Do I have complex PTSD, BPD or BP? Help.

[Evie81]

Hi guys,


Just tapping into a communal knowledge base here. Thanks for reading.


I am diagnosed as having Bipolar Disorder, I am on medication for this, which seems to have performed miracles for my depression. I have been hospitalised for BP several times, for a manic episode, a mixed episode and twice for depression.


A possible BPD diagnosis has never been brought up by any of the psychiatrists that I’ve seen. In fact, I’ve asked and it has been denied by 3 different professionals. However I feel that my symptoms have a lot in common with BPD, mostly the abandonment issues, and then there is the obvious overlap of mood instability with BP.


I have been with my partner for nearly 7 years and also enjoyed long-term relationships before this. However my partner and I have been struggling lately due to a relocation and him starting a high pressure job with long hours. We have been on the verge of breaking up and started seeing a relationship therapist.


A central theme within this therapy are my abandonment issues. I experience tremendous anxiety and/or rage when he has to go on yet another business trip, arrives home late or is not truthful about his whereabouts. I come from a family of junkies and lies about whereabouts/what they were up to/not returning home resulting in me living with family members, and 2 foster homes, were normal for me. In this context one might be able to see how this sort of trauma would affect future relationships.


Our relationship therapist has floated complex PTSD on my part, this as well as several issues my husband is facing with lying and confrontation. Meaning we are on opposite ends of the spectrum as I need accountability and truth to make sure I’m ‘safe’ from past experiences. If not I can become hypervigilant, anxious and erratic. He says he lies because a confrontation can result in strong emotions on my part and round and round in circles we go.


From my understanding complex PTSD is often interchangeable with BPD with the main difference being the abandonment issues. Obviously not negating the overlap with BP as well and one can see a red herring emerging.


My psychiatrist denies both the complex PTSD and the BPD and says everyone, including him, has abandonment issues. My reactions are perfectly in line with what to expect when a partner lies and walks out to avoid confrontation according to him.


Should I ask for a second opinion? What do you think?
 

[james1]

Hello Evie81,

Just thought I'd drop a short note here since I had a similar experience regarding borderline personality disorder (BPD) diagnosis.

I think the way the discussion here has turned out has been really great. It sounds like it's helped you get a bit more clarity on what you are looking for from your doctors and from diagnoses as well.

The only thing I would add is that I have gone through various BPD-specific treatments - DBT, schema therapy, TFP - and the common theme running throughout my on-going treatment is that my doctors have focussed on treating me as a person, not me as a BPD person.

So it maybe sounds redundant to say, but you are who you are. BPD/BP/CPTSD...you are still you and that is how your doctors should be treating you - as a complex human being.

For me, the therapy has helped me uncover who I really am. As you say, I left things buried and they seem to be surfacing now. Maybe I'll fit the BPD perfectly later, or perhaps the 'real me' is the complete opposite. The therapy will help me find out, and we'll adapt the therapy as we go along. The 'joys and harrows', as you say 🙂

James

[Just Sara]

Hi again Evie;

I've read each post here and find myself wanting to engage, not just as a support for you but as a personal interest.

You wrote;

'Again, the diagnosis makes no difference to the cure of course. Yet I still wonder where I fit for want of a ‘tidy basket’ as you mention'

These highlighted words represent a classic abandonment phrase. It's an example of how 'abandonment' can manifest in our lives in seemingly unnoticeable ways. Fitting in; feeling left out; wanting to participate but fearful of the outcome.

James mentioned 'Schemers'; (btw James, great post!) This therapy attempts to identify deep beliefs that affect how and why we make the decisions we do. Its focus, depending on your therapists skill, is to understand what drives you and your responses in certain situations.

For instance; when I was born 3 1/2 months preemie I was placed in a humid crib for 2 months separated from my mum. I was released into the care of my grandparents and was taken back by my mum at 2 yrs old; no preparation or proper goodbyes; just swooped up from my cot and put in the car.

That event was so traumatic I remember it as clear as day. The problem with this scenario was the belief it was my fault and an insatiable yearning of wanting to go back.

I was watching the Australian movie 'Rabbit Proof Fence' in my late 40's when the penny dropped. I identified with the 'Stolen Generation' to an extent which helped me come to terms with my unresolved feelings and beliefs. I sobbed for hrs grieving for the little me who was taken from the only home and family I knew.

The belief I'd done something wrong was a huge barrier for me. It invaded many aspects of my relationships, decisions and perspectives. Without reacting to the movie the way I did, I may still be trapped in that belief's grasp. At times it still pervades my thinking, but I catch myself now instead of letting it take hold.

I hope my story has in some way helped you understand the relevance of self assessment and therapy vs being labelled. An 'ah-ha' moment can occur out of the blue to help us understand who and why we are 'us'. Self-help at its best..

Have a great day!

Sez

[Evie81]

Hi James and Sara,


Thanks for your helpful responses and sharing some of your personal experiences.


I find myself in what you say Sara. Before being in relationship therapy I also had extensive personal therapy. A major ‘a-ha’ moment for me was when my therapist asked me to visualise my problem and describe it to him.


