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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Lyrical13 on January 17, 2004, at 8:45:26
I tried to go back to find the original post from back in Nov (or was it dec?) and I still can't. I haven't quite got teh hang of searching for archived posts.
Anyway, I posted a couple months ago about my sister who is probably BP of some variety... only 14 years old (15 at the end of this month) and is on meds but is still having a heck of a time. I am still very concerned about her and my parents aren't all that proactive about getting her appropriate help. She goes to her pediatrician for meds but I just found out that she doesn't even see him on a regular basis to monitor the meds. Just "call when you need me" kind of approach. That's BS. Her meds were increased in Nov about a week after she told me about the cutting adn she hasn't seen or talked to him since. She is doing better than she was but over the holiday break when her girlfriend was out in CA marching in the Rose Bowl parade (gone for a week) she was falling apart. I've talked to her about finding a new therapist (she doesn't like the one she had and so quit). From what she has told me, it sounds like the therapist didn't really have a lot of experience with cutting. And just last week she told me that my pdoc (who she had one session with back in Nov when I strongly recommended to step-mom that she get into tx pronto) actually told her she was cutting for attention! Hello! Yeah, that's why she's been hiding it from everyone since 6th grade (she's now in 9th). I'm very worried about her and wonder what I can do to advocate for more help for her.
My dad isn't really assertive or proactive about anything..basically your emotionally absent father. And when he does try to set limits or talk to my sis about her behavior, my stepmom sabotages it. She's trying to be the "cool best friend" parent...which is why my sis is still throwing tantrums at her age. They still work. I worry about my sis...she has these rages and her temper/tolerance level is very short. And the way they allow her to talk to them! The problem is, I love her very much and know she is a very sensitive caring person under that whole veneer. She would be crushed if she knew how people were talking about her...she would be crushed if she knew that my brother and his wife don't want their 4 yr old daughter around her very much because my neice is starting to behave like my sis. How can I make her see that she needs to get help before her behavior creates more problems and heartbreak for her? I dont' want to hurt her, but I'd like to spare her from the 13 years of heartache and near-suicidal spells that I've been through. She was sounding suicidal in Nov. She still seems like she's on edge. I dont' want to lose my sis. I'm so worried and I don't know what to do. How can I encourage my folks to get her the help she needs, and get her to accept that help without completely alienating anyone? And how do I find a pdoc and therapist with experience with her type of problems? Is there a way I can search for several possible candidates for this job that she can go and check out? I've mentioned this to her..finding pdoc/therapist who knows about cutting... she seems to be thinking about it...seems open to it some days and other days says, "I feel fine. I just felt worse when I talked to the therapist before"....Help help help!!!!
Lyrical13
Posted by judy1 on January 17, 2004, at 10:55:56
In reply to update on sister is cutting, posted by Lyrical13 on January 17, 2004, at 8:45:26
I'm really sorry things have gotten worse for your sister, it sounds like she has a lot of anger- and with your parent's indifference she has every right to. I would have given anything to have such a supportive sister like you at that age. I really, really feel the right therp will help your sister. I know ones in so. Cal who specialize in SI, but if you're in a different part of the country- you might try calling in-patient adolescent psych hospitals- the ones that primarily deal with SI and eating disorders (you would be surprised how they go hand in hand) and ask them for names of therps. then I would try calling them to get a feel whether they would be a good fit for your sister. and then you're going to have to convice her somehow to go; it's so difficult at that age. you might want to ask the therp for suggestions.
best of luck- judy
Posted by Bell_75 on January 18, 2004, at 0:18:30
In reply to update on sister is cutting, posted by Lyrical13 on January 17, 2004, at 8:45:26
Hi
I didnt have this advice last time i read your post but I have a suggestion for you and your sis as far as cutting goes.
I'm 19 turning 20 at the moment but when i was around 16,17 & early 18 i was heavily into cutting.
When I left school and had some time to break away from alot of the stress as well as start my meds then eventually therapy I stopped needing to cut myself.
Over the last few weeks I've had a relapse and been diagnosed with a major depressive disorder when before i had ony clinical. I've started cutting again and feelings of suicide.
