Sunday, October 31, 2010

Living with a personality disorder diagnosis

One of the hardest parts of living with my mental health problems is accepting the personality disorder diagnoses that I have been given.  When asked what these diagnoses are, I generally respond somewhat cynically "depends oon the psychiatrist."  This is true.  However, the two most popular diagnoses are Narcissistic Personality Disorder and Histrionic Personality Disorder.  In layman's terms this means that I am a self-centred drama queen.  Not exactly the most popular person at the party...

I've done enough group work to begin to recognize the traits within me that prompted these diagnoses and to begin to get a handle on muting them (at least a bit.)  While not all of the descriptors in either profile fit me, enough do.

The trouble is trying to live with this while not hating myself.  Often enough, I can manage it, but some days are worse than others.   A therapist once asked me why I hated myself so much.  I asked her if she had ever tried reading about narcissistic mothers and taking it personally.  She asked what I had been reading and I admitted that some of it was a couple of decades old and perhaps out of date.  She confidently promised to find me a more supportive description of personality disorders.  When she returned, she had a wonderful book : "I hate you, Don't Leave Me" by Kreisman and Strauss.  The only problem is that it discusses primarily borderline personality disorder...which I don't have.  It turns out that she couldn't find anyone with anything positive to say about narcissists either.

When I talk to mental health professionals myself about myself, they waver and discuss difficulties with diagnoses in the personality areas; they emphasize how these are just traits on the extreme end of a spectrum that everyone is on; they point out that I learned these behaviours trying to live with a chaotic disfunctional family and that it's not my fault.

But when mental health professionals discuss narcissists in general, a different picture comes out.  Narcissistic mothers are blamed for troubles in their childrens' lives (I am terrified to think about what I am doing to my children simply by existing).  Many psychiatrists refuse outright to treat people with personality disorders.  It seems that we are too difficult to deal with.  Now, therapist burn-out is a very real problem and anyone willing to put themselves on the frontlines in mental health is a person too valuable to be allowed to burn-out, but it leaves me in a bit of a position.  Those therapists who do take on people with personality disorders either do so only to monitor meds or in very limited numbers (wisely).

For me, the end result is that I have literally lost count of the number of therapists who have refused to treat me.  I'm not sure which is worse: the ones who do so without even meeting me, or the ones who do so knowing full well who I am.  Either way, the rejection is excrutiating.  I was advised at one point that I should stick to group therapy specifically to avoid burning out anyone who took me one-on-one.  I did for several years.  The problem with group therapy is that groups are encouraged to point out to one another the behavioural traits that grate.  This is essential since it is the only way that someone can know what to change.  But in the long-term when it is the only feed-back that I get, it gets very hard for me not to conclude that everyone would be better off if I weren't around.  It's not as if I'm not trying to change.

A few years ago, I took part in a day-treatment program.  This is a very intensive program in which you get group therapy all day long most days of the week for a period of months.  Throughout the program, I repeatedly got told that the "melodramatic pauses" that I put in my sentences were very annoying.  I had heard this before and wasn't surprised.  The problem that I had was that I couldn't understand what they were referring to.  Close to the end of the program, I finally got it.  The times in which I paused to gather the courage to say something intensely personal (where I was terrified of rejection and literally had to force myself to speak) were being interpreted as simple melodrama.  And this was by a group of people who, at the end of four months on intense group therapy, ought to know me as well as any person can know any other.  Well, I'm sorry, those pauses are here to stay.  Getting past terror is hard and sometimes takes a bit of time.  How to make them look less like melodrama, I have no idea.

So how do you live with these diagnoses without hating yourself?  Frankly, I sometimes have no idea.  Other days, I am able to remind myself that a diagnosis is not the whole of who I am.  Yes, I do automatically act to try to be the centre of attention.  Yes, I overdramatize myself at times.  But I am also a kind, empathic, honourable person (I'm not supposed to be empathic while being narcissistic but that's one of those traits that don't fit).  Some of what I do in the world has helped the people around me.  And I believe (or at least desperately hope) that my children are better off given that I have managed to choose not to suicide any time within the last eight years.  Anybody have any ideas to add to mine?

