Tag Archives: Adjustment Disorder

Diagnonsense Once Again

A few weeks ago, I wrote about my disappointment at not finding the right day activities or home support. Unfortunately, it didn’t end there. Over the past few weeks, I have been finding out about the details of my changing diagnosis. Or rather, diagnonsense, as it’s all extremely odd. Let me explain.

In late June, my psychologist pulled me out of day activities to inform me she had changed my descriptive diagnosis. A descriptive diagnosis is a brief description of what’s wrong with the patient, which should be a little more personalized than the patient’s DSM-IV (we still use DSM-IV here, which is weird enough) classification. Her descriptive diagnosis was mostly okay’ish, with one exception: she said that autism as well as dissociative identity disorder and PTSD had been previously diagnosed, but these weren’t too clear. At first, I thought she meant just the DID/PTSD wasn’t clear. I was wrong. She had, in fact, removed autism from my diagnosis.

Now I have been assessed for autism three times in the past and was diagnosed with it all these three times. There were some questions as to whether some of my problems are due to blindness, but overall it was clear that there was more that was going on with me and this “more” is most likely somewhere along the autism spectrum.

I however was also born prematurely and had a brain bleed leading to hydrocephalus (“water-on-the-brain”) as a baby. This was known to all people who previously diagnosed me as autistic and my first diagnostician even added hydrocephalus to axis III (for physical health problems) of my DSM-IV classification. This was when I was in outpatient treatment. For some reason, hydrocephalus was never on axis III while I was hospitalized. It still isn’t. Yet my psychologist says she cannot diagnose autism because of the complications associatedd with my premature birth. Never mind that there is an enormous amount of literature showing that former preemies and children with infantile hydrocephalus are more likely to be autistic than those without these experiences.

Now like I said, my psychologist didn’t add hydrocephalus, neonatal brain injury or anything like that to my diagnosis. She did briefly mention it in my descriptive diagnosis, but it’s your DSM-IV diagnosis which determines your “diagnosis-treatment combination”, ie. what care you’ll get. My DSM-IV classification now lists borderline personality disorder as my diagnosis. Oh and adjustment disorder, which my psychologist says explains why I can’t handle changing situations. It doesn’t. An adjustment disorder is an extreme, disabling response to an identified stressor. For example, when I lived independently and this caused me to land in crisis, I was diagnosed with adjustment disorder to justify my hospitalization. Back then, adjustment disorder was a justified cause for care under the basic (mandatory) insurance pacakage. It no longer is. Long story short: essentially, I’m stuck with just a borderline personality disorder diagnosis to base my care on. It doesn’t seem to matter that BPD is an adult-onset disorder and I’ve had problems all my life. It doesn’t seem to matter that BPD doesn’t explain my sensory and cognitive overload. Oh wait, maybe that’s just me trying to manipulate people into not exercising their right to overload me.

In Between Mental Illness and Wellness

I have often talked about recovery on this blog. Particularly, I have talked about recovery from my disordered eating habits and to a lesser degree self-injury. I wanted to get rid of my binge eating and stop self-injuring. Today, as I gave this some more thought, I took recovery one step further. So what if I stop bingeing and self-injuring? Would that then mean I’d be cured of my mental illness?

Of course, strictly speaking it wouldn’t. However, what if it did? What if I were cured of my mental illnness? After all, I exhibit far fewer destructive and aggressive behaviors than I did years ago. If I were to check mysel finto a mental hospital just as I am now, with no history of acute mental illness, the registrar would laugh at me. I wonder even if I’d be sick enough for outpatient mental health care if I presented with jut the symptoms I’ve been having lately. My overeating may or may not meet the criteria for binge eating disorder or eating disorder NOS. My self-harm does meet the criteria for non-suicidal self-injury, but then again these crteria are quite vague. My mood does not meet the criteria for a disorder. Heck, even when I was suicidal in 2007 and was clearly in need of acute psychiatric care, the only diagnosis the psychiatrist could come up with was adjustment disorder. Adjustment disorder is no longer covered by health insurance. In other words, under DSM-IV, which doesn’t include binge eating or self-injury as diagnoses, I would hardly if at all qualify for psychiatric care.

