Tag Archives: Depression

#Depression: What It Feels Like to Me

I have had experience with low moods since I was a child. Nonetheless, until a few months ago, I was never diagnosed with depression. During the last round of diagnostic revisions, my psychologst decided to diagnose me with depressive disorder NOS along with dependent personality disorder and borderline personality disorder traits. I am not sure I agree and my psychologist admitted at first that it was more her needing to give me a diagnosis on axis I to warrant me staying in the institution than my actually needing treatment for this.

Today, Aspiecat described what depression is like for her. I could relate to some of these experiences, but nto others. I am going to describe what it’s like to be depressed for me.

Let me first say that low moods are my default. I am pretty sure that dysthymia, ie. chronic but mild depression, is a more useful diagnosis for me than depressive disorder NOS. Apparently though my psychologist doesn’t feel I meet the criteria for that. Really not remembering a prolonged time when I did not feel low makes me wonder whether I’m truly depressed or just pessimistic. I know that depression and optimism do not mutually exclude one another, but I tend to gravitate more towards the negative than the positive.

Then there is the state, as opposed to the trait, of being depressed. Like Aspiecat, I experience two forms of depression: the first in which I feel numb and inert and the second in which I mostly feel despair, sadness and often anger. The former tends to last longer and be harder to overcome. During this state, I sleep more than usual, eat irregularly but usually more than normal, am slower than usual and generally unmotivated. I don’t usually experience the extremest of dark thoughts in this state. Rather, I worry and feel a bit anxious. I may experience suicidal ideation during this state, though it’s rarer than when I’m in my state of despair. I am also less likely to act destructively, unless you count binge eating. When I do experience suicidal ideation in this state, it’s more of a logical, thought-based kind focused on self-hate rather than an active wish to die. I just can’t be arsed to care about life.

In the state of what Aspiecat refers to as meltdown, I, like her, experience all kinds of negative emotions. I think I may be somewhat alexithymic (unable to read my own emotions) too. I often express my emotions as anger when I’m in this state anyway, even though I think I experience many other emotions. I am more likely to experience suicidal thoughts and to engage in destructive behaviors in this state. I am usually agitated rather than slow.

Unlike Aspiecat, I prefer the state of despair to the state of numbness and inertia. There are several reasons for this, one of which may just be the fact that I’m currently numb and not liking it. Any emotion seems better than this state of inertia now. I however also feel that my despair is more actionable, because it tends to be more situational.

Other people also tend to understand my state of meltdown more than my state of inertia. They see me lying in bed all day as a choice, whereas when I’m in meltdown, they see my despair. They may not accept my agitation in this state, but at least they notice that I’m not doing well. My medication also tends to help with this state more than with numbness. I do take an antidepressant in addition to an antipsychotic, but I’m not so sure it helps with my low moods. The antipsychotic and maybe the antidepressant too do take the edge off of my agitation.

Unfortunately though, people see my state of despair as more needing treatment than my state of numbness. This may be because I don’t tend to respond well to psychotherapy and medication-wise, there is simply more to be done against agitation. I take a high dose of an antipsychotic on a daily basis. I also have a low-potency neuroleptic, an anti-anxiety benzodiazepine and a sleeping pill (also a benzo) as PRN medications. All of these can be seen as depressants. Like I said, I do take an antidepressant too, though in a low dose. I am not so sure it works, but then again it isn’t a great medication for the kind of atypical depression I experience. By this I mean that it isn’t shown to be too effective with depression that is characterized by inertia, eating and sleeping too much and general anhedonia (numbness). This kind of depression is particularly hard to treat.

Because other people are more bothered by my meltdowns than by my state of anhedonia, I also feel they tend to want me to be numb rather than agitated. I mean, of course they don’t actively want me to be numb, but they see it as less of a problem, because it causes little disruption to others. I go along with this and have never asked for more help, medication-wise or otherwise, with my inertia-based depression. I am not so sure that I should.

