Do I Have A Possible Mood Disorder?

I’ve been thinking & I thought I’d do some writing to get my thoughts out. I was thinking about my medication, quetiapine & how I believe it has made such a massive difference to me at the moment. So that led me to wonder if I actually have a mood disorder. I don’t question my bpd diagnosis cos lets face it I’m quite textbook a lot of the times. But what I wonder is if I have an accompanying mood disorder. I’m not seeking labels & more diagnosis’ & I’m not one of those who loves to have every diagnosis in the DSM but I do seriously wonder if I genuinely have a mood disorder. I have had brief thoughts in the past about the possibility of a mood disorder but have never given it a serious amount of thought. I have experienced highs & lows for many years but it’s whether these are distinct from the highs & lows that accompany bpd. What has sparked these new thoughts of having a possible mood disorder is down to the quetiapine I started a few months ago. Medication isn’t supposed to be effective for bpd alone & indeed the NICE guidelines on bpd state that medication is only supposed to be used in the short term for crisis situations as there is no evidence of its effectiveness in long term use. I’ve been medicated close to 4 years now & until I started this quetiapine, medication was all about sedation especially in hospital where I’d be pumped full of benzodiazepines & heavy sedating anti psychotics. Medication never has really had an effect on the mental side of things if I am honest. After being first hospitalised & then being medicated & seeing everyone else around me being medicated, medication just seemed to be the norm. I took it cos it was supposed to help but I knew it didn’t really have much effect, but in time it became a comfort & I couldn’t Imagine not taking it anymore. But then I started on the quetiapine, an anti psychotic like the others I’d been on but also having mood stabilising properties. I started on the quetiapine in the midst of a prolonged crisis. I was suffering low mood & intense emotions & drinking to deal with those & being triggered into repeated self harm. After a while I came around & things got better, then even more better until I got to a stage where I am in a period of exceptional stability for me & a stability I haven’t had in a very long time. It’s impossible to prove but I strongly believe that the quetiapine has played a large part in this current stability. Personality disorder is a cluster of maladaptive personality traits which can’t be targeted & rectified by medication. What I wonder is that the effectiveness of this quetiapine is due to the fact it is working on a chemical in balance which would be a mood disorder. The mood disorder I think most likely if I were to have one would be cyclothymia or perhaps bipolar II. I’ve never had a manic episode so that rules out bipolar I. I’ve had what I believe are hypomanic episodes occasionally, the longest lasting about a month in which I was constantly on the move, feeling happy & being hyperactive & behaving in a silly ways such as often dancing & singing & also at the time i was hardly getting any sleep. This was followed by a massive crash in which I experienced one of the worst periods of my life. The lows are more often than the highs, I experience periods of depression far more often & these can vary in intensity. The question is though are these highs & lows distinct from those of bpd? Are they the depression & hypomania associated with a mood disorder? I’m starting to think they are distinct from bpd mood instability due to the fact that I believe the medication has made such a difference. The highs & lows of bpd are more likely to have external triggers which medication wouldn’t help with so much while those of a mood disorder are more likely caused internally with a higher chance of medication helping. Since starting the quetiapine things have got so much better for me, I actually feel like a new person. My mood is on such an even keel, I feel happy without being too happy & I haven’t felt low in a long time. I’ve even given up alcohol for 10 weeks now. That is helping the stability but if it wasn’t for the stability in the first place I wouldn’t have managed to do it. It’s surprising how easy giving up drinking has been & that’s because I feel so much better within myself. Is that the result of quetiapine? I personally believe it is. Although a mood disorder is separate to bpd being different illnesses /disorders it does not mean they don’t have an effect on each other. The mood instability caused by a mood disorder if I were to have one, would very much be a major trigger for my more bpd symptoms. If I did have a mood disorder & that was under control by medication then I’d have a much better chance at keeping my bpd under control. It could be that a mood disorder has remained undetected & untreated for many years & that’s why I’m not making any real progress & keep hitting crisis & relapsing. But now, now I’m on a medication that is regulating my mood I seem to be doing so much better. If the mood stabilising properties of the quetiapine are really what is making all this difference I suspect that a mood disorder is quite a strong possibility.