My therapist luckily has been understanding about this however he wanted to figure out a way to stop me from needing to cut because its not a safe thing to do.
He spoke to me about the feelings I have that lead up to me cutting myself (mainly on my inner arm) then said we should replace the feeling of relief i get from cutting with something else thats just as painful but more safe.
He told me that as a kid him and his brother's used to hold their arms in a bucket of ice and see who could hold it in there the longest (heh yeah I rolled my eyes at that one too).
However his point was, after awhile it really starts to sting and cause pain.
So his suggestion to me was whenever i felt the intense need to cut myself to cause the pain I feel from it I should get ice (or those ice bricks used for cooling) and place it on my skin and hold it there till it starts to really ache.
The best places are where your lymphatic glands are near the surface of the skin so the ribs area,underarms, upper thighs, neck area. Also on my arms where i do my cutting and anywhere else where it'll really hurt.
Now when he told me this I sort of thought it'd be abit strange and hard to explain to someone else but that night when i went home and started getting really out of control I had the urge to cut myself.
I got out of bed, went to the fridge and grabbed 2 ice bricks then placed them straight on both sides of my ribs. The strange thing was I also got abit of a giggle out of it because it felt abit silly but afterawhile it actually did work. It started stinging like mad but i just kept holding them there till I felt the need go away. Then even when i took them away it hurt abit to touch the really cold area. So it worked!
I got abit of comic relief and felt the desired pain without the scarring and doing serious harm to myself.
I admit that it isnt an instant cure by any means. I still think about it alot and have the urges but it was an innovative approach to a very serious issue.
Also, he was worried about me being extremely suicidal so he printed up on the computer a contract between us that said something like this:
"by signing this contract I,*insert name*, agree to not attempt suicide or harm myself before calling *therapist's name* or Lifeline.
*space to sign then person's name underneath*"
It took me a long time to sign this agreement/contract but eventually I did and he gave me his cell phone number. I agreed that I wouldnt do anything until I called him and I felt so much better after having agreed to this.
After signing both of us felt relieved and like we had a better grasp on the situation.
So maybe I thought you could pass on the ice idea to your sister and maybe even tell her you'll do it with her as moral support. It might even make you both have a much needed laugh.
Also the idea of a contract isnt a bad one, you could write one up between you and her than no one else has to know about stating that she will call you or page etc when she feels these urges and not do anything (including cutting) until she has spoken to you. If you speak calmly but seriously while you talk about the contract then she will see you're not just joking around and that you wont accept her breaking the terms of the contract.
Sorry this post is a biggie but I've had this ideas in my mind and I thought this would be a very worthy time to share the advice of my therapist. At least consider it even if some may sound abit silly because trust me, it works for me. I haven't broken the terms of the contract yet and its helped me feel in control of my suicidal and cutting urges.
I wish you the best of luck for you and your sister. You're a very brave and caring person and don't forget how much benefit it is to her that she has you there even if she may not say it.
Sometimes people just cant find the words.Much hugs to you *huuuugs*
Hope I've at least given you some food for thought. Take care :)
~Bell
Posted by Lyrical13 on January 18, 2004, at 3:07:18
In reply to Re: update on sister is cutting » Lyrical13, posted by Bell_75 on January 18, 2004, at 0:18:30
> He spoke to me about the feelings I have that lead up to me cutting myself (mainly on my inner arm) then said we should replace the feeling of relief i get from cutting with something else thats just as painful but more safe.
> He told me that as a kid him and his brother's used to hold their arms in a bucket of ice and see who could hold it in there the longest (heh yeah I rolled my eyes at that one too).I've read about other people trying this with ice. I'll suggest it to my sis. Last time we talked about it, it had been 6 weeks since she had cut. WE looked at the posts to my first query together. She said reading the posts drove her crazy and the websites I learned about because she wanted to cut. So I talked to her about always having someone with her if she was going to look up info on it. I could see her getting very squirmy and like she was jonesin to cut as we were online and reading stuff.
