Diseases & Personality Disorders Answers

Can AvPD cause more mental illnesses?

Hello, Thank you for reaching out on The BetterHelp Platform with your question: Can AvPD cause more mental illnesses? I am glad you reached out for some support and guidance with what you are going through at the moment.  It think the best way for me to answer your question is to share some information on your condition and attend to your query about medication as well as discussing other behavioral therapy interventions. What Is Avoidant Personality Disorder And What Should I Watch For? Have you ever found yourself avoiding a situation or avoiding talking to people? Chances are you've experienced at least a few shy moments throughout your life. But you've probably only had a few minutes and probably only felt a little uncertain. For those with avoidant personality disorder, however, experiences extreme shyness where they are incapable of getting through their everyday life. That's the kind of shyness that we're going to focus on for this article, the kind that interferes with your professional and social life. What is Avoidant Personality Disorder? When was the last time you had difficulty talking to someone or interacting in a social situation? Just how bad did it feel for you to have to try and participate in that social situation? Well, someone with avoidant personality disorder would find it extremely difficult to even attend and nearly impossible to interact. That's because someone with avoidant personality disorder has extreme social inhibition, extreme low self-esteem and extremely high sensitivity to being rejected. Being in social situations where all these things could happen tends to completely overwhelm them. What this means is they tend to avoid social interactions as much as possible and tend to have difficulty forming healthy relationships. Because someone who has this disorder has such a strong fear of rejection and such a low opinion of themselves, they believe everything they do or say will be subject to scrutiny. When it is, they then believe that they will always come up short and say something stupid or silly that will cause them to be rejected. As a result, they find it easier to be alone than to risk the rejection that they are certain they are going to experience. For those who suffer from it, the loneliness can most often take a toll on them personally and the inability to socialize can make even professional interactions extremely difficult. Signs and Symptoms of Avoidant Personality Disorder There are several different signs and symptoms that are used to diagnose avoidant personality disorder, so let's look at some of these. If you or someone you know has these types of symptoms you may want to talk with a professional to find out more. There's no reason that you should have to live your life alone when all you really want is to meet people and have healthy friendships or at least carry out your professional obligations in a healthy way. Extremely hurt by any suggestion of criticism or disapproval of any suggestions or actions Lack of close relationships in a personal or professional environment Avoids situations that may involve contact with other people Tend to seek out professions, hobbies or other activities that limit interaction with others Extreme shyness in social situations for fear of making mistakes Excessive restraint shown in any intimate relationships that do develop Tendency to feel socially inferior or unappealing Refusal to take risks, try new things or speak up for fear of embarrassment Extremely reluctant to speak with others or get involved with others While these symptoms may occur in any one of us at one point in time or another, someone who experiences avoidant personality disorder lives their entire life by these restrictions. Zone. They find it extremely difficult or even impossible to branch out of their comfort zone or to do anything that might result in mistakes. Any mistake, however small or trivial it might be to others, could be considered catastrophic to someone who is suffering from this disorder. This results in a complete avoidance of all interaction possible to avoid mistakes and embarrassment. Treatment for Avoidant Personality Disorder So, what happens if you are diagnosed with this disorder? Does it mean there is a cure or is it something that you just must accept and live with? Well, the answer comes somewhere in the middle. There is no actual 'cure' for avoidant personality disorder. But that doesn't mean you just have to live with it either. While nothing can cure it and take away all of the things that go with the disorder permanently, there are definitely ways that you can help yourself move on with your life in a healthy and happy way. First, medication can be a great start. Antidepressants can help with some of the side effects of the disorder that may come about as a result of loneliness. Not only that but they can actually help to counter some of the fear of rejection and the sensitivity to it when it does occur. Other types of medication may also be effective for helping treat the symptoms or side effects of the disorder, Next, psychotherapy can be an extremely important aspect of your treatment. This will help you to understand relationship building as well as increasing your ability to relate to others. As a result, you may find yourself far more comfortable having even casual conversations with others, which is a great way to start. This type of treatment will help you to slowly start branching out and improving your life, which is crucial to being able to enjoy your life the way you want to. Stats on Avoidant Personality Disorder If you've never heard of this disorder, or even if you're just a little more curious about it, knowing some of the stats that are relevant can be an interesting way to find out more. Look at each of these statistics and find out how prevalent this disorder is as well as some of the other facts that can help you understand the makeup of those who are already suffering from it and developing their own path to a healthier future. Approximately 0.5% - 1% of the general population have avoidant personality disorder Approximately 10% of psychiatric outpatients are diagnosed with this disorder As many as 50% of those diagnosed with panic disorder with agoraphobia also have avoidant personality disorder As many as 40% of those diagnosed with social phobia or social anxiety disorder also have avoidant personality disorder Avoidant Personality Disorder: How It Differs When you hear the stats and the facts about this disorder, you may think of other personality disorders where people tend to be alone. There are numerous ones, after all. Maybe you think about it and assume that it's not so bad to be alone because there are times you want to be alone. However, that's not the case with this disorder . Where everyone wants to be alone sometimes, there are other times when you really want to be around other people. Maybe you have some great news that you want to share, or you want to catch up about work or old times. Maybe you don't even actively want to be around people, but you need a new pair of shoes. You probably never really think about it, right? With avoidant personality disorder, these everyday things that you may do without thinking are nearly impossible. The individual with avoidant personality disorder wants to interact with others. They want to have friendships and relationships. They want to be able to go to the store to get the things they need. The difference is that they don't feel capable. They feel an overwhelming sense of anxiety and fear when they even think about doing these things and no matter how much they want to be able to do them, that fear and anxiety always wins out in the end because even if they manage to get out there or talk to someone, the anxiety and fear are in the back of their mind. Even if they manage to go to the store and pick up those new shoes, they worry that the people around them are judging them or that they've done something wrong. Every word they say is carefully analyzed before they speak, and they may still fear they've said the wrong thing. Where many of us simply speak without a whole lot of thought, an unintentional outburst from someone with this disorder is horrifying. Where some of us would like to sit home once in a while by themselves. Someone with this disorder would like to go out once in a while with other people. The disorder keeps them from doing it. What a Diagnosis Means for You So, what does it mean for you if you're diagnosed with avoidant personality disorder? Well, it means that you really can't do it alone and that you're going to need some help to get through the disorder. Getting started with treatment right away is the best thing you can do, so make sure that you're talking with your healthcare professional and getting advice on the type of treatment you need and what to expect. You may also want to check out BetterHelp which is an online resource that can get you connected with mental health professional's right from your own home. There's no reason you need to go anywhere to get the help you want and need to improve your life.   There is hope and there is help for you! I wish you much luck with your next step to managing this situation.   In Kindness, Gaynor 
(MA, LCSW)
Answered on 01/21/2022

How do I stop lying compulsively

Hi Tay, As a clinician, I would be curious which diagnosis came first, if there was one or if it was a dual diagnosis? Primarily because there are different schools of thought on them being dually diagnosed, as in--some think its one or the other/they cannot be both, others say it can be dual/both, and others think of bipolar II actually being a part of a spectrum of BPD/not a seperate diagnosis. All that to say, the common symptoms are the same right, so no matter what label you put on it, you're struggling with symptoms that are negatively impacting various areas of your life.  There is a ton of research to show for either of these diagnoses, childhood trauma or being raised by someone with a severe mental illness can greatly increase ones chances of developing either of these. Further, you mentioned a previous relationship that was emotionally and mentally abusive, definately that experience can be informing your current relationship in terms of ways you're coping with conflict or stressors inside or outside of the relationship and if the ways you're coping are "healthy" or contribute to more relational problems. That said, your admission to compulsively lying could be one of those 'habits' that served you at one point in your life, but now sounds like it is no longer serving you/but instead harming you/your relationship.  Conflict in any relationship can cause a person to retreat to certian coping strategies that are progressive or regressive. So learning techniques to handle conflict/arguments can be super helpful when it comes to working towards not using negative coping skills such as 'compulsive lying'. Are there other relationships, current or past, that you recognize this response? From a trauma perspective, it could be that these arguments are triggering for you an emotional response you aren't even consciously aware of. Trauma from abusive relationships can do that to a person, think of Pavlov's dogs/conditioning. Our body is very aware of trauma enlists our fight, flight or freeze response for the protection of self when faced with a "threat" whether it is still present or not. Which again, means there is hope for change. The work may not be the easiest, but its doable, many have & many still strive to. There's no one quick fix for any of these things, but instead a day by day progression, a journey towards healing which helps symptoms that you describe above, regardless of the label of a diagnosis. I would encourage enlisting the support of a trauma informed therapist to explore these things with you and progress towards healing and better relationships. Wish you well on your journey. 
Answered on 01/21/2022

