[retro_chic]

I'm so tired of everything. I saw my Pdoc this week and I told her things haven't really improved much so she decided to switch me from Cymbalta to Prozac. I am currently taking 120mg of Cymbalta so I will be tapering off very slowly and then transitioning to prozac. I'm just so over this whole thing though. Prozac will be my fourth antidepressant and I don't have high expectations. I don't really like my Pdoc very much; she reminds me of my mother. She is kind of pushy and doesn't really get me... she seems superficial. She seems to think my issues are "biological" however I tend to think it is more of a personality related thing.

I talked to T about all of this because she knows me much better than my Pdoc. I asked my T early on in therapy with her if she thought I had BPD. T basicially said she doesn't like to use labels and she wasn't sure if I had it anyway. When I brought it up again this week T still seemed reluctant to tell me if I have a personality disorder. We ran out of time so I didn't get to finish discussing it but I find it frustrating that she won't answer questions directly. I understand her perspective but having tried so many medications and years of therapy, I am starting to wonder if my diagnoses of depression and anxiety is wrong. Well not wrong as I am pretty sure I do have those things, but incomplete. I have a strong feeling that BPD is my core issue and the depression and anxiety are byproducts of it. Of course I can't just go around diagnosing myself with things which is why I want to know T's opinion.

T also asked me if I ever have doubts about therapy and her (like I do with medication and Pdoc) and I said that I do sometimes but I try not to think about it. It scares me to think that things will never ever get better so I try to believe that this is the right therapy for me. If I think things will never get better that leads to other bad thoughts and well... it just goes on from there.

Possible trigger:

Does anyone else have almost automatic thoughts about death and wanting to kill yourself? I don't actually want to die but these thoughts pop into my head over pretty minor things sometimes and it has almost become a habit.

[CharlieStarDust]

Hi Retro,
Lots of times when I read your posts I feel like could have written them myself. I too was convinced I had BPD, and like you, my T wasn't hung up on a diagnosis, but rather my symptoms. I eventually asked to be officially diagnosed and went through a formal assessment. Turns out I have a whole host of diagnoses, but the way we did therapy didn't change. My T did bring a few new things from DBT, when I expressed the place we were at wasn't working for me.
Maybe you can talk to your T about different approaches if she's reluctant to name what you're dealing with - if that makes sense.
I hope the new meds work. Good luck.

[CharlieStarDust]

Also, I can 100% relate to your last point. It's like it's the go to solution to everything.
And it's not even upsetting anymore.

[captgut]

(((((retro)))))

I have these automatic thoughts too...It's terrible. I'm so tired.
I don't know what to say. Life is so hard sometimes. Or all the time... But you're not alone.
I hope you'll be better

[LonesomeTonight]

I wanted to say that 4 antidepressants isn't really that many. Everyone reacts differently to them, so it's not unusual to have to try a bunch to find the one that works. Many people find that using 2 meds together works better, too.

Pretty sure over the past 4 years, I've tried about a dozen different meds and still haven't found quite the right fit (I'm also really sensitive to meds and their side effects, so that makes it harder). I've been diagnosed with generalized anxiety, panic disorder, OCD, and recurrent major depression. But now my new p-doc is exploring the possibility that I have bipolar II (which involves depression and hypomania, a lower level of mania than bipolar I). So she's trying me on a mood stabilizer (Abilify) along with the SSRI I've been on (Zoloft).

The recurring thoughts could be a symptom of OCD--they're known as "intrusive thoughts." So that's a possibility that's not a personality disorder. The other thing is, personality disorders can coexist with things like depression and anxiety. So even if you did have one, you could still get help for the symptoms.

Could you see a different p-doc? I've found that having one who really seems to listen to me makes a huge difference. Or if you can't find a new one, could your T talk to her?

[Elio]

As your last point, absolutely. That has been my baseline life (daily to multiple times a day) up until last depressive episode where it went "active", as I call it. Through working with my T over the last year and a half, I have backed away from being "active" through the base life and now to about 1-2 times a month.

Possible trigger:

I call this place, passive death wish. My t says that it is not uncommon for people to think that. I think that the uncommon part is the frequency or the tolerance to triggering items. I don't think I should be thinking it on a daily basis nor should just walking down the street bring it to the forefront of my thought processes.