Of course, I do have borderline personality disorder and Asperger’s Syndrome – I still meet the criteria for these. However, no general practitioner would come up with the idea that I’d have these if I asked them to refer me to mental health services, and the vague referral letter my GP wrote in 2007 would not be enough now. So if I’m not sick enough at first sight for mental health care, am I then recovered? I don’t think so.

Mental health care has in recent years been more and more reduced to mere crisis intervention or other interventions directed at averting people becoming a pain in the neck. Now I won’t say I can’t be a pain in the neck, but a GP writing my referral letter from scratch now would not know. If you aren’t a danger to yourself or others, you most likely won’t get mental health services paid for through insurance. As such, mental health treatment is focused on curing the symptoms of severe mental illness (which is in most cases impossible), whereas recovery is more than that. Recovery, after all, is getting your life back on track.

As a long-term institution patient, I struggle with this. I am relatively well mentally speaking – probably not as well as I describe in the above paragraphs, but still -, but I don’t have a life. When I was admitted to the mental hospital in 2007, I was a university freshman in a new city. Now I’m nearly 30 and have little that could fulfill my life. I have my blog, but that’s about it. It makes me depressed. Not suicidal-type depressed (or should I say “adjustment-disordered”), but it does definitely make me slightly depressed. If I am not sick enough for mental health services and not well enough to get my life back on track without help, then where do I find help in recovering my life?

I hope that outpatient mental health services aren’t really as bad as I now think they are. I can only hope the recovery model still hasn’t been killed by the push for budget cuts. It however makes me sad to read in memoirs of mental health consumers about the recovery model and using mental health services to get your life back on track. After all, I’m afraid you can’t get mental health care for that now even if you’re severely mentally ill like myself.

T – #AtoZChallenge on Mental Health

Welcome to the letter T post in the #AtoZChallenge on mental health. I’m a little late once again to publish this post, because this was a hard letter and I have once again been very tired. Here goes.

Transition

Transition or transfer happens when a patient moves from one setting into another. This could be from an acute unit to a rehabilitation, resocialization or long-term care unit. It could also be from a psychiatric unit into supported housing or community care.

Trauma

Like I said yesterday, many psychiatric patients have endured some form of trauma. Trauma is experienced differently by different people. The diagnostic manual defines trauma for the purpose of diagnosing post-traumatic stress disorder as having endured, been confronted with or witnessed a situation that is life-threatening, threatened or actually caused physical harm, or sexual violation. Starting with DSM-5, it is made explicit that being confronted with such a situation through the media does not count. As such, people who for exampe watched the 9/11 terrorist attacks on TV (ie. virtually the whole world) cannot claim to have been traumatized by it. First responders who witnessed the events themselves, of course, can. So can people who lost loved ones in the terrorist attacks.

Please note that this definition is only used for the purpose of diagnosing PTSD. People can be diagnosed with another stressor-related disorder (eg. adjustment disorder with PTSD features) if their experience does not meet the criteria for trauma but is still distressing.

Treatment Planning

Treatment plans, like I explained when discussing care plans, describe the person’s overall treatment and diagnosis. On long-term psychiatric units, treatment plans are revised every six months or so. A patient has the right to contribute to their treatment plan and to review it, but on my unit, during the actual meeting, patients are not in attendance. I have only been asked to contribute once and am lucky if I know when my treatment plan revision is. Obviously, informal patients (and most patients on a section) must consent to their treatment plan before it can be implemented. In reality though, I’ve not seen my treatment plan in years so I think consent is automatically assumed.

