Seeking a Diagnosis (part 1)

ImageIt is January 2000.

He is good-looking, 6’3” tall, with a head of thick black hair, neatly combed into a side parting.  I imagine him carefully grooming just before we meet.  His soft well-spoken English accent is calming.

Sometimes we warm to people immediately, other times, we experience a distinct lack of affinity.  This man fits into the latter.

Perhaps it is the absence of direct eye contact.  Maybe it comes from casually asking questions about areas of my life that I prefer to forget.  He frantically scribbles every hesitant word.  I want to snatch the pen from his grip.

I feel vulnerable, exposed, and terrified of expressing an accurate description of my Imagemental state.  The rapid and extreme mood swings with such bleak and desperate depression.  An inappropriate anger that rages within and then manifests as self-destructive behaviours.  Then there is the crippling paranoia, erratic impulsivity and a dark suicide ideation.  It is a catalogue of mental illness but I feel mute to enunciating the true scale of the torment.  I have a genuine fear of a forced admission into a Psychiatric ward.

I name him Dr Potty.  It’s not his real name, but close to it.  This reflects his position as Consultant Psychiatrist of the local Psychiatric Hospital.

Depression secondary to Post Traumatic Stress Disorder” He states in a matter of fact manner.

ImageI leave the surgery with a prescription for antidepressants, feeling angry and dissociated.  I wished I had said more.  How could I express this bizarre lack of identity or the way I swap and change personality to please the company I keep?  Would he understand the emotional immaturity?  Feeling like a child pretending to be an adult?  How do I admit an inability to sustain friendships or relationships?  Is it significant that I’ve told my partner to leave just because I was terrified of abandonment?  Do I even recognise that the chronic emptiness is anything other than “normal”?  

Four years – and two mental breakdowns – later, I ask my GP to refer me back to the Psychiatric services.

It is now 2004.  The waiting room is the same and I am waiting for a familiar face.  Instead, a tall man appears in the doorway.  It’s not Dr Potty.  This man is considerably older.  He looks in my direction, smiles, before ushering towards his surgery.

ImageWe sit in his small office.  There is no introduction. The first thing I notice is that he has a chronic nervous twitch that seems to resonate from the neck and shoulders, jerking his head up and down, eyes blinking in unison.  My mind wanders to the little nodding dogs in the back windows of cars.  It’s difficult to maintain focus.

I am desperate for help and a more realistic diagnosis.  I try hard to explain my experiences. Every statement I make includes disagreements about Dr Potty’s initial assessment and dubious diagnosis, “Dr Potty said this, Dr Potty said that”.. I drone on.

As I spout verbal diarrhea , the psychiatrist is busy writing notes.  I notice he is slowly becoming agitated.  Eventually, he sets the pen down with a quiet thud and turns to me with a look of, ‘I’m going to say something very important so listen carefully’

There is shock on my face when he says in a clear-slow-voice, “I am Dr PottyImage

Evidently, four years working in Psychiatric hospitals, not only ravaged his good looks, but has also had a negative impact on his own mental well being.

Despite the doubts about his original diagnosis, I instinctively know Dr Potty is not for turning.  It feels as if we were in a weird time warp, transported back to January 2000.

Depression secondary to Post Traumatic Stress Disorder” He states in a matter of fact manner.

If a Consultant Psychiatrist could not help me understand what I was struggling to live with, what hope was there for recovery?

Nothing could have prepared me for what lay ahead…

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14 thoughts on “Seeking a Diagnosis (part 1)

  1. RisingSong

    This is a pretty bizarre story. I don’t know what it is about psychiatrists that I have always found cold and antiseptic. The first one that I saw as a teenager (after a suicide attempt) had eyes the color of steel. I could not find a way to speak in her presence. The last one that I saw about ten years ago made me so anxious that I wanted to run out of his office the second I walked in.

    Sometimes it’s hard to find someone who can really reach you. I am curious to hear how the rest of the story goes and how you were able to find someone who could truly help you.

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    1. Cat Post author

      Thanks RS. I love the description, “cold and antiseptic” My experience of psychiatrists is not good, some Therapists haven’t been much better

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  2. vicbriggs

    I recognised so much of myself in what you wrote.
    I write fiction. This grounds my search for identity. It was only once I admitted to being depressed – not the colloquial, everyday ‘depressed’ that people use instead of saying ‘sad’, but the big-D depressed, when your world implodes and there is nothing you can do about it – it was only then that I was able to identify a recurring theme in my writing. All my characters undergo identity crises. These differ in type, intensity and texture, but ultimately the motif is always there.

    “How could I express this bizarre lack of identity or the way I swap and change personality to please the company I keep?” you say.
    I believe we all do that in our teens, when we haven’t quite figured out who we are. Mimetic behaviour is also normal in adulthood, it is akin to empathy, but of course, what you refer to goes far deeper than that. It comes I believe from a deep-seated need for acceptance. From a belief that we are not enough. Truth is, you are enough. We always demand more of ourselves than others ever do. Depression intensifies the pain, and makes it difficult for us to have a positive self-image.

