Termination of Therapy and a Secret Diagnosis of BPD, Part 1

April 28, 2012

I’m on the border y’all.

Not only am literally on the border (Texas borderlands) but I’m also on the border mentally.

It’s “official”.

It’s set on paper with nice black ink–though not in stone or anything–but it was kept from me, KEPT FROM ME!

Kept from ME by my own therapist, my Young Therapist.

Guys I’m going to warn you. Before you go any further with this post, know this: I’m actually going to be serious for a moment and I’m going to be saying some things that are not easy for me to say. I’m going to say some things that may be triggering to some of you. AND, I’m going to be serious without cursing! (Yeah, I know!)

Here’s where I bore you to death or at least until you’re nearly as suicidal as me. *trigger warning*

********

Let me explain, I suspected it ever since Young Therapist let it slip that her dissertation/PhD concentration is on Borderline Personality Disorder. In fact, I suspected it long before then. I suspected it nearly two years ago when I started with her and she gave me these handouts on dialectical behavioral therapy (DBT). When we began, I’d get packets–one after another. I’d get a new packet every week and now I have a damn book’s worth of packets in a folder. A chapter on mindfulness, a chapter on progressive muscle relaxation and diaphragmatic breathing, a chapter on DEAR MAN, another on Cognitive Restructuring of Mental Distortions and Distress Tolerance and the list goes on.

One day I asked Miss Young Therapist about this Dr. Marsha Linehan who was the author (you could read it on the fine print on the bottom of the handouts). Young therapist answered that Dr. Linehan was pretty much the mother of dialectical behavioral therapy (DBT) which is primarly used on borderline patients.

“But just because I’m giving you these packets P., doesn’t mean I’m saying you’re a borderline patient.”

That was, until I had my last session with her on Wednesday this week. The first half hour or so we did the usual, “How are you doing this week? Wha’ts going on? And this and that.”

I’d brought my “release of information” form signed for her so she could send my files to the new therapist I’ll be seeing at the community clinic. I was waiting for her to bring up the termination thing and sure enough she did.

“So, this is our last session,” she sighed, “is there anything you want to say?”

“Yep, it is.” I looked intently, sighed, then looked away towards my wheelchair where I’d placed my folder. “Oh, I brought the release form signed. I went to the clinic and found out the name of my new therapist and got the fax number and everything here for you.”

I pulled it out of the folder and handed it to her.

I went on and told her that I’d like a copy of the two reports she’ll be faxing in to them–the “Termination Summary” and “Intake Evaluation Report”–because since it’s a community hospital she can’t just send it directly to the therapist. And I added that since it would have to go through the medical records office which can take over a month, she might as well give me a copy of each just in case.

“Yes, of course, I’ll give you a copy when we head out.”

I wasn’t lying about the medical records office. They’re terrible! But, I did do something with double intention there. I wanted to get a hold of my records without being too obvious about it. I know right? Why couldn’t I just upright and tell her I wanted a copy? Why was I so nervous about that? It’s the dynamics I tell you, and my own anxiety and hesitance.

We went on to discuss what I’d benefited most from and she asked what I thought I’d become better at handling. I mentioned some of the mindfulness stuff and managing my anger. She said that I was one of the most “committed clients” she’d worked with as well as one of the clients with the most extreme life stressors. “You’ve had to deal with more than most people. And you’ve done extremely well considering that, I think,” she said.  She went on with the whole patting me on the back, flattering, and good job thing. I don’t doubt she was being honest though. She genuinely seemed pleased with my overall progress.

When we went out to the front desk and I paid her my dues, she wished me luck with the new therapist again and said bye. I thanked her and then just stared at her for a minute.

“Yes?” she asked looking confused.

“Um, aren’t you going to print out the Termination Record so I can have a copy?”

“Oh, oh, right.”

I don’t know why, maybe I’m just overly critical, but I once again felt she was holding back on me. She could’ve honestly forgotten but I don’t know.

Anyway, she printed it out and handed it to me and said, “If there’s anything you have questions about, about what’s on here, feel free to call me.” She gave me this look I can’t describe. It’s was a sort of apologetic look.

“Ok.” I looked at the paper and said, “This is just the termination summary, can I get the intake evaluation report as well?”

“Uh, mmm, I don’t know, I’ll really have to ask my supervisor about this P. Sorry.”

Again, I felt a little put off. But oh well, I figure I’ll call in a week and ask for her supervisor and try to get it directly from him.

