I posted a while ago, or is it blogged a while ago? … on how hard it was sometimes to provide a diagnosis. Also why some are misdiagnosed, quite often. There has to be a reason for this, it is not like the profession is inept.
So it is hard.
oh that is an excuse for messing up?
ok, so why. Look yourself over please, point out the diagnostic port that we can plug our sensor into.
So diagnosis is based on what you answer, provide, divulge. A lot too, is what you don’t say. Sometimes with deliberateness, you don’t really want to talk about it. It is very personal, you are ashamed, embarrassed.
Or you don’t feel it is pertinent.
To be fair too, things change, some disorders coexist, or develop later. One may go untreated.
Mental, Mental, Mental.
Such a simple word, but it makes people cringe.
perhaps it should be cerebral?
That makes you think of thoughtfulness. intelligence. Whereas Mental has the opposite effect.
But they mean the same thing!
Mental disorders. Perhaps if it makes you feel better you can say cerebral disorders?
Those words are simple but so hard to achieve.
ok, back to work.
Lets talk about Mental disorders, just a few, the letters in the tittle, ADHD, BPD, BD
ADHD is Attention Deficit Hyperactivity Disorder
BPD is Borderline Personality Disorder
BD is Bipolar Disorder
So why am I grouping them and what is this about.
First lets get a brief description of the disorders. So you have a basic understanding.
ADHD ~ Attention Deficit Hyperactivity Disorder ~ Someone who finds distraction easy, it is hard to concentrate on a task. Like a child with unbridled energy behaves at a dinner party, someone with ADHD may act in a similar fashion that is not quite right for the given situation. Impulsive behaviour, restlessness. This comes through with speech and thoughts as well, the mind races ahead or onto something else. It is also known as ADD. It can be genetic. Other causes could be PTSD or some studies now link food additives such as colour to this disorder. To diagnose this correctly behaviour is studied. As this is often a disorder that effects children it makes its appearance early. Symptoms often fade as one ages. Hyperactivity lessons. So with adults the term is often ADD as there is not much sign of hyperactivity.
Depression and ADD are companions much of the time. Combine deep depression with the hyperactivity of ADD. what does it look like? Yes rapid cycling Bipolar.
Now here is where it gets confusing. Other mood disorders also will often accompany ADD. Not always though.
Treatment should be both medication and therapy, therapy for the parents too in the case of ADHD to learn how to cope. Meds are usually stimulants, antidepressants are often added for adults or children if depression is an issue.
BPD ~ Borderline Personality Disorder. Someone who is very impulsive, will take extreme risks, emotionally unstable with difficulties relating to others. Self image suffers, anger with mood swings. Self harm is common, suicadal tendancies are strong. This disorder effects females more than males. Abandonment fears are strong. Depression disorders often accompany BPD. Hallucinations and delusions will sometimes occur.
To explain further, anger can flair for simple occurrences with others, being a few minutes late for example. They may tend to cling to people as they fear abandonment. In a short time, they will share more together, demand more time together, want to know more, but may shift away just as quickly fearing potential abandonment. Self image changes quickly, dramatically, usually with a negative self image, one of a bad person. They of course are not bad people. This is a personality disorder rather than a mood disorder. Hence the name. Reality becomes confused with the way they see their surroundings as their emotions are so strong. Therapy becomes more difficult, Patients cling and form bonds quickly and then just as quickly can begin to hate their therapist. Not every therapist is suited for treating this, it can be demanding. There is a lot of suicidal innuendos. Self harm/mutilation. This can be hard on therapists so many may balk at treating BPD. It can be difficult, but also rewarding.
Therapy is most successful, Meds can and are used to aid therapy. DBT being the treatment of choice. This is Dialectical Behavior Therapy is a type of cognitive behavioral therapy, known as CBT. There I am sure this clears it all up for you. :-). Other therapies are also showing great results.
