Impulse Control Disorder Answers

Thank you so much for asking this question and reaching out for help. You are definitely not alone when it comes to this problem.  In your question, you indicated that you lie in order to avoid conflict, possibly even perceived conflict. As Dr. Marks indicates, pathological lying is not a mental disorder but is identified as a behavioral disturbance. She explains that there is a difference between normal lying, prolific lying and pathological lying. She proceeds to define normal lying as the lying we engage in to spare another person’s feelings or getting out of something minor. Normal lying causes no or very little problems in a person's life. In contrast, pathological lying is a compulsive behavior that has no clear motive. On the other hand, prolific lying is defined as being deceptive for a purpose and leads to more complications in work, relationships and other areas of your life. At this point, it is important for you to take a moment and ask yourself if you are a person who is lying compulsively with no clear motive (pathologically lying) or if your lying is potentially prolific because your motive is to avoid being held accountable or to avoid engaging in any type of conflict.  Whether you identify as a prolific or pathological liar there are a few steps you can implement in order to change your behavior. First step, as always, is to admit that you have a problem. By reaching out for answers to your question you obviously understand that lying is a problem for you and may be leading to more complications in your life. The next step is to be accountable to other people in your life. You can choose one accountability partner or admit to everyone in your life that you are struggling with controlling a lying habit and need their help to change this behavior.  Of course, entering therapy to address the underlying causes of your lying as well as help keep you accountable will aid in creating change. Follow the creating accountability step with developing a list of  consequences you have experienced and will experience if you continue to engage in habitual lying. Write this list and post this list somewhere you see every morning and every night. By presenting yourself with this list twice a day you will be reminding yourself of the negative outcomes that will occur if you choose to lie that day. Journal about your progress each day. Identify where you feel you faltered and where you feel you succeeded. Create a goal to focus on the next day that will help you reduce your lying. Accountability is key - keep yourself accountable while also inviting others to hold you accountable. Commit to change every day while also acknowledging it will take time, struggles but, eventually, with attention and commitment to change you will succeed. 

Hi Phoenix22 and thank you for asking me your question about changing your thought patterns and decreasing mood swings. You mentioned that your mood swings have become more frequent and more difficult to moderate after you had your second chid about two years ago. From your description, it sounded that you were not having mood swings from feeling "high" or manic to then shortly afterwards experiencing a swing in your mood to severe depression. I am not trying to diagnose you and without conducting a diagnostic interview in person, would not be able to diagnose you with anything. In any case, my first thought, when reading the title of your question was that you were experiencing Bipolar Disorder. While psychotherapy can be helpful in decreasing severity and frequency of  mood swings in a person with Bipolar Disorder, the most important issue first would be to consult a psychiatrist to figure out which medication combination would work best. After that, therapy could be useful. You mentioned being diagnosed with Borderline Personality Disorder. If this diagnosis predates the birth of your second child, then I would want to be certain that the doctor treating you evaluated you for Post-Partum Depression, to ensure the diagnosis is correct and to rethink medication choices.  Your symptoms do sound to be consistent with Borderline Personality Disorder and assuming this is the case, it could be helpful to read about Cognitive Behavioral Therapy (CBT), particularly exercises that discuss and teach you how thoughts lead to emotions and together, these influence actions and behaviors. In addition, it would be helpful to learn about cognitive distortions which often cause us to believe that situations are much worse than they really are and happen as automatic thoughts. It could be helpful to determine which of the types of cognitive distortions influence your thoughts and emotions the most and from there, you could modify these distortions and automatic thoughts so that your thoughts are not as severely negative and then you would have less negative emotions and thoughts influencing your daily actions and behaviors.  If you were in therapy, I would also introduce Dialectical Behavioral Therapy, (DBT) the only therapy approach to lead to reliable improvements in better mood regulation in individuals with Borderline Personality Disorder.  DBT involves several modules in which a person learns to make decisions and settle disagreements only when you can approach these issues from what is called a "Wise Mind". The wise mind is not under the influence of alcohol or drugs, it is calm and able to assess all aspects of a problem and incorporate the information needed to come to an informed decision or resolution. DBT also teaches mindfulness mediation which teaches a person to be present in the here and now and not worrying about things from the past and future. Another of the core modules of DBT teaches the many activities and methods a person can engage in to help them tolerate distress, or deal with pain and other unpleasant variables without resorting to impulsive and destructive actions and behaviors. The final core module teaches Interpersonal Effectiveness. This is exactly as is sounds, how to relate to other people while remaining calm and civil as well as communicating effectively. Some versions of DBT have additional modules that are helpful, however the ones that I have mentioned here will be found in any article or book on Dialectical Behavioral Therapy. The information from Cognitive Behavioral Therapy can usually be found online with persistent searches. I wish I could come up with a single book on CBT to suggest, however all the ones that I have are written either with a lot of clinical language or written academically and would be like text books and not of help to you. As for DBT, much can be found on the internet, although an even better source would be one of the Dialectical Behavioral Therapy workbooks. There are several available and they have information and lessons that are easy to understand and are printed and bound like spiral notebooks so that you can make copies of the worksheets in the book. The worksheets are helpful because they go over lessons and ask you to think of personal examples and answer questions from the viewpoint of the personal situation that you chose at the beginning of the worksheet. Along with those suggestions, I think it is important for you to see a therapist who is well versed in DBT as soon as you are able. I hope this information gives you a helpful place to start and I wish you the best of luck and a great life, Daniel Boyle Downey, LCSW