*******

When I was in the car I began reading the termination summary, and read something that shocked me a bit it. At the end of the report, it read:

Diagnosis:
Axis I
296.32 Major Depressive Disorder, Recurrent, Moderate

Axis II
301.83 Borderline Personality Disorder

Axis III
Disease of the Musculoskeletal System and Connective Tissue: Osteogenesis [Imperfecta] <–She’d left out the imperfecta part.

Axis IV
Occupational problems
Economic problems
Problems with access to healthcare services

Axis V
GAF Current: 75
GAF Long Term: 55

What shocked me was the Borderline Personality Disorder diagnosis. But why? I had suspected it even though she never told me, ever, and even though I’m not big on holding to a diagnosis. What I mean is, I take a diagnosis with a grain of salt, a BIG grain of salt. They are merely there to draw a delineation the person’s major mental problems and a course of action.

BUT, then again, I contradict myself, because a part of me was and has been desperate, yearning even for some sort of label. With that I would have proof! I know, me wanting a label sounds shocking in and of itself! See I’d gotten a bipolar label after my monumental mental meltdown in 2008. That was the first time I’d seen a mental health professional in my life. And I got diagnosed only after the second session.

I’ll tell you though, getting something on paper felt like a relief then. It was a validation. I could no longer tell myself (even though I still do): “See P, you’re just making all this up. There’s nothing wrong with you. All of humanity is insane anyway! And you, you’re just weak! You’re just crying over nothing. Go on, cry like a baby over nothing. Always have! The baby you’ve always been. You can stop all this, you know? You’re just making it up anyway. They were right about you, your family and everyone! You and your antics and your dramatics. That’s all it is! There’s no such thing as mental illness girl! Yeah little, stupid, little selfish girl. You don’t need their help. You don’t deserve it either. Just straighten up and quit the crying! Quit it! Quit hitting your head against the wall and get that damn razor out of your hand!”

So you see, getting it in paper meant that I wasn’t just being dramatic as I’ve always been called. I’ve held my little BP label as a trophy even, in a sort of twisted way but I don’t think people can truly understand what I mean until they’ve been there in front of that psychiatrist or therapist looking like hell (oops, just a little curse).

Then, I didn’t stick around with that first psychiatrist in the spring of 2008.

“I hate them all! Nothing but drug dealers for the Big Pharma Co.s, nothing but pill pushers. They don’t care about you.” And then I caved and went back to another and then another and another all in the span of a year.

I eventually landed myself in one of the university psychiatrist’s hands by pleas and begging of my first therapist.

“Please go. Just try it,” she’d say.

So I went.

****

You? bipolar? I’m not sure. No se. Vamos a ver. I doubt it. But I’ll have to see more of you to be sure. Nos daremos cuenta con el tiempo,” he said.

He was an old Cuban man and I hated him the instant I saw him (not because he’s Cuban yall; I’m Colombian remember, so there’s a lot not to like there 😉 I kid). I just got a terrible vibe from him. I didn’t trust any psychiatrist then (am still hesitant) and I sure as hell didn’t trust some old mangy one covered in liver spots.

“I don’t think I’m going back there,” I told my first counselor/therapist, the one I was seeing at the university’s psychological services center (this is not the same place where Young Therapist works. Young therapist works at the College of Social Sciences in the Psychology  department).

“P. you really should go see a psychiatrist to help you stabilize those mood swings,” the counselor said. “Look if you don’t want to see that man, there’s this really good psychiatrist, just came back. She was going to retire but decided not to just yet.”

Needless to say she finally convinced me to go and I returned.

An awkward moment occurred when I went to see this new “good psychiatrist” and Dr. Cuban Liverspots said hi to me when he was marching with his coffee cup on the way to his office, right next to new “good psychiatrist’s”! Well, turns out this was the third or fourth psychiatrist (I honestly don’t remember how many I’d seen by then) and she said that I did not have bipolar (BP). But she didn’t say what it was that I did have. If it wasn’t BP, then what I wondered. I never asked though. I guess I can be passive in that sense. The only thing I knew, is when I went to the cash register to pay, the bill read, “Major Depressive Disorder” (MDD) and “Generalized Anxiety Disorder” (GAD).

At least I got my answer, I thought. That’s when the alphabet soup of my psychological disorders got spicy. I now had a gumbo soup of disorders.

Then this! This Borderline Personality Disorder. It sounds so macabre! So fantastical. So unreal. So STIGMATIZING! I’m sorry to break it to you guys, my dear BP internet buddies but my belief is that as stigmatizing as BP is (and it really is), the BPD label is ten times more. Why? I’ll explain in part two.

