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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 34. Go back in thread:
Posted by Racer on March 8, 2004, at 0:36:23
In reply to Males on psychobabble psychology, posted by Apperceptor on March 7, 2004, at 21:40:08
Hm... That fits with the article that I was reading when I posted my question about BPD dx above. The article itself was called The Politics of Hysteria, and was about the history of multiple personality disorder. One of the points made was that MPD was a 'disorder' of North American females, generally those who had been receiving desultory treatment for other disorders for an average of seven years, without a lot of attention to their broader social context, until they finally saw a doctor who was then diagnosing MPD. (Highest correlating factor in being dx-ed MPD, of course, is seeing a doctor who has diagnosed others with it.) Some of the other points in the article seemed as though they could be equally true of BPD, and then I read somewhere in the DSM description that it was "generally a disorder of females." That always worries me, when I see that.
I do think what noa posted above, about doctors using the dx to distance themselves from challenging patients, and help relieve their own anxiety about being challenged, makes a lot of sense. One doctor I saw said something offhand once, about wondering if I had another dx he was missing because I wasn't responding as he had expected to the first drug he tried me on. (Once the dosage was doubled, I did respond to it. Maybe one size does not fit all?) That struck me, because I'd already had several major depressive episodes, had responded well to older antidepressants at higher than average dosages, and no one had ever suggested that there could be anything beyond depression going on. You'd think, after 15 years of struggling with major depression, some other doctor might have noticed if something else had been going on, right?
Then again, I distrust doctors in general these days, so a lot of that can be chalked up to general suspiciousness on my part.
Good points, though, and I'm glad you posted it. It would be interesting to see if any other men are here to answer it.
Posted by Fallen4myT on March 8, 2004, at 0:38:50
In reply to Re: Males on psychobabble psychology trigger?, posted by Apperceptor on March 8, 2004, at 0:29:13
Exacly, on the BPD A I have read and heard it too often. One can see 6 T's and given time have about 2-3 dxes. I always score PTSD
The reason I suggested the other boards especially the substance abuse on is because I have seen men post there and maybe they can be redirected to come here and post on other issues as in DXes...I was just on there and its pretty dead but a copy of your opening thread may just wake it up :-) There may also be other areas to get them posting too. Some people from substance abuse I never see over here
Posted by Apperceptor on March 8, 2004, at 0:48:52
In reply to Re: Males on psychobabble psychology » Apperceptor, posted by Racer on March 8, 2004, at 0:36:23
Women are victimized by the very potent sword of BPD, and I will stand by that statment from licensure to retirement. Borderline Personality Disorder is a very real and serious issue; however, it is far too often used as a diagnosis of convenience, and unfortunately in some situations, of retaliation.
The history of MPD/DID is very interesting, and I agree, it's especially fascinating when held up against the historical course of borderline personality disorder. Would it offend you if I say I'm uncomfortable commenting on this? I'm not trying to hide an opinion, but honestly, I have nowhere near a sufficient amount of training, expertise, or exposure related to dissociative disorders to say anything I'd feel comfortable presenting. I do hope someone here knows more than I, and can help us all understand.
Also, I can't claim to be an authority on medications...but I have read an absolute BOUNTY of research indicating that MAOIs are perhaps more efficacious for "atypical" depressions, which would probably remotely include significant aspects of BPD. Are you referring to MAOIs when you say "older" antidepressants? I myself have considered Parnate or Nardil, because I tend to be easily "plummeted down" from a happy state by a relatively trivial issue (I mention this only with the hope of showing that I'm not viewing this as 'you poor souls').
I'd love to hear your thoughts!
Posted by Elle2021 on March 8, 2004, at 0:56:09
In reply to Re: Males on psychobabble psychology trigger?, posted by Apperceptor on March 8, 2004, at 0:29:13
Apperceptor,
Can you please explain what PANDAS is? I'm familiar with Christian Science, but I haven't heard the term PANDAS before.
