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Dr. Bob is Robert Hsiung, MD,
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Posted by floatingbridge on October 31, 2010, at 17:57:27
In reply to Re: Feeling so depressed about stigma » morgan miller, posted by Deneb on October 31, 2010, at 16:40:56
Hi Deneb,
I see my pdoc for therapy, too. It is unusual in the States, too.
There is new research being done on BPD that will, I hope, not only bring about better treatment protocols, but a kinder, more realistic view about what 'it' is.
I agree that the popular stigma is terrible, and some people have thought BPD 'incurable'. That's unscientific baloney. It also depends on what one considers a 'cure'.
I'll be taking meds until my last day. I accept that. I accept nothing will undo my childhood. I accept that I am the only child in my family to have c-ptsd,
another 'uncurable' syndrome that has much in common with BPD. I accept that I will have good times and relapses, and that many people I know, friends and family included, will not experience the pain I can on any given day (though this
does not make me special in any way).I don't know what a personality disorder is, how it differs from depression, anxiety. The word 'personality' makes the illness sound self-willed and intentional, but that isn't really how it is
at all. It's a disorder of emotional regulations. Isn't that biological?This is so long-winded. I do know that hiding my illness from people--family and friends--intensifies things terribly. At least for me. My pdoc suggested that whomever I could not tell the truth (childhood ptsd and depression) I tell them, well what we came up with was fibromyalgia which is almost true.
You sound like such a good egg, Deneb. Don't let all the negative diagnostic hype get you down. You are so much more.
Posted by morgan miller on October 31, 2010, at 18:03:20
In reply to Re: Feeling so depressed about stigma » morgan miller, posted by Deneb on October 31, 2010, at 16:40:56
Sounds like you have a good fit with your pdoc. I wasn't really challenging that you were doing the right thing by seeking therapy with your pdoc, I was just telling what I have learned about how therapy can be different between pdocs and therapists, just as it can differ between different types of therapists that solely practice therapy.
I glad you are happy with your pdoc, your very lucky for this.
Man, the more I hear about Canadian healthcare, the more I think it's really not so great.
Posted by maxime on October 31, 2010, at 18:14:07
In reply to Re: Feeling so depressed about stigma » morgan miller, posted by Deneb on October 31, 2010, at 16:40:56
I hate that psychologists aren't covered by our medicare. But at least we get to see a pdoc. My pdoc talks to me more than just about meds. I usually spend about 45 minutes in his office, sometimes more and sometimes less. I am glad he doesn't shove me out of the door.
I have my name down at several places that charge on a slidding fee scale. I wonder if my name will ever come up?
Deneb, I am glad that you can trust your pdoc. At least you have that.
Posted by Deneb on October 31, 2010, at 19:34:13
In reply to Re: Feeling so depressed about stigma » Deneb, posted by maxime on October 31, 2010, at 18:14:07
I don't know what to do.
I don't know why I've relapsed. Taking the Risperdal helps a lot, but I can't just keep sedating myself.
Something has been triggered within me and I can't shut it off.
I'm afraid if this goes on I might kill myself.
Posted by emmanuel98 on October 31, 2010, at 20:07:41
In reply to Re: Feeling so depressed about stigma, posted by morgan miller on October 31, 2010, at 16:20:01
It depends on the age of the p-doc. Mine is 71 and was intensively trained in dynamic therapy by one of the gurus of therapy in Boston (now dead). Three years of residency and 40 years of doing therapy. He's the best. I got so much better seeing him every week. He prescribed meds too and it was good to have the same person do both, since he really knew me, talked to me at length regularly and could really assess how the meds were working.
> I'm surprised by this. The therapist I've dealt with and spoken to usually do not believe that psychiatrist who practice therapy are as effective for many people. One, they do not specialize in therapy, and two, they usually cannot make the same connections that really good empathetic and compassionate therapists can. For me, the ideal therapist has a Ph.D. in clinical psychology, has a huge capacity for empathy, has a huge capacity for compassion, and is someone that the patient feels extremely comfortable with.
Posted by emmanuel98 on October 31, 2010, at 20:13:18
In reply to Re: Feeling so depressed about stigma » Deneb, posted by floatingbridge on October 31, 2010, at 17:57:27
>
> I agree that the popular stigma is terrible, and some people have thought BPD 'incurable'. That's unscientific baloney. It also depends on what one considers a 'cure'.According to Glen Gabbard, a p-doc at Baylor who writes a textbook on therapy for psychiatrists and has written extensively on BPD, most BPD sufferers get better with age, regardless of treatment, though therapy is the most helpful treatment. So it's not considered incurable. A lot of T's don't like working with BPD patients because they require a lot of energy, but others are happy to take them on. My p-doc has a lot of BPD patients. So does my DBT therapist.