A Superficial Happiness

Wrote this poem today. This is how I feel right now. It’s not the best poem I’ve ever written, it’s not even that good really but I just wanted to get some feeling out & in writing

A superficial happiness
May distract me for a while
I can sometimes feel content
& even paint a smile

I can push away the hurt
But not for very long
It rushes back so powerfully
Singing its enticing song

Negativity is me
Badness runs through my core
As months & years go by
The bad gets more & more

A deep emotional pain
Is the essence of my being
It clings to every inch of my soul
& from it there is no fleeing

A self hate so deep
That it skews all my perception
It hurts my heart
To look at my own reflection

A self defeating mentality
My mind seeks to destroy
To break me, to kill me
Is It’s ultimate ploy

Flirting with madnesses
But this is my reality
I know this will never cease
Until it causes my fatality

6 weeks, 3 admissions

So I’ve had 3 hospital admissions in the last 6 weeks. I’ve never had such frequent admissions. Its rather on the excessive side for even my own rather excessive standards. Usually they are a good few months apart. However these admissions have been different to my usual admissions being that they were informal rather than me being detained under the mental health act. Things haven’t been great since the beginning of the year. I’ve had desperate feelings of hopelessness & self hate that have become more intense than their usual presence. However I wouldn’t say throughout these past 2 months or so I’ve had a severe acute unwellness that has often caused my previous detentions under the mental health act. I’ve not been majorly unwell but I guess to a certain degree I have been unwell enough to warrant voluntary admissions to hospital. They’ve all occurred after periods of self harm. There’s something about recent times that has caused my self harm to become more frequent. Usually I only engage in quite serious self harm needing hospital treatment every couple of months, sometimes longer but recently it’s been every other week. Back in January one Monday night I self harmed. The police got involved which can make things so much worse. The police took me to A&E where I had over 30 staples put in my arms. I was then assessed by the mental health team who gave me the option of staying the night at my parents or being taken to the police cells to await a mental health act assessment. I chose to go to my parents. The next day I saw my cpn who offered me a voluntary admission. I declined even though I knew it was the right thing to do. I just couldn’t bring myself to agree to go into hospital as I’ve had negative experiences of hospital where I am usually detained under the mental health act. Later that night I self harmed again. I spoke to a nurse on the phone from the out of hours team who persuaded me to take myself to A&E & then go voluntary into hospital. I ended up on ward 18, one of the few wards in my area that I hadn’t previously been on. I didn’t like any of the wards I had previously been on but this ward was much nicer as were the staff. It was a much more bearable place to be & I managed to stay for 6 days before having enough & discharging myself. It was the first positive experience of hospital I’d ever really had & I told my cpn that in the future I’d agree to go in hospital again if needed as long as it was ward 18. About 2 & a half weeks later I self harmed again. The police were involved again & I was arrested under section 136. After treatment for my self harm in A&E I was taken to the 136 suite to be assessed under the mental health act. After the positive experience I agreed to go into hospital as there was a bed available on ward 18 & I avoided being sectioned. This time I’d had enough after 4 days & discharged myself. That was on the Monday & by Sunday I had self harmed again. The police were involved again & I was again arrested under section 136. This time however before A&E I was taken to the police cells & subjected to a strip search. That was a very unpleasant experience. Once at A&E I had 38 stitches before being taken once again to the 136 suite to be assessed under the mental health act. Again there was a bed on ward 18 so I agreed to go in voluntarily & avoided a section. The doctors who assessed me said I should stay longer this time due to all these recent admissions. So I thought that was the plan. On the 5th day I was getting towards feeling I wanted to go home but was prepared to stay as that was what I thought the plan was. However I went into ward round & was told I was getting discharged. This is the only time ever I’ve felt unhappy about being discharged from hospital. Normally it comes as a great relief. Well I guess I was more angry than unhappy. I wasn’t too bothered to be going home but angry I was being discharged if that makes sense. I thought the plan was to stay longer which I was trying to do. Another thing was what the consultant said in ward round. That if needed I could have another “crisis admission” like it was ok to keep having all these frequent admissions instead of me staying longer & attempting to sort things out for myself a bit better. So I came home quite pissed off, I had thoughts of harming myself quite seriously as a way of getting back at them. I knew that was stupid though & I was pretty drained so I never. However now I’ve resorted back to the never wanting to go back into hospital again, or more accurately unwilling to agree to go into hospital again. I don’t see the point in all honesty. I self harmed on the ward in all 3 admissions, although admittedly not as severely as I could do at home. I admit I feel safer on the ward & I take some comfort in that but at the same time I have the same thoughts to hurt myself & I do. Obviously I’m limited as to what I can do with being on the ward but its still possible to self harm to a lesser degree. I’m sure after my 3rd admission to ward 18 the staff are pretty fed up & annoyed at me too because despite agreeing to be there I don’t always work with them. I’m sure they see me as another attention seeking borderline. Oh well I don’t really care because I’m not going back into hospital anyway. This is my promise, I’ll never agree to be admitted to hospital ever again.

