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I have short-term experience with psychiatry, but it was very destructive in return. Professional health workers often have an frightening lack of knowledge about trauma diagnoses such as complex post-traumatic stress disorder (C-PTSD), dissociative identity disorder (DID), and unspecified dissociative disorder (DDNOS). 

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This is some of what appears in this anonymous guest post on hjelptilhjelp.no.

The post focuses on how dissociative problems can be misunderstood and downplayed in the encounter with the support system, and how the result can be life-threatening for the affected person. When the part of the personality that is detached from the traumas / emotions asks for help - and tells that one is about to lose control - ignorant helpers can easily sweep away the problems. When detached parts of the personality act on their own and 'force' the person into suicidal behavior, there is a risk of encountering zero understanding and help from health professionals.

It's all misinterpreted as a play. 

This lack of understanding of how dissociative problems arise in turn contributes to making the problems even greater. When a person with dissociative problems experiences that he / she is losing control, it is important to take these signals seriously - and to give help. Proper help.





The author of this post has experienced how the professional health services have failed and has experienced being both misinterpreted and ignored. In other parts of the support system, the writer has experienced that there is competence to understand and meet the problems. The writer has chosen to remain anonymous, but hopes that the post can contribute to more focus on dissociative problems, and to remove ignorance and prejudice.

Here you can read the whole post:

 

Destructive experiences

I have only short-term experience with psychiatry, but it was on the other hand very destructive.





I came to a adult mental health service due to a failed suicide attempt after an acute crisis. I cooperated well in relation to the fact that I told them everything, but I showed little facial expressions / tears and so on (which was greatly reinforced by the fact that they appeared as if suicide attempts were something commonplace). 

Nothing was taken seriously, at the same time as they triggered all the pain they could from my past, which made everything much worse.

I was given antidepressants (SSRIs), which it later turned out I should never get because of a type of gene that increases the risk of side effects along with little or no wanted effect.

Then I became constantly unstable, and I could not hold back the suicidal impulses - even though I was at work and tried everything I could, including using self-harm and asking specifically for help.

But they did not take anything seriously and did not understand the problem either.

 

Two wills that simultaneously try to control the body

I tried to explain that it was as if I were a Siamese twin, where two wills at the same time tried to control my body:

Some part of me wanted to kill me (and this part was absolutely determined that I WANTED to die) and another part of me would prevent it (for the sake of the family and because I was afraid that in the next moment I would open my eyes to "hell" ).

My body did things I could not control; and when it happened I tried to ask for help.

The situation was completely new to me, and I did not understand what was happening.

After a while, I quit the adult mental health service because I felt it only made me worse.

They did not believe what I said, and thought I was just 'joking' when I asked for help because I was hurting myself.

I got the feeling that they were trying to raise me, through 'negative rewards', and to put it mildly, it was not very pleasant.

 

Lack of knowledge about dissociation

I got worse and eventually failed to function at work, in addition to the fact that I ended up in very dangerous situations and in the emergency room (which is burdensome for both society and me).

But the psychologist at the adult mental health service did not want to take it seriously, and she said that I wasted my time and that I did not get worse at all, only better. And that was also what she wrote in the journal.

I learned a lot from this, including how prejudiced affect large parts of public psychiatry and how little they know about complex dissociative disorders.

I am a healthcare professional myself, and although it was chaotic to be a patient at the time (especially while I was on Cipralex, which they never followed up as a possible cause of the instability - they only increased the dose) I do not think it is difficult to see that it was (1) lack of knowledge and (2) poor work that made it all so very wrong.

 

It is important to distinguish between borderline and trauma diagnoses

I have since been a lot at Modum Bad (i.e. a specialized Norwegian treatment facility), including attending courses and meeting others with similar negative experience from the health service. I've also chatted with people in forums, and it's striking:

 

  1. Both patients with borderline personality disorder (BDP; also called emotionally unstable personality disorder) and those with trauma diagnoses (especially complex post-traumatic stress disorder [CPTSD], dissociative identity disorder [DID], and unspecified dissociative disorder [DDNOS) have experienced treatment that has made the situation worse (which is only natural, as even employees in psychiatry can experience negative treatment from their colleagues).
  2. Many people with CPTSD / DID / DDNOS have been misdiagnosed with BPD.
  3. This is serious as the basic problem (despite some similar symptom appearances) is different and the treatment is correspondingly different
  4. I personally think that some of the picture of BPD is colored by misdiagnosis of CPTSD / DID / DDNOS, as these latter diagnoses are quite "new" and have been less known and less used. This becomes a kind of "circular reasoning" that makes the picture of them more complex. In addition, many with BPD may have CPTSD / DID / DDNOS in addition. So the problem complex is difficult.
  5. Greater awareness of the difference between the two (even in cases where both occur in the same person) will make the treatment more targeted and correct - and make the patient better instead of worse (as many experience today)

My own experience is that the employees have LITTLE knowledge about CPTSD / DID / DDNOS, and that this helps to confuse them in meeting 'such patients'.

At the same time, many find it frighteningly easy to fill this vacuum of uncertainty with 'prejudice', and then they take what is most similar and creates the most meaning in what is confusing: namely borderline personality disorder (BPD).