Posted by sigismund on November 1, 2010, at 2:13:16
In reply to Re: Feeling so depressed about stigma, posted by emmanuel98 on October 31, 2010, at 20:07:41
>For me, the ideal therapist has a Ph.D. in clinical psychology, has a huge capacity for empathy, has a huge capacity for compassion, and is someone that the patient feels extremely comfortable with.
I don't know about where you are but I'm not over-impressed by PhD's in clinical psychology here.
Better something from a proper therapist training school, whatever such places are called.
Posted by Jay_Clockwork_Angels on November 1, 2010, at 4:07:26
In reply to Feeling so depressed about stigma, posted by Deneb on October 30, 2010, at 19:57:00
I've had to live with an intense amount of stigma over the last 4 months. It is a very long story, but I had to explain to my supervisor's at my job why I got angry and yelled at a co-worker. I was under a lot of stress at the time, and this person had been pushing my buttons for years. So I told him to "Fu*ck off and mind his own business", and then he twisted the story to make it sound like I threatened him. It was classic "he said - she said"(err..he said..he said...heh) I explained to my bosses the combination of stress and my documented mental illness are not good things, and led to my outburst, but that I didn't threaten ANYONE. They thought.. "Ohh..he is crazy...he MUST be lying..", and believed 100 percent of the other guy's version of the story.
Anyhow...I got the last laugh. They paid me for 3 months time off, because they knew they couldn't fire me or else I'd drag them to human rights. Now, I am negotiating a nice fat buyout, plus some goodies, and I have an excellent full time, very well paying job waiting for me in Toronto, to start next week. The agency I am going to work for is really progressive...thinks the way I do.
So....there is one for the good guys. :)Jay
Posted by floatingbridge on November 1, 2010, at 12:24:52
In reply to Re: I don't know what to do, posted by Deneb on October 31, 2010, at 19:34:13
Hi Deneb,
When you have time, would you drop a line and let me know how you're doing?
fb
Posted by Deneb on November 1, 2010, at 12:47:58
In reply to Deneb, how is today going? » Deneb, posted by floatingbridge on November 1, 2010, at 12:24:52
Thanks for asking floatingbridge, I went to bed early last night. I was sedated from my extra meds. I woke up early and the first thing I did was phone pdoc's office to see if I could get an appointment. Pdoc is able to fit me in on Thurs.
I'm feeling depressed and have suicidal ideations, but I can handle it for the time being. This is nothing like the other day, but I am very afraid of what my next mood swing will bring. I just took a nice long bath and that relaxed me a bit.
I'm going to try to go outside today. I think walking around and doing something will help me.
I have an appointment to see my employment specialist tomorrow. I thought of cancelling, but decided against it. I want to try to get back into normal life. Maybe it will help me.
Posted by Dinah on November 1, 2010, at 15:50:03
In reply to Re: Deneb, how is today going? » floatingbridge, posted by Deneb on November 1, 2010, at 12:47:58
It's great that you called your pdoc, and also great that she was able to fit you in. I remember times when you assumed she wouldn't see you and didn't call.
It'll get better Deneb. Really.
Posted by floatingbridge on November 1, 2010, at 16:07:04
In reply to Re: Deneb, how is today going? » floatingbridge, posted by Deneb on November 1, 2010, at 12:47:58
Sounds good Deneb. Like you took some positive action and the intensity passed. Hard work, but worthwhile. Thank you for letting me and us how you are doing today.
fb
And if Thursday gets to seeming far away, just post, o.k.?
Posted by Deneb on November 1, 2010, at 17:26:01
In reply to Re: Deneb, how is today going? » Deneb, posted by floatingbridge on November 1, 2010, at 16:07:04
Thanks Dinah, Thanks floatingbridge
I went out and walked around a bit at the mall. I seem to be better in the mornings and then get progressively worse as the day goes on, getting the worse at night before I take my meds. I'm wondering if it is the Risperdal wearing off. Anyways, I took 0.25 mg Risperdal 30 mins ago as a sort of prophylaxis as I could tell my thinking was starting to get messed up again.
Anyways, I still feel depressed. I started thinking about how I ruined my life. Not only did I not become a doctor or scientist to make my family proud, I can't even support myself and don't have a family or anything. I can't even look for a job without relapsing. I just wish I could handle normal amounts of stress like normal people. It's not fair. Why do I have so many mental problems?