****

“What?! You got that borderline personality disorder!? What is that? Is that like when you have multiple personalities? OH MY GOD, you got multiple personalities P? You gonna go Dr. Jekyll and Mr Hyde on me P?”

“No! Come on! I don’t have multiple personality disorder, that’s not even called that by the way; it’s been updated by the APA. It’s now called dissociative identity disorder, Dee-Eye-Dee (DID). I’m just me, the one and only PAZ. I’m still the melancholically manic mouse, only now I fit the ICD and DSM and [insert random acronyms for other diagnostic manuals] criteria of a borderline meloncholically manic mouse. I’m a borderline melancholically manic mouse  is all. Maybe it’s because I grew up in a very unstable environment though my family was always tightly knitted and mostly very loving. Maybe it’s because I’ve had to deal with a lot of traumatic events, especially in my childhood so I’m somehow ’emotionally scarred’. Maybe I regress to childhood if you were to ask Freud, though the behavioralists wouldn’t agree. Maybe my brain does fire off too quickly, and if that’s the case, the pharmas are more than happy to hear. Maybe my limbic system has a malfunction and thus, my amygdala is hyperactive or hypersensitive; maybe it’s a genetic mutation like my malformed bones and that’s why I’m so quick to rage. Or maybe I was conditioned to rage by my mother’s rage and abuse. The behavioralists would agree with that one. Maybe I do have a shortage of dopamine, norepinephrine and serotonin or GABA or some other neurotransmitter. Maybe I don’t, but maybe I do, and maybe I have all of the above or none of the above. All I know is I have the emotional stability of a five year-old. I guess it fits my toddler height.”

Really, how do you explain all that? It just makes my alphabet/acronym soup spicier and more foreign than a crunchy Samosa plate served with dhaal soup.

Mmmm. Samosa.

********

Alright, some of you may know what this is already, this BPD and BP and Axis I and Axis II nonsense, but to those of you who don’t and are interested, let me explain what some of this is  (it’s a good thing I’m a nerd that’s into psychology and I have several books on it).

When I got home, you best believe I dug out those books from my book shelf.

First, the various “Axis” levels go like this:

Axis degrees are used as intersections of a person’s main mental problems in order to diagnose a mental disorder. Each Axis affects the overall diagnosis as each affects/intersects and correlates with the other.

Axis I: clinical disorders.    
Symptoms that cause distress or significantly impair societal or occupational functioning such as anxiety disorders, major depression, bipolar disorders, etc.

Axis II: personality disorders and mental retardation disorders. (now why’d they have to dump me in with the mental retardation folks? It’s just like they did when I was in PE class in middle school! P in PE with the retarded kids.)
Chronic and enduring problems that generally persist throughout life and impair interpersonal or occupational functioning.

Axis III: general medical condition.    
Physical disorders that may be relevant to understanding or treating a psychological disorder.

Axis IV: current psychosocial and environmental problems.    
Problems (such as interpersonal stressors and negative life events) that may affect the diagnosis, treatment, and prognosis of psychological disorders.

Axis V: global assessment functioning (GAF).
The individual’s overall level of functioning in social, occupational, and leisure activities. (Now I’m not going to go into detail with this one but if you want more info go here. You probably won’t though since no one clicks my links. hehe

****

Then there’s the Borderline (BPD) diagnosis. I had already known about BPD but again, I thought if anything I fit more into the BP criteria (tell me if this is getting confusing). I could just relate to those who have BP, who I’ve  talked to either face-to face or in online forums. The BPD people folks though, I said to myself, are said to be manipulative and I’m not manipulative, no, no I’m not. Am I? No. I’m not.

I’m not going to talk about the major depressive (MDD) diagnosis because that was a given for me.

So a very, very short description of Borderline Personality Disorder (BPD) is that it is essentially a disorder of extreme and pervasive emotional disregulation characterized by impulsivity and instability in moods, relationships and self-image. (Karen Huffman)

None of this is catch all, you see. We are still people with unique personalities and cultures, histories and separate though connecting lives. We’re individuals, even those like myself who now have had the personality disorder diagnosis slapped on.

****

I cried uncontrollably for about two hours Wednesday night. It could’ve been PMS and a thought about L. I don’t know why I didn’t get so worked up about the other diagnosis (Dx) in my past. Then it dawned on me the more I thought about it. Could it be that  it’s because I think it’s actually the most accurate Dx I’ve had to date? And then, could it be that this has made me subconsciously think about all of the things I’ve been through, all that I’ve done? All the extremes in my life? I mean, all the psychiatrists never saw me for who I was. They never saw me more than twenty minutes at most and once every month or two (again, at most).