Bar of Expectations #MondayMusings

Last week, I was readig the book Believarexic by J.J. johnson. I have not been able to get far into the book, because I got easily triggered. The book is about a girl, Jennifer, probably the author as a teen, who has an eating disorder. She eventually decides to tell her parents and have her Mom call a hospital for help. At the intake interview, Jennifer’s Mom is skeptical that Jennifer really has an eating disorder and isn’t just seeking attention. The psychologist tells them that only time will tell whether Jennifer’s eating disorder is legitimate. Legitimate. As if it were some rite of passage. In the hospital world of course, it is: without a mental illness, you aren’t admitted to a psychiatric unit.

This all reminds me of my own experience being admitted into the psychiatric hospital in 2007. The psychiatrist had to practically make up a diagnosis to get me admitted. That is, she diagnosed me with an adjustment disorder, which is really an extreme, debilitating reaction to stress. It is serious, but it is not a severe mental illness. Basic health insurance in the Netherlands as of 2012 no longer covers care for it. Of course, there are exceptions. I was suicidal, so I probably would still get care under these new insurance guidelines.

The story goes on with Jennifer being admitted to the eating disorders unit. One of the rules of the unit is patients having to resign complete responsibility over their eating habits. That was another trigger. In today’s treatment models, patients are usually required to take a lot of responsibility for themselves. Certainly patients with eating disorders are. So are patients with, well, borderline personality disorder, which is what I’m diagnosed with.

It isn’t that I’d like to resign all my responsibility. In truth, if I could, I’d be completely self-reliant. But I can’t, and I’m stuck in the middle between self-reliance and dependence. This is terribly hard. It means I constantly need to negotiate the right kind of help and the right level of independence and assistance.

Today, as I was on the edge of a meltdown, I told a nurse I’d rather be sent to the locked ward and stay there for the rest of my life. Regardless fo the fact that no-one can just stay on a locked ward without any sort of participation in their treatment being expected of them, I’ve not had good experiences on locked units. I rather meant that I’d finally like to make a choice between being completely self-reliant and responsible and being completely dependent. As I can’t choose complete independence, I’d choose dependence instead.

More so, I don’t want people’s expectations to constantly exceed my abilities so much. Currently, I’m constantly reaching for a bar of expectations that, no matter how high on my toes I stand, I just can’t reach. I’m thinking of jumping to the bar so high I fall flat on my face. Then at least people have to lower the bar.

#MondayMusings

Breakdown: My Crisis of 2007 #Write31Days

31 Days of Mental Health

Welcome to day 30 in the #Write31Days challenge on mental health. Today, I discussed the details of the mental crisis that I had in 2007 with a nurse. This helped me feel heard but it also was a bit unsettling. I vividly remember many of the details. I feel compelled to share my story here, but I don’t know how safe a public blog on the Internet is to do so. I shared the details in a post on my old blog (which can still be more easily found by googling my name than this blog) about a month after the crisis happened. I published the raw story back then, complete with every detail of where I was and what I did. I edited it more than a year later for fear it’d ruin my chances of ever having a normal life. If future employers (of which I think I’ll have none) ever read that I’m a nut case and spent eight years in a mental institution, they’ll reject me no matter how vividly I describe the crisis that led to said institutionalization. That being said, the original story was quite badly written. I don’t want to read even the edited version now. I’ll just share what I feel like sharing now.

I remember the crisis state started right after daylight saving time ended on October 28, 2007. Of course, I was spiraling down into crisis from the moment I started livign on my own in August and I had a minor crisis about once a week. The week of October 29, I started completley losing my mind. I wandered about in the dark each evening. The police took me to the police station a couple of times that week and called the crsis service, but they couldn’t do anything.

In the afternoon of October 31, I was called by the crisis service. I still remember the name of the crisis service nurse calling me and if I ever run into her again, which is unlikely, I’m not going to be pleased. She told me that I just had to find ways to distract myself and that a hospitalization would mean I needed to go back on medication. (I’d quit an antipsychotic three weeks prior. No-one later on drew the connection.) I didn’t care about going on medication one way or the other, but I couldn’t mutter a proper response.

