Tag Archives: PTSD

Flashbacks

A few days ago, I read an article on complex PTSD symptoms. I don’t have a diagnosis of coplex or regular PTSD and I realize there’s a lot of overlap with borderline personality disorder traits, which I do have a diagnosis of. Of course, I used to have a PTSD diagnosis, but that was removed because I did not have flashbacks that often. At least, that’s what I thought. One symptom after all that I completely relate to in this list, is having emotional flashback.

I never knew emotional flashbacks are a recognized symptom. I just thought they were covered under the umbrella of emotional regulation difficulties, which is a hallmark BPD symptom. As such, I usually saw complex PTSD as BPD when the person was believed to have been seriously traumatized. If a person was believed to just have had a few negative experiences, then they’d be diagnosed BPD. In my experience at least, the BPD diagnosis was used to deny I had been traumatized.

I don’t want to diagnose myself, of course, but the emotional flashback thing really struck a chord with me. Ever since I was a teen, I’ve experienced what I used to call “time shifting”. In a “time shifting” episode I’d have a kind of déjá vu experience. Usually, this was coupled with feelings of floatiness or unreality. The mental health term for this is depersonalization.

An emotional flashback is what it’s called when a person relives the feelings of past trauma. Boy, do I relate to this. Usually, I do have a slight inkling that I am transported back in time emotionally, but not always. I experience an intense feeling of helplessness, fear or sometimes despair.

Another type of flashbacks are visual flashbacks, when you experience the traumatic event as if you’re reliving it. I don’t have these often, although I’d readily trade an emotional flashback for a visual one. At least, with visual flashbacks, I can give words to what I’m re-experiencing and thereby desentisize myself.

Somatic flashbacks, I’m not sure I have. After all, most trauma I endured didn’t leave physical damage. I mean, I do have “weird” physical symptoms, but I’m assuming these are just from mental stress and aren’t direct relivings of a traumatic experience.

Like I said, most of my trauma was emotional or psychological. I usually think this doesn’t “count”, as most people when describing trauma, describe sexual or physical abuse. I didn’t endure much of this and, as far as I know, it didn’t leave me with major post-traumatic symptoms.

I did, however, describe the few incidents of physical and sexual trauma when I was asked about trauma by the psychologist who diagnosed me with PTSD. This is just easier to grasp. When I say a person hit me or threatened to rape me, it’s understandable it was abuse. Then agian, these incidents were few and far apart. For instance, the person threatening to rape me was practically a stranger and it was a single incident that had no connection to the ongoing trauma I endured.

This ongoing trauma left psychological wounds and I endure almost-daily emotional flashbacks of it. That being said, both the flashbacks and the traumatic experience itself are influenced by my interpretation. As such, it might be it wasn’t “real” trauma, but in my BPD mind, I interpret it as such.</P.

Just One Thing

Last week, I started a journal-style blog to explore my inner world. As usual, I didn’t write in it much at all, so I’m resorting back to this blog. The reason I wanted another blog is because of the derogatory comments I’ve gotten here regarding my dissociation. No, I don’t have a diagnosis of dissociative identity disorder anymore and no, I don’t claim to be DID. I do however have insiders, parts, alters or however you’d like to call them. I don’t care what people think of this, or at least, I try not to care. To reclaim myself and my experience, here I’m sharing a post I wrote last week.

Manyofus1980 from Therapy Bits posed an interesting question: if the world could understand just one thing about your mental health diagnosis, what would it be? In the post title, the question is about your “mental illness” rather than your “diagosis”. This is important to my answer, as my short answer is: my diagnosis does not dictate my experience.

I have had countless diagnoses over the years, some of which I agreed with and some of which I disputed. I don’t even know what my current diagnosis is according to my community treatment team. According to the university hospital where I got a second opinion last spring, it’s autism spectrum disorder, recurrent moderate depression and borderline personality disorder traits. Of this, I doubt the depression, because my default mood is low. Then again, I do seem to remember feeling much lower than low in the months that I had my assessment at this hospital. The thing is, I can’t usually connect my feelings from the past to the present if they’re very different.