We have an informal anti-suicide pact...I also have a mood disorder (probably BP2 though I've thought for 13 years it was GAD/depression) I like your idea about the contract for suicide/cutting. It would make me feel a little better and maybe it would help her too. I've already told her she can call me even if it's 3am. She called me on New Year's Day crying and we talked for a while. This is the first week in a long time that we haven't done sister night. I have been trying to call her but she has been busy (that's a good thing) I had a workshop on the night we usually get together and totally forgot to call her to let her know so I was worried she thougth I forgot about her. We've e-mailed back and forth a couple times and she seems to be OK. I so so so want her to get help. I'm hoping that if she does get back into counseling and gets her meds straight she'll start to be able to process some of the feelings she's stuffed down inside. I don't think she really even knows what she's feeling or why she's angry. And hopefully the counselor will suggest family therapy and they'll actually go and maybe get some help as well. One can only hope!
Thanks again.
Lyrical
> Also, he was worried about me being extremely suicidal so he printed up on the computer a contract between us that said something like this:
> "by signing this contract I,*insert name*, agree to not attempt suicide or harm myself before calling *therapist's name* or Lifeline.
> *space to sign then person's name underneath*"
> It took me a long time to sign this agreement/contract but eventually I did and he gave me his cell phone number. I agreed that I wouldnt do anything until I called him and I felt so much better after having agreed to this.
> After signing both of us felt relieved and like we had a better grasp on the situation.
> So maybe I thought you could pass on the ice idea to your sister and maybe even tell her you'll do it with her as moral support. It might even make you both have a much needed laugh.
> Also the idea of a contract isnt a bad one, you could write one up between you and her than no one else has to know about stating that she will call you or page etc when she feels these urges and not do anything (including cutting) until she has spoken to you. If you speak calmly but seriously while you talk about the contract then she will see you're not just joking around and that you wont accept her breaking the terms of the contract.
>
Posted by Lyrical13 on January 18, 2004, at 3:11:34
In reply to Re: update on sister is cutting » Lyrical13, posted by judy1 on January 17, 2004, at 10:55:56
Judy, thanks once again for your helpful advice. You always come through for me! I hadn't thought of talking to the adolescent units in the area and interviewing therapists myself before recommending one. I see my pdoc on Tuesday and planned to ask him for recommendations and I also know of a pdoc closer to the city (Detroit) that is supposedly very good with adolescent psych issues. Is both counselor and med doc so she wouldn't need to keep up with 2 new docs. But I will definitely check into your suggestions.
thanks again
L13
Posted by Lyrical13 on January 18, 2004, at 3:17:46
In reply to counselor search idea, posted by Lyrical13 on January 18, 2004, at 3:11:34
OK..my next question is this. My sister's behavior is having a big impact on her relationships with others. She has these rages and lashes out at everyone. Yells at my parents and says mean hurtful things. Yet I know that at heart she is a very loving caring sensitive person. I think she is just hurting so much inside. And I also think she is BP and the anger/irritability etc. is part of that.
Here's the question. My brother and his wife are trying to keep their 4 yr old daughter away from her as much as possible because she has started acting like my sis..saying some terrible things. My sis would be crushed if she knew this since our neice is the light of her life. Should I tell her? The only reason I would is to convince her to get help before she damages this relationship for good or something hurtful is said to her. I don't want to hurt her but she doesn't seem to realize the impact of her behavior. Although maybe she does...I have magnetic poetry things on my fridge and when she was over one night we were fooling around making up sentences etc. She wrote, "I am the monster". That breaks my heart. Please advise on this...
L13
Posted by fallsfall on January 18, 2004, at 9:28:35
In reply to need an opinion, posted by Lyrical13 on January 18, 2004, at 3:17:46
I wouldn't tell her yet. It would be devistating for her. See if you can find softer ways to convince her to get therapy. She should be in a safe environment to hear something like that. Just my opinion
Posted by EmmyS on January 18, 2004, at 9:39:02
In reply to Re: need an opinion » Lyrical13, posted by fallsfall on January 18, 2004, at 9:28:35
Yeah, I agree...not a good time to tell her. Perhaps suggest to the parents that you understand their concern, and you will make sure to be with your sister when she is with your niece to provide a positive role model. If you see your sister acting in a negative way, maybe you could redirect the activity in some way?