Self Harm

So as today is self harm awareness day I thought I’d write something about my own self harm. I started self harming when I was about 13 years old. Up until the age of 13 as far as I can recall I was a pretty average child. Then it was almost like a switch going off in my head, I suddenly became a child with many issues; behavioural, emotional & psychological. That’s how I remember it anyhow, but it probably wasn’t like that at all if I think about it logically. I was probably troubled much before I & others became aware of it. I think the tipping point between being an average child & being an emotionally disturbed child was when I first picked up that sharp object & cut myself. Weirdly I do not recall the first time I ever cut myself. I can’t remember the specific reasons why I decided to hurt myself. I really wish I did but for some reason I don’t remember. It was like one day I was an innocent child & the next I was in a very desperate world where I felt the need to inflict harm upon myself. Things would never be the same again after that moment I first cut myself whenever that was. Of cause it started with a few scratch like cuts, I can’t remember what I first used to cut myself. I remember in my younger teenage years using anything really. A compass, a blade from a razor, glass, anything sharp I could get my hands on. I used to self harm mainly at home hiding in my bedroom but I did self harm at school too. I can’t really remember the frequency of my self harm either. It’s not just on the topic of self harm that I have a poor memory, I have very poor memories of anything that occurred in my childhood before I was about 15 years old. I remember the occasion when my mother found out I self harmed. Maybe I was about 15 years old but I’m not all too sure. I think I had self harmed the night before & I had used toilet tissue to clean the blood from my arm, I had then hid the bloodied tissue in the drawer next to my bed along with some razor blades. The next day my mother went in that drawer & found them. She then obviously put 2 & 2 together & realised I’d been cutting myself. She obviously wasn’t happy & probably not knowing how to respond got mad at me. That just made things worse. I was a very angry teenager & not only did I take that out on myself by cutting myself, I directed a lot of anger towards my parents too. School became aware at some point that I self harmed, I can’t recall how or when. I used to see the school nurse for counselling type sessions & remember discussing it with her. She was very nice & understanding but nothing helped enough for me being able to stop self harming. Once I started self harming at 13 I’ve never been able to stop. I continued self harming all throughout high school. They were never deep cuts & I never got significant scarring from them. Just a few faint lines upon my lower arms. When I moved onto college I still continued to self harm, it wasn’t all too frequent but I still did do it. By this time the cuts had got slightly deeper but still not overly bad. It wasn’t until I moved to university & where i struggled far much more emotionally & psychologically when my self harm got worse. I lasted less than 3 months at university before they asked me to leave due to me being to unwell to study due to repeated self harm amongst other things. I went back home & continued to self harm but it did calm down a bit in the months I was home. It was when I moved back to university the following September when my self harm became significantly worse. Up until this time I’d only had a few A&E admissions due to self harm but suddenly I was cutting deep & having frequent A&E visits for sutures. The first time I did it really bad was when I attempted to cut my wrist, not because I wanted to die but because I dared myself to see if I could do it. It was a very deep cut, one that exposed tendons etc in my wrist. I was exceptionally lucky not to have inflicted permanent damage to the movement within my hand. I went to A&E & was admitted to the plastic surgery unit. I had to have the wound investigated & sutured in theatre. However it still was only done under a local anaesthetic & I was awake throughout. I remember laying on the bed in theatre with silent tears rolling down my cheek. I felt so alone at that moment in time & was really upset that I could do this to myself. I still continued to self harm. Then approached a pivotal time in my life when I did the worst self harm I’ve ever done. There was lots of things going on at the time. The main thing being the attachment I had developed to my cpn & this overwhelming fear of abandonment that seemed to take over me. One night after talking to the crisis team on the phone & being exceptionally triggered by them I took it out very severely on my self. I went to A&E again for what now was a very frequent occurrence. Again I was admitted to the plastic surgery unit. From there I was admitted to psychiatric hospital for the first time, where to cut a long story short I remained for the next 2 years. While in hospital I started to burn myself with cigarettes due to the lack of sharp objects available. Burning is something I’ve never particularly liked doing, it’s always been cutting for me but at the time it was the only option & I still felt this need to hurt myself. Of cause whenever I got my hands on a sharp object I still cut myself, the need has never gone away & just because I was in hospital didn’t stop that need. However while in hospital when I did manage to cut myself it was always superficial & I’d get frustrated that I couldn’t do it properly, after all I’d got so used to inflicting quite serious damage to myself. When I got out of hospital after 2 years I went straight back to what I call “good self harm”. In the 15 months since my discharge from hospital I’ve had many admissions to A&E for self harm. It’s become something I can’t seem to control. After many years of doing it its become the norm of how I deal with things. It’s become so engrained in who I am & how I cope I don’t understand how I’ll ever stop. After years of doing it I have pretty severe scarring to both of my arms. It’s like a constant reminder of all the distress in my life. I often look down at my arms & I feel sad. Why did I do this to myself? How could I do this to myself? The scarring is something I’ll have to live with the rest of my life. As I said earlier I do not recall what lead me to first self harm. I do know why I still do it though, maybe it’s the same reason why I started, I do not know. I just feel the need to punish myself, I feel I am a bad person & I deserve to be damaged. I get angry & I take it out on myself. The deeper the better, the more damage the better. I seem to have this morbid fascination with my own blood too. I love to watch the blood flow from my arm. There’s something exceptionally satisfying with it. A lot of it is driven by this deep self hatred I feel. I feel I cannot escape that & therefore I’ll never escape this self harm. Part of me wants to stop, part of me doesn’t. I admit that quite often I enjoy self harming, I take pleasure from it. Now my arms are so significantly scarred I often think there’s no point in stopping. What’s the point when my arms are already so messed up? There’s no hiding or disguising the scars anymore. The damage is already done. I know this has all been focused on cutting, the form of self harm I prefer but I have also engaged in other forms of self harm. Overdosing, hitting myself & burning. But cutting is what I mostly do, the form I get most release from. I’ll always find one way or another to harm myself. It’s a very sad state of affairs but I just see no escape from it, I’ve been doing it throughout my whole teenage & adult life. I’m not defined by the fact I am a self harmer but it’s very much a part of who I have become

