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A New Diagnosis

Goodbye Bipolar, Hello Emotionally Unstable Personality Disorder

Earlier this week, I visited my psychiatrist for the first time in about a year. The last time that I saw her, she gave the diagnosis as “likely Bipolar II”. My Community Psychiatric Nurse (CPN) who was my care co-ordinator (until December 2017) and I were both pleased to have a diagnosis and I proceeded to educate myself in all things Bipolar Disorder Type 2. I have been on a combination of an anti-depressant and a mood stabiliser since that diagnosis. However, on Tuesday, I was given a new diagnosis. Before he left, my CPN had left notes to say that he disagreed with the diagnosis of Bipolar, and instead believed it was more likely that I had Emotionally Unstable Personality Disorder. The psychiatrist explained why she agreed. So, now, after a year of believing that I had Bipolar Disorder, I now must understand and get used to this new diagnosis. 

So, what is Emotionally Unstable Personality Disorder?

Before I continue with describing how I feel, and generally ‘blogging’ about my experiences, I first want to do a little explaining of what the disorder is. This next section might seem a little bit encyclopaedic in nature. I apologise.

In the World Health Organisation’s International Classification of Diseases (ICD-10), the disorder is called ‘Emotionally Unstable Personality Disorder’ (EUPD). However, in the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification system, which is mainly used in the USA, terms the condition as ‘Borderline Personality Disorder’ (BPD). So different professionals use the different terms to describe the same condition. So, yeah, sometimes it can be a bit confusing over what to call it. Despite this, EUPD or BPD is the same thing.

The name isn’t important. Instead, let’s discuss the symptoms. Getting a diagnosis of EUPD/BPD requires at least five of the following symptoms to have been experienced for a long time and to have a major impact on the sufferer’s daily life:

  • A fear of abandonment and doing anything to stop that happening;
  • Having intense emotions that can change very quickly;
  • Not having a strong sense of identity and that this can change depending on who the sufferer is with;
  • Relationships are difficult to make and difficult to keep stable;
  • The sufferer frequently feels empty;
  • Acting impulsively and will do things that could cause harm to self;
  • Self harm and suicidal ideation;
  • Struggle with very intense feelings of anger and difficulty in controlling this;
  • The sufferer could experience paranoia or dissociation when very stressed.

So to get a diagnosis of EUPD/BPD, the sufferer must have suffered with at least five of the above symptoms. I can put a tick next to all of them.

So, how do I feel about this?

Honestly, I feel like I have been lying for the last year. I have told people that I have Bipolar Disorder Type II. I have written articles about it. I have recognised similarities in fictional characters who have portrayed Bipolar Disorder. I have become friends with people who have Bipolar Disorder and we compared our symptoms and medication. Suddenly, everything I thought was true has now become untrue. And my biggest fear with this? That people won’t believe me. That people will judge me as an attention seeker. That people will believe that I have lied.

That was the initial feeling and the one that is still hanging around. But, how else am I feeling?

That it makes sense. I have had recognisable patterns of rapid fluctuation between times of confidence and despair. I have regularly been fearful of abandonment and rejection. As for self-harm and suicidal thinking? Yeah. A lot. I struggle with my emotions and I struggle with social, psychological, and occupational functioning. EUPD/BPD makes sense.

It makes sense and, because it makes sense, it means that my whole life is suddenly making sense. Everything that I have ever done that has been unexplainable, is now explainable. I know understand why I do things, why I think things, and why I keep screwing up with relationships, employment, and my finances. Everything makes sense. 

What next?

My psychiatrist has referred me to an organisation based in Cornwall that helps those with mental health issues. She has also promised to put me on the ‘urgent’ list for allocation to a new care co-ordinator. I am also awaiting emotional coping skills therapy and other Dialectical Behaviour Therapy (DBT). My medication regimen is also changing.

I am also keen on finding ways to help myself. I can’t keep waiting on a system that is broken to help me to fix my mind. I need to find ways to help myself. This might mean joining a gym to exercise more; eating three healthy meals a day; regulating my sleep pattern; or to come up with techniques to use in certain emotional states. I’m going to try everything I can to help me to live this life with a full understanding of my condition and with a determination to not let it hold me back. 

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