Tuesday, October 19, 2010

In Sickness and in Health

I was reminded by a friend today that marriage vows are for better and for worse.   I didn't hesitate when I gave my vows to my husband.   But, somehow, I had thought that the challenge would be (if it came) HIS sickness.   I had thought about it and knew that I would stand by him no matter what befell him.   And, to be honest, over 16 years I haven't had too much difficulty keeping to that.

What I hadn't considered was how hard it would be to accept him standing by me in MY illness.   He's working a full-time job and moonlighting while I sit on the couch trying to put my life into order.   I feel so guilty.

I hadn't counted on being the helpless one-the dependent one.   There are times when I don't know why he stays.   I'm a burden. I don't contribute much to the household. Wouldn't his life be easier without me weighing him down?   The irony is that I know that I wouldn't contemplate leaving if our situations were reversed.   But there's still a part of me that really doesn't understand why  he stays.

Jill (my psychiatrist) once suggested to me that letting someone else help me is a form of generosity.   On one hand, when I think of how frustrating it is to try to help my mother, I understand exactly what she's saying.   But when it comes to accepting help myself... that's not so easy.

Dear Lord, please give me the serenity to accept the things I cannot change.

Friday, October 1, 2010

Meditation and Mental Health

My doctor suggested that I do a group on meditation. (The MBSR program).   I refused.   Later, my psychiatrist suggested exactly the same group. I said I'd think about it.   It took me months but I finally agreed to take the course.

I approached it with some trepidation.   I knew the psychiatrist running it and I was convinced that she didn't like me. In fact, I was convinced that she had years earlier lied to me in order to get me out of her client-list.   Moreover, I had been retreating into my shell-becoming virtually housebound for a few years at that point.  The whole idea of a group - any group - was pretty scary.  I didn't particularly want to meet another collection of strangers.   I didn't want to come to care about them and then hurt with them as they discussed the pain in their lives.   I had enough pain in my own life.

But, having said that I would try, I did give it wholehearted effort.   Much to my shock, it worked!   By that I do not mean that I am no longer depressed and my life is pain-free.   But having taken the course, I found myself more able to cope with challenges that came my way.

Next, of course, I wanted to know WHY it worked.   The program has been rigorously tested - there's no question that it has worked for many more people than just me.  I already knew about brain plasticity.   Basically, that means that (contrary to previous beliefs) the brain can change its structure and function even late in life.   But what did that have to do with sitting and watching myself breathe?

 I think that I have figured it out.   In part, the mindfulness training encourages you to come off auto-pilot and become aware of what you are doing in this very instant.  That is immeasurably useful in catching the sort of self-talk that can pull me down into depression.   But there's more to it.   The meditation It was taught generally required me to focus my attention on something-often my breathing. Inevitably, I would get distracted. The advice was simply to notice that I had become distracted and to bring my attention back to the breathing.   Originally, I had thought that the goal was to be able to keep my attention focussed on my breathing. But I found that the real goal was to practice noticing when you've gotten distracted and to practice bringing your attention back to where you want it.   So that means that I can catch myself when I start drifting into a train of thought that leads to depression AND I have trained my brain to allow me to repeatedly pull myself out of that train of thought every time I drift back to it.   Through practice, I have created pathways in my brain that let me easily redirect my attention at will.   Suddenly it makes so much sense.

Sunday, September 26, 2010

Can't Sleep

It's 5:00 am and I can't sleep.   I tried going to bed-took my pill and everything. But I just kept thinking about yesterday.  So I guess I should write it up and get it out of my system.

Yesterday morning, D and I were having sex before the alarm. We ended up doing something just a bit out of our ordinary. It involved pressure on my cervix.   And then, even though I was enjoying, I also started getting very agitated.   Next thing I knew, I was curled up in a defensive ball crying.

