Coping With An Emotional Crisis Involving Multiple Diagnoses (BPD, OCD, PTSD) - There is HOPE!


Last night, I found myself struggling with the thought: "To post or not to post? That is the question."  

I have been in the midst of an emotional crisis - not a huge one, but a crisis nonetheless.  Questions that went through my mind: "Do I share this experience with my readers? Will it make them lose hope in getting well? What will they think of me and my journey?"

As I've done consistently in the past, I realized that it's a disservice to you, on your healing journey, for me NOT to share the struggles and the challenges. As I say in my bio on the About Me page of this blog:

"I am in the process of healing.  I don't claim to be all well. I have my days where I backslide on a large scale, and I have days where I show a lot of progress.  As time goes on, I seem to be more aware and insightful, as I hope you will see in my writing. But, we have to remember, it is all a journey, and we each have a voice worthy of being heard."

I realized that sharing these times with you may actually serve to give you MORE hope and a realistic expectation around what it looks like, at least for my journey, to create a life worth living and to manage Borderline Personality Disorder. I am in a constant process of healing.  I don't claim to be healed.  What I do claim is that, while I continue to, from time to time, experience emotional crises despite the ongoing intensive work in DBT (Dialectial Behavior Therapy), my REACTION and my ability to respond in ways that are helpful to my ongoing recovery and wellness have changed -- for the better.  This is where the hope is.
All we can do is our best to manage our symptoms and consistently work toward building that life that we want to have.  There will be bumps in the road. This is true for everyone -- even those with no mental health issues.  We have the added challenge of dealing with emotions that sometimes get the better of us - intense emotions that sometimes change rapidly. But, despite all of this, we can enjoy our lives.  

My motto the past few days has been: "Life is good, it's just difficult RIGHT NOW."  

*TRIGGER WARNING - Scroll down to skip if you wish *

This is quite different from the dialectical (all-or-nothing/black-or-white) thinking that I experienced at the onset of my distress, which was "Life is either worth living or it's not." That thought frightened me and set me off into a spiral of obsessive thinking that developed into this recent crisis.

I had very scary, intrusive thoughts around existential questions ("What is the point of life? Why do we go on when there's suffering? Why do people prevent others from committing suicide? Why do they care?)  My DBT therapist helped me make light of this, saying, "That's when you say, I'm not a philosopher, so I don't have to think about these things. I need to focus on what's REALLY going on."

But, needless to say, I became quite frightened and concerned about my state of mind. I knew I had no intention of hurting myself. I knew that the thoughts were distressing and that I didn't want them. Because I'd been experiencing other OCD symptoms that had been dormant for a long time (checking doors and stove, repeating things), I suspected that this familiar vicious cycle of unwanted thoughts and distressing over these thoughts were more than likely OCD.  This brought some comfort.

I reached out to my therapist, my DBT group therapist, and our clinic's medications nurse. They all agreed with my assessment that the onset of these distressing symptoms are connected to the recent issues regarding work. Recalling and sharing, in details, the way I had been violated at work was a traumatizing in and of itself. 

After speaking with the medications nurse, she checked in with my psychiatrist who recommended that I increase anti-anxiety medication at this time, and she suggested a small dose of either Zyprexa or Risperdol to help manage the obsessive thoughts and for mood stabilization. 

I researched both and was perplexed to find that these medications are normally used to treat schizophrenia and bipolar disorders.  Having neither of these, I dug further and found that others have shared that they, too, were on small doses of these meds to manage OCD obsessive thoughts. 

It still frightens me to take any drug classified as an "anti-psychotic." I know that taking it for a reason other than psychosis does not mean that I have psychosis, but I'm still weary.  I did increase the anti-anxiety med last night, which helped me feel calmer, and I admit, it did slow down my thoughts. When I did sense a distressing thought -- I only sensed it, and it had no real power on my mood. That was nice.

I'll see my therapist tomorrow for an individual session and will discuss it further with her. I'm not jumping into anything, though I am not closing my mind to it either, as my priority is to feel and be well.

*END TRIGGER WARNING*

I credit my Wise Mind for coming up with the motto: "Life is good, it's just difficult RIGHT NOW."   I literally felt a sense of relief when this thought came to mind. It led to another soothing thought that has helped before, which is, "This too shall pass."  I'm very glad to say that I have had this experience before. It ALWAYS passes. I always feel better, so therefore, it's easy for me to have hope around this.  If this is your first or second time experiencing something like this, I hope you can gleam some hope from my experience.

What has complicated my situation at this time is that, in addition to having the diagnosis of Borderline Personality Disorder, I also have PTSD, OCD, and anxiety.  With the recent upset I experienced on Friday, my nervous system and brain evidently became overwhelmed, and the OCD symptoms that have been dormant for years (but that have begun to creep up slowly over the past month or so) and the PTSD went haywire in my brain, and it was difficult to accept. It was also difficult to sort through the "what's what" of my situation (What part of this is OCD? BPD? PTSD?)