Thanks,
Elle
Posted by Apperceptor on March 8, 2004, at 1:04:56
In reply to PANDAS?, posted by Elle2021 on March 8, 2004, at 0:56:09
Elle-
I wish I could go into more at the moment, but I've got to pick my family up at the airport in 6 hours and I need some sleep!! :-D
PANDAS is an acronym...something about pediatric immune system problems. It is when your body, in response to untreated strep infection, attacks parts of your brain. Both my mother and I (thanks to CS) had rheumatic fever and then "mysteriously" developed OCD. They've now found a link. I hope you don't mind my attempting to drag Dr. Bob in, but I'm hoping he can contribute.
Posted by tinydancer on March 8, 2004, at 1:44:43
In reply to Re: Males on psychobabble psychology, posted by Elle2021 on March 8, 2004, at 0:00:50
> >I dont know where to fit him/her sooooo I'll call then BPD ..THAT IS JMO
>
> Hmm, I'm not sure if I agree with that. The DSM criteria for the disorder is pretty clear and straight-forward...but that's just my opinion. I definitely agree with you that it is overly-diagnosed though. I think T's need to do a full investigation of possible axis I disorders before going with the BPD dx.
> Elle
Maybe this belongs with the thread above, but I just wonder about this: I have a friend who was diagnosed BPD. What surprises me is this: she does and has never self injured, no financial irresponsibility, nor excesses in drugs, alcohol or similar. She has never been a drug or alcohol addict. I wonder how the BPD diagnosis could be made? Is it more important to go to the core of the BP disorder which is the emotional problems and distorted thinking? Can a diagnosis be made on that alone?
Posted by Elle2021 on March 8, 2004, at 2:30:20
In reply to Question about diagnosing BPD, posted by tinydancer on March 8, 2004, at 1:44:43
> What surprises me is this: she does and has never self injured,
There are a lot of ways to self-injure. Cutting, purposely taking too many pills, or the wrong pills, etc. I have a friend, when she gets upset she quits taking her medication. Her therapist decided that this was a form of self-injurious behavior because she was doing it to harm herself. Could it be that your friend's SI behavior is more of the obscure type?
>no financial irresponsibility, nor excesses in drugs, alcohol
So she isn't impulsive at all? What about driving? I have read that it is pretty classic for Borderlines to drive recklessly on purpose when they have a rage.
>She has never been a drug or alcohol addict.
Not all Borderlines are, I'm not.
>I wonder how the BPD diagnosis could be made? Is it more important to go to the core of the BP disorder which is the emotional problems and distorted thinking? Can a diagnosis be made on that alone?
I know that the DSM requires that a person meet several requirements before being give the dx of BPD. The common traits of Borderlines are mood instability, emotional instability, relationship problems, black and white thinking, impulsiveness.
I think that she could possibly meet the dx without being a self-injurer or addicted to drugs. But, you know her better than I do!
Elle
Posted by Racer on March 8, 2004, at 2:54:36
In reply to Re: Males on psychobabble psychology, posted by Apperceptor on March 8, 2004, at 0:48:52
Not MAOIs, but TCAs. I'm a little difficult to medicate, for a lot of reasons, and finding the dosage is hard with me, too. Some drugs wipe me out within days with side effects at very low doses, but mostly it's taken up to three times the recommended dose before any drugs have worked for me. Then there are the side effects. My blood pressure is very low to begin with, so any drugs that can effect blood pressure usually do for me. I was on desiprimine for about two weeks -- and got at least six sudden close up views of the carpet in that time. I couldn't walk across the room by the end of the second week, so I stopped taking it. (Adding to my diagnosis as a difficult patient, of course. Just can't figure out why I don't cooperate...)
I've never taken an MAOI, but have read a fair amount about them. The food restrictions are too frightening for me to consider them, really, but I understand that they are often good choices for resistant depressions. And I get knocked down, too, but I think it's mostly because I put so much energy into hiding my feelings that I don't have a lot left to deal with sudden blows.
Posted by Elle2021 on March 8, 2004, at 3:13:10
In reply to Re: PANDAS?Dr. Bob, posted by Apperceptor on March 8, 2004, at 1:04:56
>It is when your body, in response to untreated strep infection, attacks parts of your brain.