On November 1, I took a trip to my parents’ city to collect a landline phone. I don’t have a clue why I had to sleep over there for a night just to collect a phone. On the way back to my city the next day, I had a huge meltdown. This wasn’t unusual for me when returning to my city from my parents’, but for the first time, the railroad service employee who was assisting me to get on the train back to my city, called the police. I hardly realized I was speaking to the police when they told me to leave the station. I wasn’t sure what to do at first, so wandered around. I remember somoene, no clue who, told me that if I could behave, I could come back to the station and get on the train to my city.

I decided to go to the training home which I’d been a client of before going into independent living. I was allowed in, but once the staff found out the police had been called on me, they asked me to leave. I can’t remeber what I did throughout the afternoon. I was supposed to have an early train, but didn’t end up in my ultimate crisis till 8:00 PM. I remember getting some French fries at a cafeteria near the training home and calling my independent livign support worker that I’d forgotten to pay my rent for November the day before.

A housemate from the training home offered me to stay with her for the night so that we could find a solution the next morning. The staff went into her apartment and told me to leave. They initially gave me some time, but I left instantly and had the hugest breakdown I’ve ever had. I was hardly aware of my surroundings as I told some people’s voicemails that I was going to commit suicide. I inferred the time from what the bus driver, on whose bus I’d embarked, told the police. It was the 8:01 PM bus around the eastern part of the city (in that city, buses go in circular routes or at least they did back then).

I was taken to the police station by the police again. This time I was in my parents’ city so the route to crisis services was even longer. The police had to call a community physician who was the most umempahtetic jerk of a doctor I’d met by that time. (I later was treated by an authoritarian psychiatric resident, but she never had to talk to me in the midst of a crisis.) The doc told me I was making people feel responsible. While I can see eight years on that he was right, I couldn’t grasp this back then. I don’t remember my response. The community physician called the crisis service. I have recurrent dreams about the psychiatrist, the only one whose name I remember. In my dreams, I run into her again as I get treated at the mental health agency near the tiny village I’m moving to.

I am a million times thankful that this psychiatrist didn’t stick the BPD diagnosis on me, even though in retrospect my crisis could be interpreted as a typical BPD thing. Instead, she talked to me – she showed much more empathy than the community physician and eventually labeled me with adjustment disorder, which basically means an extreme response to stress. She suggested I be admitted and right away clarified that a suitable living solution would need to be found for me while I was in the hospital. No-one could’ve known back then that it’d take eight years and I’d be going to live independently once again after that.

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How I Feel About My Mental Health Diagnoses #Write31Days

31 Days of Mental Health

Welcome to day 6 of the 31 Days of Mental Health for #Write31Days. Today, I’m feeling very ill-inspired, so I checked out the 30 days of mental illness awareness master list. This is an awareness challenge in which mental health sufferers answer 30 questions about their experience of mental illness. I am going to combine day 1 and 2 of the challenge and share how I feel about the diagnoses I have been given over time.

The first mental health diagnosis I received was adjustment disorder. Okay, I received a diagnosis of autism before, but most mental health professionals do not consider this a mental illness and in truth, it isn’t. It’s a neurodevelopmental disorder.

I received the diagnosis of adjustment disorder upon my admission to the psychiatric hospital in 2007. An adjustment disorder basically means an extreme reaction to stress that doesn’t meet the criteria for any other mental disorder (eg. depression). Well, how could I not agree to thsi diagnosis? I was under a lot of stress from living independently and I reacted in an extreme way.

I was fortunate at the time that insurance still covered treatment for an adjustment disorder. It would do in my case under the current policy too, because I was suicidal, but many people with psychosocial problems related to even more severe stressors such as a life-threatening illness go untreated for their mental health problems.

As I said before, I then received a diagnosis of impulse control disorder NOS. I didn’t feel right about this diagnosis. It wasn’t that I didn’t agree I had impulse control issues, but I had so many more issues. Why not diagnose me with half a dozen other NOS disorders?