Diagnonsense, Oh Diagnonsense!

A few months ago, I wrote about my changing diagnosis. My autism diagnosis that’s been confirmed three times since 2007, was removed. That left me with just borderline personality disorder (BPD) as a diagnosis. If you thought I gracefully accepted this, you do not know me. I consulted with the patient liaison person at my institution, who recommended I seek a second opinion at another hospital. Now, three months on and we’re back at square one, and it’s not because an independent provider agreed with my psychologist.

On August 15, I talked to the patient liaison person, who on that same day E-mailed my psychologist asking her to make the necessary arrangements for me to get a second opinion. Instead, my psychologist told me she wanted to contact a psychiatrist at the brain injury unit first to inquire about the diagnosis of autism in people with brain injury. This doctor told her that indeed autism shouldn’t be diagnosed in people with brain injury, but the same is true of BPD. My psychologist would need to diagnose personality change due to a general medical conditon instead. I stupidly agreed with her changing my diagnosis herself rather than sending me to an independent psychiatrist or clinical psychologist.

My psychiatrist, who is the head clinician responsible for my care, however, disagreed with my psychologist’s diagnosis. My named nurse said they were throwing around all sorts of diagnoses at my treatment plan meeting last month. Eventually, my psychologist informed me they’d settled on dependent personality disorder, borderline personality disorder traits and a developmental disorder NOS. I hate the DPD label, but can see how I might have some of its features. I needed to see my treatment plan to see what they’d meant with developmental disorder NOS, which isn’t a diagnostic code in DSM-IV unless prefixed by “pervasive”. That would essentially mean autism. As it turned out, they hadn’t settled on this diagnosis, as the developmental disorder was gone.

Instead, I now have DPD, BPD traits and depressive disorder NOS. I asked my psychologist whether this was a coding typeo, but it wasn’t. Her explanation was that I may formally meet the criteria for this, but the main reason for the diagnosis is for insurance purposes. You see, I can’t be in the mental hospital without a diagnosis on axis I (anything that isn’t a personality disorder). A nurse even twisted my psychologist’s actions like she’d done me a favor.

Last week, when I found out my final diagnosis, I lost it pretty much and was considering checking myself out of the institution. My psychologist was called, because the nurses thought I said I was definitely leaving, which I can’t remember having said. My psychologist encouraged me to leave right then, which I refused. My husband instead came to pick me up thee nxt day for a night at home to have some distance.

Today, I spoke to the patient liaison person again. She was not happy at the fact that my psychologist had failed to cooperate with me in getting me a second opinion. This essentially means we’re back at where we started and I’m probably going to ask my psychologist to get me a second opinion again soon.

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.

Z – #AtoZChallenge on Mental Health

Welcome to the last day in the #AtoZChalleng eon mental health, dedicated to the letter Z. I am just in time to publish my post, as I was at my parents’ two hours way all day. I did take my computer, so don’t worry, this post was not my reason to leave. Anyway, today’s words are all on a common theme. Here goes.

Z-Drugs

Z-drugs are a few medications, most of whose generic names start with Z, eg. zaleplon, zopiclone and zolpidem. Besides the letter they start with, they have in common that they work similarly to benzodiazapines but are not benzos. There are three subgroups of Z-drugs, all of which are GABAA agonists, meaning they increase the availability of this neurotransmitter. Z-drugs are used in the treatment of insomnia. Some have advantages over benzdiazepine sleeping pills.

Zombie

Many psychiatric patients, especially those on long-term units, seem a bit zombielike to outsiders. I discussed this when discussing lethargy in my letter L post too. Negative symptoms of schizophrenia and other psychotic disorders may cause people to act like “zombies”, but so do many psychiatric medications, including antipsychotics, anti-anxiety medications and certain antidepressants.

ZZZ

Last year, I discussed sleep in my post on the letter Z for ZZZ. To finish off this year’s challenge, I am going to discuss the same topic. Sleep disorders are common among people with mental illness and of course can be a mental illness themselves.