Yes, I've heard of the connection to strep and OCD. I was frequently sick as a child and I often wonder if strep was the etiology of my OCD. Then I think again, and wonder... I highly suspect that my aunt, grandmother, and mother have OCD. Perhaps not "all out," but definitely display strong traits of the disorder. So, maybe it's genetic. I will probably never know. I just sincerely hope that my future children will not be stricken with it. Hopefully by the time I have children, medicine will be more advanced...dare I think that they can come up with a cure. Probably not. :(
Elle
Posted by tinydancer on March 8, 2004, at 3:19:34
In reply to Re: Question about diagnosing BPD » tinydancer, posted by Elle2021 on March 8, 2004, at 2:30:20
> > What surprises me is this: she does and has never self injured,
>
> There are a lot of ways to self-injure. Cutting, purposely taking too many pills, or the wrong pills, etc. I have a friend, when she gets upset she quits taking her medication. Her therapist decided that this was a form of self-injurious behavior because she was doing it to harm herself. Could it be that your friend's SI behavior is more of the obscure type?
>
> >no financial irresponsibility, nor excesses in drugs, alcohol
>
> So she isn't impulsive at all? What about driving? I have read that it is pretty classic for Borderlines to drive recklessly on purpose when they have a rage.
>
> >She has never been a drug or alcohol addict.
>
> Not all Borderlines are, I'm not.
>
> >I wonder how the BPD diagnosis could be made? Is it more important to go to the core of the BP disorder which is the emotional problems and distorted thinking? Can a diagnosis be made on that alone?
>
> I know that the DSM requires that a person meet several requirements before being give the dx of BPD. The common traits of Borderlines are mood instability, emotional instability, relationship problems, black and white thinking, impulsiveness.
>
> I think that she could possibly meet the dx without being a self-injurer or addicted to drugs. But, you know her better than I do!
>
> Elle
>
>
Thanks for your post, Elle. You brought up some great points and a number of possible explanations for why she got the diagnosis.Before I was diagnosed DID/MPD I had the BPD diagnosis for several years, so I suppose I was comparing her case to my own. The mood instability and other emotional traits fit well but I struggle to find any self injurious behavior. Have to think about that one based on your example.
She is definitley impulsive. In fact, come to think about it, she just told me how she had spent a lot of money last month on things she didn't need, but I think that's my fault because I'm a bad influence.
Posted by tinydancer on March 8, 2004, at 3:22:20
In reply to Re: PANDAS?Dr. Bob » Apperceptor, posted by Elle2021 on March 8, 2004, at 3:13:10
I notice you are up bright and early! Are you in Europe as well? Not meant to infringe on your privacy, so its perfectly all right if you don't want to answer, I just thought it was quite nice since *I'm* in Europe and notice that I'm often the only one posting during my waking hours...And miss all the good stuff....:(
Posted by Elle2021 on March 8, 2004, at 17:10:12
In reply to Re: Question about diagnosing BPD » Elle2021, posted by tinydancer on March 8, 2004, at 3:19:34
Hey, I'm glad I could help!
> Before I was diagnosed DID/MPD I had the BPD diagnosis for several yearsAnother article I read suggested that most all people with DID automatically fit the requirements for the BPD dx.
> She is definitley impulsive. In fact, come to think about it, she just told me how she had spent a lot of money last month on things she didn't need,
Oh yes...one time I went out and bought a diamond ring. Now, it was no 5 keret Tiffany diamond, but it was out of my price range...I had to return it two days later.
>but I think that's my fault because I'm a bad influence.
I don't think it's your fault she overspends. Since she's impulsive, she'd probably spend the money anyway. I know that when I used to go shopping with my friend, she would say things to me like, "Can you really afford that right now?" But, it hardly ever made a difference to me! Ahh!!
No, I'm not in Europe, kinda wish I were though! Lucky you. I'm in the States, but I'm hoping to qualify for an exchange student program that lets college students study in New Zealand for a year. I really want to visit over there. If you don't mind my asking, what are you doing in Europe? Your screen name makes me think maybe your a ballerina? I studied ballet forever...and then got depressed and quit after 13 years of practice. :( Oh well!
Elle
Posted by terrics on March 8, 2004, at 21:31:49
In reply to Re: Males on psychobabble psychology » Apperceptor, posted by Racer on March 8, 2004, at 2:54:36
Regarding 'difficult to medicate': I hate the term cocktail, but a med cocktail is working fairly well for my depression. I think wellbutrin is a very useful antidepressant,also lithium which they have started to use for unipolar depression. I am on a few more, but don't want to get carried away. Have you ever tried wellbutrin? terrics
This probably belongs on the medication board.
