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Thursday, 17 February 2011

Diagnonsense

I have grown increasingly frustrated regarding diagnosis the last couple of weeks. I feel quite sure that if I didn't have a BPD diagnosis, I would have received more support than I have done. I am totally convinced. What my GP said to my mum about having BPD, not depression, really clinched it for me. She had said nothing like that when she spoke to me on Wednesday and thought the crisis team should be seeing me, so either the crisis team or the CMHT manager must have told her that. And the only reason they would have told her that would be as justification for why I wasn't getting more help. The frustrating thing is, I don't even see it as relevant. I don't actually think diagnosis should ever be relevant - I think symptoms should be treated/given support for, rather than the diagnosis. But I am particularly pissed off because actually I don't even feel like BPD is relevant at the moment even in terms of treating diagnoses. I am not disputing that I meet the diagnostic criteria for BPD. However, if I look at the diagnostic criteria for Depression I literally meet every single criteria at the moment. Therefore surely that is the current problem rather than BPD, and should be treated accordingly. The diagnostic criteria for BPD relating to mood is '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).' That is not me. My mood is not reactive, and it has lasted weeks, not hours or days. The only time that applies is when I have episodes when I am particularly irritable or hyper for a few hours. It never applies to my depressed or suicidal periods, and I would not consider my mood unstable - it is consistantly very low, and has been for weeks. It makes me so angry that there is still so much prejudice surrounding BPD, which there absolutely is. I don't self harm or take small overdoses and then turn up at A&E - I have never, ever done that. I don't make threats regarding suicide - I only talk about feeling suicidal if I am feeling genuinely suicidal and unable to keep myself safe. And the times I have attempted suicide have not been impulsive - it has been at times like this when I have been feeling desperate and reach a point where I can no longer cope - they have been planned. But I feel like I am being treated as though I am the 'stereotypical' borderline who takes overdoses for attention and that giving me support would be encouraging attention seeking etc. I know I meet the BPD criteria. But I also meet the criteria for Depression, and more closely in my opinion, and that is what is making me feel like this at the moment. And I honestly feel that if Depression was my only diagnosis, I would be receiving different treatment at the moment. I am sure that would be denied by the crisis team or any other professionals, but I have seen from the experiences of friends the difference in the support given to people with a BPD diagnosis, and the support given to people with mood disorder diagnoses, even if presenting with the same symptoms, and except in a few exceptional cases, those with mood disorders virtually always seem to get given more support in crisis. I know the medications I have tried have seemed to have little effect, but I am sure that if Depression was my only diagnosis then medicaations would continue to be tried until something helped. I would not just be left, when feeling suicidal, and expected to get on with things. The crisis team would have arranged the appointment with the psychiatrist that they talked about, and they would probably have continued to visit, and although they aren't always helpful, when I am feeling like this I do find it helpful to know that I have some form of support, and knowing there will be daily visits etc does make a difference. It doesn't change how I feel, but I know from past experience that it makes it easier to take things one day at a time, which is something I am struggling with at the moment, and various other things. As I said, I am sure it would be denied, but I am convinced that had my diagnosis been different, I would have received different treatment these last few weeks, and that makes me angry.

I spoke to L earlier. I can't remember what we talked about. It was only a few hours ago, but my brain just isn't working. I remember that she was supportive though, and I didn't feel like she didn't care about me. I trust her a bit more than I did. It all feels rather irrelevant though. Nobody can change how I feel, and I still have the same level of help. Or lack of.

10 comments:

  1. Well. I don't know. I think te BPD thing is clouding there judgement. That said perhaps I am overly negative but I think the whole BPD thing is an excuse to not do wht they are paid to but f it wasn't that it would be something else. Don't know about your trust but my trust seems to be quite universally shit, with counselling only offered to BPDs ironically. they left me despite being picked up under MHA. I guess if it was a mood disorder you would def be seeing a shrink tho and meds would be offered, whih I do think could help.

    I just hope you find a way to hang on despite their negligence.
    LR x

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  2. Despite what the people responsible for your care seem to think, you can have BPD and depression. I do and I know I'm not alone. Although drugs aren't recommended for BPD itself, they are indicated in the short term for dealing with some of the short term symptoms (and that's regardless of whether you have depression as well or not). I'm amazed they're not even trying some medication, surely anything is worth a shot when someone's feeling as bad as you are. I just want to come and yell at them until they do something for you. Take care.

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  3. You're absolutely right, sadly. Like anickdaler I want to come and yell at them. Hang in there honey x

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  4. Oh, grr. Darn professionals, blinkered, see only what they want to see. I can't form a sentance properly, But like anickdaler and butterflywings i want to come yell at them.
    *hugs*

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  5. I know people with BPD and Manic Dep. I don't know how that works exactly, but probably fit the bill myself too. Ah fuck it all!

    Keep strong and keep going, all of you. (and me.)x

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  6. I think you hit the nail on the head. Treat the symptoms. Listen to and care for the person needing help. It's like, "I am here right now, in front of you. Pay attention to what I am saying! When you are home for the evening-then worry about labels." As always, I pray for you.

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  7. Are you on any antidepressents at the moment? Because if you said something like the above to someone from your medical team (e.g. GP) why would they object to you trying a course of antidepressents? I think I've been diagnosed as BPD in the past (though my doctors never said that to me I imagine that's what they all thought as I did get referred to personality disorder treatment several years ago - which is a completely different rant and off on a tangent) and when I see medical team for mood disorder they still offer me meds and support. Could you print out the diagnostic criteria for depression and take it with you to your next appointment? You're being treated shockingly at the moment and it sounds like you'll really need to push to get the help you want.

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  8. I know from personal experience how differently services treat you when you have a PD diagnosis, and it makes me angry. It's so clear reading your blog that whether you have a PD or not you are profoundly depressed and that ought to be treated. Can you ask L to arrange an appointment with a psychiatrist?
    Take care xx

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  9. Yes, exactly, treat the symptoms. Regardless of whether you have BPD, even if you were Queen Difficult Patient Biatch From Hell (and I'm NOT implying you are, honey) you still deserve treatment. We with MH issues are held to higher standards than everyone else, when we can't even live up to the usual standards much of the time. It makes me furious.
    Keep on fighting hon.

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  10. That could me me talking. I am going through all this and I won't let them diagnoce BPD for the reasons there are only 2 criteria that I meet..that being that I am depressed and I self harm. It seems as though any FEMALE in their 20's who is depressed and self harms is automatically BPD. I have argued with the PDOC soooo much over this. I am a member on a really good forum which really helps. Check out www.suicideforum.com . xxxx

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