Therapy/Diagnosis advice
Hello-
I have been suffering from mental and emotional health disorders since early childhood (6 years old or earlier, I am now 46). I have spoken with some doctors, and they suspect I am on the Autism Spectrum.
Moreso, my wife and I over the last 14 years have suspected on and off that I have some form of BPD. I have a definite fear of abandonment, boundary issues, and a push/pull relationship with her. I do not react violently/angrily often, seeming to be more of a "quiet BPD" where I am shut down most of the time but raging when triggered under certain circumstances (especially if I have not been doing enough self-care).
I am taking Effexor currently, which is helping the anxiety that comes with my issues and thereby seems to give me more control over countering my destructive patterned reactions.
Being a Canadian living in New Brunswick, there has been limited mental health resources for me. I have just now gotten an appointment through Mental Health to speak with a psychiatrist and want to make the most of the help they can provide. But I know proper BPD diagnosis can be difficult, and I want to be able to present my symptoms clearly in a way that will be productive. I do not want to be given an incorrect label of OCD, or simply Depression or Anxiety like I have in the past with less specialized therapists/medical professionals.
Can anyone here give me some tips or pointers on how to get myself across to the psychiatrist in an effective way? I struggle with being clear on my symptoms and behavior sometimes when talking to clinicians and do not want to be getting in my own way.
Thanks in advance.
@phoenixsquirrel Although I'm not an expert, my understanding is that you're right—proper BPD diagnosis can be difficult.
The criterion that mentions abandonment, for example, is: "Frantic efforts to avoid real or imagined abandonment." So proper diagnosis involves finding out whether the people around you report being subjected to these frantic efforts. Having a definite fear in your own mind is not the same thing.
The psychiatrists I know all have their own established routines for conducting assessments, and they're all different! If the psychiatrist you're seeing is the same, there will be a series of questions that mainly reflect that psychiatrist's standard assessment process. There might not be much opportunity for you to get yourself across in the way you have planned beforehand. Even so, I would hope that you'll have some opportunity to discuss the autism spectrum and the possibility of personality disorder, and to reject the incorrect labels you've had in the past.
If you've found that venlafaxine (Effexor) is helping, I suppose that does perhaps suggest that an anxiety disorder should be part of your overall diagnosis.
One approach to assessments is to write down the three (or four, or five, or six, but probably no more) most important points that you want to communicate. Towards the end, check that they have all been covered. If necessary, hand over the piece of paper for the psychiatrist to read.
Another approach that's sometimes helpful is to work backwards from the treatment you want, and aim for whatever diagnosis will get you that treatment. Some psychiatrists are OK with that. But maybe you don't know what treatment would be useful to you (and also available from your healthcare provider).
Anyway, I hope it goes well for you.
Charlie