You are taking on a LOT of stress and responsibility here. Please remember to take care of yourself. Take some time for just you and the things that make you feel warm and safe. It's too easy to give and give. Not so easy to be a little self once in a while, right? If you just answered yes....you need a to relax a bit! :-)
Emmy
Posted by Dr. Bob on January 18, 2004, at 14:32:29
In reply to update on sister is cutting, posted by Lyrical13 on January 17, 2004, at 8:45:26
> I tried to go back to find the original post from back in Nov (or was it dec?) and I still can't. I haven't quite got teh hang of searching for archived posts.
Here's a link:
http://www.dr-bob.org/babble/psycho/20031221/msgs/292089.html
For tips on searching, you can always post to PB Administration... Best wishes,
Bob
Posted by dragonfly25 on January 20, 2004, at 23:10:29
In reply to need an opinion, posted by Lyrical13 on January 18, 2004, at 3:17:46
when the time is right to tell her, i think your brother should, not you. it would be more effective.
dragonfly
Posted by Lyrical13 on January 21, 2004, at 20:57:47
In reply to Re: need an opinion » Lyrical13, posted by dragonfly25 on January 20, 2004, at 23:10:29
That's a good point, but I don't know if that ever would happen. We have a family that never talks about anything. Ever. More likely what she would get from my brother would be a sarcastic remark, snide comment or she might overhear him saying something to someone else and the tone would not be supportive. It would be blaming, accusatory and along the lines of "you're screwed up. I don't want you around me or my daughter ever again." I dont' know how effective that would be. I was hoping to encourage her to look at how her behavior is affecting her relationships with others and how it could affect her ability to achieve future goals. I was hoping that might motivate her to go back to counseling to work on getting better and getting her meds right. I also wanted to spare her from hearing snide comments made in the heat of the moment when my brother or his wife are angry. In that case, she is more likely to just get angry and hateful towards them and conclude that they don't know what they're talking about and as a result, not examine her own actions but chalk it up to something completely different.
I was upset when I heard my brother and his wife laying all the blame on my sis for their daughter's recent acting out behavior. I acknowledge that my neice is influenced by how both of my little sisters are allowed to talk to their mom and dad and treat other people. But she is also 4 years old and going to preschool where she sees and hears how other kids act. And they have just spent the past year fully immersed in building their house. Their life has been rather chaotic, going back and forth between the new house and the tiny apt. they were staying in which is located in my dad's basement and in and out of home improvement stores. NOt a very consistent structured life for a 3 year old. So while I acknowledge that my sis certainly is an influence, I have a problem with my bro and SIL laying the entire blame on her. If someone blows up at sis, she will take anything they say deeply to heart and be very hurt. She will also probably be angry and think they're jerks and don't know what they're talking about and blame the neice's behavior on everything BUT her. I am basing this on past observations of my sis's behavior, not just mind-reading. I"ve also heard my sis talking about my neice's bratty behavior and I don't think she realizes that she acts just like her. The problem is, neice is 4 and sis is 14! (15 next week)
I don't think anyone else is going to confront sis about her behavior. I don't think anyone else is going to be pro-active or firm on getting her help. She is running the entire house. I think she is upset by her own behavior and the things she does both to herself and to others. I don't remember if I said this already, but on my fridge I have magnetic poetry. We were making up phrases and stuff one day and she wrote "I am the monster". I think that says a lot right there. I see her wavering back and forth between wanting to get help and acting like everything's fine and she doesn't need help. She called me in tears on New Year's Day. We talked a long time. At one point my dad came to her room to check on her and I heard the whole exchange. I heard him trying to talk to her (which is incredible for my dad. He's not a talker. He comes from a family of ostriches). She was so hateful and hostile towards him. I don't know if she realizes that the things she says and does make her life worse than it already is.
Anyway, if my brother were someone who would sit down and have an open, calm conversation with her, that would be very effective. But I don't see it happening. I know I can't fix her, but I am worried that she will self-destruct if no one acts to get her the help she needs.