There are two forms of sleep disorders. Dyssomnias are disorders in the quantity, quality or timing of sleep, such as insomnia or hypersomnia. Parasomnias are characterized by unusual physiological or behavioral events that limit sleep, interfere with certain stages of sleep or with the transition from sleeping to waking. Sleepwalking is an example of a parasomnia.

Like I said, sleep disorders can occur on their own but can also be part of another mental illness. For example, many people with clinical depression experience insomnia, usually waking up way too early in the morning. Some people with depression conversely experience hypersoomnia, sleeping far too much.

N – #AtoZChallenge on Mental Health

Welcome to the #AtoZChallenge on mental health, day 14. Today’s letter is N. Another late post, because I slept through the day yesterday so wasn’t able to schedule it. Here goes.

Neuropsychiatry

Neuropsychiatry is the branch of psychiatry specializing in the effects recognized brain diseases have on people’s mental health and behavior. Of course, mental illnesses have a biological component too, but neuropsychiatry is particularly interested in conditions like epilepsy, Parkinson’s Disease and brain injury. Some psychiatric institutions have specialized neuropsychiatric units or outpatient clinics. Mine has both. The inpatient unit is mostly for people with brain injury. In my institution, a neurologist is in charge of directing the care on this unit.

Neurotransmitters

Neurotransmitters are chemicals that the brain cells use to communicate. They commonly have multiple functions, hence the side effects of psychiatric medications affecting neurotransmission. Well-known neurotransmitters are serotonin and dopamine.

Serotonin is thought to play an important role in mood. A deficiency in it can cause mood disorders, such as depression or bipolar disorder. Unfortunately, an excess of serotonin caused by antidepressant use can cause serotonin syndrome, which is a potentially life-threatening condition. Serotonin syndrome is particularly associated with a type of old-school antidepressants called MAOIs.

Dopamine plays a role in different physical and mental functions. Dopamine is necessary for movement. Parkinson’s Disease is caused by a degeneration in the dopamine-producing cells in the brain. On the other hand, an excess of dopamine is linked to psychotic symptoms. First-generation antipsychotics (such as Haldol) block the brain receptors for dopamine. Like I said however, dopamine is necessary in movement. Hence, peoople on first-generation antipsychotics commonly experience tremors and muscle stiffness similar to Parkinson’s patients. This movement disorder associated with antipsychotic use is called Parkinsonism.

Nicotine

Many people with mental illness smoke. Among people with schizophrenia, as many as 90% do. It is well-known among smokers that cigarette-smoking relieves stress. This coul be psychological dependence though. However, research shows that nicotine actually helps decrease psychotic symptoms specifically. It is not just a matter of psychological dependence on nicotine that causes people with schizophrenia to experience fewer symptoms after smoking. As such, schizophrenics might unknowingly use nicotine as self-medication.

Nurse

Obviously, mental hospitals employ nurses as support staff. Their primary tasks are to observe and facilitate the patients’ day-to-day functioning. Obviously, administering medications is a common task. However, nurses also use psychosocial interventions.

Community psychiatric nurses (CPNs) are employed by outpatient clinics to help support patients in the community. They often do some form of psychosocial counseling and are also often employed as case managers. As such, they do some tasks formerly done by social workers.

D – #AtoZChallenge on Mental Health

Welcome to my letter D post in the #AtoZChallenge on mental health. Today, I have quite a few words to share with you again.

Danger

In the Dutch mental health act, people can be involuntarly committed to a mental hospital if they’re a danger to themselves or others. Danger can refer to many things, including self-harm or aggression, but also to “social disintegration” or “eliciting other people’s aggression with one’s behavior”. In other words, if you’re plain irritating, you’re a “danger” to yourself.

Dependence

With the current rehabilitation model of psychiatric care, we’re not supposed to become dependent anymore. That is, we can clean our rooms and do other household chores, but often only when told to. I have often experienced the same sense of dependence no matter whether practical independence was encouraged or not.

