How I Cured My Personality Disorder Without Even Trying

…Quit going to a psychiatrist! And voila: Borderline-be-gone!

(Yuk yuk)

Seriously, since he took a vacation and I went off that fucking Cymbalta, I’ve been feeling really good. Not manic too good, but just okay. I’ve evened out. I still wake up sometimes at 3 AM, but I don’t wake up sobbing and wanting to just die. Mornings are hard, but some coffee gets me going and it gets better as the day goes on. For god’s sake, I even am running again – and I guess I also have the shrink to thank for the fitness I’ve lost over the last 9 months. I’m smarter at work, back on my game, not looking like an idiot. Getting along better with people – patients and even the wang doctors.

Problems are starting to not seem insurmountable, even if they are big, even overwhelming at times.

And two things that always happen when I start to rise out of a depression happened: one, I wanted to read e.e. cummings again – the thankful, God-love poems, and two, I had my reflexive horror at how low I had been.

The second thing always happens when I finally come out of a depression. At some point, I’m so thankfully glad to be alive that the realization that I actually considered suicide becomes as horrific and unthinkable as if I had considered murder. When the episode finally has passed, leaving me wrung out and wan, but alive, I can never quite recapture the state of mind in which suicide would have been an option.

This weekend on cable, Of Mice and Men, the one with John Malkovitch and Gary Sinise was on. The moment that caught me was when the woman is dead, with her neck snapped, and she’s just limp, lifeless. I thought of all the horrors I have seen in my medical career. It is hard to describe the feeling that came over me – mostly a massive distaste for the ugliness of death, for the strange limpness and stiffness of a body. When I think that this is what I had, not long ago, wanted to do to myself, a wave of sickness washes over me.

Now I’m faced with the task of moving on. The other day, I was writing the millionth patient note, and writing the date for the millionth time, and I realized that it is almost September. What began as a month’s experiment, and became three, and then six, is now almost nine months of crazy. Nine months of life lost.

This is another thing I think I hate about the shrink: no appreciation for this. He sees me alright now, and doesn’t understand that just because I am okay now doesn’t mean that there was no fallout, no structural damage. Just like back in one of those other freak drug experiments in the Spring, I had a two or three week block of being okay, and he said there was no reason I should delay starting a new job, no reason to take another month to catch my breath. There are few people on earth less willing to take a “sick role” than I am, but can’t anyone understand that I possibly have a right to feel bad about those nine months? Nine months is a long time. Enough time to make a new life from conception to birth. 1% of an average lifespan.

* * *

Here’s another question for the readers: a couple of weeks ago, we had an inpatient, young guy, with a chronic disease which he let get totally out of control, most likely because of depression or some other psych issues. He’ll probably end up pretty fucked up physically out of neglect.

Once when I examined him, I saw a small X-shaped scar on his wrist. Not deep, really, just one small cut X. If it had been a suicide attempt, it was a lame one. If nonsuicidal self-harm, well, also looked like a one-time thing.

I wanted to ask him about it. But it wasn’t really relevant to the stuff I was treating him for, and if I asked and all that, I’d have to document in the physical exam and, knowing how docs view anyone with anything less than perfect mental health, I didn’t want him to have to carry that on his medical record forever, to be judged by ever single person who would ever treat him. And I think I really wanted to ask him just because I was curious.

I, if not made obvious by the previous paragraph, have never self-harmed or really even seen much of it from a medical perspective. But from a lot of the blogs I read and those who link here, I see that it is incredibly common.  So I guess I’m just asking: if it were you, do you want your doctor (not necessarily psychiatrist, who has to) to ask? Or would you rather they politely ignore it?

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15 Comments

  1. Hi Sara,
    I am glad to hear you are feeling better. My sense is that you are right this is an important time for you to slow down a bit and allow the wellness you are feeling to gain ground. I am not sure what your mood/s are like, but I often think I am well, beginn planning and doing all kinds of activities, only to find myself crashin a few days later. Most people don’t cycle that fast, but sometimes a reprieve can be enough time for you to really practice immense self care, and this may help the depressive episode stay away.

    I really hope you keep looking for a pdoc who is less judgemental. I cannot express how important it has been for my mental health to have a pdoc who refuses to label me, and unequivocally cares for all of me, the sad, mad, glad, and bad (my labels). That relationship is really helping me heal, when nothing else seems to work.

    I am hoping your depressive episode has vanished, like they do sometimes, but if it sneaks back you can get through that too. I will be here to listen.
    …aqua

  2. Thanks, Aqua. And thanks for your blog. It has helped me see another side of things so clearly.

  3. I selfharmed quite suddenly for a number of years in my forties and then just as suddenly stopped again. I don’t feel uncomfortable being asked by any one what has happened to my arms (they do look pretty gruesome). Most likely I will tell the truth, especially when asked by a professional person like a doctor or a nurse. I assume they have the wherewithal to deal with it.

    I am glad you are out of your depression. Your psychiatrist doesn’t sound like a very bright light and maybe making you worse instead of better. I would seriously look for some other kind of guidance and avoid having all sorts of labels put on me, even if that is a bit cumbersome in making a diagnosis when necessary for the prescription.

    Can’t you just be a person who sometimes gets depressed and doesn’t need all this analysis? Just plain old medication works the best, is my experience. Antidepressants and mood stabilizers.

    My Social Psychiatric Nurse has done me more good than my psychiatrist has ever done me for practical guidance. My psychiatrist is good for writing the prescriptions and that is it.

    Good luck with you uplifting mood, may it last a long while.

