OK my psychiatrist didn’t exactly lie. She was just ‘groping for a diagnosis.’
In my life, I’ve been diagnosed as following by a host of mental health professionals:
Major Depressive Disorder
General Anxiety Disorder
Mood Disorder NOS
One Really Fucked Up Jerk
Histrionic Personality Disorder
But NOW! After 40 years! The absolute (perhaps), final (but who can really say?), definitive (as much as the others) diagnosis has finally been made by the third psychiatrist in my history (next to the 27 other psychologists).
Frankly, this is really not funny, no matter how hard I try to lighten it up.
Borderline Personality Disorder (BPD)
I have been able to be at peace with every other diagnosis (I am comfortable with ‘asshole’) but not this one.
If it is true that it runs in the family, then there are several, by which I mean more than four, on both sides of my family that were likely candidates. They were (and in one case are) assholes most of the time. One might have been my father. His father. My maternal grandmother. My aunt. It goes on and on. As you can imagine, holidays were fun with this group, no matter which side of the family was celebrating.
So I have the ‘family stain.’ Wonderful. But I should have known. The diagnosis was in front of my face all this time but I didn’t want to look at it.
Because BPD is bad. Really bad. Many mental health professionals do not even want to work with people with BPD because they are resistant to most treatment modalities and they tend to be assholes, even if they don’t mean to be. And the meds I’ve been taking? Yeah, they really don’t have much of an effect on BPD. Basically we need a treatment program known as Dialectical Behavioral Therapy (DBT).
Here is a brief description of BPD from the National Institute of Mental Health:
Borderline personality disorder (BPD) is a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships. A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days (even a few minutes – ed.).
Some people with BPD also have high rates of co-occurring mental disorders, such as mood disorders, anxiety disorders, and eating disorders, along with substance abuse, self-harm, suicidal thinking and behaviors, and suicide (10% mortality rate – ed.).
By the way, all my other conditions (my little friends as I am wont to call them) are still trundling along with me, just in the background, behind big bad BPD.
I was right in the middle of recounting my last major problem (the job interview that went awry) when my psychiatrist looked at me with one of the ‘my God, why didn’t I get this sooner’ looks and interrupts me to say “actually what you’ve been describing sound a lot like borderline personality disorder.”
She went to get her annotated People’s Guide to the DSM V, and went to the page describing the nine basic symptoms or behaviors of people with BPD. To get the diagnosis you need to answer yes to five of them. I had nine of nine. I handed the book back to her and – bingo – diagnosis.
Here are the nifty nine if you’re interested:
- Frantic efforts to avoid real or imagined abandonment.
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating). This does not include suicidal or self-harming behavior.
- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
- Affective instability due to a marked reactivity of mood – intense feelings that can last from a few hours to a few days.
- Chronic feelings of emptiness.
- Inappropriate intense anger or difficulty controlling anger.
- Transient, stress-related paranoid ideas or severe dissociative symptoms.
Nine of nine. Who am I to argue with the DSM V?
And, of course, in expressing my rage to co-workers on the Thursday I returned, I got in trouble again. I won’t go into details; let’s just say it was the old ‘I didn’t know you perceived my ranting as a threat’ routine which I seem to be so good at.
Of course, I caught myself (too late) and apologized profusely as I do. But the employee in question had to twist the knife anyway. She did back in 2015 and I guess that sort of thing comes naturally to her, even though she knows full well of my condition. Some people are just like that. These people are regarded as normal.
Anyway, once again I am awaiting my possible career execution although my boss is recommending no action be taken because, well, I have a condition now regarded as an official Federal disability.
It ain’t easy being the office crazy, but now I have the paper. It may save me from termination.
My boss has already suggested possible work environment modifications which are going to be very difficult in my case since I work in a section where contact between employees and clients are expected. I had suggested being sent so deep into the bureaucratic cubicle maze that I wouldn’t hear the dogs bark and be given mind-numbing paperwork to shuffle with a minimum of human contact. There are always those jobs in the Federal Government and despite what politicians say, they are not going away.
In the interim, I could move my desk back to where I was or to a more isolated hole in the wall. I just moved back here two months ago. I sit right across the cubicle wall from the person who reported on me. She knows I know and therefore I am not speaking to her not out of spite but fear.
It feels like the bad old days all over again. Perhaps in reality, they never left.
In any case this is a diagnosis no one wants including me. I have to deal with it before my behavior, which I can’t seem to control at times, paints me into a corner I can’t escape from.