Depression

One of the more common mental illnesses within the general population. It is not as common among long-term mental hospital inpatients, although some will claim they feel “depressed”. That usually refers to minor, everday depression. I was once screened for depression because a mental nurse insisted I get screened after teling him how low I felt. Being borderline, I often feel slightly depressed but my emotions also shift rapidly.

Diagnosis

What the mental health professionals say is wrong with you. You need a primary diagnosis, which dictates practically everything about your treatment. If you happen to have more than one mental disorder, too bad.

Discharge

When you’re let out of the mental hospital or, in outpatient treatment, when treatment is discontinued. Discharge is usually a mutual agreement between the patient and their treatment provider. An exception is involuntary commitment, when someone can be discharged when their section runs out. People can also be forcibly discharged if they have improved so much that they no longer need the mental hospital, have broken the hospital rules multiple times, or refuse every treatment offered.

Drugs

This can refer to either the drugs handed out like smarties by mental health professionals or to the street drugs patients get in the hospital parking lot. Seriously, drug dealers wait right outside of a mental hospital and patients with privileges will get their (and other people’s) drugs. Outside of my unit is a billboard that says drug use is prohibited, but I’ve smelled people smoke marijuana and who knows what else right next to the billboard.

Fear of Joy

Fear of joy. Some people find this hard to imagine, but it is real for some of us who’ve experienced depressive symptoms. It is real for me.

I have a really hard time experiencing joy without sabotaging it with fear. I don’t deliberately do this, but quite often I tend to feel intense anxiety when I notice I am in a good mood. Then obviously my mood goes down again.

It’s probably because of expectations. There is this man on my unit who always says he’s doing so-so or bad and never says he’s doing well. He says it is because, if he says he’s doing well, they’ll think he’s no longer mentally unwell and will expect him to leave the psychiatric unit. I can relate to this. Now I myself don’t want to be on this unit forever, like this man does. What I can relate to is the expectation that, if I’m well once, I should be able to keep the feeling and not fall unwell again. Worse yet, I fear that if I say I’m feeling well, I will be expected to cope with less support, more independence. In this sense, I can relate to the fear of being kicked off the unit if I say i’m well. Though I don’t want to stay on this unit forever, I do want to maintain a certain level of support.

Of course, everyone, whether we’re mentally ill or not, experiences highs and lows. People who aren’t mentally ill aren’t expected to keep feeling well forever if they say they’re well once. Why should people with mental illness be expected to be cured if we say we feel well once, then? The truth is, no good mental health professional or understanding relative expects this out of us.

Of course, I remember the situation a few years ago where a woman with depression was denied sick leave benefits because she “didn’t look depressed” in Facebook photos. That sort of thing may happen, and I’m sometimes afraid of this too. Like, yesterday I told my named nurse I’m afraid of not getting community support once I live with my husband. The reason is my staff aren’t coming to the tiny village to assist me with my application and the social consultant there isn’t coming to my institution. This means I’ll need to file the application all by myself. Of course, my husband will be there, but I doubt he knows what care I’ll need. Now I’m at once afraid that I’ll not be able to clarify what I need so that the consultant won’t be able to get me care, and that I sound too capable. The care needs paperwork that the Center for Consultation and Expertise created for me in 2013 lists my intellectual giftedness. I’m tempted to delete that in the process of updating it for the current application. The first reason is because I have no clue what significance a high IQ has over a normal IQ when applying for care. I mean, it means I can’t get care from the intellectual disability agencies, but I couldn’t if I had a normal IQ either. However, the other reason is I fear it will be seen as significant by the social consultant and they’ll determine that if I’m so intelligent, I should be able to solve my own problems.

This is what’s behind my fear of coming across like I’m doing well, and consequently my fear of experiencing joy. Of course, like I said, every understanding person should realize that having a good day doesn’t mean being cured of your mental illness. Then again, I’m not sure most people are all that understanding. Could be my stress-related paranoia though.