Posted by dragonfly25 on January 21, 2004, at 23:37:29
In reply to brother telling her, posted by Lyrical13 on January 21, 2004, at 20:57:47
i hear ya, maybe that wasn't the best suggestion.
i didn't realize he wasn't that "caring" towards her.
this is a really tough situation (as you probably know), in my opinion, i think your parents are the root of it. (just a thought???) if things are going to change for her, it NEEDS to start with them, or she needs to get out of the house, (is that an option? boarding school. i understand your brothers feelings about his daughter, see, they are probably coming more from the wife...yes? it is understandable to want to protect your child, and i would. but your sister is still a kid as well. could you talk to your dad about things around the house? from the sounds of it your sisters are running wild, and they have NO responsibility for anything???
unfortunately no matter what you do, i don't think it will make a difference until your parents change things. i hope i am not coming accross...um... insensitive. sometimes i think i have a hard time expressing myself correctly when writing.
but back to the original issue, i think the timing is FINE for you to talk to your sister about your niece. she needs to know who she is affecting. maybe you could talk to your shrink about it. but having been a terror of a teenager myself i think that a dose of reality can do alot of good sometimes.
oh ya- i remember reading about your sis freaking out whiile reading "certain" sites. i worry those sites might be dangerous sometimes, putting ideas in kids heads. (just a thought)
i really feel for you...
good luck with this
drgonfly
Posted by Lyrical13 on January 23, 2004, at 5:41:16
In reply to Re: brother telling her » Lyrical13, posted by dragonfly25 on January 21, 2004, at 23:37:29
I definitely agree about parents being the root of it. There is definitely something biochemical but there is little structure in that house. They really need some family therapy. I have been looking into finding her a therapist that has experience with cutting. Her meds aren't right yet. I had a long talk with my step-mom last night. I showed her some of the articles I dug up on the web about BPD, BP, finding a therapist, interviewing a therapist to see if they're right for you. I also talked to her very strongly about figuring out a support person for my sister at school...someone she can go to when she's having a rough time...a safe haven. She says that the counselor sis is assigned to (by alphabet) is a real dick. I told her she could demand a different one. She needs to let the school know that her daughter is going through major problems and demand a different counselor that sis can be comfortable going to when she's having a difficult time. Step-mom also brought up that their "hands are tied" by the insurance company in terms of pdocs. I told her that there are plenty of good docs and therapists out there that are on her plan...it will just take some work to find the right one and it probably wouldn't be in our town (it's fairly small). I told her I would help drive my sis to appts. if that would help. I showed her this site and the posts about sis and people's responses. Hopefully they will see the seriousness of this. My sis knows that I am looking into finding a pdoc and therapist with experience in her problems.
The other thing is this...step-mom is hiding the severity of the problem from my dad. He doesn't know about the cutting. He comes down hard on sis quite a bit...he's quick to blame whoever is in his path if soemthing isn't going right. Like the computer locked up one night when sis was writing a report. She was already upset b/c her report was lost and then he comes in and starts yelling at her about locking up the computer. It wasn't her fault but he was pissed about it having problems and she was within striking distance. (figuratively). She has a lot of anger at him. I don't know if it is just because of this kind of thing or if there is something else. She says often that she hates him. I feel bad for even thinking this, but I wonder if he's done something to her?
I mentioned to sis that I hoped she would get help and get things straightened out now while she's young. I told her I had lost a job, spent a month in the hospital and am thousands of dollars in debt b/c of my BP2 that is just being dx'ed after years of tx. I told her I hoped she could avoid that because life would be so much easier for her. Please keep her in your thoughts.