Years later, I was diagnosed with dissociative identity disorder (DID) and post-traumatic stress disorder (PTSD). To be very honest, these never sat right with me. Though I did feel validated that I had some dissociative experiences, I felt I may not meet the full criteria for DID. I did have a lot of identity confusion and depersonalization/derealization (feelings of unreality), but I didn’t have a lot of identity alteration (switching to different personalities) till after my diagnosis and never quite had amnesia (memory loss). Okay, let me clarify this: I did have a sense of identity alteration long before my diagnosis, but I tried to never show it on the outside. That changed after my diagnosis. Now I feel I might have dissociative disorder NOS, but I don’t want to bring up my experiences again for fear of being told that I imagine it all.

That was, after all, exactly what happened after a few years. I went to a dissociative disorders support group, where the support group leader, herself a DID sufferer, eventually kicked me out. Her reason was that she felt I had an imaginary dissociative disorder. My new therapist, who changed my diagnosis to BPD, didn’t exactly go along with this, but she did say that BPD better explained my symptoms than DID.

With regard to PTSD, I never felt I had the full classic PTSD symptom presentation. Though I did and do have flashbacks and nightmares, they aren’t necessarily specific to the trauma I survived. This is possible in PTSD with young children but not adults. I also did experience emotional numbing but not avoidance of triggers. In fact, I was often drawn to triggers. I still am. I did and do however experience many symptoms of complex PTSD. Then again, these are similar to those of BPD.

In 2013, I was finally diagnosed with borderline persoanlity disorder. I almost instantly agreed I have it, but then again, I did with most conditions I’d been diagnosed with. I do still feel I meet enough criteria for a diagnosis, though I don’t exhibit as many classic BPD behaviors as I used to when first coming to my current institution. This is possibly related to my autistic difficulty adjusting to change.

My #InvisibleFight for Mental Health #IIWK15

Today is the start of INvisible Illness Awareness Week. I already shared a post on ths year’s theme, my invisible fight, last week. This was about my fight for a correct diagnosis and treatment of my physical symptoms.

If all goes as planned, I will be participating in a 31-day writing challenge in October on the topic of mental health. I have lived with mental health problems pretty much all my life, though I didn’t get into the care system till 2007. In today’s post, I’m sharing my fight for proper mental health care.

I have had a number of diangoses for my mental health problems over the years. At first, in 2007, I was diagnosed with an adjustment disorder caused by the stress of my living independently while being multiply-dsabled. I was hospitalized on a locked psychiatric unit and stayed there for 1 1/2 years. An adjustment disorder can only persist for six months after the stressor has gone (so after I’d been hospitalized), so I had to be diagnosed with something else eventually. My new diagnosis was impulse control disorder nOS. Several years later, I got diagnosed with dissociative identity disorder (formerly known as multiple personality disorder) and post-traumatic stress disorder (PTSD). These finally got changed to borderline personality disorder in 2013.

It’s been a long fight to get the care I deserve and the fight is ongoing. In 2008, when on the locked unit, I was treated with seclusion or threatened seclusion whenever I acted even slightly irritable. I wasn’t told that, being an informally-admitted patient, I had to give consent for this treatment. My problems were treated like willful misbehavior, even though my diagnosis of impulse control disorder should suggest the behaviors were at least to an extent beyond my control.

I had a horribly authoritarian social worker at the time. She was mostly in charge of my care, because I was at this unit awaiting appropriate long-term residential care. At one point, when I objected to applying at a certain supported housing place because I didn’t meet half the admission criteria, she threatened to get me a guardian. Not that my parents, who would’ve been the most likely choice for guardianship, would’ve stood in the way of my making my own decisions. I have said many negative things about my parents, but one positive quality of theirs is that they allow me to be in charge of my own life.

I had to fight to be admitted to a resocialization unit in 2009. I first had to fight my social worker, who wanted to transfer me to a low-level supported housing placement instead. That was just too big a leap. I also had to fight the treatment team at the resocialization unit, who were skeptical I’d be able to cope on an open unit.