How do I deal with broken promises and a alcoholic

Hello there, This sounds like a very difficult scenario. I am going to send you some information from priorygroup.com. However, keep in mind that with this information, the main priority as to be your safety. If anything is suggested or recommended that could put you in danger or at risk, do not do it. The dos and don’ts of dealing with an alcoholic partner If you are living with an alcoholic partner, you have probably faced a lot of challenges and experienced many different emotions. Right now, you may be exhausted from having to pick up more of the responsibilities, terrified about the health and future of everyone in your household, as well as sad and angry about the situation that you are currently living in.   Dealing within an alcoholic partner can have a massive impact on a person’s life. Within this blog, we will look at the dos and don’ts of living with someone addicted to alcohol. We have also put together the dos and don’ts of talking to the person about their drinking, which you can use if and when you are ready to have this conversation. The dos of living with an alcoholic partner Living with an alcoholic partner can be physically and emotionally draining. Learning how to deal with an alcoholic spouse as well as looking after yourself can be stressful and often, support is needed to help manage. We have put together some recommendations on how to look after yourself and the other people living in your household. DO try to maintain a level of normality throughout your days. Stick to a family routine, so go to work, eat meals, relax and go to bed at the same time every day DO focus on yourself and the others in your household who are affected by your alcoholic partner. This should be your priority, so concentrate on yours and their physical and mental health DO learn to step back. We understand that this is a really difficult thing to do, but if you try to step in and save the person every time there is an incident or issue, their alcohol addiction is likely to continue. They may need a crisis to happen in order for them to recognize that they need to change DO seek outside support. It is important to have a trusted group of people who can listen and support you. As well as speaking with close friends and family members, think about joining a group like Al-Anon, where you get to speak to people who have had similar experiences with family members. Alternatively, you may want to try seeing a therapist, so that you can get the right level of support you need and are able to stay well The don’ts of living with an alcoholic partner DON’T give up. Remember that you are not alone and you can handle today. There are people who care about you and who will support you so that things can get better DON’T focus your time and energy on trying to control or stop your partner’s drinking. We understand that this can be tough as you care for the person and have a history together, regardless of how much they have hurt you. But remember, they can’t control their drinking, so it is highly unlikely that you will be able to change it either. Also, withdrawing from alcohol can be extremely dangerous and even life threatening, so if the person does decide to stop, they should access professional support to do so. Encourage them to speak to their GP or get in contact with a specialist treatment centre to discuss the best steps forward DON’T spend your time and energy on covering up for the person. It is likely that they won’t want other people to know how much they drink, but it isn’t your responsibility to help them try and keep it a secret DON’T remain in a position where you feel that you and others in your household are physically or emotionally unsafe. Seek immediate professional support and don’t try to handle the situation yourself The dos of talking to your alcoholic partner about their drinking The idea of talking to your alcoholic partner about their drinking can be daunting. We have put together advice so you can go into the conversation with confidence, and make sure that it is as effective as possible. DO carry out some research and get a good understanding of alcohol addiction beforehand. This knowledge can help you when explaining the types of behavior that are worrying you. It can also help you to recognize any attempts to deceive or undermine you, which your alcoholic partner may try to do during the conversation DO look into the addiction treatment that is available in your area. That way, if your partner decides that it is the right time to think about getting help, you can show them the professional support that is available to them DO have the conversation when they are sober. That way, they are more likely to listen to what you have to say DO let them know the impact that their drinking is having on you and others within the household. By keeping the conversation on you rather than them, it can help them to understand the emotional impact of their drinking. You could say something like: “You came home really drunk and woke up the children. I’m really worried about the impact that this will have on them. What can we do about this?” Or: “You didn’t come home last night. I’m starting to feel really alone. What can we do to address this?” DO let them know that you love them and will be there to support them through their recovery. Admitting that they have a problem and accessing support can be really scary, so knowing that they have your support can help to get them on the right path The don’ts of talking to your alcoholic partner about their drinking DON’T talk to them when they’re drunk. They are unlikely to take in what you have to say and may become defensive and angry, making it an even more challenging situation DON’T shout, judge or blame. This may understandably be very hard, because of the pain that they have put you through, but the person is likely grappling with a lot of fear and shame, so approaching the conversation in a negative way could cause them to retreat further away from you into their addiction DON’T accept that you are the reason for their drinking or any requests for you to change your behavior. An alcoholic partner may say that they’ll cut down if you don’t nag them, tell anyone or put pressure on them. Remember that this isn’t your fault, and that the person would be battling with an alcohol problem whether or not they were with you DON’T rush into coming up with a plan together and avoid having unrealistic expectations, even if they say that they are going to cut down or stop drinking. We understand that this can be difficult as you want this part of your life to be over. Instead, allow there to be a period of reflection after the conversation, and continue to express yourself openly and honestly. If they want to change, encourage them to take small steps, like getting in contact with their GP to discuss their options Alcohol addiction treatment at Priory Group At Priory Group, we have rehabilitation centers throughout the UK. Typically, when a person comes to us with an alcohol addiction, they will go through an Addiction Treatment Programme, which includes the following: A pre-assessment meet-up with one or two members of our team, where they have a chance to look around the facility and get any questions answered An addiction assessment, where one of our team works with them to determine the best approach for their treatment and recovery Medically-assisted detoxification, so the person can rid their body of alcohol in a safe space A residential program, where they have an opportunity to learn about their addiction and take steps towards their recovery, through group and one-to-one therapy, workshops, seminars and individual working time An aftercare program, where the person attends weekly sessions following on from their residential stay, allowing them to continue getting the support they need as they take their first steps on their journey to recovery  
(LPC, NCC, CEDS-S)
Answered on 01/21/2022

I am bipolar. I am having manic moods of spending way too much money. I am also looking for a job.

Hello Barbie, Working from the information you have provided; it appears as if you have not been in therapy services before and have only been working with a psychiatrist. I feel it would be most appropriate at this time to discuss the difference between psychiatry and therapy and why your psychiatrist would have suggested this option to you. Psychiatrists are medical doctors who specialize in the medical treatment of mental health disorders via psychotropic medications. When attending an appointment with your psychiatrist, as you may already know, they will ask you about medical and mental health symptoms to help find you a medication(s) that could help alleviate such symptoms. They do not typically talk about what is causing you these problems but, more of how to medically treat them. A therapist helps you navigate your problems, point out patterns of choices and behaviors, and help you build a plan to change what is making you unhappy or distressed. Therapist do not solve your problems nor validate how you want to feel; we help you find a way to change your thinking and offer coping skills to help you manage your feelings. I often encourage people in psychiatric services to also attend therapy services so they can learn to manage their behavior while stabilizing their symptoms on medications. For some people, it’s difficult to address what is bothering them in therapy if their mind is all over the place and are unable to regulate their moods. This is when I would suggest seeing a psychiatrist to help them gain some stability mentally so they can be in a better place and ability to address their thought processes. So, in your case, in therapy we would look at why it bothers you that your sister thinks you are just trying to get out of work and process through your feelings for having to leave your job due to medical problems. Additionally, you could learn a few coping skills to help you tend to your mental health stability like building a routine, altering your thinking about jobs, and finding joy in the things you have accomplished. Therapy would build upon the momentum you already have for change but, to also know that a person never stops changing and improving upon themselves. We work to encourage you to reflect on your own choices and how they have led you to the place you are currently and whether you want to change.  All this work comes from within and not from us – we just work as the guides to help you get through it.  If you want to continue to lose weight, then that’s great!  My question would be what are you doing that works, what are you doing that does not, and what are you willing to do to get you to a realistic and healthy weight in your eyes? Also, I may want to ask about your thoughts surrounding “healthy” weight and what this looks like to you. As for the spending too much money and other manic type of behaviors, we could also look at some behavior modification to help you better navigate your impulses and to implement some change. So, in a long roundabout way, yes, therapy can help you but, maybe not in the way you may be thinking it can. I view it as you have a big puzzle in your mind and when you come to therapy, you lay all the pieces out on the table and then we help you find a way to sort through the pieces and guide you to put it together in a way that makes sense to you. We don’t put the puzzle together for you.
(MA, LMFT)
Answered on 01/21/2022

How do i know if i have bipolar

You pose a really good question. So there are different types of Bipolar disorder. As you noted, Bipolar disorder can include symptoms of both mania and depression. These symptoms or episodes can be different for everyone. During a manic phase some symptoms may include Inflated self-esteem or grandiosity, decreased need for sleep, increased talkativeness, racing thoughts, becoming distracted easily, increase in goal-directed activity or psychomotor agitation as well as engaging in activities that hold the potential for painful consequences such as unrestrained buying sprees and even sexual acting out behaviors. Sometimes these periods can last from days to weeks and sometimes even longer than that. Then of course there is the depressive phase which can include depressed mood most of the day: nearly every day, loss of interest or pleasure in all, or almost all, activities, significant weight loss or decrease or increase in appetite, engaging in purposeless movements, such as pacing the room, fatigue or loss of energy, feelings of worthlessness or guilt, diminished ability to think or concentrate, or indecisiveness and recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt. And again these periods can last for weeks or even longer. Experiencing these highs and lows can be very scary especially without understanding what is going on. It is especially important during the low periods to communicate with your support system and reach out as needed because as noted sometimes during these low periods you can experience thoughts of self-harm or ideations of suicide. You may not experience all of these symptoms and it may vary from person to person. It is important to try not to self-diagnose and if you are really concerned about having bipolar disorder to schedule an appointment with a professional who can do a full evaluation in order to determine if you do infact have bipolar disorder. Typically bipolar disorder can be effectively managed with medication and some individuals don't even need medication but learn how to manage their fluctuating emotions through learning different therapeutic techniques through therapy. I hope this has been helpful for you and has been able to answer some of your questions. 
(MA, LPC)
Answered on 01/21/2022

BPD??

Hello AB, Thank you for reaching out with your query about whether you might be having symptoms of BPD. To truly understand what you are experiencing it would be advisable to contact your mental health provider for a full assessment. You include symptoms of struggling with mood stability - mania and low moods which is a recognized symptom of bipolar.  The mood swings could be a sign of this together with your other symptoms.  You also mention the possibility of bipolar traits in your family.  I will share some information about the condition and what testing you might wish to pursue. I will also include some information about getting help beyond the diagnosis should you wish to pursue this option further. No matter what your diagnosis might reveal there is help available for you. When you suspect you may have a mental condition, amateur psychiatrists seem to pop up everywhere. So many people have either had a mental illness or known someone that has that it can seem like everyone has an opinion on what your problem is and what you should do about it. When you're concerned about the possibility of bipolar disorder, it would be great if there were a test to answer this question for you. There are many different tests for bipolar disorder. Do I Have Bipolar Disorder? What can you do when you wonder 'Do I have bipolar disorder?' You could go immediately to a mental health professional and ask them for a diagnosis. List your symptoms and describe what you've been going through. They would be happy to provide a clinical evaluation and additional tests to determine what you are experiencing and provide you with a diagnosis. If you're having thoughts of harming yourself or someone else, you should visit your local emergency room, crisis center, or doctor right away. What if you are only having slight mental health concerns and wondering whether they could be symptoms of bipolar disorder? In this case, one of the easiest and quickest way to put yourself on the right track is to take a bipolar test. Bipolar Test Types Reliable tests to determine the presence of bipolar disorder are administered by a psychiatrist, psychologist, or licensed therapist. Some of these tests are paper and pencil and require you to answer a few questions. Others may involve entering answers into a computer, which the professional will then review as part of your diagnosis and to help provide treatment recommendations. For those with concerns about bipolar disorder, testing alone isn't the only thing necessary. Clinicians must also conduct an evaluation interview for a proper diagnosis. The interview includes questions about family medical and mental health history, your background information, and information about where your present situation. This process may also include a referral to a medical doctor to rule out physical concerns and underlying medical problems. Quizzes that are found online aren't checked for validity or reliability in actual diagnosis. Genetic Testing Genetic Testing is still in its infancy, but some are very encouraged by results that demonstrate a likelihood of development of bipolar disorders. It is important to note that these types of tests can only show that you might develop it, not that it is a current issue for you. A licensed mental health clinician will examine other factors in your environment and history along with genetic test results to determine your diagnosis.   What to Do Next After you take tests and consult with a mental health professional, you may be quite anxious for a direct answer. Your mental health care professional, psychiatrist, psychologist, or therapist will discuss results with you to help you understand what these results mean for you. They will also go over treatment options should your results indicate treatment is needed.   Get Help Interpreting and Evaluating the Results Treatment for bipolar disorders often involves medication, which requires visiting with a psychiatrist or medical doctor for both prescription of medication treatment, and ongoing evaluation to determine its effectiveness. Your testing may reveal that you don't seem to have bipolar disorder at all. If so, you may have other issues you need to deal with. Licensed counselors are available at BetterHelp to teach you stress management techniques to help you overcome these problems, too.   Begin Treatment If You Have Bipolar What if the bipolar test shows you probably do have bipolar disorder? What should you do, then? If you want to live a happy and productive life, you need to get into treatment as early as possible. Don't wait for the 'right' time. Don't wait for your symptoms to get worse. Early treatment is the best way to reduce the effects the disease has on your mental and physical well-being. Talking to a therapist is an excellent first step whether you have bipolar disorder or not. They can prove to be a valuable resource throughout your life, whether you have bipolar or not. Everyone has problems to deal with, and for most people, those problems seem unmanageable at one time or another. Getting help with mental health challenges is a sign of strength, not weakness. No matter what your diagnosis maybe there is hope. I wish you luck with your next step in the process of pursuing your diagnosis.   in Kindness, Gaynor   
(MA, LCSW)
Answered on 01/21/2022