A Letter to My Body

Dear body,

I am sorry. I have not been taking good care of you lately. I have not been exercising regularly, have been binge eating a lot and have slept at all the wrong moments and been awake at night.

Of course, I could blame my eating disorder and see it as something entirely separate from myself. I could blame the holiday season. I could blame the winter blues (or general blues, since I’m not sure if it’s seasonal at all) for my laziness regarding exercise, my increase in binge eating and my poor sleeping habits. Then again, that’d be avoiding my responsibility.

Sometimes, I feel as though you don’t deserve to be taken care of. I feel you’re ugly, fat and unheathy anyway. You’re fat, but at least my husband doesn’t consider you ugly and you could be a lot less healthy than you are.

Besides, right now I don’t have as poor an image of you as I had before. I like my skin feeling softer when I apply shower cream, then scrub it, then apply body butter. I particularly even like my belly, which is the part you seem to be storing most of your fat.

I want you to know there’s nothing you did to deserve me stuffing you with binge food and depriving you of the exercise and sleep you need. I’m stressed, but you didn’t cause me to be stressed. I’m slightly depressed, but you didn’t cause me to be depressed.

So I want to thank you for being relatively healthy while I don’t take as good care of you as I should. All your major functions (except for vision of course) are intact. You keep your vitamin and mineral levels okay. You haven’t developed diseases like diabetes or heart disease in spite of your obesity, caused by my lack of proper care. You are okay.

As I said, I could look at your negative attributes: your not being as fit as I’d like you to be, your causing me acid reflux, irritable bowel syndrome and random pains and aches. Then again, whether it’s you causing me these problems or me causing you these problems, could be debated. The thing is, I can’t change your functions without taking better care of you first.

As dialectical behavior therapy also teaches, I can’t change you witout accepting you as you are first. You are okay as you are. Now I can work on improving you.

Yours,
Astrid

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Mom's Small Victories

Tips for Coping with Suicidal Thoughts

Screw you, #BEDN. I screwed up the day after I planned to continue writing everyday this month. Yesterday was a bit stressful. I baked an apple pie to remember the eighth anniversary of my psychiatric institutionalization, but I also felt overwhelemd with memories from the day of my crisis. In addition, yesterday was designed to be plan your epitaph day by the inventors of weird holidays. I only found out through this week’s #TuesdayTen. I was originally planning on writing a post on tips for coping with suicidal thoughts for #TuesdayTen, but the pressure of having to think up ten coping strategies and the doubts as to whether it’d fit in, made me skip the occasion. The idea stuck around though, so I’m going to write down some coping tips today.

The first important key is realizing when depression or despair sets in before you reach rock bottom. When you are acutely suicidal, most of the tips I’ll mention below will sound completely useless. However, if you’ve realized you are depressed or otherwise severely distressed, you may be able to enlist the help of others in staying safe. Here are some tips that can help you through some suicidal ideation. When you are actively planning suicide, these tips may no longer work and you’ll need to go to the emergency room or psychiatric crisis service.

1. Enlist the support of family or friends. Like I already said, supporters, such as family may be able to help you remember why you want to live. If not, they may be able to intervene to keep you safe whilst getting a mental health professional involved. When I was in my crisis in 2007, I had no support in the city I was in at the time. That is, I had my parents, but they weren’t particularly helpful (and I honestly can’t fully blame them) at the time.

2. If you don’t have family or friends to support you, there are support sites and telephone hotlines for people in crisis around the world. While again, if you are in acute danger, you need to go to the emergency department or psychiatric crisis service, when you are still able to talk it through, do so.

3. Think of what your goals are, what you want to get or avoid with suicide. Obviously, religious beliefs about an afterlife aside, you won’t gain anything from suicide. That doesn’t mean it doesn’t seem like it. Some people believe: “At least I’ll be able to rest then.” In this sense, what you want to avoid through suicide is important too. Discuss with your family or a mental health professional how you can reach this goal while remaining alive. For example, I knew as I was talking to the crisis service psychiatrist in 2007 that I didn’t really want to die – I mean, who wants to? -, but that I couldn’t cope with my life as it was anymore.