I don't actually have any memories of sexual abuse. But I've got an awful lot of reasons to consider it likely to have happened.   This is the closest I've gotten to a memory. My mind might not remember but my body sure does.   Afterward, I found myself asking D over and over again to reassure me that I hadn't done anything wrong.

I hadn't thought about it but it makes sense.   I know that my father currently believes that young girls intentionally tease him and try to seduce him.  (He's explicitly said so.)   It hadn't occurred to me that be might have believed that when I was a child too. But if I assume that, everything fits together.  It explains why I still wonder whether I've done anything wrong when a man expresses interest in me. It explains why I never thought about sex outside of the context of punishment until I met D.  I think that my dad used to molest me. And I think that he used to tell me that it was my fault for tempting him.   It I'd been a "good" girl, he would have left me alone.

 No wonder I'm so messed up!

Wednesday, September 22, 2010

How do I decide?

Given: I choose to continue existing because I have a responsibility to my sons.   However, being a mother to two teens cannot fill all of my time.   Thanks to the university, I now have a lot of time on my hands. How do I choose to fill it?

Sensibleness and practicality says I search for another job /carreer.   But even though I have an idea for one that suits my abilities, training, and disabilities that's not how I'm choosing to fill my time.   Why not?   Should I be listening to this other drive or surpressing it and doing the sensible thing?   On what basis do I choose?

I've never had to choose before. Its always been obvious what I should aim for. This is distinctly uncomfortable.

Wednesday, September 15, 2010

Access Denied

I've been thinking about starting a blog about my journey through depression for a while.   When I was first diagnosed 8 years ago, blogs were just starting and I'd never heard of them. So I went to the library looking for information. I found lots of information about depression but almost none documenting how it goes from the inside.  I suspect that by now other people have built blogs that file this gap but one more won't hurt.

Today's news: Access Denied

The university failed to renew my contract as an instructor at the beginning of the term.   It's having money troubles and I'm far from the only sessional out of a job this term. I tell myself this regularly and sometimes it even helps make it feel less like rejection. 

Really, it's just as well. I was struggling to keep up and, even though it was very part time, I suspect that it was a bit too much for me.  I knew that my use of campus resources would be limited without the status of a staff member but I didn't expect this.

 I can't get library access!   More accurately. I can get at the books as long as I walk in personally to pick them up.   But... there is apparently no way that I can maintain internet resources.   I can't do database searches or read journal articles from home.

If I were well enough to walk in and do my research in person, I'd probably still have my job and then I'd be able to do it from home. Talk about a Catch-22!   God I hate being disabled!

I hate even more being invisibly disabled.   I look fine.  Having a tiny amount of stamina and getting the shakes doesn't show.  When I'm in public, I have to have people behind me - I can't keep my back to a wall all the time.  That keeps me permanently on alert (PTSD among my other problems) and tires me out even further.   I do as much as I can by internet: it minimizes the amount of energy I have to devote to each individual task and so maximizes the number of things I can do. 

I'm feeling bitter. I had a good life. I had a good marriage, two great kids and my career (in grad school) was progressing nicely.   Then my life fell to pieces.   I managed to hold things together for about a year or so through sheer will but finally the nervous breakdown came.   Now, eight years later, my life is a mess. My career is now officially on the junk heap.   I still have the great husband and kids but there's nothing I can give them anymore. My life is a burden on them.  To be fair, they don't seem to agree.   But it sure seems that way to me.  I can't cook; I can't clean; I can't shop... I have to work hard and ration out my energy just to be able to pay attention to my sons.

 "Pay attention" is a wonderful phase isn't it?   Once I felt like the amount of attention I had was practically boundless.   But now it's a valued commodity. I hoard it. I only have so much and then I start to fuzz out. 

This is getting too bitter and self-pitying. I'm going to logoff for now. Maybe tomorrow will be better.