Posted by dragonfly25 on January 23, 2004, at 8:33:13
In reply to Re: brother telling her, posted by Lyrical13 on January 23, 2004, at 5:41:16
oh lyrical,
that sounds awful. that was a great idea having your stepmom read teh posts- that way she sees that these opinions aren't coming only from you. could you therapist give you a name of someone for your sis? have you gone throught the hospital yet?....seeing if they can give you a name of a T? it is so ridiculous how the system works and people have to suffer while searching for a competent therapist.
good luck- i hope you find someone soon
dragonfly
Posted by Lyrical13 on January 23, 2004, at 11:04:53
In reply to Re: brother telling her, posted by dragonfly25 on January 23, 2004, at 8:33:13
Thank you Dragonfly so much for your support. I talked to a nurse that I work with and she said she thought there was an adolescent group and outpatient tx for kids with these problems at a hospital about 30 min. away. When she worked at the hospital here in town, they referred kids there all the time. So I will contact that hospital and see what they have to offer. I also contacted a therapist that I used to work with at Catholic Social Services. If they don't take a particular insurance, they have a sliding scale. When I was in grad school, I paid $10/session and my T told me that if I didn't have that much money, to come to therapy anyway...the United Way money would cover it. I will try that route to advocate for help for my sister.
Also, S-mom just told me that someone my sis knew when she was younger...someone who is a year behind her in school...committed suicide about a week ago. I didn't learn of this till late last night. I'll have to see how my sis is doing with that. Also, have decided not to tell sis about the brother/neice thing right now. I talked with s-mom about it and she thought that might push sis right over the edge right now. I don't want to risk that.
Please keep us in your thoughts.
Posted by Lyrical13 on January 25, 2004, at 6:16:09
In reply to possible help, posted by Lyrical13 on January 23, 2004, at 11:04:53
I found a couselor and pdoc that I think might be right for sis. They are at an outpt. clinic associated with a local psych hospital that has a very good rep. I think they are affiliated with teh U of M Depression Center (I didn't know there was a whole dept. just about depression there. How cool is that?) Anyway, the staff at this clinic is mostly female and they all have experience with cutting. There is a female doc on staff who works with adolescents. And the clinic accepts my parents' insurance. It is about 30 min. away from us. I told stepmom I would drive her there if they needed help with that. I gave her the info on Friday. Told her they were open 9-3 yesterday. The ball is in their court now. I hope she made the call. Keep your fingers crossed or say some prayers or whatever you do that this will be the right place to get sis some help and that parents will follow through with this.
Posted by dragonfly25 on January 25, 2004, at 8:00:02
In reply to Re: possible help, posted by Lyrical13 on January 25, 2004, at 6:16:09
That is Great Lyrical!! I am so happy for you. I am sure that they will call, they have sounded like they wanted to get her help as well. I will be thinking of you :)
Posted by Lyrical13 on February 4, 2004, at 19:38:15
In reply to Re: possible help » Lyrical13, posted by dragonfly25 on January 25, 2004, at 8:00:02
I had an opportunity to talk with my dad about my sis. I went to pick her up for sister night and she wasn't there. We hadn't actually confirmed plans so I didn't know. Well, it worked out really well cause my dad was the only one home. I have been wanting to talk to him about the whole situation and didn't feel it was right to keep it a secret from him.
so my dad and I had a really good talk. He talked about what he had noticed with my sis and how frustrated he was because she seemed really angry at him and he didnt' know why. I told him what I had learned about cutting and bipolar etc. and he was very receptive. He asked for more info and for the info on the clinics that I had found. I also read a poem to him that I wrote about my sis and I. He cried and hugged me and thanked me for telling him. I felt much better. He said he would talk to step-mom about this. I told him I didn't want to get in the middle of his marriage but I really thought he had the right to know what was going on with his daughter.
If you want to read the poem, I'll post it at the creative writing part of psychobabble. If I post it here, Dr. Bob will probably redirect it anyway.
PS My pdoc was saying that cutting isn't a bipolar thing. He says it's characteristic of borderline personality disorder. What do y'all think? what dx did docs give those of you who SI?
I didn't think it was exclusive to one dx over another.