4. Think of the people you’ll leave behind. No, I don’t mean thinking of them having to make funeral arrangements and how selfish you are for leaving your family with the financial burden. That is not going to be helpful. Just for your information, as a family member, don’t ever burden a suicidal relative with this kind of crap, no matter how confident you are that they are “just doing it for attention”. However, if you do have people you still care about when you’re in despair, thinking about them can help lift your mood. Despair is an incredibly lonely feeling, but there are people who care about you.

5. Be careful about chanigng medications or other treatments for depression while you are actively suicidal. Though electroconvulsive therapy (ECT) is relatively safe for severely depressed people, antidepressants carry the risk of increasing suicidality. Always be sure to discuss suicidal ideation with your mental health professional and don’t change your medication regimen without close supervision, preferably from a psychiatrist.

What My Mental Illness Feels Like #Write31Days

31 Days of Mental Health

Welcome to day 29 in the #Write31Days challenge on mental health. Phew, we’re almost done. I truly find it a challenge and unfortunately don’t find it particularly rewarding.

Today, I’ll give you a glimpse into my unquiet mind by describing what it feels like tohave my mental illness. I have been diagnosed with borderline personality disorder, which is characterized by self-regulation difficulties. It also overlaps with other disorders.

Once, years before I had been diagnosed with any mental illness at all, I read a description on a Dutch site of the “borderline feeling”. It described a starting point at which you are feeling fine, or at least appearing as though you are fine. Then, a minor annoyance occurs. You start feeling frustrated, angry, infuriated. Then you feel sad, depressed, depserate. Fear and then panic also comes in. Finally, all feelings tumble over each other and create a big emotional whirlwind. That’s what the experience of BPD is like.

I can illustrate this with an example. This afternoon, I was feeling slightly on edge because it was time to make afternoon coffee and no-one was available to assist me. Then, when I noticed the nurses were flipping through some seemingly unrelated photos at the nurse’s station, I completely lost it. They had told me they were busy and now they were just chattering! I can’t even remember how the situation progressed, but within minutes I was banging my head, screaming and then ran off. When I came back to the unit (I had the sense of rationality to find my way back myself), I accused the nurses of faking being busy and ignoring me. They had truly ignored me (or been oblivious to me at least) when i stood at the nurse’s station and I still cannot be sure what thing was keeping them so busy. That being said, I couldn’t politely ask them whether they truly didn’t have time to help me make coffee.

We had a group discussion, in which I was again relatively calm. Then we had dinner, after which I went on the computer for a bit. I still was feeling slightly on edge but not over the edge. I wanted to talk to the nurse, so made use of my daily talk time to discuss my tension. However, I couldn’t get it out clearly what I was feeling and why. At that point, all emotions started coming together and I became angry and depressed and fearful at the same time. I went outside, accompanied by the nurse, to blow off some steam.

Usually, this feeling I had in the evining for me is triggered by some flashbacks or relivings of past “trauma”. I put that between scare quotes because the events I am reliving can be relatively minor. However, they can cause distress nonetheless.

During such episodes I also often feel dissociated. I used to completely regress into a child mode, but now I just feel as though I’m small and start speaking or babbling incoherently but don’t fully act like a child.

When an episode is severe, I may resort to self-destructive behaviors such as binge eating or self-injury. Usually, these behaviors temporarily relieve the tension but obviously they aren’t the solution. I often relapse soon after I engaged in destructive behaviors. With PRN tranquilizers, especially benzodiazepines, the same used to be true: they temporarily calmed me down, but when they wore off, I was increasingly agitated. Research shows that borderlines often become more agitated and may become aggressive when given benzodiazepines, because benzodiazepines reduce their anxiety and thereby their impulse inhibition. I do not personally experience this.