[AnxiousGirl]

Originally Posted by retro_chic

I'm so tired of everything. I saw my Pdoc this week and I told her things haven't really improved much so she decided to switch me from Cymbalta to Prozac. I am currently taking 120mg of Cymbalta so I will be tapering off very slowly and then transitioning to prozac. I'm just so over this whole thing though. Prozac will be my fourth antidepressant and I don't have high expectations. I don't really like my Pdoc very much; she reminds me of my mother. She is kind of pushy and doesn't really get me... she seems superficial. She seems to think my issues are "biological" however I tend to think it is more of a personality related thing.

I talked to T about all of this because she knows me much better than my Pdoc. I asked my T early on in therapy with her if she thought I had BPD. T basicially said she doesn't like to use labels and she wasn't sure if I had it anyway. When I brought it up again this week T still seemed reluctant to tell me if I have a personality disorder. We ran out of time so I didn't get to finish discussing it but I find it frustrating that she won't answer questions directly. I understand her perspective but having tried so many medications and years of therapy, I am starting to wonder if my diagnoses of depression and anxiety is wrong. Well not wrong as I am pretty sure I do have those things, but incomplete. I have a strong feeling that BPD is my core issue and the depression and anxiety are byproducts of it. Of course I can't just go around diagnosing myself with things which is why I want to know T's opinion.

T also asked me if I ever have doubts about therapy and her (like I do with medication and Pdoc) and I said that I do sometimes but I try not to think about it. It scares me to think that things will never ever get better so I try to believe that this is the right therapy for me. If I think things will never get better that leads to other bad thoughts and well... it just goes on from there.

Possible trigger:

Does anyone else have almost automatic thoughts about death and wanting to kill yourself? I don't actually want to die but these thoughts pop into my head over pretty minor things sometimes and it has almost become a habit.

Currently going through the same thing. i was so quiet and down in session last week that my T actually asked if I was having any thoughts of taking my own life. Obviously I said no, but I did. Ive been so tired of everything lately and these thoughts come to mine like 3 times a day. I don't want to act on them or anything either. I plan on telling T next week but still not sure.

[MBM17]

I personally think that after we sufferers have depression and

Possible trigger:

suicidal thoughts for long enough, it becomes a habit. Elio's phrase "passive death wish" sounds excellent to me. I suspect that I will dealing with death thoughts for the rest of my life after having years of deep depression and thinking about it and wishing for it so often. It's like it's automatic. But it still scares me when they happen. I see a bus and think about jumping in front of it, even if I'm not even feeling really sad/depressed right then. Automatic.

Lately I've been feeling tired, too, so tired of trying, so tired of keeping on fighting, so tired of the maintenance, the meds, the side effects, having to work every.single.day. I am sure that the passive death thoughts contribute. It takes energy to keep them passive, and it's tiring.

[thesnowqueen]

I think the system for categorizing mental illness is vague and inefficient and often more destructive than helpful. These diagnoses can also be self-fulfilling prophecies - tell someone they have a particular illness and they may well subconsciously start manifesting the relevant symptoms. For these reasons (and perhaps others) I think professionals get edgy around the issue of diagnosis and start worrying about 'labels' etc. I have one DBT workbook that is supposed to help people with borderline PD but be useful for many others too. The main symptom it deals with is 'overwhelming emotions'. In a very basic and common sense way I think the issue of regulating emotions is core to many mental illnesses and all the other claptrap is superfluous.

I honestly didn't know I was bipolar until I read it upside down on a nursing form at the hospital. As for this psychiatrist it will be interesting to see what he has written down as my diagnose(s) on a form I gave him to fill out for Veterans' Affairs (Canada).

[satsuma]

I didn't do DBT therapy, but I have a DBT workbook that I find helps with these kind of feelings. I know what you mean about the habitual suicidal feelings. I think it's important to try to learn another reaction to these bad feelings. In my experience it can take time, and some deliberate effort (hence I find the workbook helpful). My T and I also worked on flashcards for these times, which is part of schema therapy. Eventually, it can become habitual to think through the things that are on the flashcards.

[thesnowqueen]

Originally Posted by justafriend306

I honestly didn't know I was bipolar until I read it upside down on a nursing form at the hospital. As for this psychiatrist it will be interesting to see what he has written down as my diagnose(s) on a form I gave him to fill out for Veterans' Affairs (Canada).

There can be various reasons for making such a diagnosis. Where I live, medical aids provide better coverage for bipolar than unipolar and so mental health professions use that code more often!

[retro_chic]

Thank you so much everyone for your hugs and replies!