Young Therapist did see me for who I was, at least partly. She saw me for an hour every week for almost a year, then every two weeks for another. And she had me do tests and talk about so many things which I never did with the others. Young Therapist actually saw me cry. I cry a river damn near ever day when I get depressed but I don’t cry in front of people! And Young Therapist saw me get shaky to the point of telling her I had to puke, to the point of having to put my arms down and sit on them. Young Therapist, if anyone, would know how to diagnose me. So maybe I cried because I got the sense that not only did I get diagnosed with a very severe, very misunderstood and stigmatized disorder (albeit relatively treatable), but I felt for the first time they got to the core of me. Maybe, I was also crying out of relief.

In order to qualify (ha,  “qualify” like a merit) as having BPD in America, you have to fit at least five of these within your problem scheme. Here are some of the criteria according to the damn (oops) DSM-IV:

  1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Ok this one got me. I don’t think I make frantic efforts to avoid any kind of abandonment. Do I? No, you don’t P. But maybe I fear it so much I’m in denial? Maybe P, maybe. Or maybe this one just doesn’t pertain to me. Remember, it’s not a catch all.

  2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

Yes. Yes. Yes. That’s definitely me. Just this week I said, “Damn you WordPress. You suck! Why do I bother with you,” then, “Oh Dear WordPress. Don’t leave me. I love you. You’re the best. What would I do without you?”

  3. identity disturbance: markedly and persistently unstable self-image or sense of self.

Yes. Maybe. Yes. No. Maybe. I’m the best! I’m the worst! I’ll talk about this later. What do you mean by this anyway? Of course I have an identity! It’s not disturbed. Ok. Hmmm. Maybe. I don’t know. I change my mind about what I think about myself, what I want to do with my life and many people do that right? Yes P, but not at such extremes. I doubt what my strengths are. Am I good at writing? No! But I love writing. I’m good at it. Yes? Should I stick with editing video then? But I want to write documentaries and dramatic films. I like to draw too. Could I write comics? Who am I kidding, I’m not an artist. Should I be a therapist? Yes. Yes! I’m so wise, so loving. I want to embrace everyone. No! You’re a misanthropic nihilist. Nothing fits. Am I splitting? What about the web design thing you were trying to do, and what about the multimedia journalism masters at UT? What about the Latin American Studies masters you’d thought about too P? What about your music P? What about your photography P? And what about your poems P?

Yeah, I’ll have to get back to this one later.

  4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Yes. I’m a highly reactive and highly impulsive person even though I tend to over-think things before I do them–so in that sense I’m not impulsive. I hesitate too much on doing them, say choosing a college degree or buying a flavor of yogurt or talking to someone I find attractive. My impulsivity in other aspects, however, has gotten me in trouble and put me in dangerous situations. I’ve done drugs. Many. I did cocaine with L. I was always a bummer, never a buyer. I bummed drugs off of people whenever they were offered, so I never considered myself a “real” user. I was a functioning alcoholic or as the AA people would say, I am an alcoholic in recovery.

I’ve also had phases in my life where I binge eat, particularly to deal with stress. People with BPD, especially young women tend also have a comorbid eating disorder, most notably bulimia nervosa. Though I’ve never been bulimic per se, I have always punished myself in some way or another after binging. My weight has also fluctuated drastically throughout my life. Right now I’m more on the healthy weight to slightly-underweight side.

Sex. That’s a difficult one. I was a shy, late bloomer, a wallflower. But I knew a lot about sex at a very young age. Growing up with an older brother and always hanging out with the guys, you find out about porn early on. Then I lost a close friend because of my impulsive sexual behavior. However, I’m still extremely shy, self-conscious and have issues about my body so I’ve turned down many sexual encounters due to the fact that I have terrible anxiety about it. I’m really short, have brittle bones (some of which are a bit disfigured), use a wheelchair and I always felt no one would find me attractive. I mean, really, who would find a girl in a wheelchair attractive, I’d tell myself. There are ignorant folks out there who still refuse to believe someone like me could have a thriving sexual life.

Who would find a midgety, malformed mouse attractive? So when I found out that I was found attractive indeed, when I was put on the spot, I often backed away. I’m very impulsive sexually though so there’s a tug of war going on in my head. “I can’t but I want to so bad”. Once I get comfortable enough, I’m very impulsive with sex so much so that L and two male “friends” of mine who used to called me a nymph. That’s when the alcohol and drugs come in to play as well.

Oh, and I’m also bisexual, though I mainly just identify as queer and don’t tell people I am. I guess I’m still in the closet about it.