I've decided that the best thing I can do is have compassion for myself and ride this out. It *will* pass.  In the meantime, I've taken these self-care actions:

  • Checked in with therapist about symptoms
  • Checked in with DBT group therapist about same
  • Checked in with medications nurse and psychiatrist about same
  • Increased anxiety meds as prescribed/recommended by psychiatrist
  • Researched and am considering additional medication for mood stabilization and obsessive thoughts (I have questions though, such as: Is this as-needed or a daily thing? Are these addictive? Do the potential benefits outweigh possible side effects? How quickly do they work? Is this just temporary, during this stressful time? What other non-medication solutions are available to me? .... I'll be asking these questions today to medications nurse and then discussing with therapist tomorrow.)
  • Keeping my appointments (2 DBT groups this week and 1 individual session tomorrow.)
  • Self-Soothing:
    • I've been wrapping myself up in my favorite fleece blanket and swaddling on the couch, watching TV shows that make me smile
    • I bought some cherry blossom scented body wash and used some body lotion with the same scent. I also got some new shampoo to have a new sensory experience in the shower.
    • Ate a fudge brownie
    • Lots of encouraging self-talk
  • Being willing to explore ways to feel and be well.

I hope that you are feeling encouraged after reading this post.  No matter what you are going through now...no matter how overwhelming or hopeless it may feel, we CAN push through to make choices that will make our situation better. We can choose to refrain from behaviors that will make our situation worse or sabotage us and the hard work we've been doing.

I have a book coming out next month.  This is a huge accomplishment. I need to focus on that.  I also radically accept that, as I discussed with my DBT group therapist, this particular crisis is probably an old coping mechanism (possibly related to OCD) to distract me from the REAL, intensely difficult situations I am facing right now (trauma related to work and discussions with significant other about his plans to return overseas to be with his parents) and that simply acknowledging this allows me to have more compassion for the fact that, as Dr. Marsha Linehan says: "Everything has cause." It will pass.

I will continue to self-care and will keep you posted on how things are going.

How are YOU doing right now?  What are you doing to take care of yourself?  
Do you have more than one diagnosis, and how has this complicated things for you?  Have you found ways to cope?  I'd love to hear about your experience.

Thanks for reading.
More Soon.


5 comments:

  1. I'm not doing well right now and am also in a 'crisis mode' and this is made worse by the fact that I will probably lose my job because of it. I did DBT about 8 years ago and it worked out great for about 5 years. The past 3 years has been really bad with the past couple months being the worst. I just can't make my skills work anymore and it is so frustrating! I am on the waiting list for the only DBT program in the area and I will hopefully hear something in about 4 months. It is comforting to hear that your skills come in handy for you. You are a sign of hope! Thank you!

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    Replies
    1. Nicki, I am so sorry that you're going through this right now. Remember how DBT has helped you in the past. That means it can again. I know it feels like you can't make them work anymore, but I challenge you to challenge that thought. Maybe with, "It's difficult to practice my skills, but if I put in enough effort, I really can." I hope you'll find lots of ways to implement the skills here. In the meantime, I recommend My Dialectical Life at: http://mydialecticallife.com/subscribe_to_my_dialectical_life/?source=hfbpdpost She sends you a DBT skill everyday by email along with ideas for implementing them. I bet this could be a really helpful resource to you while you're waiting. Let me know if you give it a try and if you like it. Good work getting on that waiting list!

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  2. Debbie, I really want to thank you so much for having this blog. I got diagnosed with bpd 2 years ago and I finally had my first DBT session yesterday. Your blog and the things in your life that you share, gave me the little extra push I needed to advocate for myself to my parents in getting DBT. I'm so sorry that you are still struggling from time to time because, believe me, I know it's not easy. I commend you, though, for having the strength to use your skills. :-) I'm super excited for your book! Take care.
    ~ Cheryl

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  3. Dear Debbie, I was diagnosed with BPD 3 years ago when I was in crisis and I was so troubled by the sound of the diagnosis I really ignored it. I went throigh a suicide attempt and some dark times and somehow came out the other side. Now a painful breakup and a confluence of stress in my life has brought about another acute crisis and once again BPD has been suggested. I think I feel ready to accept it, but I'm ashamed in a way, it sounds so final and personal. Anyway, DBT has been recommended but may be difficult to get as i live in Germany. I just wanted to reach out and make contact and know I'm not on my own. Thank you for your blog.
    Sue

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  4. Hi, Debbie. I was diagnosed with Major depressive disorder 10 years ago, alcoholism 8 years ago (been sober since), then the major depressive disorder was changed to bipolar type II disorder 5 years ago, anxiety disorder with panic attacks began 3 years ago, and OCD, complex PTSD and BPD "traits" were added to the mix about a year and a half ago.

    So, needless to say, I completely understand your frustration with not knowing what diagnosis is causing what symptoms. Symptoms overlapped too much impossible for me to weed them out definitively. My doctor and I are never sure what is hypomania verses anxiety/ocd behaviors for me. She tends to lean toward anxiety while I think its hypomania. The problem with this is that medication changes for one could exacerbate or excellerate the symptoms of the other. So, unfortunately it is often a trial and error game (a friend of mine calls it "medication roulette")

    To get through these "try-this-then-wait-and-see" times, I typically resort to radical acceptance (of my present symptoms) while also employing the "this too will pass" ideology.

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