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Diagnosis: I’m a Little Confused

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Hello,
I struggle with low mood which usually lasts a few months during the year (partly due to past trauma memories, partly seasonal). I can become irritable, lose interest in hobbies, and cry far more than usual. I tend to self- isolate more, find daily tasks like looking after my hygiene harder, and often think about suicide (more as I feel utterly hopeless). I don’t self- harm but occasionally I think about it.

Normally, I’m quite upbeat, I try to find the positives in everyone and all situations unless it’s about me and it’s like the same rules don’t apply.

I’ve always seen myself as inferior to others, a burden and despite having amazing friends, I never feel good enough. I’m very self- critical, a people pleaser (conflict frightens me), and am a bit of a perfectionist. I also usually prioritize other’s health and happiness over my own as I struggle to believe I deserve anything good in a good life.

Even though I want to get well, I often push those who try to care for me away as I’ve been so hurt and let down by those who were meant to in the past. I left home at 17 after a long history of physical, financial and emotional abuse from my mother who I believe has BPD/ narcissistic traits. Her temper is frightening and unpredictable. Other traumas have happened but I won’t go into them.

Since I was 22, I’ve been in and out of hospital for anorexia and seem to go round in cycles of trying to sort my anorexia but as soon as I get past a BMI of 15 or begin trauma therapy, I begin to vulnerable, uncomfortable in my own skin and feel disgusting. I start to have vivid nightmares, flashbacks and generally get very low. That’s when I lose the weight again to cope but I feel so afraid all the time. My anorexia provides a simplicity/ calming effect and I know what to expect but I can’t live like this either.

When I was 19 I was diagnosed with BPD but have since seen several psychiatrists/ clinical psychologists and they’ve said I don’t but recently it got mentioned again.
I’ve been diagnosed with PTSD, severe depression, and anorexia. Does this sound correct? I don’t understand as there’s CPTSD but I don’t think it fits (I know you can’t diagnose)? (From the UK)

Diagnosis: I’m a Little Confused

Answered by on -

A.

There are several things to unpack here, but I want you to know how much I admire your resilience and bravery as you have consistently dealt with these issues. Before we tackle the riddle of identifying a diagnosis, I want to honor your greatest strength of grit. Your tremendous perseverance in trying to find some relief is impressive and I want you to know how precious this effort is and will continue to be in your recovery.

I think any one of these diagnoses anorexia (losing weight by refusing to eat); BPD- borderline personality disorder (usually characterized by unstable relationships and large emotional swings); Posttraumatic Stress Disorder (PTSD) with its intrusive thoughts of memories of the trauma, flashbacks, and or nightmares; or the difficult to diagnose, Complex Posttraumatic Stress Disorder (CPTSD), where the symptoms of a PTSD have had an impact on one’s personality or identity could be overwhelming, but to have each of their powerful impact balanced and evaluated in trying to come to a type of stability and balance is exceptionally courageous. My concern is that there are many people offering an opinion and treatment options, but what might be needed is a primary person to coordinate the medicines, therapy, and progress. I am say ing this because you’ve suggested that when you are recovering from the anorexia and begin trauma therapy the stress of doing that triggers the flashbacks and the need to not eat returns as it calms you down. This is a cycle that may be better managed with one person understanding all of the moving parts so that therapy and success in treating the anorexia are happening in concert with one another.

See if you can find one person — most likely a psychiatrist, to take on the job of looking at all of this. Sometime when one person can see all the parts of the puzzle he or she can gain some insight as to the best way to go forward.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

Diagnosis: I’m a Little Confused

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Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Dan Tomasulo Ph.D., TEP, MFA, MAPP teaches Positive Psychology in the graduate program of Counseling and Clinical Psychology at Columbia University, Teachers College and works with Martin Seligman, the Father of Positive Psychology in the Masters of Applied Positive Psychology (MAPP) program at the University of Pennsylvania. He is Director of the New York Certification in Positive Psychology for the Open Center in New York City and on faculty at New Jersey City University. Sharecare has honored him as one of the top 10 online influencers on the topic of depression. For more information go to: http://www.dare2behappy.com/. He also writes for Psych Central's Ask the Therapist column and the Proof Positive blog.

APA Reference
Tomasulo, D. (2020). Diagnosis: I’m a Little Confused. Psych Central. Retrieved on November 22, 2020, from https://psychcentral.com/ask-the-therapist/2020/05/15/diagnosis-im-a-little-confused/
Scientifically Reviewed
Last updated: 12 May 2020 (Originally: 15 May 2020)
Last reviewed: By a member of our scientific advisory board on 12 May 2020
Published on Psych Central.com. All rights reserved.