We didn’t really go into my trauma experience, as my assessment was primarily focused on autism. However, the university hospital psychologist did recommend I get EMDR treatment for the negative experiences I had in the process of moving towards independence. I have not had a trauma-based diagnosis since 2013 and that’s fine by me. I don’t need a diagnosis to justify my experience.

I am who I am. We are who we are. We don’t fit in a diagnostic box, because, well, we’re we.

Sometimes, we feel upset that we don’t get recognition from our treatment team (as far as we know) for our traumatic and post-traumatic experiences. I had a lot of difficulty answering my psychiatrist’s questions about this during my intake interview. I mean, most of the trauma we endured, didn’t leave visible wounds. I know that dissociation can be caused by attachment issues, sometimes even too mild to create PTSD. However, there is still a common belief that only prolonged sexual or ritual abuse can create alter parts. I try not to care. We are we are we, so deal with it.

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.

Then and Now: A Timeline of My Mental Health

It is often hard to see how far we’ve come on our journeys in life until we look back at where we came from. I am no exception to this. I tend to feel that I’m not improving in my coping with my mental health issues. There’s still this hurricane in my mind, after all. It is also hard because, whenever I seem to improve in my behavior, people’s expectations rise even higher. To shed light on the positive changes I’ve made on my journey through life with mental illness, today I will write a timeline of events related to my mental health.

2007: I was hospitalized on the acute ward on November 3 of this year. I was not allowed to leave the ward without someone accompanying me. For the first few days, I even had to have a nurse accompany me. After those first few days, any adult could accompany me, but they had to sometimes assure the nurses I was safe with them.

2008: I started out the year with a setback: I was given a seclusion plan, which meant I could be secluded if I was a burden to other patients or staff. By early February, however, my privileges were finally extended so that I could go off the ward unaccompanied for fifteen minutes. By early March, my privileges were quite suddenly extended to four hours of unaccompanied time off the ward, which is the maximum you could get at that unit. If you had this privilege, you could ask for extended leave if you had a reason for it. My seclusion plan was also lifted, only to be reintroduced again by June. Fortunately, I never had to actually be secluded, but the nurses frequently used it as a threat. The plan was lifted again in September, but only so that I could be moved to the resocialization unit.

2009: I transferred to the resocialization unit in March of 2009. I did mostly okay until September, when I had a major meltdown which elicited another patient’s aggression. The possibility of moving me to the locked ward for a few hours if I acted out was introduced into my treatment plan.

2010: I was sent to the locked unit for the first time. This did lead the staff to consider medication, and I agreed. I started on a low dose of Abilify, an antipsychotic, in late February. It had to be increased to a moderate dose by the summer and by September, Celexa, an antidepressant, was added. Both helped calm my anxiety and irritability. In November of this year, I was diagnosed with dissociative identity disorder and PTSD.

2011: I was on the waiting list for an autism-specialized group home and went there to stay over for a week-end in October of 2011. Unfortunately, the group home had changed its target population and there was too little support by the time I stayed over there. I didn’t end up going.

2012: I started planning to live with my husband by this time, originally pretty much solely because I didn’t have any suitable alterantive. I don’t mean this to insult my husband, but I didn’t feel I should be burdening him with care duties if at all possible. We moved into our aparetmetn by December. Meanwhile, I was trying to get treatment for my DID/PTSD.

2013: I had an intake interview with a psychiatrist who thought she could treat my DID/PTSD. She ultimately ended up turning me down. It had nothing to do with me, but she was too busy with her physician duties. I moved to my current institution, where i was soon diagnosed with borderline personality disorder. I started schema-focused therapy, but this had little effect. My Abilify also got increased some more.

2014: I continued to struggle, but for the most part was quite stable. My Abilify had to be increased one last time in late 2014 (I am now at the highest dose). I did improve in my behavior and got a more cooperative relationship with my staff. I spent a few times in seclusion, but always voluntarily.