 

An auxiliary device that would not correct its own errors

My own experience is that the employees in such cases are surprisingly rigid in relation to correcting their own mistakes. The mistakes were based on what I told them. But sometimes they misunderstood. I tried to solve it - something you would not think was a problem. But here they stood like mountains. Even I - who was the original source of all their information about me - sat in front of them and explained that things were not so and so, but that it was so and so, and they would not listen.

I can add that I do not yell, swear or shout. I started to cry sometimes, but otherwise I said everyting calmly and matter-of-factly. But the journal was as written in stone. It colored them frighteningly much.

Suddenly they had managed to write that I had self-harmed and had suicidal behavior since I was a teenager - something that on the surface can fit nicely with BPD.

But - the problem was just that I had never said this, nor done it. I was depressed at times and thought a lot about death, but that was it and I never saw it as something I needed to make a number out of. I had friends who talked about suicide, and asked in my quiet mind why they did it, as this was to be considered completely normal. It lasted a few weeks / months, and then it passed when I felt better.

And the self-harm? I was over 20 years old when I first scratched myself discreetly with a paper clip on my wrist to avoid crying in a formal meeting where I had failed with a major school assignment. This was merely because I knew that my brain could not focus on many stimuli at once and I needed something relatively quick to distract myself.

I barely hurt myself for the next ten years, before I was up for the episode in question. Then it took off completely, not least after I got SSRIs. 

But what I said or wrote to the DPS did not help much. They had now decided, so then I might as well forget my own story and my own problems.

I felt that I had not only lost what I lost in the original crisis, but that I now also lost my own history, my own problems, my last remnant of dignity and myself.

 

Dissociation is misinterpreted as mood swings

I have been diagnosed with partial dissociative identity disorder [P(DID)] which corresponds to unspecified dissociative disorder (DDNOS). I have benefited greatly from the treatment at Modum Bad. But in the public health care system, it has literally been a nightmare.

After the violation from the original crisis, an equally strong 'violation' continued on the adult mental health clinic, and it dragged on for a few years.

In this process, I have become more divided in my head. The part of me that is depressed and suicidal (and that also acts on it) has become more isolated and harder for me to control.

It can come again - and then it acts. I mean everything it does. I totally agree with killing myself, because I do not want to be here anymore.

The public psychiatry has also here, I have noticed, operated on prejudice. They think I have mood swings - that everything is fine, and then suddenly it changes and I intox because I... well, yes why? Maybe I would try to kill myself, as I said, or maybe I'm just pretending, as many BPD patients (supposedly) do.

 

Met with trivialization 

But my periods have never been like this. I fall away, becoming more and more distant, before it happens. At first I did not understand it, but it did not take long to recognize the "pattern".

That's why I soon started saying that now I'm getting sick. But I was calm - because the part of me that speaks out is not related to the emotions. They live their own lives. So I was just encouraged to try to do it. And then it went awry.

Somatics does a good job. But they put their full trust in the psychiatrist who makes the assessment - and who does not seem to have much experience with dissociative disorders, at least not in relation to what actually works.

I would say I am a "light" patient. I'm losing control, but I'm not having a hard time getting back (when it's gone so far, I can not do it myself because I do not understand what to do, but I can easily talk in or come back if I get help to start with grounding, I have now learned!). But nothing happens, even though I say I have no control.

Out of the hospital, "just try, you can do this" - - - and then back with new intox or other injuries. 

 

Different, dissociated parts of the personality 

I feel complex dissociation is a bit like psychosis - you have no control. I only have one ANP (it means 'appearantly normal parts' - a part of the personality that is separated from the emotions). But I have several EPs (it means 'emotional parts' - a part of the personality that carries the emotions from a trauma or an offense).

My EPs have become quite independent after the last few years (not least thanks to psychiatry, which has only asked me to ignore them and try ... quite the opposite of what Modum Bad has learned and what works).

When the EPs control me, my "thinking brain" is not engaged - you can not expect to make rational assessments or what you really want.

I'm NOT suicidal - but I have two EPs that will / can try to kill me. One because I'm naughty (punishment) and the other because I can no longer bear it (give up).

They do it differently, and it is only the one who punishes me that I notice sufficiently to try to fight back. The other I think is me. I think it has always been depressed and did not want to live, and the way I was met at the public adult mental health service, and by psychiatry in general, has strengthened this as an independent personality entity.

 

Every part of the personality must be recognized and talked to

The reason why it can no longer stand has never been talked about.

It has always been "no, you do not feel that way ... you do not feel that way ... you do not get worse", and I have tried my best to cope - by pushing it even further to the side. Thus, it has become stronger. Contrary to what Modum Bad teaches (and which works) that you have to talk to all your (dissociated) personality parts and acknowledge them - otherwise they just shout louder.

I have no emotion of dependence on either psychiatry or specific people.

But when I have lost control - especially before when it was new and I did not know how to regain it - I have needed help. Proper help.

I think many are in the same boat, and hope more focus on this can help remove ignorance and prejudice.

- Posted by Anonymous

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