Need help on understanding if I’m a narcissist and help moving forward.

Thank you for your question. Narcissism is a term that is heard a lot when identifying someone who seems to only think about themselves because they think a lot of themselves rather than considering others. Narcissists can also be known to be manipulative but yet easily able to draw social attention and can even come off as likable to others at times. However, the question lies as to whether these notions of what is narcissism or who a narcissist is are an accurate reflection of the diagnosis. Someone who is selfish or only thinks about themselves can be called a "narcissist" by others but this does not necessary mean that the person meets criteria for the official diagnosis.The specific or technical diagnosis of narcissism is known as Narcissistic Personality Disorder (NPD). Being diagnosed with having a personality disorder means that there is a pattern of behavior that is displayed by the person. For someone diagnosed with Narcissistic Personality Disorder, the pattern of behavior is displayed as grandiosity and having a disregard for the feelings of others.  Some of the specific criteria that is needed to meet to be diagnosed with having Narcissistic Personality Disorder includes the following: showing arrogance, lacking empathy, exploiting others for his/her own personal advantage or gain, having a sense of entitlement, and seeking attention or admiration from others to the extent of demanding it.  Additional characteristics include an exaggerated since of self-importance and feeling unique or as it one has more power or is higher in status than others.   Treatment for Narcissistic Personality Disorder can be difficult as it is an investment that takes commitment but change is possible.  There has not been a specific form of treatment, whether it be medication or therapy, that has been identified as the most effective for treating Narcissistic Personality Disorder.  However, depending on areas that you feel you need to move forward in, a recommendation may be made to assist in identifying helpful coping strategies.  For example, Cognitive Behavior Therapy (CBT) may be useful in identifying and replacing unhelpful thoughts that may contribute to the pattern of behavior while Dialectical Behavior Therapy (DBT) may be useful at teaching you skills to improve interpersonal effectiveness. Again, thank you for the question.  I hope that this information serves to give you clarification on Narcissistic Personality Disorder and potential treatment options that will assist in breaking the unhelpful pattern of behavior and improving relationships.  I also encourage you to consider therapy as an option if you feel need further guidance and support. 
(MS, LPC, MAC)
Answered on 01/21/2022

Is there a way to treat or combat BPD without medications?

Is there a way to treat or combat BPD without medications? You shared that you were diagnosed with Borderline Personality Disorder 8 months ago and you weretaking Zoloft and Seroquel to help treat it. You shared that you took your medication until about 3 weeks ago but you hated the side effects. You shared that they made you super drowsy and groggy during the day which was hard to deal with because you are a stay at home mom with a 10 month old. You also shared that you are not super comfortable with the idea of taking medications and would rather a more holistic approach for treatment.  Based on your question, it is ultimately up to you if you decide that you do not want to take your medication anymore and you would like to focus more on a holistic approach. If you decide to seek therapy, I would highly suggest that you try to seek help for your specific mental health needs from a local licensed professional counselor and or licensed professional mental health therapist. A licensed professional counselor and or licensed professional mental health therapist can properly assess based on your official diagnosis of Borderline Personality Disorder.  Along with an official diagnosis, a licensed professional counselor and or licensed professional mental health therapist can support you in assessing your specific mental health needs in regards creating a treatment plan specifically for you.Therefore, I highly encourage you to continue or to begin to search for a licensed professional counselor and or licensed professional mental health therapist who can properly assist you if you decide to give therapy a try. Once you find a licensed professional counselor and or licensed mental health therapist the you can also discuss your wishes to begin and follow a holistic approach. I also highly recommend that you run your plans of getting off your medication with your psychiatrist and or professional medical practitioner who was prescribing your medication to see if there are side effects of stopping your medication at this time. Since you have been properly assessed and diagnosed once you find a professional to provide you therapy, you can then both discuss and process what your current emotional distress looks like at this. Going to therapy is a great way to minimize the severity of your emotional distress if needed. Individuals who receive therapy can often see quicker improvements and overall better outcomes over time. Borderline Personality Disorder does not look the same for everyone; therefore, a licensed professional counselor and or licensed professional mental health therapist can support you in discussing what your emotional distress and or personal experiences look like in your own words. A licensed professional counselor and or licensed mental health therapist can effectively assess your needs for mental health treatment if needed at this time. Emotional distress is a huge factor in possibly adding to some of your current thoughts of deciding if therapy is right for you at this time. It is quite beneficial to have a licensed professional counselor and or licensed mental health therapist to discuss your specific thoughts and feelings in a safe and conducive environment of your choice. Taking the time to find the proper licensed professional counselor and or licensed mental health therapist is very important, so you can feel comfortable in working to making the necessary changes to improve your mental well being as a means of decreasing your emotional distress at this time. Emotional distress, can be treated with the use medication and therapy combined if that is the best option for you at this time. Behavior interventions, Psychotherapy, and Cognitive Behavioral Therapy (CBT) have all been beneficial in treating individuals who have struggled with emotional distress. A licensed professional counselor and or a licensed mental health therapist can provide you counseling in a safe and confidential setting without feeling judged or ridiculed. A licensed professional counselor and or a licensed mental health therapist can also introduce you to deep breathing techniques, stress relaxation techniques, calming techniques, progressive muscle relaxation, grounding techniques, positive interpersonal social skills and imagery as a means of decreasing your thoughts of emotional distress at this time. In an effort to decrease your thoughts of emotional distress, you can also try to commit to changing the way you think. It will take a lot of practice, dedication and determination to alleviate increased thoughts of feeling about your emotional distress and personal experiences. However, trying to do this will help you feel better and it can lead to your feeling much better and becoming more productive. You can recognize when it is happening and when you find it happening you can choose to think about something more productive. You can also look for solutions by committing to learning from your mistakes and solving your problems so you can productively move forward, set aside time to think when you notice you are not feeling emotionally distressed outside of that scheduled time, remind yourself that you will think about it later, distract yourself with a self-care activity and you can practice mindfulness. Mindfulness is the key to living in the "here and now." When you become mindful, you will be completely present in the moment. It can be like a form of meditation that takes a lot of practice, but over time and with consistency, it can be very beneficial in decreasing thoughts of not being productive in an effort to help you experience an overall healthier mental well-being at this time. Overall, It is your choice and your choice alone if you decide to seek help from a licensed professional counselor and or a licensed mental health therapist to properly assess your current diagnosis of Borderline Personality Disorder at this time with your personal experiences. Emotional and mental distress can look different for everyone because mental health is not a one size fits all. Therefore, it is very important to get personalized treatment for your specific and current mental and emotional needs in regards to decreasing your thoughts of emotional distress at this time if you decide to seek therapy and or counseling for yourself. Best regards to you!     
(EdS, LPC-S, NCC, BC-TMH)
Answered on 01/21/2022

How do I even begin to figure out what I am supposed to be doing with my life?

Perhaps you are just starting out in your professional Journey, coming out of school and full of energy but no concrete directions on how to proceed with your life. Or perhaps you decided on a career path but have since learned that it is not for you and would like to make a career shift. Or perhaps there is a thick layer of ambivalence that stands in the way of your ability to see beyond what is before you, and this stifles motivation or clarity on a path for a life purpose. What does one do in order to figure out what his or her purpose is in life? There are one of a few approaches that may be considered. For some who are faith-based, the spiritual route begins with prayer and quiet time with God for guidance on what their life's purpose is. The answer you may hear first, followed by confirmation in the form of a dream, through prayer, or in the words of a friend / family member, or some other means. There may be those who find their life's purpose by reviewing their personal interests or skill sets and aligning it to a profession or job. What has been found, in my humble opinion, to be a common theme among most of us humans searching for purpose is the ingrained desire to help others. Therefore, if there is a particular approach that you have demonstrated to help another- mentoring disenfranchised children, volunteering at a hospital, prepping meals for the food insecure are examples- then perhaps this is an area that can be pursued further as a  possible career move. The idea behind this exploration is that you are looking within your past interests, affiliations, passions and pursuits that may be converted into a professional career. If you're going to rain gauge in a life purpose, by all means, you want to engage in activities that you enjoy. Therefore seek out that thing that makes you happy when you do it. Chances are good that if you enjoy what you are doing, then it will not feel like work. You'll be good at it and this can turn into your life's purpose.
(MA, LMHC, CASAC)
Answered on 01/21/2022

How to navigate functioning in a relationship with a narcissist?