2015: I decided I wanted to live with my husband for real this time. We have been making arrangements, though it’s been slow-going. We will be moving to the tiny village sometime in December, so concrete arrangements cannot be made till then. I have been trying to get a med review for a few months now. Though my mind is still very unquiet, particulalry as my discharge out of the institution draws closer, I don’t tend to act out as much as I used to. I was in seclusion for a while last Monday, but before then it’d been over six months.

As I look back, I see that sometimes I take steps back and sometimes I take leaps forward, but in general, I’m moving up. I’ve never had to be moved back to a more restrictive unit, though I’ve sometimes wanted it. My medication did have to be increased a lot, but I don’t see that as entirely negative.

I am linking up with the 1-word blog challenge hosted by Lisa and Janine. The word choices for today are THEN and BREAK.

Dissociation #Write31Days

31 Days of Mental Health

Welcome to day 28 in the 31-day writing challenge on mental health. Today, I will be discussing dissociation. I used to have a diagnosis of dissociative identity disorder, but dissociation is also common in post-traumatic stress disorder and borderline personality disorder.

Dissociation refers to a detachment from reality: disconnection from one’s surroundings, one’s own body, one’s mental processes or one’s identity. there are five different domains of dissiociation:


  • Depersonalization: a disconnection from one’s own body or mental processes. People who experience depersonalization feel “unreal”.

  • Derealization: a disconnection from one’s environment. The world around people who are derealized seems unreal or vague, as if looking through a glass wall.

  • Amnesia or memory loss. People who experience dissociative amnesia can be triggered by things that remind them of an unpleasant memory, but they do not remember the unpleasant event. Amnesia can also refer to “time loss”, where the person does not know what happened during a specific time period. Identity amnesia refers to a person not remembering who they are.

  • Identity confusion. This refers to being unsure of who one is. I have always believed that everyone has a level of identity confusion, but when I did a structured interview for dissociation, it appeared as though this isn’t really normal.

  • Identity alteration or “switching”. This refers to a person becooming “someone else”. This ccan be apparent on the outside, like by the person having a change in non-verbal communication that is unlike them. It can also be apparent on the inside, where the person just feels as though they’re “someone else”.


Dissociation is different from psychosis in that people who dissociate are still aware of reality. Most people with dissociative experiences do not experience delusions or hallucinations, though a PTSD flashback coupled with dissociation can look like it. At least in my case, I’ve appeared quite disorganized and out of my mind when in a flashback.

Dissociation to a certain extent is normal. Most people on occasion get “lost” in a book or movie, for example. When dissociation is more severe, you may have a dissociative disorder. There are several different dissociative disorders.


  • Depersonalization/derealization disorder is characterized primarily by depersonalization and/or derealization. This disorder can only be diagnosed if the depersonalization/derealization is not due to another mental disorder, such as a panic disorder.

  • Dissociative amnesia is primarily characterized, as the name suggests, by amnesia.

  • Dissociative fugue. This is a subtype of dissociative amnesia where the affected person travels away from their home or work and has amnesia for their entire life prior to travelling away. They also often adopt a new identity.

  • Dissociative identity disorder is characterized by both amnesia and dissociative phenomena affecting identity, ie. identity confusion and alteration. DID is considered to be the most severe dissociative disorder.

Depersonalization and derealization can, as I said, be part of another mental disorder, such as panic disorder. There is also a subtype of PTSD which is characterized by depersonalization and derealization. Other causes of depersonalization and derealization include stress and certain substances, such as marijuana.

The other dissociative disorders are believed to be trauma-based. Treatment involves psychotherapy. The psychotherapeutic treatment of DID consists of three phases:


  1. Stabilization. In this phase of treatment, a person learns coping skills to deal with flashbacks, keep themself safe and stay grounded.

  2. Processing the trauma that caused DID.

  3. Integration. This can refer to merging of the alters, but also to rehabilitation.


In 2011, Onno van der Hart, Kathy Steele and Suzette Boon published a manual for skills training in the first phase of DID treatment called Coping with Trauma-Related Dissociation.