  5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

Triple yes. Though I’ve never really attempted and don’t think I make “gestures” of my suicidality to people. In fact, I try to hide it as much as possible. I don’t talk about my suicidal ideations or depression, the only exception being the therapist and even then I’m very vague about it.

As far as gestures… I don’t know. Maybe I make them and don’t realize it? There was, however, one time when I got in a huge fight with my brother not too long ago and I became a “maniac P., you’re acting like a manic! Chill! Chill! What are you…? Oh, f****, hi officer. No, no she’s alright. No, I don’t think I need to take her to the ER. She’s my sister. Yes. She just needs to sleep. I just need to get her to bed. No, I got it. Ok, yes, I’ll see if I take her to the nearest ER. I’m just getting to my apartment right around the corner. I will call them once I’m there, yes. Thank you.”

A cop had pulled us over because my brother wasn’t watching the road because he had to pull me back as I was trying to jump out of his car while screaming, “LET ME OUT”. Maybe that’s a suicidal gesture? I’m not sure. I don’t recall much of of it since I felt out of my body. I only remember sitting on the curb of some parking lot near his apartment complex that night crying and shaking uncontrollably and then, eventually, getting picked up by my dad who later said I couldn’t make a coherent sentence. Very impulsive indeed. Oh and that’s another thing with BPD. Borderlines supposedly have a tendency towards depersonalization  and derealization as well as transient psychotic or psychotic-like breaks under crisis situations, something I’m very familiar with.

Self-mutilation. Yes. I’ve never been much of a cutter, but when I have, it’s been extreme. I’m going to leave it at that. And I’d banged my head against walls ever since I was about ten or eleven or younger even. When I was in middle school, I got into the habit of scratching and slapping and punching myself and pulling bits of my hair. So triples yes on that one too. This is embarrassing guys.

  6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

Yes, it’s one of the things that got me the initial Dx for bipolar. There’s something that should be said about this one though, because unlike the criteria, I usually don’t just have these episodes for only hours or days thought that is the case sometimes.

  7. chronic feelings of emptiness

Not as much as years back. It fluctuates for me. The way I see it: I fill up and then I drain, I fill up and then I drain.

  8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Yes to the power of ten. I’m a recovering rageaholic too. When I was a kid, I threw a butter knife at my brother over a simple remark he’d made and smashed all the plates. It hit him in the forehead. Fortunately, it was only a butter knife and my weak hands couldn’t throw hard enough for a blunt force to seriously hurt him. And these types of violent outbursts were not at all uncommon for me. I have dozens of similar stories ranging as early as when I was four.

  9. transient, stress-related paranoid ideation or severe dissociative symptoms

Yes. People are after me. I make terrible, mean comments on WordPress and that makes everyone get offended and so on and so forth. I have dissociation episodes galore. Where am I? Are those shadows moving? Are they people? Am I there and not here. I’m outside of myself!

********

Ok, I’m going to leave it here for now, but I plan to write more about BPD, what I think of all of this and all of the psychological research I’ve read about it as well as the co-morbidity of BP and BPD.

Hey? 🙂 You there?

See, I bored you to death. 😦

*Le mouse sigh*

***********************************************************************

Resources

Handbook of Personality, Third Edition: Theory and Research edited by Oliver P. John, Richard W. Robins, and Lawrence A Pervin

Psychology In Action, 6th Edition by Karen Huffman

PsychCenteral

Mayo Clinic

National Education Alliance Borderline Personality Disorder (NEA BPD)

National Alliance on Mental Illness

National Institute of Mental Health

About.com, Borderline Personality Disorder Guide

Wikipedia, Borderline Personality Disorder

BPD Today – DSM-IV TR Diagnostic Criteria

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39 Responses to “Termination of Therapy and a Secret Diagnosis of BPD, Part 1”

  1. I wonder if she hid it from you so you would not be stigmatized? Have you ever read that book The Buddha and the Borderline? It’s fantastic. If you can, consider taking time to read it. She wasn’t told for NINE YEARS. To protect her, they said. But of course, that doesn’t protect you from another mental health care provider. I relate to all of what you wrote (obviously) and i just want to say that I am proud of you for working so hard. This is a great post packed with a lot of information.

    • PAZ said

      I really want to read it now that you mention it! Sounds interesting. I also saw your other list of suggestions and put them on my amazon wishlist for when I actually have a job. hehe.

      Yeah, like I said in the other comment, I’m not big on Dx’ing either but considering how I grew up trying to live up to “the strong one” who shouldn’t be down–honest to god that’s what my dad would say–so considering I’ve always tried to live up to that a Dx can be reassuring. It’s like a pat on the back, saying “hey, you have tried. it’s not your fault” you know?

