next minute you're doing the exact thing you swore against). That's really impressive.

LizBeth replies: the not self harming is a weird one; I was having a really really bad day a week or so back, and I suddenly realised that surprisingly enough I had no desire to self harm. And that I hadn't for months! I can't say I'll never do it again mind you, that would be tempting fate

Originally Posted by Ubiquitous Maninlev

I must say I've been offered group therapy and have my reservations - I'm really not sure I'd ever bring anything up.

LizBeth replies:Well, this is my second go. The first group just didn't work out at all and I really disliked it. This one is good though.

Originally Posted by Ubiquitous Maninlev

I really really appreciate your response. Responses like these mean I can go and face the psychiatrist with a bit more confidence, and get him to seriously consider comorbid diagnoses rather than wait yet another month for the medication to not take effect.

Many many thanks. I wish you the very best of luck. I can't tell you how much your response has helped me.

UM

LizBeth replies: You're welcome, & I'm glad to have helped you. Please stay in touch, even if you just want to let off steam sometimes!

[ECHOES]

Sure it can be. The symtpoms listed as part of BPD can be things that are not obvious to us. And we develop ways of dealing with the fears that can be part of the symptoms but don't seem like it. For example, a person who is extremely fearful of rejection may not have volatile relationships, but instead may have learned that avoiding relationships means avoiding the hurt as well, so they may have relationships that seem calm and steady on the surface. Those relationships can also feel empty or unfulfilling because intimacy is being avoided.

So I guess I'm saying that the same underlying feelings and fears can lead one person toward volatile relationships ("Don't leave me!") or toward avoiding relationships or avoiding meaningful relationships ("If you do leave me, which I expect, I won't feel hurt because I haven't let you get close.")

[Ubiquitous Maninlev]

Thanks echoes. That is the way I have been looking at it, too. Especially as I have just heard about how my Dad used to behave - which I was unaware about - which to me would be classic BPD. So the family link appears to be there too.

Many thanks for your comments. They are much appreciated. I have just been to see the conslutant psychotherapist today - and they don't seem to keen to diagnose, but rather keep trying treatments til one works. I just have a strong feeling I don't have time for this approach.

Something is very wrong and I am certain that depression is just the symptom of something greater. I really think that treating just the depression will only leave me back in the same place again and again and again.

[Rapunzel]

Originally Posted by Ubiquitous Maninlev

Something is very wrong and I am certain that depression is just the symptom of something greater. I really think that treating just the depression will only leave me back in the same place again and again and again.

I think that is often true of depression, especially persistant or recurrent depression. Most of the time there is something behind it that contributes to it (personality disorder or patterns of behavior, lack of coping skills, trauma, medical issues, etc.) I hope that you and your team can find what it is and start getting it worked out.

[ECHOES]

The therapeutic approach to BPD can't be rushed. It's a process.

My T does not diagnose. The only reason I know my diagnosis is that I read a lot and when I read "get me out of here" and "I hate you/don't leave me!" and "Understanding the Borderline Mother" I felt the diagnosis might apply so I asked her. She readily agreed and said she had thought that very early on.

Trust the process, my T tells me. I do. I have been in therapy for a year and 9 months, recently beginning twice weekly sessions. I do feel better, although I think it took a while for me because I have a hard time talking in session.

Trust the process.

[Ubiquitous Maninlev]

Thanks guys. I appreciate your comments - all of which are useful to me.

Putting my trust in a process is very difficult for me, as my natural inclination is to distrust other people and their motives. But I am trying to be more open and have more faith in others. I just want to make sure I am on the right path. Your comments have reassured me somewhat in this.

I am especially pleased that you all seem to be making progress. I am very pleased for you. For someone with BPD to even state something like 'trust the process', is surely a big step forward.

Many thanks to you all and I hope you all have a good time over the holiday season.

[Ubiquitous Maninlev]

Dear all

Thanks once again to you for all your help.