Thank you for reaching out Barcelona! I know it is never easy to ask for advice or help from people you don't know, so I will do my best to help you with your question. Anytime we are dealing with a person who may exhibit certain traits, it is safe to try and understand what those traits are and where they originate. If your husband truly is a narcissist, then this information would pertain to you: People with narcissistic personality disorder often come across as selfish or superior, but it’s because they’re making up for a fragile sense of self-worth. The disorder can make it hard to get along with others, but counseling can help people with NPD learn healthy ways to connect with others. A narcissist is a common catchphrase describing someone who acts self-absorbed or vain. What many people don’t know is that narcissism, or narcissistic personality disorder (NPD), is a serious condition.   It is estimated that up to 5% of people have NPD. Narcissism is one of 10 personality disorders. These disorders cause people to think, feel and behave in ways that hurt themselves or others. Signs of personality disorders usually appear in the late teen years and early adulthood. The exact cause of NPD is not known. The disorder may result from a combination of factors that include:   Childhood trauma (such as physical, sexual, and verbal abuse). Early relationships with parents, friends, and relatives. Genetics (family history). Hypersensitivity to textures, noise, or light in childhood. Personality and temperament.   Healthcare providers diagnose NPD when you have at least five of the following characteristics:   An overinflated sense of self-importance. Constant thoughts about being more successful, powerful, smart, loved, or attractive than others. Feelings of superiority and desire to only associate with high-status people. Need for excessive admiration. Sense of entitlement. Willingness to take advantage of others to achieve goals. Lack of understanding and consideration for other people’s feelings and needs. Arrogant or snobby behaviors and attitudes.   A mental health professional such as a psychologist or therapist can determine if you have key symptoms of NPD. Your psychotherapist will give you questionnaires and then talk with you. You’ll go over what’s causing you distress. The focus will be on long-term patterns of thinking, feeling, behaving, and interacting with others. Your psychotherapist will also identify and rule out any other mental health conditions. Your therapist may give you personality tests to see if you have narcissistic traits. The tests are just questions you answer honestly. They give your psychotherapist better insight into how you think and feel. Tests include:   Personality diagnostic questionnaire-4 (PDQ-4). Millon clinical multiaxial inventory III (MCMI-III). International personality disorder examination (IPDE).   Long-term counseling is the primary treatment for NPD. It helps you gain greater insight into your problems and learn what changes you can make to:   Relate to others in a positive and rewarding way. Develop healthy self-esteem. Have more realistic expectations of others.   A psychiatrist may also recommend medications to treat symptoms like anxiety and depression. Medications include:   Antidepressants: These medications treat depression. Healthcare providers commonly prescribe selective serotonin reuptake inhibitors (SSRIs). This class of drugs has fewer side effects than other antidepressants. SSRI medications include fluoxetine, sertraline, and paroxetine.   Mood stabilizers: To reduce mood swings, your provider may prescribe a mood-stabilizing drug such as lithium. Antipsychotic drugs: This type of medication can help with symptoms of depression and anxiety. Aripiprazole and risperidone are two kinds of antipsychotic drugs.   Without treatment for NPD, you can have trouble maintaining positive relationships at work and home. You might also be more vulnerable to abusing drugs and alcohol to cope with difficult emotions. Also, feeling alone can lead to deep depression and suicidal thoughts. Starting counseling is half the battle with NPD. When you have the disorder, your self-esteem is fragile, and criticism hurts you easily. Fear of criticism can keep you from getting the help you need. Willingness to change is vital. With counseling, you can start to change your thought patterns, which change your behavior. Over time, those changes can improve the quality of your relationships and life.   Keep in mind that he may not have the disorder per se, but some traits and symptoms. The best way to navigate around these types of situations is to use techniques such as grounding techniques to help you focus on things that are unrelated to what the "narcissistic" person is attempting you to focus on. Some of the most common and easy to apply grounding techniques are:   The 5-4-3-2-1 Technique: This is the most common grounding technique because it calls upon all the senses to bring you back to the present. It involves thinking about:     Five things you can see; Four things you can feel; Three things you can hear; Two things you can smell; and One thing you can taste in your immediate environment.  Identifying things in your physical world slows your heart rate and takes your focus off the intense feelings of anxiety.   Memory game: A memory game is an effective and fun way to manage anxiety attacks. Play a memory card game on your phone or try to memorize details in a photograph and recreate the picture in your mind.   Picture someone you love: Who is your biggest confidant in life? Who is the one person who can comfort you no matter how bad things get? Imagine that person is right there with you, what they’d be saying to you, and what their voice would sound like.   List your favorite things: Make a list of things that make you happy. Break it down into categories. What is your favorite food? song? hobby? movie? color? travel destination? This line of thinking will put you in a more positive mindset.   Play the categories game: Similar to listing your favorite things, you can also list out a handful of categories and challenge your brain to list as many things in those categories as possible. Who are five authors, football players, or movie stars? What are five European countries, car brands, or types of flowers?    Spell some things backward: Spelling something backward is a mental challenge that forces you to concentrate. You can do lots of things backward — like counting down from 100 in increments of 6, reading a page of a book backward, and so on.    Visualize turning down an emotional dial: You’ll have strong emotions at the onset of a panic attack. By visualizing an emotional dial and making the conscious choice to turn it down, you’re putting yourself in charge of your feelings.   Listen to your surroundings: Simply taking a moment to be quiet and listen to your environment can bring you back to the present. If you’re inside, listen to the clock ticking. Listen to people chatting or breathing around you. If you’re outside, listen to leaves rustling in the wind. Listen to birds chirping, children playing, or dogs barking in the distance, and remind yourself that you are in the here and now.   Think about numbers: Doing math in your head is a great way to center your thoughts. Go through the timetables mentally or think of a few different equations that yield the same answer.   Recite something: Have you memorized the pledge of allegiance? A famous poem? A scientific theory? An important speech? A noteworthy quote? The preamble to the Constitution? Whatever you have in your head, speak it out loud or say the words mentally. Think about your mouth as you vocalize it or imagine the words appearing on a piece of paper as you go.   Watch a movie or TV show: If you enjoy watching it, television can transport you to another place and time, allowing you to live in another person’s shoes for a little while. After an episode or two, you might even forget that you were anxious, to begin with.    Listen to music: Putting on your favorite song not only boosts your mood but also elicits emotions that bring you back down to earth. Focus hard on the lyrics and think about what they mean to you in this particular moment.   Watch a funny YouTube video: Nothing alleviates anxiety like a good laugh. Put on your favorite comedian or whatever else you find funny and allow yourself to laugh away the negative feelings.   Recite a to-do list for the day: If your to-do list gives you anxiety, you can skip this one. But if it helps you to think about the things you want to accomplish in the present moment, speaking your to-do list out loud can refocus your thoughts on something productive you can do at the moment.    Focus on an object: Pick a small trinket you find interesting, whether it be a coin, a piece of jewelry, a polished rock, a pressed flower, or a figurine — and keep it with you at all times. Focus on this object when you’re feeling a panic attack coming on. Are there imperfections in the jewelry? How has the coin deteriorated over time? How does the polished rock look when it’s glinting in the light?    Physical and Mindfulness Grounding Techniques Clench your fists and release: Focus all the negative and nervous energy on your hands. Clench them into fists, squeeze as hard as you can, and let go. Do this 10 times in a row and think about how your body feels as you release the tension. Feel the blood flow back into your fingers.   Rub your palms together: This is another way of channeling energy to your hands. Rub them together as fast as you can and generate heat through friction, focusing on expelling anxious energy through that heat.   Stomp on the floor: It might feel good to stomp around a little bit, thinking specifically about how it feels when your foot lands on the floor. Focus on the ground beneath you and the sensation it causes when it makes contact with your foot.    Designate a grounding chair: Pick a cozy chair in a quiet space in your home. Sit in it and think about how it feels as you sit. How does the material feel on your skin? How does your body fit into it? Lean back in the chair and imagine all of the negative emotions spilling out of your feet and onto the floor and relax every muscle on the way down.    Bring attention to your breath: Breathing exercises help you take control of your heart rate and your muscle tension. Breathe in for four seconds, hold it for four seconds, and let it out for four seconds. Repeat this until you feel calm.     Do some vigorous exercise: Feeling your heart pounding in your chest and the sweat forming on your body can bring you back from a place of fear. Do a form of exercise you enjoy, whether it be a light jog outdoors, a dance exercise at home, or a kickboxing session at the gym.    Stretch your body: As you stretch, focus on the areas of the body that carry the weight of your anxiety. For most people, anxious tension is carried in the back, the shoulders, and the neck. Think about how your body feels and try implementing breathing exercises throughout.   Take a shower or bath: Take your time in drawing yourself a bath or shower. Feel the water and how its temperature brings you back to reality. How does the warm or cool water feel on your muscles? What do the sounds of the water do to your mind?   Make a comforting, hot drink: Coffee, tea, and hot chocolate are cozy beverages that calm your body and mind. As you prepare it, think about the cool mug in your hand and the motions of stirring the drink. How do you feel as the liquid trickles down your throat and the warmth spreads through your body?    Smell something familiar: Smells, especially familiar ones, are powerful sensations. These can help you come back to the present moment. Pick a candle, a lotion, a cologne, an essential oil, or a hot beverage to smell when you need to ground yourself.   using these techniques, you could potentially lessen the severity of how much your husband's behaviors affect you if you practice them regularly and with teh same intensity. Hopefully, this was helpful, best of luck, and have a great day!
(MA, LPC)
Answered on 01/21/2022

How could bpd be diagnosed. ( Or any other mental illness as i believe something is wrong)