Posted by Racer on March 8, 2004, at 22:00:43
In reply to Re: Males on psychobabble psychology » Racer, posted by terrics on March 8, 2004, at 21:31:49
Just to make this fit on this board, let's make it partly about therapy, too heheheh, then we won't have to move this.
Let's see, therapy, psychology, nope, can't figure anything out to say about that, so here's the answer to your question: I was put on wellbutrin in hospital, but shouldn't have been. It seemed to help, but the risk of seizure is too high. {sigh} It was the only drug that seemed to do anything useful this time around. I've been on cocktails of varying sorts, and with the latest events -- squiffy generic reaction, withdrawal, pain, myoclonus, etc -- I just stopped EVERYTHING. Next time around, we'll just have to start from scratch.
OK, how's this for making this post fit: how do you deal with it when your pdoc provides empirical evidence that what you say is not being heard? I have this problem a lot, so it should be a focus of therapy. I'll say "NO!" to someone, and that person will just continue on, steamrolling over me. My family have taught me so well, that if I say, "that's not a topic I'm willing to discuss" they'll just make it more painful for me by making my 'lack of cooperation' an additional topic in the conversation. The pdoc's behavior is reinforcing my difficulties in expressing myself, and is not hearing me when I say things like, "I can't tolerate this medication." He'll change the dose, or add another drug, but he doesn't quite get the "I just plain cannot tolerate this" message. And then the stuff comes up for me about "gee, if I'd only cooperate with his treatment plans..." Yeah, well, they're not working, I have cooperated, and maybe my fears of side effects are well founded, ever think of that? OK, deep breath... (Not sleeping, so getting wound up easily...)
Anyway, thanks for your suggestions. Best luck to you, and I hope you feel some significant relief soon. (And I do think it would help if your T would talk to you about the SI. Letting it sit aside like that keeps it in that dark place with fears and shames, and I would think it would feel better to get it into the light, where you can examine it more deeply.) Best wishes to you.
Posted by gardenergirl on March 9, 2004, at 15:39:44
In reply to Re: Males on psychobabble psychology, posted by Apperceptor on March 8, 2004, at 0:48:52
Apperceptor,
I take Nardil for atypical depression. My main symptoms were extreme sensitivity to rejection, excessive sleeping, and leaden paralysis. Basically, I am highly sensitive, so if it seems like I make mountains out of molehills, then it's because they really are mountains to me in terms of how stimulated by something I can get. I would often sleep til noon everyday, even when I had to be somewhere. If awake, I would tell myself, "I need to get up" over and over, but I just couldn't do it.Nardil has been the only antidepressant that has worked for me. I finally found the old gg back again. Others have noticed too. Mainly my sleep patterns have changed to a more normal and productive habit and I have much more inner confidence than before.
Not really sure if it would be helpful for someone with BPD, but it surely helps me!
gg
Posted by Dinah on March 9, 2004, at 17:47:55
In reply to MAOI's and atypical depression, posted by gardenergirl on March 9, 2004, at 15:39:44
I'm glad you've found relief.
Posted by terrics on March 9, 2004, at 20:36:47
In reply to Re: Males on psychobabble psychology » terrics, posted by Racer on March 8, 2004, at 22:00:43
Racer, I promise to listen to you, and to hear you.
Have you explained to your pdoc that he is not listening either? terrics
Posted by gardenergirl on March 9, 2004, at 23:39:35
In reply to Re: Wow. That sounds so much like me. » gardenergirl, posted by Dinah on March 9, 2004, at 17:47:55
Posted by gardenergirl on March 9, 2004, at 23:40:35
In reply to Re: Males on psychobabble psychology » Racer, posted by terrics on March 9, 2004, at 20:36:47
Posted by Racer on March 9, 2004, at 23:51:57
In reply to Re: Males on psychobabble psychology » Racer, posted by terrics on March 9, 2004, at 20:36:47
Well, terrics, I would explain to my pdoc that he's not listening to me if he'd return calls, or allow the subject to come up in his office, or respond to the letter I sent him telling him I was having trouble getting this stuff across to him... If it weren't so serious, I'd be laughing about it, but dang it! it is serious! This is my life we're talking about, whether he cares or not.