I'm just so disappointed in myself. I really thought I was over the borderline personality. I was doing so well! I don't think my latest relapse is a result of me skipping meds because borderline personality is not helped by meds. I'm really not supposed to rely on meds. They probably help me because they just calm me down. They would probably calm anyone down. It's just so disappointing. I was using my new coping skills and everything, I don't understand why I relapsed. I just hate myself. I'm so weak.
Posted by maxime on November 1, 2010, at 19:22:57
In reply to Re: Deneb, how is today going?, posted by Deneb on November 1, 2010, at 17:26:01
Don't be so hard on yourself. I don't think you ruined your life. What did you do to ruin it? Getting a mental illness wasn't your fault. Also, there is a lot of litterature that says that meds do help BPD. So don't feel bad that you are on meds especially if they do help you.
You have your whole life ahead of you. I am sure that one day you will be able to manage your stress better.
Posted by morgan miller on November 1, 2010, at 19:50:12
In reply to Re: Feeling so depressed about stigma, posted by sigismund on November 1, 2010, at 2:13:16
> >For me, the ideal therapist has a Ph.D. in clinical psychology, has a huge capacity for empathy, has a huge capacity for compassion, and is someone that the patient feels extremely comfortable with.
>
> I don't know about where you are but I'm not over-impressed by PhD's in clinical psychology here.
> Better something from a proper therapist training school, whatever such places are called.The Ph.d.'s I have had experience with have been through the most extensive training in therapy and they are the most down to earth, compassionate, and empathetic people. I have to believe that a Ph.d. has the intellect and knowlegde that gives them an advantage. As long as they are personable, down to earth, empathetic, and compassionate, a Ph.d. would be preferable for me. Maybe I've been lucky. I live in the Washington D.C. area.
Sorry Deneb for interrupting your thread.
Posted by morgan miller on November 1, 2010, at 20:09:05
In reply to Re: Deneb, how is today going?, posted by Deneb on November 1, 2010, at 17:26:01
> Thanks Dinah, Thanks floatingbridge
>
> I went out and walked around a bit at the mall. I seem to be better in the mornings and then get progressively worse as the day goes on, getting the worse at night before I take my meds. I'm wondering if it is the Risperdal wearing off. Anyways, I took 0.25 mg Risperdal 30 mins ago as a sort of prophylaxis as I could tell my thinking was starting to get messed up again.
>
> Anyways, I still feel depressed. I started thinking about how I ruined my life. Not only did I not become a doctor or scientist to make my family proud, I can't even support myself and don't have a family or anything. I can't even look for a job without relapsing. I just wish I could handle normal amounts of stress like normal people. It's not fair. Why do I have so many mental problems?
>
> I'm just so disappointed in myself. I really thought I was over the borderline personality. I was doing so well! I don't think my latest relapse is a result of me skipping meds because borderline personality is not helped by meds. I'm really not supposed to rely on meds. They probably help me because they just calm me down. They would probably calm anyone down. It's just so disappointing. I was using my new coping skills and everything, I don't understand why I relapsed. I just hate myself. I'm so weak.Your not weak, you've just had it rough in life, like many of us have. Try to take it easy on yourself. That's why I emphasize a good therapist so they can hopefully help us realize that our struggles are not our fault and we can let ourselves off the hook for not matching up to what we think we should be or should have been.
You are just hitting a rough patch, a really bad one. This often happens on the path to healing and getting better. I understand you just want to be better, believe me I do. One of the only ways to begin to move forward from this and get back on the path to being better is to take it easy on yourself.
I understand not having a job and having to look for one is making are complicating things at the moment. Hopefully you get a job soon and the structure and stability it gives you will help you to start feeling a little better.
I didn't know that BPD was not really able to be treated with medication. So are you not really supposed to be on medication long term?
Hang in there Deneb, things will get better.
Morgan
Posted by Dinah on November 1, 2010, at 22:54:29
In reply to Re: Deneb, how is today going?, posted by Deneb on November 1, 2010, at 17:26:01
> I don't think my latest relapse is a result of me skipping meds because borderlinepersonality is not helped by meds. I'm really not supposed to rely on meds. They probably help me because they just calm me down. They would probably calm anyone down. It's just so disappointing. I was using my new coping skills and everything, I don't understand why I relapsed. I just hate myself. I'm so weak.
I don't agree with this at all. Well, I agree they would calm anyone down, perhaps. But it's not like BPD is a lock that needs a special BPD key to solve. The fact that a medication has a anti-anxiety or anti-agitation for people whether or not they have borderline personality disorder, does not mean it has no effect on borderline personality disorder. It has an effect. That effect can be helpful in many conditions.