My Experience With Therapy and Counseling #Write31Days

31 Days of Mental Health

Welcome to day 23 in the #Write31Days challenge on mental health. Today, I’ll focus on another question in the 30-day mental illness awareness challenge. For day 23, the topic is your opinion on therapy. I will share my experiences of therapy and my opinion on various approaches. I have decided to include both traditional psychotherapy approaches and non-verbal approaches.

I had my first experience of therapy as a child, when I had four sessions of play therapy. I didn’t like the therapist, didn’t have insight into my problems, and four sessions obviously wasn’t enough to garner any results. In hindsight, my play behavior did show my problems with rigid thinking, emotion regulation and behavioral control. For example, I’d throw out the dollhouse dolls with purple hair because “people don’t have purple hair”. I also preferred to play with toys that allowed me to show anger, such as toy guns. One vivid memory I have is of me trying to overflow the water tray. The therapist did show me why it wouldn’t work, but I tried anyway.

My first experience with verbal therapy was when I was nineteen and attending the rehabilitation center for the blind. Once again, I didn’t like the therapist, who appeared a bit inpatient towards my difficulties adjusting to blindness and misunderstanding of my social ineptitude. She tried to offer practical advice, while I felt I needed to process the rollercoaster ride that my life had become. Of course, time constraints – I had only about twelve sessions -, prevented us from going deeper.

During my first sixteen months in the psychiatric hospital, I didn’t have a psychologist. I did do movement therapy, which helped me greatly to release my emotional tension. It was here that I learned to rate my distress level – I came up with a system myself. Thhat being said, when later people asked me to rate my distress level, I was often stuck. This moveement therapist I had at the acute ward was one of the more helpful therapists I’ve had.

At the resocialization ward, I tried cognitive-behavioral therapy for a bit. It hardly worked, because I and my therapist agreed I had good reason to be anxious. Then, when I was diagnosed with DID and PTSD, the therapist pushed me to try EMDR, but I resisted. I didn’t have that severe PTSD symptoms, after all, and did have quite a bit of trouble with self-regulation and dissociation.

When I moved to my current institution, I got diagnosed with BPD. My therapist’s expertise was schema-focused therapy, an approach I’d wanted to use for a while. Unfortunately, it didn’t work out. The therapist told one of my parts, who hides her inner weakness behind a stubborn attitude, that she’s a “punitive parent” and needs to disappear. I strongly feel that each part of my personality has a function, so this dismissive attitude didn’t fit me well. Besides, though I learned some from the book the therapist recommended, most of the information was just a bit too abstract.

This therapist left in 2014 and I’ve had a new psychologist for a little over a year now. With her, I focus on supportive counseling and rehabilitation. I find this is most constructive. I do hope that, in the future, I can get some formal psychotherapy again. I have a dialectical behavior therapy self-help book, which is quite interesting. Then again, I find it hard to make a long-term commitment to sticking to one thing to focus on. That is probably the main thing keeping me from engaging properly in psychotherapy.

Animals and Mental Health #Write31Days

31 Days of Mental Health

Welcome to day 21 in the 31-day writing challenge on mental health. Today on a mental health E-mail list I’m a member of, the daily question for discussion was about animals. This inspired me to write a post on how animals can impact mentnal health and help people who struggle with mental illness.

There are many ways in which animals, and especialy pets, can help someone with a mental health problem. For example:


  • Pets provide uncomplicated love. While your relationships with family and friends might be strained because of your mental illness, a pet doesn’t care whether you hurt its feelings and doesn’t give you unwanted advice.

  • Pets give you a sense of responsibility. While pets do not ask for much, they require a certain level of care. This may seem overwhelming when you’re struggling with mental illness, but it can actually help you focus on something positive instead of on your negative mood.

  • Pets require you to get moving. While becoming physically active may seem hard when you’re in the pit of depression or another mental illness, it will actually help improve your mood. Having a pet who requires you to be active, such as a dog, can really help you get motivated to get your butt off the couch.

  • Pets help establsih a routine. They need regular feeding, walking or other care. A proper daily routine is good for your mental health.

