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Hi and thanks for writing JA
Medicine is an art and not a science so that in and of itself makes diagnoses more or a "rule out" than a definitive diagnoses realm and psychiatry is such that behaviors or rather patterns of behavior over time are what play into the differential diagnosis. Does this help or can you be more specific on this?
You know I have answered them but you are not happy with my answers so I am not sure what I can do for you.
1. Medicine is not a black and white/cookie cutter service. The human body is a complicated organism and so more often than not we know first what something is not and then through the process of elimination can determine what is.
2. Mental illnesses are not isolated incidents but rather patterns of behaviors. Therefore no isolated incident can conclusively be diagnosed.
Finally most diagnoses are accurate. It may not be the case in your instance but most cases are properly and appropriately diagnosed with the exception of bi polar diagnosis which is over diagnosed by 65 percent and usually for reasons not at all helpful here. Most of us can only be as sure of a diagnosis as what a client tells us. If the client is honest and forthcoming we can usually make an accurate diagnosis fairly early and if not we cannot. I have no idea what your diagnoses might be so I cannot answer that question and again
the biggest single challenge in making a diagnosis is the veracity and honesty of the client. Let me know if I can guide you further on this. Cathy
HI and first I would have to ask how old you are?
50? and that is far too late for onset of true bi polar disorder and unlikely that you have undiagnosed borderline personality disorder. I would have to leap to agitated depression which would account for suicidal ideation, labile mood, irritability and poor impulse control but none of which would lead me to bi polar, ocd,bpd. I think this is a very common Depressive episode that often comes after cva that would very much lend to irritability, poor impulse control and even some of your ruminating thoughts and behaviors.
The botXXXXX XXXXXne is that we do not treat diagnoses we treat people and it does sound to me as if you have had appropriate treatment. I would think one mood stabilizer, an anti depressant and an anti anxiety might do the trick, but also in many many cases like this I have seen a good anti depressant along with a good anti anxiety med do the trick. Tell me what is going on for you in therapy which is actually the best medicine for all that you describe. Let me know. Cathy
Was the group therapy DBT? Dialectical Behavioral
Therapy? Let me know..
Okay then so if that is the case it means you probably do have BPD or some strong Borderline traits or at very least problems with emotional regulation. Which begs the question why are you cutting when you have your dbt skills to use?
I think you might have bpd or borderline traits and the best way to work on this with the dbt treatment. Can you get back into a group where you live? Hard illness to treat but does so much better with dbt. Let me know. Cathy
You know BPD is just that kind of disorder that responds best to group therapy, its just the way it works. I think though that seven hours is so far out of line. Three hours maybe but seven hours is outrageous. Really.
The other thing you can look into is a classical Freudian analysis which does not work as well as DBT but works and the problem with this is that it is five days per week and an hour a day.
I would look around for an Advanced DBT group that meets twice a week for three hours a time. And stop cutting yourself so you stop getting such a bad rep with admitting docs at hospitals. Use your dbt skills and dont self mutilate. Use a warm line for heavens sakes but dont play into the game that all bpds are pains. You need to be smart about this. Use those skills girl.
I have no idea if all your symptoms are related to bpd but now that we have it on the table I would say yes. probably all.
You need to work your skills and get past all the pain. It is time now to do that. and also that will help you to get off so many meds. Two stones killed with one bird I think.
Let me know where you wish to go further on this and you have my attention.