Once at the rsocialization unit, I got better treatment than I’d gotten at the locked unit. However, I didn’t get much better. Eventually, medicaiton was suggested. This was a huge step, as the doctor at the locked unit had always ignored my questions and suggestions about possibly going on medication. My antipsychotic is truly a lifesaver. Its dose had to be increased several times and an antidepressant had to be added, but now I’m quite stable.

In 2012, when I’d been diagnosed with dissociative identity disorder for some years but was noticing my psychologist didn’t have a clue how to treat it, I took it upon myself to find a suited therapist. I E-mailed around, was rejected many times, but eventually found someone. Unfortunately, by the time she had a spot for me, I’d transferred to my current institution and my diagnosis had just been changed to borderline personality disorder.

As the years passed, I got to know and love my husband and we eventually married in 2011. We originally weren’t planning on living together, but early this year, I changed my mind. We’ve been working towards discharge for me ever since. Thankfully, my psychologist and social worker are quite cooperative. The fight is not yet over. In fact, now that my discharge is coming closer being probably around three to six months away, I have to fight my inner demons. In other words, I have to fight the fear that I’ll break down again, like I did in 2007. Thankfully, my psychologist and social worker are understanding of this. I am hoping that, once I am settled in at my and my husband’s apartment, I can finally get treatment for my emotion regulation problems.

Everyday Gyaan

Also linking up to Invisible Illness Awareness Week 2015: Your Invisble Fight.

Suicidal People Need Support, Not Judgment

Through my feed reader, I follow a fair amount of mental health blogs. I don’t follow any of the mainstream media and I don’t watch or read the news frequently. I did hear of Robin Williams’ suicide through the mianstream news, but anything more in depth has come to me through blogs.

I see a lot of discussiono n suicide and its reasons. “Reason” is really the wrong word, as Bill Brenner of The OCD Diaries points out that suicide isn’t a rational act. Brenner writes about the differences between long-term depression leading to suicide and a “spur of the moment” suicide when someone kills themself after a disaster, such as the 1929 economic meltdown..

I myself have experienced a mixture of the two when I’ve been suicidal. In 2007, I had the worst suicidal ideation I’ve ever had three months into living independently. My crisis appears like a “spur of the moment” crisis, and in a way, it was. I wasn’t diagnosable with depression at the time, or ever for that matter. I was labeled with adjustment disorder for lack of a better diagnosis.

This is probably too what the people killing themselves in 1929, that Brenner refers to, could’ve been diagnosed with. Adjustment disorder refers to a maladaptive response to an identifiable stressor, where the response (depressive mood, anxiety, disturbance of conduct, etc.) is grossly out of proportion to the stressor and/or causes significant distress or impairment in functioning. The condition can only be diagnosed if other mental health conditions, such as clinical depression, have been ruled out, but it is a mental disorder nonetheless.

Another condition which can come with apparent “spur of the moment” suicide is my current diagnosis, borderline personality disorder. Unlike adjustment disorder, this is considered a severe and usually lifelong mental illness, yet people with this condition who attempt suicide, especially if they don’t succeed, are even more often seen as selfish or manipulative. People with BPD are seen as attempting suicide over the tiniest thing, yet their suffering is severe and chronic, like the suffering of people diagnosed with clinical depression.

In none of the above cases, suicide is a rational act. People with BPD are overwhelemd by intense emotional turmoil. People with adjustment disorder cannot see a life beyond the stressor affecting them at the time. People with clinical depression, the ones who are given the most sympathy when suicidal, are, of course, overcome with depression and hopelessness. These are different emotions and thought processes overcoming different people, but the bottom line remains the same: suicide is not a rational act.

I remember during my suicidal crisis in 2007 being told that I was selfish. In a way, I was, but not out of malice. I was unable to think of other people due to being consumed with intense emotion. Being told I was selfish only worsened my depressed mood.

