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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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i have a mixture of anxiety, anger, tiredness, crohns disease

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i have a mixture of anxiety, anger, tiredness, crohn's disease and feel really up and down with my moods on quite an extreme level and i think it's related to previous experiences
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr John B replied 2 years ago.

Hi,

Sorry to hear of the situation. I can see that you have tried a variety of different methods for improving how you and so I will presume that you have heard many ideas as to why you are having the difficulties you are experiencing. Have you ever received a diagnosis and if so what is it? Do you agree with it? You mention that you connect your difficulties with past experiences, can you provide some more detail abut what happened (as much or little as you feel comfortable with)?

Customer: replied 2 years ago.
My mum suffered from manic depression and I think mild schizophrenia and was on long term medication including lithium, im worried m following in her footsteps. I have a very sensitive mind and react negatively to almost everything and don't trust anyone, feeling like everything could be a conspiracy against me a lot. My trust has been taken for granted many times previously and all my life been treated like a hypochondriac even by doctors when I was seriously ill, later to lead to being hospitalised for three months through them ignoring the seriousness of my health. I feel. Can't do anything right but then when things are great, I find something else to bother me and don't know why, maybe natural reaction. I'm concerned I might be bipolar or permanently scarred with anxiety and have considered suicide many times. Please help men desperate, I'm supposed to be happy I'm getting married soon
Expert:  Dr John B replied 2 years ago.

Hi,

Thanks for the extra information. Some more questions so I can get a better understanding of the situation. Please take your time and answer each one.

Can you tell me a little about what your previous relationships have been like (both romantic and platonic)?

You mentioned that you've considered suicide on numerous occasions, have you ever felt the urge to self harm? For example, cutting picking or bruising yourself?

You mentioned that you have trialled antidepressant medication, was it in any way helpful?

What was your relationship like with your Mum?

You mentioned that you are concerned that you may bipolar, is this because you experience intense mood swings?

Customer: replied 2 years ago.
I always put a lot of effort into my previous relationships with partners and now I'm too scared to give everything because I was usually lied to or treated as a convenience partner when I loved them before. Admittedly I cheated on one boyfriend before and he was he one that treated me the best but everything had to be his way so I felt a little trapped. But he really was generally good to me. I have a major problem with authority and being told what to do because my mum was a serious nag more than average! In the long term she meant well but she made me get voices in my head and scream and developed moods when I was in my teenage years which was also a hard time, there was lots of issues In my family then with my mum having breast cancer and dad left us because he found my godmother provided him more with what he desired than my mum did. I was very confused growing up and feel like I never had the same chances in life as lots of people around me regards XXXXX XXXXX happy life and financial help. Now I'm with the most amazing man and I've also converted to Islam because it has offered me a chance of hope but I still feel lost and I hate that the one person who deserves my love and attention is suffering with the negativity I provide him with. I was always angry at my mother in life but I've learnt to see that she means well and just wants what's best for her children but now I've become like this, sometimes I can't help but resent her. Regards XXXXX XXXXX I don't have many because most have them have misunderstood me and decided to not be my friend or I've decided not to be theirs. Now i feel very lonely and if I don't find some cure soon I know nothing will help me and I'm destined for doom. Sometimes if something is frustrating I can't find any answers when I need to and feel obliged to have an outburst or scream or bang my head up against something or hit my arm against a wall and of course suicide crosses my mind almost every day. My heart feels like its going to explode and I feel sick and anxious. Anti depressants haven't really helped me. The first one made me numb to emotion but sometimes just go hyper, the second one didn't do anything, the third one made me violent and aggressive, and after that I just came off them cos I thought they were useless and preferably I don't want to be taking them anyway. I've spoken to a couple of friends with bipolar and they have felt and done similar things to me, and along with my mums medical record and my own, Im fairly certain that I'm abnormal. I want to become calm and positive and like I was once, I want to trust again and I want to not have these problems
Expert:  Dr John B replied 2 years ago.

Hi,

Thanks for the extra information. You are right in thinking that your mother's psychiatric history might make you more vulnerable to developing Bipolar Disorder but given what you have written so far my initial response would be that you may be experiencing the kind of difficulties associated with Borderline Personality style or Borderline Personality Disorder (BPD). BPD is frequently mis-diagnosed as Bipolar Disorder or recurrent Depression due to the powerful mood instability BPD sufferers experience. The mood instability is however different to the kind that develops in mood disorders and so BPD sufferers almost never get any relief/benefit from antidepressants (although they are usually prescribed them very quickly).

BPD sufferers often experience difficult childhoods, particularly in the relationships they have with their parents. Often we see BPD develop when children are unable to form stable attachments to their parents due to parental illness, abuse or divorce/separation. This later leads to what could be described as intense and chaotic relationships - where relationships tend to swing from extremely good to extremely bad.

BPD sufferers experience very strong and intense emotion in general and often feel like they are unable to control, predict or manage their own emotions. It is common for BPD sufferers to have difficult controlling their anger at times and they frequently take their anger or distress out on their own bodies. They also tend to experience frequent suicidal ideation.

I am by no means saying you have BPD but your description has several similarities to the illness and I think the first thing to do is take a close look at BPD and decide whether it is a diagnosis that should be discounted or investigated further. BPD sufferers often spend yeas trying different things to feel better and end off largely frustrated because they are often mis-diagnosed. I will provide a more detailed description of BPD below and wait for your to let me know whether you think this may be something worth considering. if it is I'll provide you with suggestions on what treatments are available (there is a very effective treatment available) and how you can begin to make the changes your are seeking. If it's seems that the BPD description doesn'töt fit with your experience then we can look at some other possibilities.