BPD?

Bpd. Borderline personality disorder. What kind of bullshit disorder is that? Is it even a real disorder? Or is it that I just don’t have bpd? I often flip between thinking that i definitely do not have bpd to thinking my thoughts & behaviours are very typically bpd. I just feel its a crap disorder. Maybe it’d be easier to accept & deal with if it was a real illness. It’s not that I want an illness it’s just that if I had a proper illness I could accept it as then I’d really know what abnormality of mind was & how it really felt to psychologically suffer. Bpd is not an illness, it’s a disorder. Or is it even a disorder at all? Or maybe it is & I just don’t have it? I just feel I am an incredibly weak & pathetic person who doesn’t seem to be able to deal with things that most people don’t even feel the need to deal with. Should that be clinicalised, should a label be placed on me for that reason? They say bpd is developed due to experiences as we are growing up & as our personalities are developing. I’d just like to add that I didn’t have a bad childhood & I suffered no trauma in childhood either. To me that says I have no reason to have developed this disorder, if indeed I have it at all. When I was in hospital they taught us the bio social theory of developing personality disorder. That is a biological predisposition to personality disorder but experiences in childhood triggered the onset of the disorder. For one minute lets accept the fact I do have bpd. Then for me it must be that I have a strong biological predisposition to the disorder given the fact nothing out of the ordinary occurred in my childhood. I would say I feel emotions pretty intensely at times & I do recall being somewhat of an emotional child growing up. It does lead me to believe that if there are stronger biological factors in the development of my bpd that there is less chance of recovery. However biological factors lean more towards the illness side of things rather than a disorder. I am not ill & it’s questionable that I have a disorder. It’s not that my brain chemicals are out of sorts or my brain is wired incorrectly giving symptoms of psychosis or mania. That’s illness, an organic cause. It’s more that I have disorganised & I guess disordered thought processes. But then again where do emotions come into this? There’s the thought processes & the emotions. Which comes first? or do they coexist together? Do emotions have a biological root or are they a merely a response to thought processes & patterns? That I do not know, perhaps it’s a mixture of the 2. I guess whatever the cause or the reasons behind it, it doesn’t make it easier to accept. I think I’ll always flip between acceptance & denial. Maybe the denial is another form of invalidation that I inflict upon myself. Invalidation being another key aspect in the theory of developing bpd. Self invalidation is something that’s become quite habitual & something I’ve become quite expert in in the last several years. I guess all I was trying to say was that despite theory & explanations to the cause of bpd it seems to be a poor disorder. Then there is the question of if I even have it at all?