      Thanks for reading! And for saying you’re proud. It’s difficult stuff to talk about. This one was long. 🙂 I’m so behind on my poems now…

      Night night

  2. I can understand why this must have been a big shock to you, kind of rocked your foundation, you know? But maybe you can go into therapy now actually on the same page as your therapist, and consequently get the right kind of help for you.

    Whatever your diagnosis, that’s really what matters, isn’t it? That you get the kind of information and therapy and skills and understanding that you need to cope and thrive in life.

    And whatever letters they throw your way, you are still the same wonderful mouse to me. You always will be. 🙂

    • PAZ said

      Thanks so much Ruby, that’s so sweet of you. You’re too kind. And you’re right, I can now have a better game plan when I go see this new therapist for the first time, and hopefully he’s understanding.

      xoxo

  3. the howler and me said

    Knowing the root cause, and accepting it – helps you learn to cope. Helps you learn to rise above it. To heal.

    It is tough to hear something you weren’t expecting. But sometimes it is what we need to move forward.

    I know I had a hard time coming to terms with my diagnosis… GAD and Social Anxiety Disorder…. I didn’t want the prescription drugs to take the edge off. I was afraid.

    But 5 years of therapy… yeah…. it has def. helped.

    Keep your head up. A Diagnosis code, is just that… and the great thing about it is…. labels can be changed. 🙂 They aren’t set in stone.

    THAM

  4. stigmatizing people for mental and physical illness has pretty much evaporated in today’s society. The problem is we stigmatize ourselves and live with this unnecessary self persecution. I think you would profit from blog – A Friend to Yourself. I follow Dr SJQ every day.

    • PAZ said

      D’Agostino, I used to think the way you do about the stigmatization of mental illness, but I’ll have to disagree with you now that I’ve read and heard so many horror stories—stories you would think would’ve only happened some fifty years ago.

      I’ve heard of people who were fired from and/or pressured to quit their jobs when their boss found out about their mental diagnosis, which is completely unethical and not to mention illegal in the States as well as many other countries.

      So people do anything in their power to avoid the liability a “mental person” could create.

      Say I work at company A. And I have to take a leave of absence for a week due to my mental problems, then I make the mistake of telling my boss why I have to take a leave of absence. And this particular boss isn’t very happy about it. Word gets out that I was diagnosed with BPD. Right? So when I get back to the office after my leave, I hear two women gossiping about how they watched a news report about a young man that killed his cheating girlfriend and then himself. I hear one woman remark, “yeah, just horrible. And did you hear the guy had borderline personality disorder? I heard P. is also borderline” and they both eye me with disgusted looks. It’s not really paranoia; it happens. Some ignorant people will look at you differently and it makes being in social situations like that difficult because your liable to be seen as untrustworthy of doing your job. They may devalue your previous achievements.

      I’m in a wheelchair. And I’ll tell you an anecdote. A former friend of mine worked as a piano instructor at a piano store. She taught the little ones. Well, her boss asked her one day if she could think of anyone to hire because one of the instructors was leaving and they would need a replacement. She knew I was (and am) desperate for work, so she called me and I was thrilled. I said, “hell yes, please tell her about me”. Well, she did. But she made the mistake of telling her that I was in a wheelchair. And upon hearing that word “wheelchair” she immediately changed her demeanor and told my friend to tell ME that they had already hired. Turns out she didn’t want to deal with the city which had cracked her down the previous year for not having a ramp and such things.

      Now, you tell me if that’s not discrimination and stigmatizing? The same thing can happen with a mental illness. And the only reason I didn’t show up myself and tell the lady off or sue her was because I was afraid of getting involved with the law seeing as I’m still not a legal resident.

      Yes, racism, sexism and other forms of discrimination like that towards the mentally ill has died down. But it is not completely dead.

      I do see the self persecution as a valid thing though. We need to do less of it as it’s first and foremost for change. 🙂 And where can I find A Friend to Yourself? Here on WordPress?

  5. DeeDee said

    I had a similar reaction to the bipolar dx – someone mentioned BPD in the past and it just confused me and eventually made me angry because it was such a poor fit. But when I heard bipolar over and over, eventually it made me have that crying jag where you realize that there’s finally an explanation to everything – more out of relief than anything else.

    By the way, they HAVE to release your medical records to you. The only reason they can withhold them is if they think it would be psychologically damaging to you. You should be able to sign a medical records release to your new therapist and have the records sent over. But the delay is absurd.