This form of behavior therapy DBT deals with more of the social aspects. Relationships, interactions with others. This therapy teaches the individual to deal with their strong emotional swings. As self esteem is usually very low, it helps them identify and understand their strengths. To build on this, raising their self worth. This is similar but not the same as Group schema therapy which is also used to treat BPD. GST is showing great success in treating the full range of issues associated with BPD.
DBT will focus on Relationship building as well. With homework assignments. Discovering and working out ways to interact with others. I will do more on DBT, CBT and perhaps GST, in future posts.
BPD is hard to diagnose. Other disorders are often present including anxiety and eating disorders. There is a mood instability not unlike bipolar. More so with rapid cycling bipolar as the mood swings in BPD are very quick. Impulsive behavior is also common with both disorders, as is self harm and suicidal tendencies.
BD ~ Bipolar Disorder. This was at one time refereed to as manic-depressive disorder. This is a mood disorder, moods will change go from mania to depressed.
So what is mania? this is an elevated mood. It can also be an irritable mood. Generally it is an euphoric mood, you feel indestructible You can conquer the world. Mania is a very impulsive period. Promiscuous behavior is not uncommon. Speech may be very fast as will thoughts, concentrating on one task is difficult. Money spending becomes a problem with impulsive purchases.
Depression is not what you feel when you are sad, this is deep depression, end of the world crawl into a hole depression, depression like you can not imagine.
Mood shifts will vary, this is known as a cycle, some may cycle not that often, perhaps only a few times a year, some much more. There can be mixed episodes as well, where both depression and mania coexist. Mixed episodes. they can be dangerous as impulsive behavior is combined with depression. Mixed episodes are terrible.
There is also hypomania. This is not as sever or as extreme as mania. not as dangerous. Usually a cheerful mood, but can also be irritable. Restlessness not needing much sleep. So similar to mania? yes but not as extreme. It may be the precursor to mania.
So with Bipolar there are different types. Bipolar l, Bipolar ll, nos and Cyclothymia.
Bipolar one has moods that move between extreme depression and mania.
Bipolar two has moods that move between depression and hypomania. Not mania.
Bipolar nos, is not otherwise specified. This means mood changes have not yet been identified.
Cyclothymia has moods of depression or hypomania but are not as extensive.
This is not to say that conditions and symptoms will vary with each individual, depression may be just as deep with bipolar 2.
Treatment for Bipolar involves regulating moods, to reduce the frequency and severity of the changes and treating depression using medication. Therapy can help identify triggers that may bring on episodes of mania or depression, knowing these can help you make treatment adjustments. Life style changes can also be very powerful in helping. Exercise, diet being major.
There are a host of medications, and combinations, meds have side effects though and some can be terrible, it is crucial to have feedback with your doctor and understand what side effects to watch for. Some could be long term, do not dismiss them as trivial. When things are not going well, again feedback with your doctor is important, med changes can do wonders. A dosage change or a different medication. Never give up!
CBT can be very helpful with depression. Group therapy is in my opinion also helpful.
This was just a light touch on each of the above disorders. To help provide you with an understanding, for how can the stigma be removed without understanding?
Having put you through all of this, you can see how diagnosing can be difficult, there are overlapping symptoms. ADD can appear as bipolar as can BPD. There are times when symptoms are not that different. ADD will appear in children at younger ages, will often have symptoms of bipolar which normally appears in early twenties or late teens. This is not to say bipolar does not happen or appear at a younger age, it is just not as often, so many times a misdiagnosis may occur, attributing the symptoms to ADD rather than bipolar.
Unfortunately many that suffer with any of the above disorders may also suffer with more than one of them. Anxiety disorders and panic disorders are also normal partners.
Diagnosis can be difficult, the question is asked are you depressed, how depressed.. well how can that be answered? What is there to compare it to if you are talking to a child of nine?
When you are depressed for a period, very deeply and then come out if it, to what would be your normal, but you haven’t been normal for a while, normal may feel like a hypomania period, when hyperactivity from ADD is added, the symptoms become indistinguishable.
Ride the Wave
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Remove the Stigma