How could bpd be diagnosed. (Or any other mental illness as I believe something is wrong) I read where you shared that you are experiencing bad sleep and numbness for more than a year. You also shared that you are experiencing jumping from one emotion to another emotion in a matter of minutes. You also shared that you are experiencing stress, breakdowns, the need of constant validation, anxiety, and dissociation. You questioned how can Borderline Personality be diagnosed. You also questioned how any other mental illnesses can be diagnosed and you shared that you believe something is wrong with you. Based on your statement, I would highly suggest that you try to seek help for your specific mental health needs from a local licensed professional counselor and or a local licensed professional mental health therapist. A licensed professional counselor and or licensed professional mental health therapist can properly assess you for an official diagnosis to see if you actually have Borderline Personality Disorder. Along with an official diagnosis, a licensed professional counselor and or licensed professional mental health therapist can support you in assessing your specific mental health needs in regards creating a treatment plan specifically for you in regards to you experiencing stress, breakdowns, the need of constant validation, anxiety, and dissociation. Licensed professional counselors and or licensed professional mental health therapists on the Betterhelp platform are not able to diagnosis you because we cannot see you in person to get a thorough assessment. Therefore, I highly encourage you to continue or to begin to search for a local licensed professional counselor and or licensed professional mental health therapist in your local area who can properly diagnosis you at this time. Once you have been properly assessed and diagnosed by a licensed professional counselor and or licensed professional mental health therapist you can both then discuss and process what your current symptoms of Borderline Personality Disorder, stress, breakdowns, the need of constant validation, anxiety, and dissociation. look like at this time. If your symptoms Borderline Personality Disorder, stress, breakdowns, the need of constant validation, anxiety, and dissociation. are severe, a licensed professional counselor and or licensed professional mental health therapist can provide you with a referral to a professional psychiatrist and or medical provider for medication after they assess what your specific mental health needs are in regards to your symptoms of Borderline Personality Disorder, stress, breakdowns, the need of constant validation, anxiety, and dissociation. Therapy and medication together can help minimize the severity of your Borderline Personality Disorder, stress, breakdowns, the need of constant validation, anxiety, and dissociation if needed. Individuals who receive therapy and medication often see quicker improvements and overall better outcomes than those who only receive therapy or those individuals who only take medication. Behavior interventions, Psychotherapy, and Cognitive Behavioral Therapy (CBT) have all been beneficial in treating individuals who have struggle with Borderline Personality Disorder, stress, breakdowns, the need of constant validation, anxiety, and dissociation.  A licensed professional counselor and or licensed professional mental health therapist can assist you in learning how to effectively implement coping skills to decease Borderline Personality Disorder, stress, breakdowns, the need of constant validation, anxiety, and dissociation. A licensed professional counselor and or licensed professional mental health therapist can introduce you to deep breathing techniques, calming techniques, grounding techniques, stress management techniques, progressive muscle relaxation, and imagery as a means of decreasing your current symptoms. In an effort to decrease your current symptoms you can also try to commit to changing the way you think. It will take a lot of practice, dedication and determination to alleviate your symptoms of Borderline Personality Disorder, stress, breakdowns, the need of constant validation, anxiety, and dissociation. However, trying to do this will help you feel better and it can lead to your feeling much better and becoming more productive. You can recognize when it is happening and when you find it happening you can choose to think about something more productive. You can also look for solutions by committing to learning from your mistakes and solving your problems so you can productively move forward, set aside time to think when you notice you are feeling like you want to engaged in emotional distress, outside of that scheduled time, remind yourself that you will think about it later, distract yourself with a self care activity and you can practice mindfulness. Mindfulness is the key to living in the "here and now." When you become mindful, you will be completely present in the moment. It can be like a form of meditation that takes a lot of practice, but over time and with consistency, it can be very beneficial in decreasing emotional distress in an effort to help you experience an overall healthier mental well being. Overall, I highly recommend that you seek help from a local licensed professional counselor and or licensed professional mental health therapist and a medical provider if needed to properly assess and diagnose your symptoms of Borderline Personality Disorder, stress, breakdowns, the need of constant validation, anxiety, and dissociation, as it can look different for everyone. Please remember that mental health is not a one size fits all, so it is very important to get personalized treatment for your specific and current mental and emotional needs at this time. I highly recommend that you contact the Betterhelp team to discuss what specific payment options and payment plans are available for you to access counseling services at this time. Betterhelp does offer financial aid and various other options for individuals who are seeking counseling for their personal and or emotional well-being through the use of affordable therapy sessions. The Betterhelp Platform is designed to be able to assist you better if you contact them directly. Contacting Betterhelp directly is the best way for them to verify your identity and securely help you with your specific account information and needs. When it comes to questions, issues or concerns in regards to the cost of using the Betterhelp platform please contact the Betterhelp team. You can reach out to the Betterhelp team for issues including but not limited to the following: billing issues, account questions and or concerns, and or subscription questions and or concerns. The Betterhelp members are there to help answer your questions, concerns and or issues, so if you have a question in regards to what the cost would be to begin using the Bettehelp platform you can contact the Beterhelp team members directly to gain accurate information in regards to what payment options are available for you if you decide to join the Betterhelp platform in regards to possibly talking to a licensed professional counselor and or licensed professional mental health therapist. Please feel free to reach out to the Member Success Team directly by emailing contact@betterhelp.com to discuss what payment options are available for you to use the Betterhelp platform for you counseling needs and or therapy needs at this time. Best regards to you!       
(EdS, LPC-S, NCC, BC-TMH)
Answered on 01/21/2022

I suffer with borderline personality disordee in what way can i help stop the thoughts and moods

Dear Hagegdudnebwhahdidne,   Thank you very much for your message.   I understand that we are going through some fluctuations with our emotions and often it can feel like we are going backwards. However the reality is that the night is always darkest before the dawn. The reason you are feeling discouraged is because you are trying to move forward in this healing process, therefore when you do experience any kind of anxiety or depression you begin to doubt yourself in this process.   Meanwhile, as a human being we will always have times when we feel anxious or depressed. That is normal and natural. Just like there are days that it rains, there are also days that the sun shines. This isn't a problem to be fixed.    We will only feel more depressed if we constantly compare ourselves with our old selves in the past that seemed to be happier, while we forget that back then we did not have this much on our plate to worry and we did not experience what we have experienced recently that gave us hurts and pain. Therefore it isn't fair to our current self if we always think about how to go back in time, that isn't possible anyways.   To further recover from feelings of depression and anxiety, we must constantly be thinking about how to develop a healthy, positive interaction with ourselves.   Happy relationships all depend on how happy we are with ourselves. So how happy are we?   If you feel like you're on a constant quest for inner bliss, you might be asking yourself: If there was one secret on how to be happy in your relationship or marriage, workplace, home life and family wouldn't you have learned it by now?   Are you constantly searching, asking people who seem happy, reading articles and watching videos on how to be happy? If so, you're certainly not alone. Online search engines get millions of people asking this question, and the internet is full of promises that this strategy or that formula will deliver you to a place of lasting happiness. Yet, many miss the main point: they never even touch on the fact that the real key to happiness with others is happiness with yourself.   If you haven't noticed or been here yourself (most of us have), an insecure person's need for constant approval is exhausting. Those who are happy and love themselves don't hang around with that kind of negative energy. Since we can't change other people, lead by example and others will follow in your footsteps, becoming good role models themselves. Here are 5 lessons that I learned (still learning) to find peace within ourselves and enjoy true happiness that does not depend on others.   1. Forgive Yourself   Forgive yourself for anything and everything you think you caused that was bad in your or someone else's life. You can't go back for a do-over, so learn the lesson and move forward, promising to better handle any similar situation that may arise. Now you're freed up to relax more and have greater peace of mind without beating yourself up over guilt and resentment.   2. Understand That You Are Complete   And understand that, "You complete me," was just a cheesy line in a Tom Cruise movie. (I loved that line at first too... for a few seconds, until I realized how inaccurate it was. Keep reading to learn why!) The reason most of us don't feel complete, and latched onto that line like it was the end-all be-all relationship concept is because we're waiting for someone else to be or do something that makes us feel whole.   First of all, as mentioned, we are already complete. But even if we weren't, no one else would be able to complete us anyway - it's impossible. When we put our happiness in someone else's hands we set them up for failure. Why would we do that to someone we care about? Because we don't realize we are the only ones who control our happiness.   Does this mean if you're unhappy it's your fault? Yes. Does this also put you in a position of power in your life? Absolutely. You want your relationships to be the joining of two complete individuals to create a third, larger entity so that you're a part of something, not just half of something. The whole "my other half" thing just breeds insecurity, which leads to the most painful relationship challenges like jealousy, abuse and infidelity. Why on earth would you want your happiness to be determined by someone or something outside of yourself?   3. Get To Know Yourself   When do you feel you're at your best when you're alone? Are you reading your favorite book overlooking a beautiful view? Enjoying your favorite tea, watching a movie? Shopping outside at the farmers market? Listening to your favorite music? How does your body feel? Healthy? Need some work? No one will be happier than you when your body looks good and functions well. This is a good confidence builder and when you have more confidence, you look better and healthier, and carry yourself in a completely different way that attracts confident people to you.   Here's a personal example: I had a spider vein on my lower leg and didn't feel comfortable in shorts for years. I finally had it removed and couldn't believe how much better I felt. My posture and confidence in shorts was much improved. Some things are easily fixable and for the others we may need to adjust our perspective a bit.   What are your favorite parts of yourself - your appearance, your character traits, your values or your personality? Do you get a kick out of your great sense of humor? I get a kick out of mine. I laugh to myself quite often! Are you really excited that you value honesty, which has attracted honest, genuine people to you? Are your eyes or hands or knees your favorite part of your body? Get to know your favorite parts and love them all.   4. Take A Good Look At Yourself   Take a look and notice how amazing you are. Keep your self-talk positive. There are things supermodels hate about themselves, so don't go thinking you're the only one who has dislikes. You can be happy with yourself even if there are things you'd like to change. I've always been shorter than most other people and would have given anything to be "normal" height. It took me 27 years of hating my height when many other people always wanted to be taller and would have traded me in an instant. Look how many years I experienced self-induced suffering. (This describes all suffering by the way. Pain is inevitable; suffering is optional.)   What are you good at, best at and want to improve at? What are your talents and what skills have you developed? What would you like to do in your life that you haven't done yet? What is the best thing you've ever done? Are you noticing that you might ask some of these questions on a date to get to know someone and determine if you like them or not? We get to know people by asking questions although we rarely ask them of ourselves. And when someone else asks, we sometimes answer differently than when we're asking ourselves.   5. Ask Yourself Questions   To find out more about yourself, ask yourself the questions you would ask on a date. The quality of your relationships is determined by the quality of the questions you ask. Ask good questions and lots of them (more than you would ask on a date; it's OK to be a chatterbox with yourself) to build that strong, healthy relationship with yourself.   Take time away from other people and be happily alone. At first, it might feel weird choosing to be alone but being alone and being lonely are two very different things. Dr. Wayne Dyer says, "You cannot be lonely if you like the person you're alone with." I went from being scared to sit alone in Starbucks for fear some stranger would think I didn't have any friends to loving going places alone. I have attracted wonderful friends by learning how to like myself and since like attracts like (energy), they happily do things on their own too. Yes, we do enjoy each other's company as well; we don't just talk about all the things we did by ourselves (although that would be funny).   Welcome to your inner power. You are qualified, capable and worthy of being happy with yourself regardless of anyone else on the planet so lead by example and show others how it's done. You will see that you can have much more fulfilling relationships without putting the responsibility of your happiness on someone else.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/21/2022

Is the all suitable for someone diagnosed with personality disorder?