I have just come back from a psychiatrists appointment. He has said 'the diagnosis is most probably BPD' and has completely changed the approach to medication - which means I stop taking the things that don't agree with me. This is in no small part due to your goodselves and the help you have provided. This enabled me to approach things far better informed.

I know a diagnosis is not a cure, but at least it is a good starting point to getting the right treatment.

I owe you all a great deal,

UM

[Beth1957]

Originally Posted by Ubiquitous Maninlev

Dear all

Thanks once again to you for all your help.

I have just come back from a psychiatrists appointment. He has said 'the diagnosis is most probably BPD' and has completely changed the approach to medication - which means I stop taking the things that don't agree with me. This is in no small part due to your goodselves and the help you have provided. This enabled me to approach things far better informed.

I know a diagnosis is not a cure, but at least it is a good starting point to getting the right treatment.

I owe you all a great deal,

UM

That's great news, UM. Well done to you for researching the issue and for standing your ground with your psychiatrist - that's not always easy!

[Martina]

I don't have the book to remember - but don't you only need like 4 or 5 of the 9 criteria to get the BPD diagnosis? I know I don't meet ALL the criteria, but I meet most of them.

Therapy, especially DBT, will be more crucial than medication if it is truly BPD. But you may want to ask about Lamictal. It's being studied to be FDA approved for treatment of BPD. It just went generic (in the US..not sure about UK). Anyway, just a thought.

Good luck!

[ECHOES]

I know a diagnosis is not a cure, but at least it is a good starting point to getting the right treatment.

I wasn't looking for a diagnosis, and T doesn't dwell on them and doesn't want me to get hung up on the diagnosis. But in a strange way it felt releiving to hear. That there is a reason I am how I am, a name for it besides the degrading names I had for it. It isn't a cure, but it is a starting point. Awareness is the needed for understanding and then change.

[StrawberryFieldsss]

Hi UM,

Although this is an old thread, I just wanted to tell you that I saw a lot of myself in your description.

I just recently self-diagnosed as BPD, and it has been a real eye opener for me. One thing that I realized in reading through outside sources and this board is that there are "degrees" to this disorder. I probably would characterize mine as mild based upon the things that I have read. This could be for a number of reasons, one being that I have been working on myself for 25+ years. I've never taken meds of any kind.

Another thing that I am realizing as I read these boards is that there are areas in my life that definitely need tweaking. I'm not considering therapy again, but just taking steps on my own to think differently. For me, it has always been about awareness and not acting till I figure out where my head is at. One day I will blog about how I do this, as I see this site has a blogging module available.

Thank you again for your post, UM. Reading it and the responses have been helpful.

Melanie

[Michah]

Hi there, I was very violent and close to jail. When I was dx 15 years ago I was a complete maniac. Promiscuous, self medicating, criminal, paranoid, self-harming, homicidal and completely out of control. I was also dx schizoeffective. I had terrible, passionate relationships and was in and out of hospital. On and off meds, running amok, raising a child as a single parent and basically being an urban terrorist.

I have now been diagnosed bipolar, take my lithium and look at my life 15 years later. My son is 13 and great and does well in life, I have met someone who loves me for all my complete mental breakdowns and the times that I have accused him of not loving me enough(I hate you, don't leave me!), the times, though rare now, that I completely lose my mind and fly into intense rage, when I spend 2 weeks obsessively trying to apply quantum theory to environmental issues( he actually helps me! to a degree and then he points out the futility of my theories) and a whole bunch of other stuff. He teaches me how to love peacefully and that sex is about LOVE not POWER.

You can get to a good place with all this and I fall off a lot of the time but I just get up and make peace with God and get back on the wagon. I have learn't to start loving myself! Terrible cliche but true nonetheless.

[Ubiquitous Maninlev]

Dear StrawberryFieldsss and Michah

Thank you for your posts. It is very encouraging to hear of others who have made such progress. I hope this progress long continues.

Many thanks

UM