Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
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I believe that I can help.
You are diagnosed with BPD when you meet certain criteria in the estimation of the assessments or interviews she or he has done.
I do not understand the "team" approach of your organization.
Sure. My therapist isn't qualified to do these assessments. I think they have to be completed by a psychiatrist
That is not true.
Psychiatrists are no better trained in making assessments than other mental health therapists. They just give medications, and the best treatment for BPD is psychotherapy and not medications. However, psychiatrists approach most disorders with medications.
Are you in the UK...the team approach is based on primary and secondary mental health care. My therapist is classed as primary care but she is private not part of NHS
I have lived in the UK but I am in the US.
What are your symptoms?
She recommends DBT but think I have to have an official diagnosis for this. Was wondering about the diagnostic process
Do you get very angry? Do you fly into a rage?
Do you hurt or cut yourself?
Do you engage in reckless behaviour?
Are your triggered by feeling abandoned?
Symptom wise, dissociation when very distressed. I've always called it a transient personality where younger distressed parts of myself come to the surface
Yes self harm. Yes am triggered by rejection and not understanding emotions or relationship
You have other personalities within you with different characteristics (including personalities, voices changes, etc.)?
Yes some voice changes, my bodily movements change and speech becomes stunted
Yes most recently burning
Fly into a rage?
No, neither reckless
I can get very angry but gets internalised into distress
That will then affect relationship
Reckless includes spending, driving, gambling, drugs, sex.
Do you get very angry at others?
I tend not to communicate in that state because it makes the situation worse,
Reclessness as defined above is not something I do
If someone hits my triggers then yes I get angry
What is your biggest trigger(s)?
People misperceiving me or rejecting me
Were you abandoned or abused as a child?
If I can't make myself understood or think people are not listening. Yes I was badly abused as a child
Went into care when I was 15
Do you have moments of forgetfulness?
Don't remember important personal information sometimes?
Especially if my personality switches
Not so much that, more that I might not remember what I was doing, have done that day, what day it is or what I'm meant to do
DBT, by the way, is the best therapy for you.
Yes I think so from looking into it, just wondering how I go about accessing it
If I were your therapist I would give you a dual diagnosis and begin treatment immediately
Not so common in UK. What is a dual diagnosis?
Borderline Personality Disorder and Dissociative Identity Disorder (multiple personality disorder was the old term for it).
Ah right, not heard of it. It's not like my alter personality is called Fred or anything. I worry people won't believe me
Let me give you some helpful information: the official criteria for diagnosing these two disorders - both of which are related to childhood trauma and abandonment.
Personalities may not have names but you may conveniently name them. I have a client with several: one is a baby and she names it Baby.
Here are the official (DSM-IV) criteria for BPD:
BPD – DSM-IV
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterised by alternation between extremes of idealization and devaluation.
3. Identity disturbance - markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging, e.g. spending, sex, substance abuse, reckless driving or binge-eating.
5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.
6. Affective instability due to a marked reactivity of mood, e.g. intense episodic dysphoria, irritability or anxiety, which usually lasts for between a few hours and several days.
7. Chronic feelings of emptiness
8. Inappropriate, intense anger, or difficulty controlling anger, e.g. frequent displays of temper, constant anger or recurrent physical fights.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
Anyone with six or more of the above traits and symptoms may be diagnosed with Borderline Personality Disorder. However, the traits must be long-standing (pervasive), and there must be no better explanation for them, e.g. physical illness, a different mental illness or substance misuse.
and for Dissociative Identity Disorder (DID):
Diagnostic criteria for 300.14 Dissociative Identity Disorder
(DSM IV - TR)
A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
B. At least two of these identities or personality states recurrently take control of the person's behavior.
C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
D. The disturbance is not due to the direct physiological effects of a substance(e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, thesymptoms are not attributable to imaginary playmates or other fantasy play.
I have a couple of books to recommend to you. The first is about a young woman's recovery from BPD and it will inform and inspire you (available to order online in the UK - just click the link).
Thank you that is helpful and the book sounds good too
and a book to get started on DBT - a workbook:
The crisis team report says my history is consistent with an emotionally unstable personality disorder. Is that another way of saying BPD in your opinion?
Yes, in words that are obscure and not plain.
It means that people with your childhood history can get a personality disorder (usually BPD). The same history can produce DID or PTSD (posttraumatic stress disorder).
I have a couple of choices for DBT workbooks.
and one other
I hope that this helps. I see you have left the chat and gone offline.
Please remember to leave me positive feedback for our session.
I shall keep you in my prayers.
Elliott, MAE, LPCC, NCC, CCMHC
Thanks just had a call
Will leave your feedback now
Thanks for your help and recent email. I have had the good news that the complex care and treatment team have taken me on from referral and there is a dbt service in my area. Waiting to hear from them. I got the skills manual from above and think it's a good help.
Regards Susie, UK