Hi, thank you for your question! BetterHelp is a company that provides an online platform for potential clients to receive individual or couples therapy services. Once matched with a therapist that fits your needs you are then able to begin communicating with your therapist and schedule an initial appointment for your first therapy session. BetterHelp is convenient in that you the client have the ability to choose how you would like to participate in your session. Of course since BetterHelp is an online service provider in-person sessions are not an option, but BetterHelp offers three easily accessible ways to have a therapy session online. The options include having your session via video, phone or live chat where you are communicating with your therapist in real-time by typing out your responses to one another. You are also able to message your therapist anytime if you have questions or concerns or just want to share information. Each therapist will usually indicate  within his/her introductory message to you how quickly he/she can respond to your messages. BetterHelp does have therapists that indicate that they are experienced in treating individuals diagnosed with Borderline Personality Disorder (BPD). This may mean that the therapist is certified in Dialectical Behavior Therapy (DBT), which is the recommended treatment for Borderline Personality Disorder (BPD). It can also mean that the therapist has gained experience in working with individuals diagnosed with Borderline Personality Disorder (BPD), but rather than being certified in Dialectical Behavior Therapy (DBT), has only received a certain extent of training in Dialectical Behavior Therapy (DBT). This type of therapist is typically considered to be DBT Informed and is able to provide skills training to the client in the four skill areas outlined in Dialectical Behavior Therapy (DBT). These four skill areas include mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. I highly recommend taking the time to specify your needs of wanting to be matched with a therapist with experience treating individuals diagnosed with Borderline Personality Disorder (BPD) and/or is knowledgeable of Dialectical Behavior Therapy (DBT) skills. I also recommend thoroughly reading through the different therapist profiles to see who indicates that they have experience treating individuals diagnosed with Borderline Personality Disorder (BPD) and/or have training or expertise in Dialectical Behavior Therapy (DBT). Again, thank you for your question and I hope that this information has been helpful in deciding whether BetterHelp may be a good option for you to receive therapy services. 
(MS, LPC, MAC)
Answered on 01/21/2022

Hi I strongly believe I have bipolar disorder what advice can you give to help me through this

Hello,   Thank you for reaching out on The Betterhelp Platform with your question: I strongly believe I have bipolar disorder what advice can you give to help me through this? I will share some information about Bipolar disorder and how you can manage some of the symptoms.  I would recommend that you seek a professional opinion to consider an assessment of your symptoms.   How to cope with bipolar disorder   No matter how down or out of control you feel, it’s important to remember that you’re not powerless when it comes to bipolar disorder. Beyond the treatment you get from your doctor or therapist, there are many things you can do for yourself to reduce your symptoms and stay on track. Living well with bipolar disorder requires certain adjustments. Like diabetics who take insulin or recovering alcoholics who avoid drinking, if you have bipolar disorder, it’s important to make healthy choices for yourself. Making these healthy choices will help you keep your symptoms under control, minimize mood episodes, and take control of your life.   Managing bipolar disorder starts with proper treatment, including medication and therapy. But there is so much more you can do to help yourself on a day-to-day basis. These tips can help you influence the course of your illness, enabling you to take greater control over your symptoms, to stay well longer, and to quickly rebound from any mood episode or relapse.   How to live with bipolar disorder    Get involved in your treatment   Be a full and active participant in your own treatment. Learn everything you can about bipolar disorder. Become an expert on the illness. Study up on the symptoms, so you can recognize them in yourself, and research all your available treatment options. The more informed you are, the better prepared you’ll be to deal with symptoms and make good choices for yourself.   Using what you’ve learned about bipolar disorder, collaborate with your doctor or therapist in the treatment planning process. Don’t be afraid to voice your opinions or questions. The most beneficial relationships between patient and healthcare provider work as a partnership. You may find it helpful to draw up a treatment contract outlining the goals you and your provider have agreed upon. Improve your treatment by:   Being patient. Don’t expect an immediate and total cure. Have patience with the treatment process. It can take time to find the right program that works for you.   Communicating with your treatment provider. Your treatment program will change over time, so keep in close contact with your doctor or therapist. Talk to your provider if your condition or needs change and be honest about your symptoms and any medication side effects.   Taking your medication as instructed. If you’re taking medication, follow all instructions and take it faithfully. Don’t skip or change your dose without first talking with your doctor.   Getting therapy. While medication may be able to manage some of the symptoms of bipolar disorder, therapy teaches you skills you can use in all areas of your life. Therapy can help you learn how to deal with your disorder, cope with problems, regulate your mood, change the way you think, and improve your relationships.   Monitor your symptoms and moods   In order to stay well, it’s important to be closely attuned to the way you feel. By the time obvious symptoms of mania or depression appear, it is often too late to intercept the mood swing, so keep a close watch for subtle changes in your mood, sleeping patterns, energy level, and thoughts. If you catch the problem early and act swiftly, you may be able to prevent a minor mood change from turning into a full-blown episode of mania or depression.   Know your triggers and early warning signs   It’s important to recognize the warning signs of an oncoming manic or depressive episode. Make a list of early symptoms that preceded your previous mood episodes. Also try to identify the triggers, or outside influences, that have led to mania or depression in the past. Common triggers include: stress financial difficulties arguments with your loved ones problems at school or work seasonal changes lack of sleep Common red flags for relapse Warning signs of depression • You’ve stopped cooking your own meals. • You’ve stopped mixing with friends. • People bother you. • You crave sugary food such as chocolate. • You’re getting frequent headaches. • You don’t care about others. • You need more sleep and take naps during the day. Warning signs of mania or hypomania • You can’t concentrate. • You find myself reading lots of books at once. • You’re talking faster than normal. • You feel irritable. • You’re hungry all the time. • Friends have commented on your irritable mood. • You have more energy than usual so need to be moving. Knowing your early warning signs and triggers won’t do you much good if you aren’t keeping close tabs on how you’re feeling. By checking in with yourself through regular mood monitoring, you can be sure that red flags don’t get lost in the shuffle of your busy, daily life.   Keeping a mood chart is one way to monitor your symptoms and moods. A mood chart is a daily log of your emotional state and other symptoms you’re having. It can also include information such as how many hours of sleep you’re getting, your weight, medications you’re taking, and any alcohol or drug use. You can use your mood chart to spot patterns and indicators of trouble ahead.   Develop a wellness toolbox   If you spot any warning signs of mania or depression, it’s important to act swiftly. In such times, it’s helpful to have a wellness toolbox to draw from. A wellness toolbox consists of coping skills and activities you can do to maintain a stable mood or to get better when you’re feeling “off.”   The coping techniques that work best will be unique to your situation, symptoms, and preferences. It takes experimentation and time to find a winning strategy. However, many people with bipolar disorder have found the following tools to be helpful in reducing symptoms and maintaining wellness:   Talk to a supportive person. Get 8 hours of sleep of sleep. Cut back on your activities. Attend a support group. Call your doctor or therapist. Do something fun or creative, or write in your journal. Take time for yourself to relax and unwind. Increase your exposure to light. Exercise Ask for extra help from loved ones. Cut back on sugar, alcohol, and caffeine. Increase or decrease the stimulation in your environment.   Create an emergency action plan Despite your best efforts, there may be times when you experience a relapse into full-blown mania or severe depression. In crisis situations where your safety is at stake, your loved ones or doctor may have to take charge of your care. Such times can leave you feeling helpless and out of control, but having a crisis plan in place allows you to maintain some degree of responsibility for your own treatment.   A plan of action typically includes:   A list of emergency contacts for your doctor, therapist, and close family members.   A list of all medications you are taking, including dosage information.     Symptoms that indicate you need others to take responsibility for your care, and information about any other health problems you have.   Treatment preferences such as who you want to care for you, what treatments and medications do and do not work, and who is authorized to make decisions on your behalf.   Reach out for face-to-face connection   Having a strong support system is essential to staying happy and healthy. Often, simply having someone to talk to face-to-face can be an enormous help in relieving bipolar depression and boosting your outlook and motivation. The people you turn to don’t have to be able to “fix” you; they just have to be good listeners. The more people that you can turn to who will be available and good listeners, the more likely you are to manage your moods.   Don’t isolate! Support for bipolar disorder starts close to home. It’s important to have people you can count on to help you through rough times. Isolation and loneliness can cause depression, so regular contact with supportive friends and family members is therapeutic in itself. Reaching out to others is not a sign of weakness and it won’t make you a burden. Support for bipolar disorder starts close to home. Your loved ones care about you and want to help. In order to manage bipolar disorder, it’s essential that you have people you can count on to help you through rough times.   Join a bipolar disorder support group. Spending time with people who know what you’re going through and can honestly say they’ve “been there” can be very therapeutic. You can also benefit from the shared experiences and advice of the group members.   Build new relationships. Isolation and loneliness make bipolar disorder worse. If you don’t have a support network you can count on, take steps to develop healthy relationships.  Try taking a class, joining a church or a civic group, volunteering, or attending events in your community.   Tips for reaching out and building relationships   Talk to one person about your feelings. Help someone else by volunteering. Have lunch or coffee with a friend. Ask a loved one to check in with you regularly. Accompany someone to the movies, a concert, or a small get-together. Call or email an old friend. Go for a walk with a workout buddy. Schedule a weekly dinner date. Taking a class or joining a club. Confide in a counselor, therapist, or clergy member.     Develop an active daily routine   Your lifestyle choices including your sleeping, eating, and exercise patterns, have a significant impact on your moods. There are many things you can do in your daily life to get your symptoms under control and to keep depression and mania at bay.   Build structure into your life. Developing and sticking to a daily schedule can help stabilize the mood swings of bipolar disorder. Include set times for sleeping, eating, socializing, exercising, working, and relaxing. Try to maintain a regular pattern of activity even through emotional ups and downs.   Exercise frequently and avoid sitting for long periods of time. Exercise has a beneficial impact on mood. and may reduce the number of bipolar episodes you experience. Aerobic exercise such as running, swimming dancing, climbing or drumming – all activities that keep both arms and legs active are especially effective at treating depression. Try to incorporate at least 30 minutes of activity into your daily routine. Ten minutes here and there is just as effective as exercising for longer periods of time. Walking is a good choice for people of all fitness levels.   Keep a strict sleep schedule. Getting too little sleep can trigger mania, so it’s important to get plenty of rest. For some people, losing even a few hours can cause problems. However, too much sleep can also worsen your mood. The best advice is to maintain a consistent sleep schedule.    Healthy sleep habits for managing bipolar disorder   Go to bed and wake up at the same time each day. Avoid or minimize napping, especially if it interferes with your sleep at night. Instead of viewing screens or other stimulating activities before bed, try taking a bath, reading a book, or listening to relaxing music. Limit caffeine after lunch and alcohol at night as both interfere with sleep.     Keep stress to a minimum   Stress can trigger episodes of mania and depression in people with bipolar disorder, so keeping it under control is extremely important. Know your limits, both at home and at work or school. Don’t take on more than you can handle and take time to yourself if you’re feeling overwhelmed. Learn how to relax. Relaxation techniques such as deep breathing, meditation, yoga, and guided imagery can be very effective at reducing stress and keeping you on an even keel. A daily relaxation practice can improve your mood and keep depression at bay.   Make leisure time a priority. Do things for no other reason than that it feels good to do them. Go to a funny movie, take a walk on the beach, listen to music, read a good book, or talk to a friend. Doing things just because they are fun is no indulgence. Play is s an emotional and mental health necessity.   Appeal to your senses. Stay calm and energized by appealing to your senses: sight, sound, touch, smell, and taste. Listen to music that lifts your mood, place flowers where you will see and smell them, massage your hands and feet, or sip a warm drink.     Watch what you put in your body   From the food you eat to the vitamins and drugs you take, the substances you put in your body have an impact on the symptoms of bipolar disorder—for better or worse.   Eat a healthy diet. There is an undeniable link between food and mood. For optimal mood, eat plenty of fresh fruits, vegetables, and whole grains and limit your fat and sugar intake. Space your meals out through the day, so your blood sugar never dips too low. High-carbohydrate diets can cause mood crashes, so they should also be avoided. Other mood-damaging foods include chocolate, caffeine, and processed foods.   Get your omega-3s. Omega-3 fatty acids may decrease mood swings in bipolar disorder. You can increase your intake of omega-3 by eating cold-water fish such as salmon, halibut, and sardines, soybeans, flaxseeds, canola oil, pumpkin seeds, and walnuts. Omega-3 is also available as a nutritional supplement.   Avoid alcohol and drugs. Drugs such as cocaine, ecstasy, and amphetamines can trigger mania, while alcohol and tranquilizers can trigger depression. Even moderate social drinking can upset your emotional balance. Substance use also interferes with sleep and may cause dangerous interactions with your medications. Attempts to self-medicate or numb your symptoms with drugs and alcohol only create more problems.   Be cautious when taking any medication. Certain prescription and over-the-counter medications can be problematic for people with bipolar disorder. Be especially careful with  antidepressant drugs, which can trigger mania. Other drugs that can cause mania include over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid medication.   There is hope!  Recovery is possible and this is help.  Consider reaching out to a mental health therpist for support and guidance. I wish you luck with your next step!   In Kindess, Gaynor   
(MA, LCSW)
Answered on 01/21/2022