Remember, people who are suicidal, are in pain. They need support, not judgment. They don’t choose to burden you with the consequences of their death – and yes, I was actually told that. Guilt trips, if they do anything, make the suicidality worse. What someone needs in an urgently suicidal state, is to be kept safe and to be loved. They may understand your point of view once they’ve climbed out of the depths of their suffering. If a person is at the stage of comtemplating suicide, supportive talking can help. If they’re acutely suicidal, all you can do is call emergency services and make sure they’re kept safe and sit by them until they hopefully get out of this state. It’s as sad as that.

Mental Health Awareness: Living with Significant Mental Illness

Today, I’m linking up with Vicky’s mental health linky for Mental Health Awareness Week in the UK. As regular readers will know, I’ve been diagnosed with a mental illness for years. My original diagnosis was adjustment disorder, because I had landed in a psychiatric crisis when living indpendently and just didn’t meet the criteria for depression. My parents joke that I just didn’t wake up at the right time, because my doctor told me when I had sleep disturbances, that they weren’t typical of depression. I’m pretty sure I wasn’t clinically depressed.

Then came impulse control disorder NOS, which was basically an extension of the adjustment disorder I suppose, except that it reflected just my behaviors and not my moods.

In 2010, I was diagnosed wit dissociative identity disorder and PTSD. I want to tell anyone with a diagnosis of PTSD that it’s not a life sentence. I had a mild case as far as the regular symptoms were concerned (I also had symptoms of complex PTSD, and still do). EMDR treatment was suggested a few times, which can be very effective. However, because I had such a mild version of PTSD, the symptoms lessened to the point where I no longer needed the diagnosis with a lot of talking about my traumatic experiences. I later found out that talking and talking on about your trauma under a therapist’s guidance until it doesn’t hurt as much anymore may in fact be effective in people not responding ot EMDR. I don’t know the specifics of this therpay, which is called imaginary exposure, and I didn’t get any formal form of treatment for the PTSD myself.

As for the DID, I have or had a mild version of that too, probably more dissociative disorder NOS, and was able to hide the symptooms when people weren’t accepting of them anymore. There are many people, mostly peers, who believe my diagnosis of DID was incorrect. As for my therapist, she changed it to borderline personality disorder and feels this includes mild versions of DID too, so that I don’t need an additional diagnosis.

What is it like living with a mental illness? Well, for me, it is one confusing experience. I am very suggestible and have a poor sense of self. This means that I absorb many emotions from other people, and yet I do not know how to handle these emotions. I can have rapidly shifting, dramatic mood swings. One momnet, I’m fine; the next, i’m raging. Then again, my definition of “fine” is probably not the same as a currenlty mentally healthy person’s, because I’m always somewhat anxious and/or depressed.

Borderline personality disorder often co-occurs with other disorders. I have no additional diagnoses (other than autism, which I don’t consider a psychiatric disorder), but I could likely have been diagnosed with a range of disorders if this would make a difference. As I said, I have dissociative symptoms. I also have suffered from chronic, low-grade depressive moods since my teens, and likely had what is now called disruptive mood dysregulation disorder as a child. I also have some level of anxiety and used to have quite bad obsessive-compulsive symptoms in my teens and early twenties. They however went away witout treatment when I was hospitalized, so were likely a response to stress. Same with many of my somatic symptoms.

There is treatment for most of my mental health symptoms. In fact, I have improved a great deal over the years. That doesn’t mean my mental illness can be cured. I strive for recovery, which means living a meaningful life in spite of my mental illness.

Living a meaningful life, for clarity’s sake, does not necessarily mean not needing mental health support. It is a common misconception, which I fight even with my therapist, that needing less support is the ultimate measure of quality of life. I, for one, am likely to need support for the rest of my life. This doesn’t mean I can’t find joy or even happiness. I find joy in my hobbies, which include blogging, crafting and reading. I find happiness through my relationship with my husband. I do still have significant mental health problems, and I won’t say they don’t limit me. Then again, I’m more limited by the idea that needing less support is more important than feeling better.