If stress causes overarousal of your nervous system, or even if you have an easily overaroused nervous system, meds help keep that under control. Skipping meds not only does not give your body the rest it needs from overarousal, but because of the nature of medications, anxiety and agitation can actually be worse skipping meds than if you were never on them.
You can't believe what some people say about treating BPD. There is no consensus out there about treatment, and I think it's a sadly misunderstood issue.
IMO, it's not all that helpful to think of yourself as BPD anyway. Isn't it just as helpful, if not moreso, to think of yourself as having a reactive nervous system? An intolerance to stress? And wouldn't it make perfect sense that a medication that reduces reactivity would be helpful, and cutting back on that medication in a time of stress might precipitate a crisis?
Posted by morgan miller on November 2, 2010, at 0:06:18
In reply to Re: Deneb, how is today going?, posted by Dinah on November 1, 2010, at 22:54:29
>IMO, it's not all that helpful to think of yourself as BPD anyway. Isn't it just as helpful, if not moreso, to think of yourself as having a reactive nervous system? An intolerance to stress? And wouldn't it make perfect sense that a medication that reduces reactivity would be helpful, and cutting back on that medication in a time of stress might precipitate a crisis?
I actually think a diagnosis of BPD can help because I believe illnesses such as BPD develop in large part due to emotional disturbances that result from childhood neglect and trauma. If you can pin down a diagnosis, it may empower and motivate the patient and therapist to look into the patient's childhood and begin to address the issues that may be causing some of the emotional unrest that is contributing to the BPD symptoms. A diagnosis is mostly important because there are some established and effective treatments, without a diagnosis, these treatments may not be pursued.
All that said, I don't like labels. I'm bipolar and it took me a while to feel comfortable with it. I don't care if anyone knows that I am bipolar. That's just me though. I understand why being labeled with borderline personality may be more difficult.
Posted by Deneb on November 2, 2010, at 0:17:05
In reply to Re: Deneb, how is today going?, posted by morgan miller on November 2, 2010, at 0:06:18
The thing about the childhood trauma thing is that there was NONE!
I've never been abused or neglected, not that I remember anyways. My parents love me very much. I really don't understand why I have this emotional instability when I don't take my meds.
Posted by Dinah on November 2, 2010, at 0:37:38
In reply to Re: Deneb, how is today going? » morgan miller, posted by Deneb on November 2, 2010, at 0:17:05
I've got the same thing, Deneb.
I don't beat myself up about it. There are good things to a sensitive nervous system too, even if there are definite down sides as well.
For me, when stress is less I need medications less. When stress is more, I need medications more.
Therapy has helped a lot. Linehan's DBT workbook helped a lot. But I'll always have very little ability to deal with stress or overstimulation. That's just part of who I am.
I don't see a lot of reason to be upset by it either. Yes, it's annoying. But with medications and therapy I do ok. I'm not going to reject anything that makes me feel better, or feel guilty or bad about taking it. Any more than I feel bad about taking diabetes medication.
I've known you for a very long time. Most times I've seen you melt down, you haven't been taking your meds. Now, whether you don't take your meds because you're already starting to melt down, I don't know. But I hate to see you feeling worse than you need to feel.
Posted by Dinah on November 2, 2010, at 0:43:49
In reply to Re: Deneb, how is today going?, posted by morgan miller on November 2, 2010, at 0:06:18
If it were a more well defined disorder, I might feel differently.
BPD has always been ruled out for me. But I definitely identify with many aspects of it, and my therapist will agree I have some traits.
I wasn't abused as a child either. It may have been what Linehan would call an invalidating environment. Deneb's may have been too, even in the absence of abuse. But without the underlying reactivity and slow return to baseline, the childhood environment alone wouldn't have caused harm.
When the literature starts recognizing the underlying physiology of many, if not all, "borderline personality disorder", I would be more inclined to worry about the diagnosis.
