Psychiatric Appointment. [Part 1]

I saw my psych for the first time, alone. Considering I have been with him like 12 months now, you'd think it would have happened before now but for various reasons; being ill, being 'unsafe' and not wanting to be alone with a man among other issues. But it finally happened, and was still fairly a waste of time, I spent a lot of time arguing with the man over my diagnosis and I think even though it would have fustrated me if he'd disagreed and had reasons against my own for everything I said, the fact that he seemed to agree with me and kept telling me 'that was a good point but' made it even more fustrating because I still cannot really see where he's coming from as his standpoint on the subject anymore. Also; 'but' being the word I'm sure many people hate to hear made me feel slightly patronised. I know at the time of diagnosis I fit the criteria. Of course, hence getting the diagnosis. I truely believe they misinterpreted a lot of what I was saying and were ignoring my reasons for doing things and just seeing the actions or 'behaviour' as they like to call it but at the time being so wrapped up in my pain, still living with my parents so I didn't really have to function, now don't get me wrong, I should have been, but by the end I was only participating in my CAMH's sessions and appointments. I'd been struggling with college in a big way, had plenty of my own personal disasters and was slowly but surely falling apart.

DSM IV criteria. Then and Now.

A pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
   I did used to cry and hold onto people's legs/body parts in attempts that they did not leave me, but by the time of my diagnosis I hadn't done that for a long time, over a year I think and a lot of wanting people to stay was because I never felt I could keep myself safe if I was alone and struggled to cope with the flashbacks by myself. [Abuse still occurring] I didn't cope well with cancellations and would often get extremely distressed over people being late, sometimes self-harming - although the person who was late never knew -
   I now have a better sense of 'abandonment' I suppose, I am not bothered by cancellations and lateness only bothers me because I am a perfectionist rather then setting me into the whole 'she hates me' bit. I truely relish my 'aloneness' and to be honest am now more bothered if people try and 'intrude' on this rather then the other way around.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
   I had an extremely unstable relationship with my family although I don't ever think there was idealization and devaluation regarding any of my relationships. I only ever fell out with my best friend once during our 4 year friendship and although that was pretty bad and we didn't talk for a year, we'd fallen out because she'd accused me of lying about the abuse because I wouldn't/couldn't talk to the police. Despite her seeing bruising and things over the years. This wasn't just a silly childish argument, this was someone I'd trusted, the first person I'd ever admitted to what was happening and it all suddenly got pulled out from beneath me.
   Now I am back in contact with that friend and have been for over a year, once we got back in contact she clarified that it wasn't that she didn't believe me but rather that she'd hoped having it questioned would give me what I needed to be able to complete statements and things with the police. I wont pretend to understand her reasoning but I wont hold it against her, ever. I have brilliant relationships with my family now, even for the most part my mum aswell. I have close contact with my 3 'close' friends and it's all fine and good for most of the time.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.I don't think I really knew who I was or where I was going, but then again how many 17/18 year olds do?! I don't think I particularly changed much in terms of trying different 'me's' on because I always had a rough idea of the type of work I wanted to do and just tried to stick in that kind of area. I had thoughts of wanting to be a therapist ever since during EMDR therapy my therapist let slip that she'd been through something similar, she didn't go into specifics obviously but I suppose I'd always assumed I was too 'screwed up' to help others like that.
   I know what I think I want to do, and it isn't that far away from where I was going originally I suppose. I am still only 19, not far off 20 and even though the area I want to work with [children and adolescents] I have faith in the fact that I can do well in this, and if it changes anything else I may choose to do.
   
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5I have always had eating disorder behaviours probably right across the spectrum by now, I was heavily abusing alcohol on pretty much a daily basis and consequently ended up having sex alot, but does that count as promiscuous sex if your drunk? I don't really recall the sex much to be honest just being told about it. More normally I am a spender. Money seems to be so easily spent and half the time I don't know why I've either spent so much or brought something that I didn't really want/need.
   I still fit into the eating disorder part, but I no longer abuse alcohol and due to that very rarely have sex - absolutely terrified of it due to abuse - I am still reckless/impulsive with my money but I am able to be more reasonable generally and make sure I pay the bills and stuff first.
   
5. Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself.I was extremely suicidal a lot of the time, and quite regularly overdosed and occasionally tied ligatures, attempted to hang, etc. I was self-harming every day, multiple times a day and still interfered with the healing processes.
   I haven't either overdosed or attempted to hang myself since April 2010 and neither have I planned/attempted to jump in front of a train since May 2010. Self-harming is a rareity, I still want/need to sometimes and sometimes it feels like the easiest, quickest option to feel 'x' again.. I didn't do it for 6 months at first, slipped a little and have now been another 2 months without.
   
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).I had mood swings, but it wasn't, even back then, hours and days, I think in terms of observing my mood the biggest problem was me refusing to admit to/let it show, so alot had to be taken on what I was telling them, and typically they don't like to listen.
   I do still have mood instability but it lasts a hell of a lot longer then hours or days [months] plus I don't just have all the negative moods, I get 'high' too, I can be fairly hyper and excitable, purposeful and able to manage anything and everything. Feeling 'on top of the world' and been described as euphoric.
   
7. Chronic feelings of emptinessIs empty the same as numb? I can never decide, but I don't think I did, I just think so many of my feelings confused me and typical teenager really all asked of my mood/feelings were likely to get an 'I dont know' response.
   Again with the numb bit.. I'm not so confused by my moods/emotions but I still can get overwhelmed and sometimes that can trigger the numbness.
   
8. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).I was a VERY angry person, generally I took it completely out on myself [self-harming] I blamed my mum, without realising it, for the bullying and the abuse and everything else, for making me feel like an outsider and for us not having the relationship I wish we could of had. In the hospital I could get a big physical I suppose only when they were trying to restrain me from hurting myself, but also more then anything because they took away my coping mechanism [self-harm] and was forcing me to feel things I didn't want/couldn't cope with feeling. Being and feeling trapped are big triggers for me.
   I am not so angry. I have let go of a lot of it, and any left is directed at where it should be - my abuser. I cope now, without self-harming behaviours and am a hell of a lot better talking through my anger then before.
   
9. Transient, stress-related paranoid ideation, delusions or severe dissociative symptomsI had thought my mum was trying to posion me, kill me, through my meds and food, hence refusing both, voices were talking to me and everything was part of a 'wider' plan that I couldn't know because it wasn't safe for it to be in my consicous. I used to dissociate a lot whilst in hospital I was send for EEG's because they were worried it was a form of epilepsy. I would sit in my cupboard [where I felt safe] unresponsive and completely blank out often for 4 hours and had no recollection of them being with me and talking to me during the time or often even the fact that I had got into the cupboard. Afterwards I was still quite unresponsive and 'dream-like' for a while and then things were okay until it happened again. This was happening more then once a day, and when something takes up a good 6 hours for it to happen once, twice or more becomes ridiculous. I have had a 'apparent psychotic episode' since then and I felt like I was in hell, but largely don't recall it by choice. Apparent because they cannot decide if it was a true episode or a 'borderline transient one' It's hard to judge my dissociative episodes now I live alone because I very often will look at the time and think "where the hell have the last 'x' hours gone" If I was going to use that as a basis for there frequency it's about the same if not worse, but then I know when I'm dissociating to 'lesser' levels and that seems to be quite alot, feeling 'spacey' 'dream-like' and 'unreal' probably fill more of my day then any other thing I feel but I do realise it's all a lot worse when my mood is lower.. perhaps a trigger?!