I’ve talked so much today my throat hurts and I’m tired but all in a satisfyingly weary kind of way.
It’s obvious from my Interlude how nervous I was about the psychiatric thunder rumbling over me as I drove to the hospital. Call it a hospital, more like an abandoned old convent or boarding school, actually quite like where I enjoyed my secondary education which was funnily enough, an old convent boarding school.
The waiting room was full of crazy people and I was one of them. Turns out I haven’t been making this shit up. I’m really not ok, I’m not just a massive drama queen looking for attention. I feel validated, justified (good album), relieved.
I was so scared the consultant would be intimidatingly dismissive having much crazier patients waiting to scream, cry, howl at her, or like me, sit there petrified like a a reprimanded young girl in that old convent school.
But she wasn’t. I got a full explanation of my diagnosis. Turns out I had completely misunderstood what Borderline Personality Disorder means and where I am on the spectrum. (What shape is a spectrum? Is that a stupid question?)
I thought “Borderline” meant I was approaching Loonyland but not quite there yet- I was on the cusp of a clinical or behaviourial postcode but ultimately confined to the hinterland of proper mental health care.
Borderline, it turns out:
was first used by early psychiatrists to describe people who were thought to be on the “border” between diagnoses. At the time, the system for diagnosing mental illness was far less sophisticated than it is today, and “borderline” referred to individuals who did not fit neatly into the two broad categories of mental disorder: psychosis or neurosis.
Today, far more is known about BPD, and it is no longer thought of as being related to psychotic disorders (and the term “neurosis” is no longer used in our diagnostic system). Instead, BPD is recognized as a disorder characterized by intense emotional experiences and instability in relationships and behavior.
Many experts are now calling for BPD to be renamed, because the term “borderline” is outdated and because, unfortunately, the name has been used in a stigmatizing way in the past. Suggestions for the new name have included: “Emotion Dysregulation Disorder,” Unstable Personality Disorder,” and “Complex Posttraumatic Stress Disorder.”
My Psych called it EDD I think.
Here are some diagnosis criteria:
Fear of abandonment
Unstable or changing relationships
Unstable self-image; struggles with identity or sense of self
Impulsive or self-damaging behaviors (e.g., excessive spending, unsafe sex, substance abuse, reckless driving, binge eating – or in my case, not eating)
Suicidal behavior or self-injury
Varied or random mood swings
Constant feelings of worthlessness or sadness
Problems with anger, including frequent loss of temper or physical fights
Stress-related paranoia or loss of contact with reality
And some causes:
Research on the causes and risk factors for BPD is still in its early stages. However, scientists generally agree that genetic and environmental influences are likely to be involved.
Imaging studies in people with BPD have shown abnormalities in brain structure and function, evidence that biology is a factor. In people with BPD, more activity than usual has been seen in the parts of the brain that control feeling and expressing emotions.
Certain events during childhood may also play a role in the development of the disorder, such as those involving emotional, physical and sexual abuse. Loss, neglect and bullying may also contribute. The current theory is that some people are more likely to develop BPD due to their biology or genetics and harmful childhood experiences can further increase the risk.
So now I have the awesome job of getting my head around the whole thing.
Apparently, I will have dual psychiatric and psychological treatment – there is a clinical imbalance in my brain that could be genetic and and needs to be treated with medication (I’m off the old quick go-to Lexapro prescription) and I’ll undergo intense psychological therapy – no more hour a week sessions for me – there was mention of day hospitals which sound like they’ll be conducted in a suitably chaste and lonely convent cavern.
The consultant is bumping me up the list for the Psychology Department.
I’m not scared about the therapy, I’m scared it won’t happen soon enough. In this health service of ours I’m terrified I’ll slip down the list again. Dotty’s EDD is by no means the worst thing that can happen to someone’s brain and there are plenty of heads ahead of me in the queue for help. But if I don’t get help this time… I don’t want to think about it. Which means I must want to get better.
I suppose I should start thinking about how this impacts my present but in order to do that I need to go over how it’s affected everything in my past. I can’t blame it for everything but it explains alot. Going back twenty five, maybe close to thirty years, I’ve been caught between reality and my head, somewhere between the outdated terms of neurosis and psychosis and the dissociative element of the Cluster C Personality Disorder I verge into when I’m veering off my main Cluster B direction. I’m too tired to get into that fucking mess of historical histrionics tonight and The Apprentice is back anyway.
Such egotistical, narcissistic, argumentative, aggressive, uncooperative bitches… ha, that’s rich.