Posted by morgan miller on November 2, 2010, at 1:21:02
In reply to Re: Deneb, how is today going? » morgan miller, posted by Deneb on November 2, 2010, at 0:17:05
My parents love me very much and there was no obvious trauma or neglect, but there was. If you have a predisposition to mental illness, which you likely have, it doesn't take much to be missing in your childhood to contribute to that mental illness. It is very common for us to remain in a state of denial, thinking our childhood was fine and our parents were great. We stay in denial to protect ourselves from the anger and sadness that we may feel if we faced reality. Unfortunately, staying in denial also prevents us from ever getting better. I'm not saying you are in denial, I'm just saying it's so common that about everyone has been in or is in some state of denial over themselves and/or their past. This is why I'm concerned that your pdoc may not be doing a thorough job as a therapist. Maybe she just fears that if she goes to certain places with you, you may not be able to handle it, further destabilizing you. Or, maybe you don't remember anything obvious-most of us do not, which is why we go to therapy-and your therapist can only suspect that you may not have gotten what you needed from your parents. Look, it's almost part of the human condition, or at least it has been for a long time now, that parents often fall far short of giving their child almost everything they need-proper amount of unconditional love, proper amount of nurture, proper amount of structure, care without criticism, etc. As far as neglect goes, it could be as simple as a mother not being as loving as a child typically needs her to be, parents letting their children get away with too much and not setting the right boundaries, or not teaching a child how to protect and take care of themselves through properly protecting a child from things like the sun or bad food. All of these things can also instill anger in a child, especially a mother not being able to love through physical touch or parents not giving a child the right amount of attention and care that they need.
Posted by morgan miller on November 2, 2010, at 1:26:29
In reply to Re: Deneb, how is today going? » morgan miller, posted by Deneb on November 2, 2010, at 0:17:05
My parents love me very much and there was no obvious trauma or neglect, but there was. If you have a predisposition to mental illness, which you likely have, it doesn't take much to be missing in your childhood to contribute to that mental illness. It is very common for us to remain in a state of denial, thinking our childhood was fine and our parents were great. We stay in denial to protect ourselves from the anger and sadness that we may feel if we faced reality. Unfortunately, staying in denial also prevents us from ever getting better. I'm not saying you are in denial, I'm just saying it's so common that about everyone has been in or is in some state of denial over themselves and/or their past. This is why I'm concerned that your pdoc may not be doing a thorough job as a therapist. Maybe she just fears that if she goes to certain places with you, you may not be able to handle it, further destabilizing you. Or, maybe you don't remember anything obvious-most of us do not, which is why we go to therapy-and your therapist can only suspect that you may not have gotten what you needed from your parents. Look, it's almost part of the human condition, or at least it has been for a long time now, that parents often fall far short of giving their child almost everything they need-proper amount of unconditional love, proper amount of nurture, proper amount of structure, care without criticism, etc. As far as neglect goes, it could be as simple as a mother not being as loving as a child typically needs her to be, parents letting their children get away with too much and not setting the right boundaries, or not teaching a child how to protect and take care of themselves through properly protecting a child from things like the sun or bad food. All of these things can also instill anger in a child, especially a mother not being able to love through physical touch or parents not giving a child the right amount of attention and care that they need.
I understand your point of view and frustration. Just try to be open minded to exploring the possibility that you may be carrying some anger left over from something, maybe related to your childhood and your parents maybe not. If you figured out there was something going on or missing in your childhood that you needed, this would empower you to start to let yourself off the hook and stop blaming yourself for your struggles. This process can be difficult, but if you take it on courageously, it really can help you in the long run.
Posted by morgan miller on November 2, 2010, at 1:34:07
In reply to Re: Deneb, how is today going? » morgan miller, posted by Dinah on November 2, 2010, at 0:43:49
>I wasn't abused as a child either. It may have been what Linehan would call an invalidating environment. Deneb's may have been too, even in the absence of abuse. But without the underlying reactivity and slow return to baseline, the childhood environment alone wouldn't have caused harm.
I said neglect or trauma, this doesn't mean abuse in the classic sense that everyone thinks in. I don't think childhood environmental factors alone necessarily cause BPD, but I do think they can make matters much worse and can also be a trigger and contributor to the development of disorders like BPD. And if someone with BPD is carrying around any deeply rooted subconscious anger and/or sadness as a direct result of childhood environmental factors, this is a very good reason to explore and deal with this anger and/or sadness as they may be greatly exacerbating BPD symptoms.
Posted by emmanuel98 on November 2, 2010, at 2:16:07
In reply to Re: Deneb, how is today going?, posted by morgan miller on November 2, 2010, at 1:34:07
Well, I was abused and neglected as a child but I built up this defensive wall and left home at 14. I had "issues" but kept myself together until my daughter entered her teens. Then I fell apart and developed these horrible fears of abandonment, became addicted to drugs and developed all these symptoms of BPD. It's interesting because BPD usually manifests in one's twenties and then resolves itself as one enters middle age. For me, I didn' have any symptoms until my mid-forties.
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