    I similarly got a copy of my progress notes – by having them sent to my therapist, who had to call to get them sent after waiting 2 weeks – so I could see what info would go to a new doc, and also get a non-redacted copy. I ended up sending them over myself because I knew the psych’s office wasn’t going to do it without prompting from another health professional. Plus I have to sign new paperwork for every single release and it’s massively easier to send the stuff myself.

    • PAZ said

      Bipolarmuse just mentioned that I don’t have a right to my psychological records which I think I did. Hmmm. But you’re saying I do have that right? I don’t know. I really want to get those records now! ha. Like I said to Elaine, I’m not sure how it would be psychologically damaging to me, unless there’s something I’m missing. But you know, maybe I’ll ask New Community Therapist once (if he ever does) get them.

      The aburd delay is terrible. I asked for some records back in February for the immigration lawyers and I didn’t get them until just three weeks ago. My dad and I would go every week to ask and nope, nothing. They would shove us one way and another. It was so frustrating, so ridiculous. But it’s a community hospital where you pay real cheap, so I’m kinda tolerant considering I didn’t have any means of medical care for about six years (between my 18th and 24 birthday) because I’m an “illegal”. So I’m glad I’m able to get any kind of care at least, even if it takes for ever with everything. For example, I would’ve had to wait six to eight months for that therapist had I not already been assigned to a psychiatrist at the clinic. Good thing I already was.

  6. well, i say “like” i’m not sure that is exactly the right word.

    not knowing you well, but having read through this one post my immediate impression is of someone who is very self reflexive. your first instinct is to look at the diagnosis in it’s parts and reflect upon whether you fit the criteria and if so then how. obviously i don’t know what your affect was like when you first saw young therapist, but since she remarked that you were hard working at your therapy, that you took it seriously and did well, it annoys me that she didn’t share this information with you earlier so that you could talk over all these points in therapy in a partnership rather than with her witholding the diagnosis from you.

    this makes me feel rather angry on your behalf.

    • PAZ said

      Yes, Elaine. I’m grateful that you understand/empathize and see what I mean when I say I feel frustrated that she withheld that info from me. I felt very put off.

      I understand if she didn’t tell me initially but why not after? Especially knowing that, although I can be volatile, I’m generally very intuitive and analytical and like you said self-reflective. So I just don’t see how telling me would’ve been a danger to my already screwed mental health. I generally put myself down about my character but one think I do love about myself is that I believe I’m a very open-minded and understanding person (given time to calm down at least) so I think it would have been beneficial to tell me… I don’t know.

      Say I saw New Community Therapist and didn’t know I’d been diagnosed BPD, then I wouldn’t be able to tell him things that I am not prepared to tell him. See?

      🙂

      • feels like time wasted to me, but you know now, so can go into the next situation more fully informed and with more information you can choose what you want to tease apart more skillfully. why she withheld this from you for so long beats me. like you say, it is understandable that she might want to get to know you for a few weeks first, but after that? wtf?

  7. I have asked repeatedly for my mental health records and have never gotten them. My sister works in the medical field and informed me that the laws state that they have to turn over records when asked EXCEPT for mental health records and Test results. Great.
    My GAF score was 50-55…

    • PAZ said

      Aw, BPMuse, that’s gotta be so frustrating. :/ So you’re saying I DON’T have a right to that Intake Assessment Report? I was planning on calling for it in a week or two. Meh…

      I was quite surprised that my current GAF is 75, though overall it’s the same as yours. Guess I function more than I think I do.

      xoxoxxx

  8. rlf15 said

    Powerful-and informative-post. I’m so sorry. And no-not bored to death at all.

  9. Really good post. Now I want a samosa…….
    Love HS xox

    • PAZ said

      Me too. They’re so good. There are a ton of Indian restaurants in Houston. It’s awesome. There’s an entire sector called Little India. 🙂

      • Oh wow that’s awesome 😀 I prefer Indian food to Chinese, but we only have a China town here. Well it’s called “China town”, but it’s really a China “street”. They have a nice cake shop though.
        xox

  10. lyxia said

    If you are borderline, you were so before you got the paper, so dont worry to much about the words that some people like putting down on paper just because the combination might look esthetically pleasing. This should not change you just because there is a name to your wonderful personality,

    • PAZ said

      Lyxia, thank you my dear! You are very right and that’s one of the many reason’s you’re wonderful. (Watch out though, I’m borderline, so I might be saying you’re terrible instead of wonderful in a minute 😛 )

      And I told myself the same thing you just said. I said, “P, these are just words on a paper. The things you’ve dealth with are the same. History hasn’t changed one bit.” But of course, something about the frustrations with the mental health system got to me. Something, like I mentioned, about my own troubles became relevent for a moment. And again, I’m also dealing with grief, not quite out of that winter depression, and am having PMS which I call PMSS (Premenstrual Suicidal Syndrome) hehe. I don’t like the term premenstrual dysphoric syndrome psych uses so I made up my own. How’s that for terms?

