Tag Archives: Impulse Control Disorders

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.

Overeating or Binge Eating Disorder: Is It “Food Addiction”?

I have had issues with disordered eating since early adolescence. I mostly engage in overeating or maybe even binge eating (a binge being a distinct period of severe overeating accompanied by a feeling of being out of control). When I still purged regularly several years ago, I took my eatig issue much more seriously than I do now, despite my overeating/bingeing having gotten worse over time and my weight recently having increased to a number that is within the obese range for my height.

Overeating is often seen as an addiction. I’ve never really seen my eating habits as such, and I wonder what the implications would be if “food addiction” were formally recognized. Curtis & Davis (2014) ask the same question in the conclusion to their qualitative study of “food addiction” in obese women with and without binge eating disorder (BED). In their study, all BED women met criteria for “food addiction” when DSM-5 criteria of substance use disorder were used with food being the substance. Obese women who didn’t suffer from BED also often displayed “food addiction” symptoms. They however attributed their inability to stop overeating more to liking the food or not wanting to stop than to feeling intrinsically unable to stop.

Interestingly, many women in the study weren’t sure whether they were food addicts when directly asked about it. I can relate to this. I at one point participated in an unofficial Overeaters Anonymous online group, and didn’t feel this suit me really. I do notice that I hold many of the same misconceptions about what an addiction is that the study authros found. For example, I tend to believe food cannotbe addictive because we need it, that substance abusers use their substance all the time, etc. The idea of food as an addictive substance does raise questions about what it is to be dependent on a substance. I know that the DSM-5 removed the distinction between substance abuse and substance dependence, and, in a way, this is good. Then again, you can get physically dependent on certain substances, and that makes an addiction to that substance (eg. alcohol) look more real than an addiction to a substance that you won’t develop physical dependence. Addiction to a substance you can’t get physically dpeendnet on, in turn, looks more real than behavioral addictions like “Internet Addiction”. These novel addictive disorder concepts do create fundamental debates about personal responsibility, which do have implications for treatment. After all, an impulse control disorder is treated differently from a substance dependence.

Reference

Curtis C & Davis C (2014), A Qualitative Study of Binge Eating and Obesity From an Addiction Perspective. Eating Disorders: The Journal of Treatment & Prevention, 22(1):19-32. DOI: 10.1080/10640266.2014.857515.