Posted by CareBear04 on February 5, 2004, at 9:48:49
In reply to wonderful (and surprising) news, posted by Lyrical13 on February 4, 2004, at 19:38:15
hey lyrical,
i haven't been following all your posts, but i'm so glad things went well with your dad. i hope your sister gets the help she deserves. i think too many shrinks see cutting as sufficient for a diagnosis of borderline, but i'm not very sure. i don't meet many of the borderline criteria except that i have, on occasion, cut, primarily when i've been extremely and psychotically depressed. the better doctors i've had have diagnosed me as having a mood disorder and not a personality disorder. hope this helps. cb> I had an opportunity to talk with my dad about my sis. I went to pick her up for sister night and she wasn't there. We hadn't actually confirmed plans so I didn't know. Well, it worked out really well cause my dad was the only one home. I have been wanting to talk to him about the whole situation and didn't feel it was right to keep it a secret from him.
>
> so my dad and I had a really good talk. He talked about what he had noticed with my sis and how frustrated he was because she seemed really angry at him and he didnt' know why. I told him what I had learned about cutting and bipolar etc. and he was very receptive. He asked for more info and for the info on the clinics that I had found. I also read a poem to him that I wrote about my sis and I. He cried and hugged me and thanked me for telling him. I felt much better. He said he would talk to step-mom about this. I told him I didn't want to get in the middle of his marriage but I really thought he had the right to know what was going on with his daughter.
>
> If you want to read the poem, I'll post it at the creative writing part of psychobabble. If I post it here, Dr. Bob will probably redirect it anyway.
>
> PS My pdoc was saying that cutting isn't a bipolar thing. He says it's characteristic of borderline personality disorder. What do y'all think? what dx did docs give those of you who SI?
> I didn't think it was exclusive to one dx over another.
Posted by pegasus on February 5, 2004, at 10:37:12
In reply to wonderful (and surprising) news, posted by Lyrical13 on February 4, 2004, at 19:38:15
I think the thing about the diagnosis is that BPD is the only dx that actually mentions self injury as a criterion (and it lumps it in with suicide, which IMHO is not appropriate). So some Ts will dx anyone who cuts as BPD. I think that's lazy diagnosing, personally. It's a good example of the problems with the DSM-IV system for diagnosing mental disorders.
I'm a perfect example of a non-BPD self injurer. My diagnosis is major depressive disorder (although apparently that's up for debate at the moment). But I've been SI-ing for years. I may have some of the criteria for BPD, but not nearly enough for a dx. I've never had anyone suggest that dx for me, and I don't think it fits.
-p
Posted by gardenergirl on February 7, 2004, at 13:34:56
In reply to Re: wonderful (and surprising) news, posted by pegasus on February 5, 2004, at 10:37:12
Posted by Lyrical13 on February 8, 2004, at 7:55:26
In reply to Re: wonderful (and surprising) news, posted by pegasus on February 5, 2004, at 10:37:12
Thanks to those of you who addressed the SI thing. I have noticed that the majority of the folks who have posted at various threads who SI mention a dx of BP or depression. A few mention a co-morbid dx of BPD but for the majority it is the mood disorder that is predominant. I feel that this is a more accurate dx for my sis. She has almost all of the criteria for BP and only the cutting fits with BPD. I am hoping that more and more docs will become less tied to the DSM-IV and the be-all and end-all when it comes to diagnosis and treatment of their patients. My pdoc says that there is a great debate going on in the psych community re: treatment of BP as well as dx of BP vs depression with GAD. It seems like the good pdocs are trying other non-traditional treatments for BP and treatment-resistant depression to the benefit of their patients. (ie. using AS and AP meds to augment ADs or used as a mood stabilizer)
Also, depression and BP are starting to be seen as more of a spectrum of disorders rather than concrete diagnoses...a mood disorder spectrum that ranges from unipolar major depression to classical bipolar (manic depression) with mood swings from the far ends of the spectrum (major depression to full blown mania) BP2 falls somewhere in the middle with varying degrees of severity and varying degrees of moods. That is, I fall closer to the depression end of the spectrum since that is my major problem but I also am now realizing that I have periods of hypomania. Also, some docs think that you can have mixed states... dysphoric mania e.g. where you have symptoms of mania but also of depression at the same time. Of course, on the other side of the coin are the pdocs who think all of the above is a bunch of poppycock. I'm not sure what their rationale is. The spectrum hypothesis makes a lot of sense to me and I have lived the mixed state experience. Any thoughts from others?
This is the end of the thread.
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