I will be continuing the whole "diagnoses" conversation with my T next session because like I said, we ran out of time. One of the reasons I want to know is so I can set realistic expectations for myself and not beat myself up over things as much. The other reason is that if I do have BPD then that means medication won't have as much of a benefit as it would if I had actual biological depression and I should focus my energy on therapy instead. That's my reasoning anyway.

As far as the Pdoc situation goes, it is pretty hard to get into see one in the first place. Most of them have at least a 3-6month waiting list where I am and I really just can't be bothered. I did sign a form giving my T and Pdoc permission to talk about me to one another but I don't think that has happened so I will follow up on that and see what happened.

Regarding the "trigger" stuff, I will talk to my T about that as well.

Possible trigger:

I know I don't want to die because the times that I have really thought about it in detail I have just been like "ugh, no that's a terrible idea, I don't want that at all!". And yet the thought still pops into my head regularly

[skeksi]

Regarding the thoughts, I think they can become a habit. I have something similar and it becomes my go-to when things are hard. T has suggested to me that at one time, those thoughts were helpful, so they've become an automatic response, even when they are not helpful.

I read a great book about the brain that talked about how when you do something over and over, it's like riding a sled down the same path on a hill. It's very hard, after a while, to try to change the path of the sled. You have to forge an entirely new path through the snow. I think about that when I get frustrated with myself for repeating patterns.

Does anyone else have almost automatic thoughts about....these thoughts pop into my head over pretty minor things sometimes and it has almost become a habit.

Hey retro_chic,

Yes, I have those too. I think this comes from early attachment issues, as you are experiencing your early relational feelings and schemas with your therapist now. A lot of times, this represents the inability to 'process' anger. You experience being angry with your therapist from a child's perspective, but it gets absorbed back into you like the original projections of your mother. People often refer to this as "turning anger against yourself".

My therapist acted like yours when I asked him questions about my diagnosis. I ended up letting it go, but I did want to hear his perspective about it...However, I've been searching for answers for most of my life, and I have come to the conclusion that it doesn't matter much what your diagnosis is. A personality disorder just means you had developmental trauma. Not too many people fit into the exact boxes of those diagnoses, as they largely point to specific behavioral expressions of inner states. We're just so different in how we express ourselves.

Diagnosis isn't that important for psychiatry either as you'll be treated for symptoms--sleep, depression, anxiety regardless of your 'official' diagnosis. People take stimulants, antipsychotics, and mood stabilizers for depression; whatever works. I know there are psychiatry manuals that recommend certain medications for certain conditions, but since one person can get 5 different diagnosis from 5 different psychiatrists, and everyone reacts differently to medications regardless of diagnosis, it still ends up being trail and error. And for example, say you have borderline, which is sure to cause anxiety. Anxiety leads to insomnia, lack of sleep leads to 'biological depression'. Being in a state of anxiety all the time leads to hormone imbalance, health problems, which leads again to 'biological depression'. Or take for example, someone with a grief depression. Having temporary depression leads to lower self-confidence, which can spiral to affecting sense of self, thus becoming 'emotional depression'. They are overlapping, not binary. Many people experience temporary depression from grief, then they are put on medications for depression when they would have been better off waiting it out. That's different...but largely, there is not much science behind it. I think it's silly to categorize biological vs emotional. I've had long talks with a psychiatrist about this, and they just can't be distinguished like people would like to think.

It can be interesting reading about all the diagnoses, for sure, but that's about the extent to which I think they are useful. From a psychoanalytic perspective, they are are treated just about the same anyway.

I think it will be all good. You're young enough to be able to shape your future. Even if you feel anxious and depressed, being in this therapy will provide the opportunity for you to set the path of your life rather than being driven by unconscious motives, influences, or drives. You'll be able to make decisions that are non-destructive. Making your unconscious conscious prevents self-sabotage and lets you choose relationships for the right reasons rather than for the wrong reasons. Or for the avoidant, lets you choose to be in one to begin with. I know for sure that I'd have a much, much better life had I done therapy sooner. Of course people who do therapy young won't really know what choices they would have made; how their life would have ended up had they not been in therapy.

Feeling your feelings makes a big difference in managing behaviors. You'll likely get to the point where you feel safer with relationships and more content with yourself. All these things lead to a better life, which has an effect on depression and anxiety.

Sometimes it helps to lower your expectations. Therapy isn't a cure by far. Also, I don't think resolving depression necessarily leads to doing and feeling better. I actually think it's the other way around-doing leads to feeling better which leads to depression remission. Therapy can help you with the doing part, which will ultimately help with depression. It's the tiny, marginal changes that add up over time. It takes a lot of patience, too.