  • With a pet, you’re never alone. You may withdraw from contact with friends or relatives, but your pet is always by your side.

  • Pets can help you engage in social interaction. Pets can be an easy topic to talk about that is not laden with negativity. Pets also often function as ice-breakers, for example when you are walking your dog or waiting at the vet’s. Even when your mental illness makes you appear reclusive, people will start interacting with your pet.

  • Touching pets can be soothing and thereby improve your mental health.

The benefits of pets can be even greater when the pet is trained as a service or therapy animal. Pet therapy, also known as animal-assisted therapy, is a form of therapy by which a specially trained pet interacts with individuals with mental health problems. The benfit of animal-assisted therapy over human interaction is that an animal accepts the individual as they are without judging or being threatening. Like I said before, they don’t care whetehr their feelings are hurt. People with emotional difficulties in particular often find it easier to trust pets than humans.

Like I said, animals can also be an ice-breaker, allowing the mentally ill person to open up more eaisly when interacting with the pet and its handler.

Psychiatric service dogs can be helpful to people with post-traumatic stress disorder and dissociative identity disorder, among others. They can, for instance, signal when a person with PTSD or DID is going to dissociate or have a flashback. They can then comfort the person or alert someone else. PTSD service dogs can sense when the sufferer is experiencing a nightmare and then wake them up. They can also enhance the sufferer’s feelings of safety by for example keeping strangers at a safe distance while at the same time encouraging social interaction.

Emotional support or companion animals do not provide any specific tasks for a person with a mental illness, like service animals do. Rather, they are solely there to provide emotional stability and companionship to the mental health sufferer. A licensed mental health professional should indicate that a mental health sufferer requires an emotional support animal. Emotional support animals should wear an identification vest or tag that says they’re an emotional support animal. In the U.S., people with registered emotional support animals are allowed to have their pets live with them even when no-pet policies are in place. People are also entitled to fly with their emotional support animals. However, unlike service animal owners, people with emotional support animals cannot claim access to other public or private places (such as restaurants) with their animals.

What Are Personality Disorders? #Write31Days

31 Days of Mental Health

Welcome to day 10 in the #Write31Days challenge on mental health. Today, I will discuss the broad category of disorders I’ve been diagnosed with: personality disorders. Though there is some debate as to whether borderline personality disorder should be conceptualized as a personality disorder, it currently is.

A personality disorder is a pervasive pattern of dysfunctional thought, behavior and emotion that is stable across time and across situations. It is out of line with cultural expectations and causes distress or impairment. It usually emerges in early adulthood, though adolescents may be diagnosed as being at risk for developing a personality disorder. In fact. when I attended a conference on BPD in 2013, a psychiatrist specializing in this said that BPD can be reliably diagnosed from age sixteen on. In other disorders, such as antisocial personality disorder, there is a specific age requirement of being over eighteen.

The Diagnostic and Statisticla Manual of Mental Disorders, both DSM-IV and DSM-5, divides specific personality disorders into three subcategories, called clusters. These are:


  • Cluster A includes paranoid, schizoid and schizotypal personality disorders. Individuals exhibiting these disorders often appear odd or eccentric. The disorders in this cluster can precede schizophrenia. I tend to think of cluster A personality disorders as “psychosis light”.

  • Cluster B includes antisocial, narcissistic, borderline and histrionic personality disorders. Individuals with disorders in this cluster are often seen as dramatic, emotional or erratic. People with cluster B personality disorders are often perceived as among the most difficult people to get along with. When peope think of personality disorders in general, they mostly mean cluster B disorders. The same goes for treatment programs focused on personality disorders.

  • Cluster C includes avoidant, dependent and obsessive-compulsive personality disorders. Individuals with cluster C personality disorders tend to be anxious or fearful.


In DSM-5, it is stated clearly that the clustering of personality disorders, while it has some merit, may not be very useful in clinical practice. After all, many people exhibit traits of personality disorders across clusters. When a person has features of more than one personality disorder but doesn’t teet the full criteria of any, they may be diagnosed with an unspecified personality disorder. People with other specified personality disorder display behavior that is seen as a personality disorder but isn’t listed specifically in DSM-5. Examples include passive-aggressive and self-defeating personality disorder.