Description


The main feature of borderline personality disorder (BPD) is a pervasive
pattern of instability in interpersonal relationships, self-image and emotions.
People with borderline personality disorder are also usually very impulsive.
This disorder occurs in most by early adulthood. The unstable pattern of
interacting with others has persisted for years and is usually closely related
to the person's self-image and early social interactions. The pattern is
present in a variety of settings (e.g., not just at work or home) and often is
accompanied by a similar lability (fluctuating back and forth, sometimes in a
quick manner) in a person's emotions and feelings. Relationships and the
person's emotion may often be characterized as being shallow.

A person with this disorder will also often exhibit impulsive behaviors and
have a majority of the following symptoms:


Frantic efforts to avoid real or imagined abandonment


A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation


Identity disturbance, such as a significant and persistent unstable self-image or sense of self


Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)


Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior


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


Chronic feelings of emptiness


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


Transient, stress-related paranoid thoughts or severe dissociative symptoms


Key Features in Detail


Frantic efforts to avoid real or imagined abandonment

The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in self-image, emotion, thinking and behavior. Someone with borderline personality disorder will be very sensitive to things happening around them in their environment. They experience intense abandonment fears and inappropriate anger, even when faced with a realistic separation or when there are unavoidable changes in plans. For instance, becoming very angry with someone for being a few minutes late or having to cancel a lunch date. People with borderline personality disorder may believe that this abandonment implies that they are "bad." These abandonment fears are related to an intolerance of being alone and a need to have other people with them. Their frantic efforts to avoid abandonment may include impulsive actions such as self-mutilating or suicidal behaviors.



Unstable and intense relationships


People with borderline personality disorder may idealize potential caregivers or lovers at the first or second meeting, demand to spend a lot of time together, and share the most intimate details early in a relationship. However, they may switch quickly from idealizing other people to devaluing them, feeling that the other person does not care enough, does not give enough, is not "there" enough. These individuals can empathize with and nurture other people, but only with the expectation that the other person will "be there" in return to meet their own needs on demand. These
individuals are prone to sudden and dramatic shifts in their view of others, who may alternately be seen as beneficent supports or as cruelly punitive. Such shifts often reflect disillusionment with a caregiver whose nurturing qualities had been idealized or whose rejection or abandonment is expected.


Identity disturbance


There are sudden and dramatic shifts in self-image, characterized by shifting goals, values and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with borderline personality disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing and support.
These individuals may show worse performance in unstructured work or school
situations.



Customer: replied 2 years ago.
You have hit the nail on the head, I'm in shock because you have basically described how I am in almost every way. No one has even ever come close to saying the description of it all back to me and I could never even try to begin to explain about it because it's such a whirlwind of confusing thoughts and emotions that I don't have a clue where to start when explaining what goes through my mind but you have made sense of a lot of it. It's like you have just written a book about me! So what's next? Where do I go from here?
Expert:  Dr John B replied 2 years ago.

Fantastic that we're on the right track!

 

I actually work with BPD on a regular basis and I am constantly amazed/dismayed at how many people spend years struggling to get help because nobody manages to get the diagnosis right. I should stress here that I would strongly encourage you to go and get an assessment for BPD performed so that a diagnosis could be confirmed - the service here is to provide information and it is impossible to diagnose someone via the internet.

 

That being said let me start straight off by reassuring you that many, many people suffering from BPD are able to make great gains with the right help. The treatment generally regarded as the best approach to BPD is Dialectical Behavior Therapy (DBT). DBT is a system of therapy developed specifically to treat persons with BPD. DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice. DBT is the first therapy that has been experimentally demonstrated to be effective for treating BPD.

DBT is usually offered by Clinical Psychologists (although not exclusively) and you can contact The British Psychological Society here for assistance with finding an appropriately trained Psychologist in your local area who can firstly conduct an assessment for BPD and secondly offer DBT. The NHS covers sessions with a Psychologist in many circumstances and you can begin to check this option here. Also, take a look at an article published by the American Psychology Association here. It's an interview with a senior Psychologist and covers some of the things you should consider when you looking for a Psychologist.

While you are in the process of organizing and assessment (or perhaps even as a first step before consulting with a professional) you can read a number of books that can assist people to learn Dialectical skills at home and to generally manage typical Borderline difficulties. If you are interested in doing some reading I can recommend both this book here and this book here . Alternatively, take a look at this excellent self help program for working with distress tolerance here http://www.cci.health.wa.gov.au/resources/consumers.cfm/infopax.cfm?Info_ID=54 It's the workbook titled Facing Your Feelings (it's completely free) and while it isn't a complete DBT package it does offer a great place to start working on one of the more difficult aspects of BPD - tolerating your own intense emotions. I notice that the link appears not to be working today so if it doesn't get back up and running in the next 24hrs let me know and I'll find another way to get the workbook to you.


I hope this has been of some help. If you have further questions or would like me to elaborate further on any part of my answer please let me know!

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and other Mental Health Specialists are ready to help you
Expert:  Dr John B replied 2 years ago.
Hi Aimee,

I hope you have found the resources I sent you helpful so far. If I can be of further assistance, or if you ever have other questions in the future please don't hesitate to contact me directly.

Regards,

John

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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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Dr John B
Dr John B
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PhD in Clinical Psychology, registered clinical psychologist.