Q. Please explain the exact diagnosis of my condition.

Answered by Dr. Nidhi Jain Bukharia and medically reviewed by Dr. Sneha Kannan

 

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Hi doctor,

Is diagnosis important? I have been diagnosed by many therapists and each one has had a different diagnosis. One doctor says it might be BPD and other says it might be a bipolar disorder or Asperger syndrome or cyclothymia. Why is it so? I am starting to feel like I am wasting my time trying to get diagnosed correctly.


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Dr. Nidhi Jain Bukharia
MBBS., D.P.M.(CENTRAL INSTITUTE OF PSYCHIATRY)., EX SENIOR RESIDENT AIIMS
Psychiatry, Psychologist/ Counsellor, Sexology

Hi,

Welcome to icliniq.com.

BPD and bipolar disorder have similar symptoms. Cyclothymia is its minor form.

Persons with BPD are said to be on the borderline between neurosis and psychosis, persons with bipolar disorder experience episodes of extreme mood swings ranging from depression to mania.

Asperger syndrome is disorder of autism spectrum.

PTSD is posttraumatic stress disorder. Depression like features after significant trauma.

As you mentioned, your problem and medication (attachment removed to protect patient identity) along with your history seems that you are having severe depression with psychotic symptoms or bipolar disorder.

Tell me your problem in detail, so I would be able to provide you a definite diagnosis.

 

Hi doctor,

My detailed history is as follows. I would like to start from my child hood. My mother was extremely emotional and verbally abusive. She always made me feel lower than dirt. My dad used to sit there and let it happen. I remember hating him for that. I always wanted to please my parents, but I feel like I never did, and I never will. My mom will punch, kick and slap but not daily. Maybe once or twice a month. Her tongue was her greatest weapon. My grandmother babysat me a lot. I love her house. She loved me just the way I was. She never made fun of me or judged me. She tried to teach me to hold my head up high no matter what. I guess I was not able to do that. My paternal grandmother always called me lazy. To this day, I dislike her for that.

I loved my school up until 7th grade. Later I was teased in school daily. I felt so ugly because no boys liked me. I did not know how to do cool things with my hair so I was made fun of tremendously for that. I was a loser and everybody reminded me of it. I never told my parents. I was too ashamed. It was not much different with my cousins. They made fun of me as well. I felt like I just could not ever win. I still feel like an eternal loser. I was molested by an older cousin but I do not like to talk about that. I have never told anyone, and I am only writing it now because I want to be completely honest.

One of my main symptoms is anxiety. I am always nervous and worrying. I am very anxious about my life. I have no idea what I want to do. I try to choose based on my likes and dislikes. But I cannot think of any likes or dislikes that I actually have. I also have a fear of death and often induce panic attacks when I think about it. I hate going to sleep at night because of this fear. I also get depressed quite often. I often have no motivation to get up and shower. I spend most of my days in bed. I have no motivation to find a job. I want to do things, but actually doing things very rarely happens. I do not know who am I or what I want and that creates more sadness. 

I also lie frequently. I lie to my husband about bills being paid. I will spend the money on something else instead. When we get a late payment notice I convince him that they are mistaken. I have also lied in the past about having a job. I did not want my parents to know that I did not have one. I have even convinced my husband that I had an online job when I really did not. I tell them things are fine when they really are not. I have also stolen money from my parents in the past to buy expensive things. I like to buy expensive things for my husband to make him happy. It started when we were dating. He does not know that I was stealing. Most of the times I will know we cannot afford, but I will tell him we are fine financially so that he can buy what he want. The most disturbing symptom is feeling empty. I do not even know how to fully explain it, but I feel like I am not living, simply existing. I am just here because I was born. I have no purpose, no aspirations, no motivation, just existing. I have experienced most of these symptoms since 17 or 18.As far as work, I have had only one job. I loved it at first, but about a month in I became bored. I was able to switch departments, and I thought that would help, but I soon become bored with that as well. Working there had become unbearable in my mind. I just decided to quit one day. I did not really give it much thought until about a month later when I was on the verge of becoming homeless. I have not really looked for a job since then because I feel the result would be the same.  When it comes to personal relationships I do not really have any, and sometimes I like it that way. There is no one to judge me or tell me what to do. I am in control. But then there are days where I long for a girlfriend or two to go shopping, or get our nails done. It would be nice to share secrets with someone, but I do not trust people to keep secrets. I do not have any good experiences regarding keeping secrets. In the past, when I have had friends I grew bored of them and would try to push them away. I became annoyed by everything they did and wanted to replace them with someone else. The cycle would repeat itself. I feel that my current condition may affect my children, and that is the main reason why I seek a help now. I do not want them to be a confused adult like me. My relationship with my husband is alright. I can be mean to him at times. I hate being away from him. He went on a business trip for four days and I felt like I was dying. I constantly sent him text messages asking what was going on. When he did not respond I would freak out and send him even more messages, some like accusing him of ignoring me.I have constant mood swings. My thoughts dictate my day. I can be content one minute and irritable the next. I frequently become anxious in the evenings. Usually I am content during the middle of the day. It is rare that I am truly happy, and when I am it is often short lived. Daily I used to think I was betrayed or victimized. I will go out of my way for people and they will not do the same. Doing things for others always backfires. I feel unappreciated and ignored on a daily basis. I am incapable of being angry with anyone other than my husband. I am afraid to show anger to others. I fear they will disappear if I do, or cut me off. With my husband I can be quite nasty with the things I say and do when I am angry. In the past, I have even physically attacked him.