Self Hate

It’s on obvious well known fact I hold this deep hate for myself. I’ve felt it for so long it’s hard to remember a time it wasn’t there. As far as my mind will allow me to remember it was triggered on like a switch. However the intensity wasn’t sudden it built up more strongly & intensely as the years went on & the older I got. My theory is that the way in which I acted on my emotions fed this self hatred due to the guilt & embarrassment of my impulsive & more sustained behaviours. This was also intensified by the nature of my mind which thinks & over thinks then thinks some more in an exceptionally judgemental & self critical manner. As the thoughts intensified the hate got stronger & the hate made the thoughts more critical. It is a vicious circle that goes on & on. I still act on these emotions & the hate is still very much there in an in your face presence. My actions now breed a frustration too. As the years have gone on I have become accustomed to these actions & behaviours. Some awareness has undoubtedly been created yet I still feel unable at times to control them. I find it frustrating I am not changing these actions & behaviours as quickly as I like, if I am even changing them at all. I still feel that I am not in control at times. I know I should be but I can’t do it. All reason goes out of the window. I hate the feeling of being out of control which in turn creates more actions & behaviours which strengthen this self hate. The hate is always there, there is no escaping it but it becomes more & less bearable as my mood changes. A negative mood & sometimes I can’t bare to be in my own skin but when more positive it’s just another thing I have to deal with & I can push it away slightly. However essentially it’s always there. I feel like there’s no escape. Everything feeds into each other & the problem becomes complicated. How do I begin to work through it? If I am right then perhaps the first link in the chain is emotions. How do I manage those if I am naturally just that way. I could get into the whole nature nurture debate but I think it generally accepted that BPD is down to both. So naturally I am emotional. How do I go about fixing that if I was born this way? Say I could find a way to manage those, would years of all these hate inducing behaviours have damaged me beyond repair. Is my mind scarred? Have these actions & behaviours become so normalised & ingrained that there really is no hope of changing for the better? And yes I feel more hate for thinking these thoughts.

Self Medicating

I wake up, the shitness is still there. As the day continues the feelings & thoughts intensify. My head is messy & I feel emotional pain throughout my body. I become exceptionally needy & desperately hope somebody can make all this go away. Nobody can. Nobody ever will & I have no hope of ever managing to summon the ability to make this go away myself. I try & I fail. I turn to weed. It half helps & it half makes things worse. Before the weed I feel unsafe. I know that one way of trying to put a stop to all this badness is to turn to my razor blades or turn to alcohol. Weed is a safer option. The weed numbs the emotions & relaxes me physically but it intensifies my already speeding mind. The thoughts come in overwhelming waves of negativity & judgement. I get brief periods of anger but at the same time I am stoned & I don’t care. Periods of paranoia sweep over me & i become fearful of the world. i begin to have intense thoughts of being unable to deal with the world around me & the situations i have to face. i just want to live in this moment forever because tomorrow is another day i cannot face. I alternate quickly between intense thoughts of a self critical & self hating nature to ones of extreme amusement at the way in which my life has unfolded. My mind becomes messier, busier & more conflicting & chaotic but at least the emotions are numbed. Throughout all this there is a deep underlying sadness throughout that is clinging tightly to my existence. I think essentially that is what I am trying to kill but it seems indestructible. I sacrifice my mind in order to dull my emotions but the one emotion it refuses to relieve me from is this overpowering sadness. Nobody & nothing can take it away.