It doesn't help that I've been getting so fed up by the whole boondoggle that I've been losing my temper easily, and not thinking ahead much. For example, I'm so stressed it's triggered a shingles outbreak. I called to leave a message for the pdoc, 'reminding' him that, while physical dependancy on xanax is not medically significant, abrupt withdrawal of the drug does tend to have unpleasant consequences for the patient. I included in the message that I wasn't able to sleep, and that I was breaking out in shingles from the stress and hoped he'd prescribe whatever flavor of anti-viral was favored these days. Then, last night, I started getting a burning sensation on one lower eyelid, which got worse and worse and is now swollen and red and burning. So, miraculously, the office clerk returned my call! She called today, saying that she had spoken to the doctor and he suggested I see a doctor about my shingles, because he couldn't do anything about it. It wasn't his area of practice. (Mind you, I've told him repeatedly that I don't have access to any other health care.) While she was on the telephone, I didn't think about the eye thing, nor about the fact that I can't make my next appointment. So, now my choices are to call again, and reinforce their idea of me as calling too frequently, whining, generally making trouble, or worrying about the burning eye and how to arrange to be in two places at once. The eye makes me worried, because I'm afraid it's a side effect of stopping all my meds. I'm also afraid that if I do call, and say, "Gee, I think this might be what you warned me about with the Lamictal..." he'll just tell me to see a dermatologist. When I asked him about The Rash, he said, "Well, if you do start to feel something, get to a dermatologist right away." So easy for him to say, and thus absolve himself of all responsibility -- even though he prescribed the damn drug in the first place.
Anyway, I'm pretty obviously overwrought right now. Still not sleeping, after more than a week. Nightmares that could stop traffic, etc. I'm sorry for just going off at the slightest provocation.
Meanwhile, thank you so much for your post. It seems so silly, but it does help to have you say, in words, that you'll listen. You don't even have to promise to hear me, just to try. That's really all I ask. Thank you.
Posted by ryan312 on March 10, 2004, at 1:53:20
In reply to PANDAS?, posted by Elle2021 on March 8, 2004, at 0:56:09
Hey there. I am actually new to the this board. I have unrelenting OCD and typically take the PTSD/Dissociative Disorder-NOS label as opposed to Borderline. However, that's just because I have never had a doc or therapist who was into using the BPD label on Axis 2. Usually, they just "personality disorder-nos" me out of kindness :) In any case, have you read the APA practice guidelines for treating / medicating borderlines? Those might help you. I will try to find the link and post it separately in a minute.
Posted by ryan312 on March 10, 2004, at 2:09:22
In reply to I am a male borderline, posted by ryan312 on March 10, 2004, at 1:53:20
Sorry. I was actually trying to post this to the initial thread "starter" who on mar 7 asked about male borderlines. However, in my newness to this board, i put the post in a "sub thread" thingy and can't get it out. sorry...
Posted by ryan312 on March 10, 2004, at 2:11:18
In reply to Males on psychobabble psychology, posted by Apperceptor on March 7, 2004, at 21:40:08
You may wanna check out this good APA info regarding medicating both male and female borderline patients :) take care ...
Posted by fallsfall on March 10, 2004, at 8:44:38
In reply to male borderline here, posted by ryan312 on March 10, 2004, at 2:11:18
Thanks for the link - that was very informative.
Posted by terrics on March 10, 2004, at 18:57:41
In reply to {{hysterical screams}} Well, I would IF-- » terrics, posted by Racer on March 9, 2004, at 23:51:57
Hi Racer, You really are having a hard time. It's a shame your pdoc doesn't listen. I thought that was what they were supposed to do. I have a medical question for you. Are the shingles anywhere on your face? If so the swollen eye could be a part of the shingles and you really do need to see a Dr. If you are worried about the lamictal rash maybe you can find a picture of it online. If you are really worried maybe you don't need the aggravation and pdoc[hopefully] can find another mood stabilizer for you. It's to bad you have such a hard time with meds. Hope you feel better. Let me know. terrics
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