  4. Oh, Sara, i am sooo happy you are feeling better…maybe i should dump my shrinks as well…in answer to your question, if it were asked kindly (as i am sure you would) i would be happy (?) to explain my scars…but i have had so called “medical professionals” say the most hurtful, demeaning things…it makes me not want to give out any onfo at all, you know what i mean? if all the doctors were like you, i would be glad to share the “dirt”. i hope you are well….and happy.

  5. “And two things that always happen when I start to rise out of a depression happened: one, I wanted to read e.e. cummings again – the thankful, God-love poems, and two, I had my reflexive horror at how low I had been.

    The second thing always happens when I finally come out of a depression. At some point, I’m so thankfully glad to be alive that the realization that I actually considered suicide becomes as horrific and unthinkable as if I had considered murder. When the episode finally has passed, leaving me wrung out and wan, but alive, I can never quite recapture the state of mind in which suicide would have been an option.”

    Yes, (Literally – even to the e.e. cummings!) and YES. Once again, you’ve described my thoughts so clearly.

    “He sees me alright now, and doesn’t understand that just because I am okay now doesn’t mean that there was no fallout, no structural damage. Just like back in one of those other freak drug experiments in the Spring, I had a two or three week block of being okay, and he said there was no reason I should delay starting a new job, no reason to take another month to catch my breath. There are few people on earth less willing to take a “sick role” than I am, but can’t anyone understand that I possibly have a right to feel bad about those nine months? Nine months is a long time.”

    And YES again. 15 months here of constant and acute suicidal depression with a few bits of hypomania tossed in for fun. I am still learning to take the fallout, so to speak, in stride. Of course, there has been fallout in the past, but I have never had a major depressive episode with a duration as long as this one. I don’t want a “sick role” – that’s the last thing I want – but I’m beginning to realize that whether I want it or not, I do need some breathing space to put things back together a little slower then I’d like…and that it’s okay to grieve, a little, for the 15 months of my life that I lost to this latest stay in hell.

    As far as self-injury, it’s something that I engaged in for years, but haven’t done so since college. Most of my scars are not in easily visible places; it’s unlikely a doctor would notice on a routine, or even not so routine, medical problem – and possibly might not even recognize for what it is, given the location. I’m not sure if I’d want a doctor to ask about it; I think it would depend on where I was in life, psychologically/emotionally/mentally/whatever. If the question was asked tactfully, gently, and with kindness, while I was “in crisis” (whatever that means) and not in any kind of treatment, it might just have the effect that I would be able to accept help. On the other hand, if I was healthier, and/or in treatment, I don’t know that I’d want a hospital doctor intruding, so to speak. I also didn’t realize that everything discussed would be documented (silly, I guess, not to have realized that – thankfully I haven’t had too much experience with physical illness). I do know, though, that when I had appendicitis a couple of years ago, my last thought as I lying there was word for word “thank God I no longer have any fresh scars to brand me as mentally ill.”

    And on that note, I will end my incredibly long comment. :-/

  6. Ok, for anyone following along – and I may put this at the top of a new post so everyone sees…the patient got sent back to the ER and I saw him and asked him. He said it was from a cat. Bullshit. But crazy that a couple days after I wrote this, I got a “do-over.”

  7. Sar,

    Is there anything saying that you HAVE to see a shrink for meds? Do family practise docs in the HMO not prescribe psych meds – if that were the case, could you not combine that with therapy from a social worker or psychologist, or someone a little more… well, understanding?

    Maybe that’s the answer to getting both the psychopharmaceutical care, along with supportive therapy that will help, rather than harm you – ie: do more good than harm in the end.

  8. Yes. Once you are into mood stabilizers, 1. Family docs don’t feel comfortable – most of them anymore are immigrants with no post grad medical training, and 2. they can only be prescribed by a psychiatrist or neurologist in the country either legally or depending on the particular drug, if I want insurance to pay for it. (Though actually, food for thought, as insurance is NOT paying for it because I’m paying cash for everything to keep it oout of my medical record.)

    I probably really just need a better regular doc. But I don’t think they are going to prescribe Lamictal or whatever the hell my particular crazy needs.

    The option would be going to this guy for meds and just no therapy…which I hate and don’t really want anyway. I’ve been sort of hinting to him for referrals, and he brought up the name of a psychopharmacologist he knows that might be able to advise on the med mess…

  9. And Sarah, thanks for your insightful remarks, as always. I keep waiting for you to start a blog!

  10. Yay for quitting the stupid among the shrinks!!!!!!!

  11. Oh grasshopper, not yet. He should be back from vacation this month. I have not yet had the guts to have the firing scene. “I’d rather be miserable for the rest of my life than go through a scene like that…”

    And I keep wondering, why do I keep ending up with male doctors (him and the GP)? Since I was about 12, I insisted on women for doctors…so how they hell did I end up with these two clowns?

  12. I think you should have asked him not in particular to the scar, whether he was seeing a mental health professional, and if he said no, leave it at that. If he said yes, than you could have opened a discusion about his scar. And you could attribute the non-intrusive question to updating medical records. And he might have seen you noticing his scar, and you not mentioning anything could’ve just added to “nobody cares” mindframe if indeed he was having mental health issues. At least it wouldve given him the option to open up if he felt the need.

  13. Thanks for clarifying. I have a feeling I’ll have about 676 similar questions between now and like, December.

  14. I am so glad that things are getting sorted and that you sre feeling “better”. Hannah X

  15. Hi.. I’m glad you’re feeling better. I have bipolar and I also think I have borderline personality disorder, not a good combo…we’ll see how it goes I have an appt with my tdoc tomorrow…hope you’ll check out my blog…http://justcallmecrazy.wordpress.com
    I think you could probably relate to some of posts…I know I relate to yours.

    Good luck! I like how you express yourself as well. 🙂


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