There are some clear gender differences in how commonly personality disorders occur. Antisocial personality disorder occurs far more often in males than females. Borderline, histrionic and dependent personality disorder occur more in females. Though this may reflect real gender differences, it is also likely that stereotypical views shape clinicians’ diagnoses. For example, I once read that BPD is really about as common in males as in females but is overdiagnosed in women and underdiagnosed in men. Women misdiagnosed with BPD are often later found to have ADHD, which interestingly used to be seen as a typical male disorder.

diagnosticians always need to be aware of a patient’s cultural background and life history. After all, in some cultures, behavior that is seen as disordered in the western world may be normal. People who experienced extreme stress or trauma may also exhibit long-lasting dysfunctional behavior patterns and be misdiagnosed with personality disorders when they really have PTSD. Veterans are disproportionately often diagnosed with personality disorders, for example.

Mental Illness: Nature or Nurture? #Write31Days

31 Days of Mental Health

Welcome to the seventh installment of the 31 Days of Mental health series. Today, I picked another of the 30 questions from the 30-day awareness challenge: do you believe nature (biology, physiology, etc.) or nurture (your psychosocial environment) causes mental illness? I am very tired, too tired to find the scientific evidence to back my post up with. will share what I do know off the top of my head, but please don’t ask me to cite my sources.

In medicine in general, there used to be a strictly nature-based model of illness and health. This determined that biological and physiological processes in the body caused illness and there was no contribution of psychological or social influences. This model is called the biomedical model and my health psychology book used it to describe the history of views on physical illness.

In mental illness, there have been many schools of thought that laid blame on the environment, in fact. For example, Freud blamed fixations in one’s psychosexual development for mental illnesses. The school of behaviorism also blamed the environment. Watson, the founding father of behaviorism, at one point said that, if given a handful of babies at birth to raise, he’d be sure he could make whatever you wanted the babies to become from them purely by processes of conditioning (behavioral learning).

It is interesting that there is such a distinction between the biomedical views on physical illness and the psychosocial views on mental illness. After all, though religion may say otherwise, scientists usually see the mind as part of the body. At least the brain is and dysfunction in the brain can cause mental disorders.

I currently study healht psychology at university. Health psychology feels illness as resulting from an interplay of biological, psychological and social factors. Again, they usually study physical illness, but I must say I believe the same goes for mental illness.

I remember when I was still diagnosed with dissociative identity disorder reading a scientific article that said in part that the role of psychological trauma in the cause of what is often diagnosed as DID may be less significant than people think. They used the analogy of borderline personality disorder, which they said most people diagnosed with DID truly have. BPD is commonly thought of as a developmental trauma disorder, but research shows that there may be genetic and other biological factors predisposing to its development. Then again, trauma researchers have made it very clear that trauma and other strong environmental factors alter the brain.

I personally tend to believe there is not a single mental illness that is solely caused by nature or nurture. There are illnesses where biology is the main causative factor, such as schizophrenia, and illnesses where psychosocial factors are the main cause, such as post-traumatic stress disorder. However, stress can trigger psychosis in vulnerable people and trauma only causes PTSD in some of its victims, presumably those biologically predisposed to PTSD.

As for my own mental illness, there are biological factors predisposing me to developing mental disorders. Though I don’t have any family members diagnosed with a mental illness, autistic traits run in my family. NOw again I don’t see autism as a mental illness, but autistic people are more vulnerable to mental illnesses than neurotypicals. I also was a preemie, which may’ve caused brain dysfunction. Lastly, though none of my famly members are mentally ill, a difficult temperament tends to run in my family.

As for psychosocial factors, I am a childhood trauma survivor. I also have had high levels of stress in my life, possibly due to the incongruence between my autistic self and the neurotypical environment. It was a stressful event that sent me over the edge, but it was probably biology that predisposed me to vulnerability to stress.

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.