      You’re so wonderful C. Lyxia, did I tell you that. 😉 Thanks for your comment.
      ♥ un beso y un abrazo

    • PAZ said

      Also, how did you react when they told you you’re “bipolar, type one, like oh my god, the most severe type”? pfffft. I’d be like pfffft.

      pfffft. So fuckin’ what? I knew I was fuckin mental. What else you got for me before I leave? Is all i have to say to that.

      Just curious. 😉

      Just simply call us mental and I’m happy with that. heheh.

      besos querida.

      • Lyxia said

        well I had two issues going at the time. The first, which i will not elaborate here and dealing with BP1. I cried both times and I still do for the later especially that things. I dont cry anymore when they tell me but when I reconize symptoms and such and Im like oh nooooo…. I do not care for people classifying me as much as I used to when I was 20. And when I got diagnosed I did not even know of such illness. most of past experiences with friends and family revolved around suicide and alcoholism, not really big words like B-i-p-o-l-a-r….

      • Lyxia said

        corr: I cried both times and I still do for the later especially that things are not getting better. (more intense episodes and symptoms)

        • PAZ said

          So sorry to hear lady. :/ I think that’s why I cried. Id made me think of all the symptoms = all the things I’d dealt with.

          It’ll be alright though, in its own way, in our own ways.

          xoxoxxx

  11. […] So, here I am! I’m jumping on the band wagon y’all! So unlike me? Or is it? (oh oh borderline identity disturbance in the process here ) […]

  12. […] Sir Bruce Banner aka Hulk is borderline and I can say this without offending because I’m officially certified borderline myself and yes, I’ll take the label and milk it for what it’s worth for now). Yep, I just got […]

  13. Yup. I have one coming out tomorrow morning like this. Except, I forgot about the part about how the people are out to get me.

    For me, it appears atypically too. But, there are other forces at work, I know it. It’s really a tangled mess.

    Thanks for directing me here. It makes me feel a little better about it. It makes me feel like someone shares it with me that’s not over-the-top, you know? I’m careful not to draw attention to myself, because the anxiety of interaction is too much. I can’t even call people. I don’t manipulate. I don’t lie. Those things make me nervous. But, that’s some childhood trauma talking there.

    Again, thank you.

    • PAZ said

      I’m glad it helped a little to read this. I find it’s comforting to read the accounts of others. I still need to finish writing “Part II”.

      And yeah, I have trouble even calling people too. I get anxiety when I have to make a phone call for something business-y and even when I plan to call a friend. It’s the reason why I don’t like to talk on the phone much.

      HUGS xoxoxxx

  14. Holy mackerel, Ms. P., you’ve written a tome that is all at once intimate, informative, hilarious (Dr. Cuban Liverspot! I laughed till I almost puked!), and courageous beyond, beyond. Yeah, I actually find the labels liberating, for me. It’s like, whew, this is a known-about thing, yeah, I’m f***ed up but we knew this, didn’t we, only now we have a name for it and some possibilities for treatment, for feeling better even. That’s what I hope, anyway, for you and for me and for all of us mentals. Pass the samosas. I like them with the tamarind and mint chutneys.

  15. […] my experience. To an extent, I’ve done that, though not as much as I’d like. And when I found out about the BPD diagnosis, I began to look deeper at how my medical condition has been a factor in my development of […]

  16. […] been in my life. I’ve been fit before and I’ve also been overweight, as I mentioned in Termination of Therapy and a Secret Diagnosis, my weight has fluctuated A LOT throughout my life, and I have serious body image issues. But now […]

  17. […] this spring, 2012, I saw that young therapist. I made a drastic improvement. As it turns out, she had diagnosed me with borderline personality disorder (BPD, or Emotional Dysregulation as it’s now called) and […]

  18. […] fact, I mentioned this when I found out. People are people regardless of their mental problems, illnesses, religion, sexual preference, […]

  19. […] someone dear, had a ton of medical issues, and made a suicide attempt. Then I found out that my Ex-Young therapist had diagnosed me with Borderline Personality Disorder, my therapist left (that was just before the suicide attempt) and in June of 2012, I finally got […]

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