Sometimes I just want to be alone and control myself instead of letting myself be controlled by others. If I am alone for too long it becomes a problem. I do not think much of myself. I think I look weird, I am not smart, I am a failure, and that I will never amount to anything. I have a tendency to be chill, so there was a time when I thought I was a sociopath. Then I realized I was far too sensitive to be a sociopath. I am a binge eater. I have been for some time. I am very impulsive, and have two arms full of tattoos to prove it. I have 16 tattoos and I now hate each and every one. Yet, I still want more. I have a history of cutting which I recently resumed. I have thought about suicide, but never seriously. I went through a phase of using drugs because I wanted to feel something. I stopped it when I became pregnant. I wanted to resume after pregnancy, but I no longer had a connection by then, so I just gave up.

My grandmother had dementia. I am not sure if that counts. Now, I am relatively healthy. I have slight high blood pressure, but I am not being medicated for this. I am just trying to control it with diet and exercise. I was on Welbutrin for anxiety and depression, but it made me act odd. I had a lot of energy and could not sit still. Xanax too did the same. When I went to the mental hospital I was given Celexa for depression, Loxitane for my mood swing and Ativan for anxiety. I did fantastic while in the hospital, but once I left and ran out of medicine I resumed my old ways.

 

Dr. Nidhi Jain Bukharia
MBBS., D.P.M.(CENTRAL INSTITUTE OF PSYCHIATRY)., EX SENIOR RESIDENT AIIMS
Psychiatry, Psychologist/ Counsellor, Sexology

Hi,

Welcome back to icliniq.com.

After reading your history in detail, I reached in conclusion that your diagnosis is borderline personality disorder.

It is a personality disorder because it is persistent and pervasive. You are having this for 10 years, (16 years of age). It started after the development of your personality.

It is not a bipolar disorder or severe depression. Because these disorders have an episodic course. It will resolve after a few months or year by itself.

  1. It is not PTSD, because it also resolves after a limited duration. So, it is a personality disorder.
  2. Dialectical behavior therapy (DBT) is psychotherapy for borderline personality disorder. Tablet Oxcarbazepine will be effective in this disorder.
  3. But, you should not think much about your diagnosis. Just take medication or receive psychotherapy.
 

Hi doctor,

Thank you for your response. Is this disorder life long? Or can it be cured? Do you offer psychotherapy through this site?

 

Dr. Nidhi Jain Bukharia
MBBS., D.P.M.(CENTRAL INSTITUTE OF PSYCHIATRY)., EX SENIOR RESIDENT AIIMS
Psychiatry, Psychologist/ Counsellor, Sexology

Hi,

Welcome back to icliniq.com.

  • Frankly speaking, without medication or psychotherapy it will remain lifelong. But, short term medications and long term psychotherapy can change its course.
  • It would be better, if you would receive psychotherapy in your place (face to face).

For further information consult a psychiatrist online -->  https://www.icliniq.com/ask-a-doctor-online/psychiatrist

 

Hi doctor,

Thank you very much for your answer.

 

Dr. Nidhi Jain Bukharia
MBBS., D.P.M.(CENTRAL INSTITUTE OF PSYCHIATRY)., EX SENIOR RESIDENT AIIMS
Psychiatry, Psychologist/ Counsellor, Sexology

Hi,

Welcome back to icliniq.com.

You are always welcome dear.

 
 
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