I have borderline personality disorder and ADHD. What types of therapy would be good for both?

Attention-Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD) are two distinct mental health diagnoses. ADHD is comprised of symptoms such as being impulsive and hyperactive, having difficulty concentrating and focusing and having trouble paying attention due to a short attention span. Individuals diagnosed with ADHD can also experience other mood related symptoms such as anxiety, depression, and mood swings. Borderline Personality disorder is characterized by intense emotions that are erratic and unstable at times, difficulty maintaining relationships, impulsive, risky or reckless behavior that is self-defeating, self-harm and/or suicidal ideation and fear of being abandoned as relationships are unstable. Although distinct, there are commonalities between ADHD and Borderline Personality Disorder such as acting impulsively and having difficulty regulating emotions. Dealing with both sympotms from each of these two diagnoses can make it very difficult to function from day to day. Dialectical Behavior Therapy (DBT) is a form of treatment that can be effective in managing symptoms of ADHD and BPD. DBT is widely known for the treatment of Bordeline Personality Disorder specifically. However, even though DBT is mostly known for the treatment of BPD, the skills taught have been shown to be widely useful in managing an array of symptoms in relation to mood and anxiety related disorders. DBT teaches skills in 4 different areas. The areas include mindfulness skills, distress tolerance skills, emotion regulation skills and interpersonal effectiveness skills. If you have engaged in therapy before and are familiar with Cognitive Behaivor Therapy (CBT), it is good to know that DBT is a form of CBT. The focus is different however. While CBT focuses on reframing thoughts and changing our behavior to create different emotions, DBT focuses on changing a pattern of behavior and overall gaining mastery over our emotions by way of acceptance among other techniques. My suggestion would be to begin focusing on the two modules that would be most closely related to managing both ADHD and Borderline Personality Disorder. These modules would be mindfulness skills training which can assist with being in the present moment and shifting your attention and focus and emotion regulation skills training which would assist with managing your emotions by not letting your emotions or urges dictate your behavior such as by acting opposite of your urges. I hope that this information has been helpful in identifying what may be the best form of treatment for treating both ADHD and Borderline Personality Disorder. I encourage you to look into this modality of treatment and seek out a provider that would be able to teach you DBT skills. 
(MS, LPC, MAC)
Answered on 01/21/2022

How hard is it to be diagnosed with bpd?

In the years I have worked with folks who have one or both diagnoses, I have discovered that the diagnosis itself is only part of the resolution, and I explain why below. That said, a definitive diagnosis for bipolar spectrum d/o and/or BPD takes time and should be done with a therapist or a mental health agency in collaboration with a prescribing psychologist or psychiatrist. That's because medication is usually indicated if one or both diagnoses are present, and these professionals would have the experience to prescribe and provide the continual monitoring and medication adjusting necessary. So first of all, find a psychiatrist or prescribing psychologist in your community to speak to about your concerns. The right medication may make a world of difference. By license and experience, I and many mental health professionals are licensed and qualified to make either diagnosis and when we do we recommend the involvement of medical professionals. On BetterHelp, therapists are not allowed to diagnose. When I have worked with someone on BetterHelp and suspect bipolar spectrum or BPD, I recommend qualified medical involvement. That brings me to my very first sentence above. There are overlapping qualities of both diagnoses that may or may not be present. Particularly with BPD folks may find themselves making decisions impulsively; getting mad and yelling at others, and not understanding when friends and family react negatively to the harshness when the yelling makes you feel better; using substances excessively to self-medicate which leads to greater isolation, or more extreme behaviors that drive people further away; feeling insecure, upset and even abandoned when feeling lonely, and maybe feeling suicidal.   Many folks with both diagnoses have histories of trauma. Symptoms of PTSD also may overlap with bipolar spectrum d/o and BPD, another reason to seek out psychiatric assistance. There are many effective treatments for trauma now that can help with some of the behaviors described above. Medication can help a person establish a more stable baseline. But equally important, skills must be learned and practiced consistently to calm these behaviors and help introduce longed-for feelings of well being and calm. Dialectical Behavioral Therapy (DBT) teaches these skills, and I've seen many folks feel so much better practicing DBT.  I've noticed BetterHelp offers groups with DBT modules. Honestly, everyone can benefit from DBT and it is now in wide use. You may also find some DBT groups in your community. Not many folks are willing to stick with DBT because it takes commitment.  Not many are willing to  see a psychiatrist because that seems "over the top." But if you are in that kind of pain, and you want to feel better, please do both. You deserve a life you can celebrate.
(MA, LMHC)
Answered on 01/21/2022

Is my symptoms related to borderline personality disorder?

Hello Glyn,   Thank you for reaching out on The Betterhelp Platform with your question:   Is my symptoms related to borderline personality disorder?   In reviewing the details you have shared with me about what you are experiencing and some of your symptoms I would support the belief that you most likely do have a diagnosis of boderline personality.  This of course is not a formal diagnosis. It is important to know that your diagnosis would need to be fully assessed and explored by you attending a full evaluation with your mental health provider. What is most important for you is to consider reaching out to seek help from a licensed professional - someone who can advice you with the best course of treatment geared for you.   I will share some information that may be of some help to you about Borderline Personality Disorder.   Borderline personality disorder is a mental health disorder that impacts the way you think and feels about yourself and others, causing problems functioning in everyday life. It includes self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships.   With borderline personality disorder, you generally indicate an intense fear of abandonment or instability, and you may have difficulty tolerating being alone. Yet inappropriate anger, impulsiveness, and frequent mood swings may push others away, even though you want to have loving and lasting relationships.   Borderline personality disorder usually begins by early adulthood. The condition seems to be worse in young adulthood and may gradually get better with age.   If you have a borderline personality disorder, don't get discouraged. Many people with this disorder get better over time with treatment and can learn to live satisfying lives.     Symptoms    Borderline personality disorder affects how you feel about yourself, how you relate to others and how you behave.   Signs and symptoms may include: An intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection. A pattern of unstable intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn't care enough or is cruel Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours. Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship. Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection. Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety. Ongoing feelings of emptiness. Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights.   When to see a professional   If you're aware that you have any of the signs or symptoms above, talk to your doctor or a mental health provider.   If you have suicidal thoughts If you have fantasies or mental images about hurting yourself or have other suicidal thoughts, get help right away by taking one of these actions: Call 911 or your local emergency number immediately. Call a suicide hotline number. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) any time of day. Use that same number and press "1" to reach the Veterans Crisis Line,. Call your mental health provider, doctor, or other health care provider. Reach out to a loved one, close friend trusted peer, or co-worker. Contact someone from your faith community. If you notice signs or symptoms in a family member or friend, talk to that person about seeing a doctor or mental health provider. But you can't force someone to seek help. If the relationship causes you significant stress, you may find it helpful to see a therapist yourself.   Causes of Boderline Personality Disorder   As with other mental health disorders, the causes of borderline personality disorder aren't fully understood. In addition to environmental factors — such as a history of child abuse or neglect — borderline personality disorder may be linked to: Genetics. Some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental health disorders among family members. Brain abnormalities. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity, and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly. Risk factors Some factors related to personality development can increase the risk of developing borderline personality disorder. These include: Hereditary predisposition. You may be at a higher risk if a close relative — your mother, father, brother or sister — has the same or a similar disorder. Stressful childhood. Many people with the disorder report being sexually or physically abused or neglected during childhood. Some people have lost or were separated from a parent or close caregiver when they were young or had parents or caregivers with substance misuse or other mental health issues. Others have been exposed to hostile conflict and unstable family relationships,   Borderline personality disorder has the potential to damage many areas of your life. It can negatively affect intimate relationships, jobs, school, social activities, and self-image, resulting in: Repeated job changes or losses Not completing an education Multiple legal issues, such as jail time Conflict-filled relationships, marital stress, or divorce Self-injury, such as cutting or burning, and frequent hospitalizations Involvement in abusive relationships Unplanned pregnancies, sexually transmitted infections, motor vehicle accidents and physical fights due to impulsive and risky behavior Attempted or completed suicide In addition, you may have other mental health disorders, such as: Depression Alcohol or other substance misuses Anxiety disorders Eating disorders Bipolar disorder Post-traumatic stress disorder (PTSD) Attention-deficit/hyperactivity disorder (ADHD) Other personality disorders   There is hope.  Recovery is possible! No matter what you are going through and what your diagnosis maybe there is help for you.  I would encourage you to reach out to your medical provider and seek some support or seek some support and guidance from a professional mental health therapist who can guide you with some effective interventions to reduce any negative symptoms you are experiencing so you can live a more satisfying life.   I wish you much luck with your next step!   Kind Regards, Gaynor 
(MA, LCSW)
Answered on 01/21/2022

Do you have psychiatrist on here?