    “Would he understand the secret emotional immaturity, like a child pretending to be an adult?” you continue.
    Pretence… We all do it. Most of us most of the time, or perhaps some of us some of the time, fake it. Sometime we make it, other times we don’t. There is nothing wrong with keeping the child within alive, but I would like to hear more from you about this. I am not sure I fully grasped what you meant by it.

    “How do I admit an inability to sustain friendships or relationships? Is it significant that I told my partner to leave because I was terrified of his abandonment?”
    Attack as a form of defence. Building walls. Keeping all at a distance. Depression does that. Admitting that it is not you, but the depression in you that makes all this happen, can help lift the burden of guilt. A small step perhaps, but a step in the right direction nonetheless.

    “Do I even recognise that the chronic emptiness is anything other than “normal”?”
    This hollowing out is the worst thing that depression does. We project all that is good outwards, and are left completely empty. I don’t have the answer to how the process can be reversed. Acceptance. Perseverance. Openness. Every attempt can make a difference. In time…

    You story-telling technique is wonderful. The twist unexpected. Thank you.

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    1. Cat Post author

      Thanks for the pingback, Vic.

      Depression is different things for all of us. It’s thrown around to mean anything from feeling a little blue to darkness and suicidal ideation.

      What I am not mentioning in my post…just yet, is that the symptoms ravaging my MH were consistent with Borderline Personality Disorder. It was a long journey before someone picks up on the condition.

      Some of the symptoms of BPD were in my post.
      – There is the identity disturbance (or identity crisis); being all things to everyone, with unstable interpersonal relationships
      – The emotional immaturity. Many people describe this as being childlike. The most mind-blowing statement I read was MIND’s info on BPD
      “I feel like a child being forced to live in an adult world. I feel too fragile and vulnerable for the world I live in”

      I agree, there is nothing wrong with keeping the child within, although that can take on a different meaning if that child is traumatised. I suppose the crux for me is the “pretending to be an adult” I am too emotionally immature to deal with certain parts of our adult world, so I tend to hide.

      This is the link to MIND’s information on Borderline Personality Disorder, otherwise known in the UK as Emotionally Unstable Personality Disorder.

      http://www.mind.org.uk/mental_health_a-z/8037_borderline_personality_disorder

      I’m a new and very amateur writer. Your kind comments are encouraging. Earlier, when I first logged on, I edited loads of that post because I was sure it was rubbish. Thank you for the encouragement.

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  3. Pingback: My travels with depression | vicbriggs's Blog

    1. Cat Post author

      On the NHS, these people know they don’t need to work hard to gain our business. That’s maybe rather cynical but it is largely my experience

      Thanks Merry, hope you’re doing okay

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  4. Astrid

    Interesting to read someone else’s journey to a diagnosis. I have been in the psychiatric systme for almost seven years and to this day am not sure I have the right diagnosis. It used to be DID/PTSD, now it’s BPD.

    Fortunately my experience of psychiatrists is different from yours. my former psychiatrist was really thorough and empathetic. My current psychiatrist I only see for meds and she is a bit antagonistic (or I am). I remember when I was first assessed in 2007, it was hard to pin down what I had because I came in suspecting something. It is my experience that a single consltation can never accurately diagnose people. I was diagnosed with BPD after three months of therapy. The diagnosis of DID/PTSD took even longer but it was made more offhandly based on my reported symptoms rather than observations.

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    1. Cat

      psychiatrists have very different ideas. That can be unsettling for their patients. Sometimes I wonder if we experience various symptoms form a number of conditions. Not sure if that makes sense but it’s bedtime.

      Thanks for dropping by and commenting

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  5. mm172001

    I have BPD and have been diagnosed with it for 8 years possible more, my prior pdac never told me about it. I agree I have BPD, I do not dispute that. Mine manifests differently and I think my symptoms are improving. My problems is I have other diagnosis (primarily schizoaffective) and my pdoc keeps saying my symptoms are BPD related and doesn’t want to over medicate me, I’ll probably vent in a post soon but it’s frustrating as hell. I deal with psychosis on a regular basis in a variety of forms: detachment, hallucinations, and paranoia but he thinks it’s all related to BPD. >: (

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    1. Cat Post author

      I use to deal with psychosis until I started Quetiapine (anti-psychotic/mood-stabiliser). Like you, my new Psychiatrist always claimed it is BPD related, my old psychiatrist (Dr Potty) just shrugged his shoulders!

      I’m still very uncertain where I fit into the BPD scale. This is partly due to my lack of research. It’s great to hear other people’s opinions and experiences. Thank you so much for commenting, Marci

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  6. Gel

    I love your writing style .
    The content of this story…so weird to be so dependent on people who we can’t really connect with.
    And this: “I have a genuine fear of a forced admission into a Psychiatric ward.” Me too. I don’t know where it comes from though.
    I look forward to reading the next part of the story.

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