I painted a picture, out of the blue and entirely surprising to myself, of what can only be described as rot. You know how strawberries grow that grey spiky mold on them when you leave them in your fridge to long? I came up with that and some other utterly gory descriptions of decay.


This might sound vague and perhaps like utter Freudian nonsense to someone who was not there in the moment but it sure gave me a glimpse into my inner workings. Beliefs that fall into the category of ‘what you didn’t know you didn’t know’ if that makes sense?


I cried for days and didn’t know why as it was just a visualisation that I performed on the spot under what seemed like weird request by my psychologist, right? But then the point of the exercise hit me, what cannot be explained in words can still float around as an inner concept. The picture painting more than a thousand words as they say, and it painted myself as being rotten to the core. Ding! Lightbulb moment.


We spoke about this extensively in the following sessions and came to the conclusion that I had convinced myself that was I was so ‘rotten’ that I did not deserve caregiving. If only I could somehow not be so putrid I would be able to make my mother, selfishly - as arguably all children are, attend to my needs of nurture.


In this context it makes sense that I get utterly erratic when I feel ‘abandoned’ as I perceive it as a measure of how ‘good’ I am.


*There you go, failed yet again. You sodding substandard lousy excuse for a human. You have not tried hard enough, who the f*** do you think you’re kidding?*


Anyway, I’ve gone off on a tangent and a Freudian one at it. I wonder if any of you have similar experiences?

[Just Sara]

Hi Evie;

Yes, your anecdote makes sense. Knowing what you know now though, do you feel your attitude/responses towards situations that challenge have changed for the better?

Sez

[Evie81]

Hi Sara,

Thanks for your reply!

To be frank yes and no. Empowering my ‘rider’ has done very little for strength of my ‘elephant’, the rider pulls and pulls but he’ll never be able steer the elephant on strength alone. He has to outsmart and/or tame him or simply agree on the path he is taking.

I got this metaphor from a book that I thoroughly recommend; The Happiness Hypothesis by Jonathan Haidt. His theory is based on a Buddhist concept that has a lot in common with Freud’s ego/superego/id. The rider being the rational mind and the elephant being instinct and emotion brought about by affective priming.

My rider knows what is wrong with the path the elephant is taking but he still struggles to steer him as he is so bloody strong. So my attitude has changed, as my rider has been empowered with knowledge to perhaps eventually outsmart the elephant, but my responses still very much originate from the elephant.


I guess a lot of therapy is based on this model as well with CBT focussing more on the acceptance of the path and psychotherapy on empowering the rider. Perhaps medication is the answer to taming the beast.


Anyway, thanks for listening/reading. It’s been very therapeutic to get some of my inner workings out on paper and read all your insightful responses.

[Just Sara]

Hi Evie;

I'm glad you're enjoying our chats.

The elephant is surely a metaphorical master isn't it! It says on my fridge; 'Eat the elephant one bite at a time'. It was relevant when I lived moment to moment..

I see you're in the realm of metaphors and similes. When I was really 'ill' they drove my resolve. Unfortunately though, decades of 'sayings' kept me stuck in my head. I had to become more pragmatic to survive the obsessive thoughts and dissociation.

I use them at times to help me understand certain behaviours or beliefs I need to change. I tend not to follow Buddhism due to it being written by men who've never had intimate relationships with women.

After 7 yrs of bullying in my workplace, I broke. At home one morning electricians were walking in and out doing a job for me. That day I had a huge panic attack and thought I'd take a PRN to calm. Instead I sat and went back over the day seeing if I could identify the trigger.

I remembered the workmen had walked mud thru my house. Instead of groaning about it, I went inside myself to feel what I felt in that moment; the penny dropped. I was too scared to approach and ask them to take their boots off when coming inside.

Internally, those 7 yrs came back to haunt me. I was afraid of speaking up for myself fearful of consequences, as had been the case at work when I defended myself.

The truth really did set me free that day. I accepted and forgave my failings and immediately the anxiety/panic stopped. It was a wonderful lesson on real life vs analysing.

I like that you've 'got the bull by the horns' re your healing. lol (Had to throw that one in) 🙂

Till next time;

Sez

[james1]

Hello Evie,

That's a really great metaphor to use and it sounds like you're really trying to get the rider and elephant going in the same direction. I also understand the feeling of being an increasingly better informed rider on top of a very strong elephant, yet unable to change the direction. The wonderful thing with therapy and just talking to people, as you are already doing, is that it is like training for the rider. The longer you stay up on the elephant, pushing along and getting help, the more you'll learn about how the elephant behaves and how to work with the elephant to move in the direction you want to go.

In my own experience, the elephant was not bad or even wrong. In the wild, they behave very much based on instinct, and in particular, fear. I think the same applies to our elephants. Over time, we will learn how we can control and ease this fear, and help the elephant come along the way that we know to be a more helpful path. It sounds like you're already on this path and working hard to learn more about your emotions.

Did you know that DBT (dialectical bheavioural therapy) is based on a similar concept? Logical Mind and Emotional Mind are at odds, and we need to learn to blend the two to create "Wise Mind". Interesting that it has such common traits with this other buddhist concept. Perhaps there's something in this dichotomy we can learn from.

James