Hello! I am so glad you are reaching out, it's important to address mental health, so I'm glad you are here and asking these questions. Now, bipolar has a lot to consider, first, diagnosing should have an extensive history review, including family history, mood history, biopsychosocial history. Second, depressive and anxiety disorders must be ruled out before bipolar is assigned as a diagnosis. As a clinician I follow the outlined criteria in the Diagnostic Dratistical Manual version 5, as well as, the completed history of the individual, if possible I get collateral feedback from friends or family as well about what it looks like outside of the client. This helps me identify the best and most comprehensive outcome/diagnosis. Many clinicians follow this course or similar to it.  If someone is diagnosed with bipolar, I would encourage them to evaluate all tools available to them, this would include medication management, anger management, psychotherapy for the client, their family or the couple. Utilizing these tools help with the best prognosis for the client and increases stabilization in mood and helps stabilize relationships and even employment.  Coping skills for the client will be important and crisis planning because the more skills a person has (in general) the less likely they have high risk behaviors that put their life, wellbeing or employment in Jeopardy. Now with this said, it's important to know that a diagnosis is not an excuse or a label that defines you, the diagnosis only guides clinicians and doctors in how to treat you, it's not a death scentence or a soul crusher or a deal breaker to wellness. It is a small peice and I have seen and worked with individuals who are incredibly in control of their diagnosis and have a very fulfilling life. Additionally to proper diagnosing, learning coping skills like emotional regulation, anger management, distress tolerance, decision making, crisis planning and effective communication styles (Just to name a few) can be very very helpful managing mood swings and negative thought cycles.  Taking the next step to speak with a clinician who can properly diagnose you is something that may provide you peace of mind and stabilization, regardless of the cause of the mood changes.  Take care and be well!
(MS, LPC, NCC)
Answered on 01/21/2022

Is it possible to go 18 years of life unknowingly having being on the Autism spectrum?

Hi Averagejoshmoe, Thank you for asking this question about autism and possible undiagnosed Autistism Spectrum Disorders. The short answer to your question is, yes it is possible for a person to have Autistism Spectrum Disorder and make it to the age of 18 or even further into adulthood and never receive an official diagnosis. As with every mental disorder or illness diagnosed using the criteria contained in the Diagnostic and Statistical Manual of Mental Disrders Fifth Edition (DSM-5), Autism Spectrum Disorder will only be diagnosed or rather should only be diagnosed when the minimum criteria are met, the person seeks assistance from a menta health professional or assistance is requested on behalf of an individual and this professional is able to complete a full diagnostic interview that includes the individual in question and the involved parents or other care givers. If this diagnostic interview takes place later in the individual's life, such as in K-6 grades, then at least one teacher and a person involved in professionally supporting the individual, such as a social services worker or a developemental aid who might asist in supportive educational activities and possibly a behavioral analyst who has cloosely and extensively observed the individual interacting with peers should also be included as sources of information so that a clear clinical picture can be put together. Using evidence from this number of reliable and specialized sources will allow the clinician to put together a very detailed diagnostic assessment and it would be extremely unlikely that a diagnosis would be missed. The deficits that come together for a diagnosis of Autism Spectrum Disorder include persistent impairments in social communication and social interaction along with repetitive behaviors and restricted intersts in activities and topics of interest or discussion. There are additional criteria, although the ones just mentioned are not just present in an individual. A person could display evidence to meet every diagnotic criteria, yet may also have above average intelectual developement such that an individual could create or develop methods of coping with the deficits so that they are not imaired to a significant degree.  I think it would be highly unlikely for an individual to meet all of the diagnostic criteria for Autism except for the criteria that the deficits cause significant impairment in functioning in either social, occupational or self care activities. However, I do not think it is impossibe that perhaps an individual could have mild to moderate  impairments in most of the diagnostic criteria and if the individual does not have an intellectual impairment,  maybe even above average or superior level of intellectual development (in other words, an IQ in the range of 110-130), this could allow a person to overcom the deficits by compensating for them using creative strategies. However, because Autism is generally evident between 12-24 months of age, and intelectual development is in early stages at this age, an individual meeting diagnostic criteria for Autism Spectrum Disorder at this young age is not going to have compensatory mechanisms in place. The social and social communication deficits at this age are going to be fairly obvious, such as a child at this age might not be pointing or follow a poined finger or does not pick items up to show his mother , they often have little interest in other children their age just as a couple of examples. Care givers are usually very sensitive to differences and particularly things their child is not doing that most other kids of the same age are doing at this age and the deficits of autism are unikely to escape the notice of a mother.   This brings up a question that is beyond the scope I think of what you were asking, if a person meets the criteria for autism as a child and as an adult they have learned to compensate for some of their deficits, is the person still consider to fit the diagnosis of Autism Spectrum Disorder. Technically yes, and probabally functionally yes also, although it might not be as aparent. I hope this has helped you come to your own answer to your question. answers your question. Austism Spectrum Disorder is included in the DSM because the number of deficits a person has all but ensures an individual will have significant impairments in functioning. 
(LCSW)
Answered on 01/21/2022

I'm not sure if i might have a form of quiet bpd, maybe narcissistic, or some attention deficit.

Hello Petra,   Thank you for reaching out on The Betterhelp Platform with your query: I'm not sure if i might have a form of quiet bpd, maybe narcissistic, or some attention deficit. It is not possible to give you a diagnosis based on the information you have shared but I can certainly share more information about narcisissim.  If you have further questions or concerns you should consider reaching out to your medical provider to request a full assessment of what might be going on for you. Narcissistic personality disorder — one of several types of personality disorders — is a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others. But behind this mask of extreme confidence lies a fragile self-esteem that's vulnerable to the slightest criticism.   A narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial affairs. People with narcissistic personality disorder may be generally unhappy and disappointed when they're not given the special favors or admiration they believe they deserve. They may find their relationships unfulfilling, and others may not enjoy being around them.   How can you tell if you are a narcissist? I will share a list of signs of narcissistic personality disorder (NPD)   We live in an increasingly self-obsessed culture, and we hear the word narcissist thrown around quite often in social media. But what is narcissism, and how can you tell if you are a narcissist?   Here are signs of a narcissist:   Inflated sense of superiority and entitlement Excessive need for constant praise and admiration Perfectionism Lack of empathy Need for control Easily provoked Extremely selfish Unable to deal with criticism, perceived slights, or disagreements Hypersensitive, defensive, and anxious Not settling for anything less than what you think you deserve Surrounding yourself with people who constantly admire you Expecting everyone to comply with your wishes and whims Thinking others always need a favor from you Exploiting others without guilt or shame Taking unfair advantage of others Frequently demeaning others Getting intimidated by others you perceive as stronger than you Fantasizing often about power, brilliance, beauty, and ideal love Ignoring facts and opinions that contradict your own Refusing to change your behavior no matter how much chaos it creates in your life Blaming others for your behavior   What causes narcissistic personality disorder?   While many use the word narcissist to describe someone who is arrogant or self-absorbed, it’s important to understand that Narcissistic Personality Disorder (NPD) is an actual serious condition.   However, the exact cause of the disorder is unknown. It may stem from a combination of factors such as:   Genetics (if one of your parents had a Narcissistic Personality Disorder, you have an increased chance of developing it) Personality and temperament Childhood trauma Childhood relationships with parents and siblings Narcissists have troubled relationships due to their defining traits. Nevertheless, behind the mask of a confident person, they often have fragile self-esteem.   Can you avoid becoming a narcissist?   If you are concerned about your own behavior or that of a loved one, consult a mental health professional. If you are a parent, you can avoid promoting habits that can contribute to narcissism in your kids:   Showering them with unnecessary praise and attention Treating your kids as exceptional or more deserving than anyone else Not setting limits and boundaries Not teaching respect for others Allowing them to get exposed to things that influence them in a negative way   Can people with narcissistic personality disorder get better?   Counseling and talk therapy (psychotherapy) seem to be the most effective treatment for narcissistic personality disorder.   Accepting that you have the problem and wanting to start counseling means you are already halfway there. People with NPD are often incredibly fearful of criticism, which can stop you from accepting help.    However, with counseling, your thought pattern can start to change for the better. Over time, you may notice positive changes in your behavior, and as a result, see improvements in your relationships with others and increased quality of life.   People with narcissistic personality disorder may not want to think that anything could be wrong, so they may be unlikely to seek treatment. If they do seek treatment, it's more likely to be for symptoms of depression, drug or alcohol use, or another mental health problem. But perceived insults to self-esteem may make it difficult to accept and follow through with treatment. If you recognize aspects of your personality that are common to narcissistic personality disorder or you're feeling overwhelmed by sadness, consider reaching out to a trusted doctor or mental health provider. Getting the right treatment can help make your life more rewarding and enjoyable.   I encourage you to reach out for further exploration of what might be going on for you.  Regardless of the diagnosis there is help and support for you with what your anxiety and mood swings in your relationships.  There is always hope and you do not have to go through this on your own.    A mental health therapist can help you with some effective interventions that can make a big difference in your life. I wish you much luck with you next step and your path to a calmer life! Best Gaynor   
(MA, LCSW)
Answered on 01/21/2022