It sounds like you're feeling a lot of confusion, you recognize that what you are doing isn't working, yet you can't seem to find a way to make the choices that you want to make. This is a place many people find themselves in and feel like it is impossible to get out of, but the important thing to remember here is to take things in baby steps.  There are a number of questions that need to be covered here. First of all, you have a question about a potential diagnosis of bipolar which seems to potentially underly much of your behavior. For that, you would need to meet with a provider for a diagnostic interview or psychiatric intake, typically done by a psychiatrist or psychologist.  There does tend to be genetic predispositions with certain types of mental health disorders; however, just because it runs in your family doesn't mean you have bipolar disorder.  Sometimes, growing up in a situation where certain behaviors are the norm leads to others adopting those behaviors as their own. Once the individuals realize it and get out of the situation, they can make changes that are more within their personal norms and feel more comfortable.  When we find ourselves avoiding tasks that we know we need to do there are a few different ways to handle the situation. First of all, working on your mindset and realizing that saying yes to one thing means saying no to another. As you sit down or head out to do something, ask yourself first, "If I do this, what am I saying no to?" just making a habit of stopping and thinking about the choices that you are making, while it may not fix everything immediately, is a step in the right direction. It is important to remember that you have been living in this pattern for a long time, so even making the decision to change is the first step, but the steps to follow must be made in small manageable chunks where you can easily see success so your brain will see the reward and then want to continue making those changes.   Create a system that only asks for small changes of yourself, instead of focusing on the large changes that you are wanting to make overall. If you want to start a regular exercise routine, think about when is the time that you will be best motivated to do something, and instead of making a large goal like: I will go to the gym and workout for an hour at this time; start off with something that is just activity that you like it may be just committing to 15 minutes walking in the neighborhood, or 15 minutes dancing in the living room. Once that 15 minutes becomes a habit then increase it and gradually it will become something you look forward to and you won't have to fight yourself to get it to happen.  For budgeting, creating space between you and spending you money so you have to think about it helps with starting to get in the habit of saving.  An example may be setting up a savings account that you don't have easy access to from your checking account. This ensures that savings are only used for emergencies or for the purpose the money was set aside for.  With relationships, if you find yourself in an on-again-off-again situation; it's important to sit down and ask yourself why that is the pattern you are following. Are you comfortable and happy when you are alone? If not, then you will find yourself compromising your own happiness and goals in relationships, and they will be unpredictable and potentially border on toxic for both of you.  It's important to be happy and content with who you are before you add in the complications of a relationship with another person.  You have a lot to unpack here and if you try to focus on everything at once, it will be overwhelming. It's important to pick one or two areas of focus and take small steps in those areas, make those small things a habit before you try to take on anything else. 

Thank you so much for your question. Coping with Borderline Personality Disorder (BPD) can be very challenging. BPD is characterized by the difficulty in being able to regulate one's emotions. Emotions can be felt more intensely for extended periods of time for people who are diagnosed with this condition. These challenges in healthy mood regulation can lead to impulsivity, poor self-image, conflict in interpersonal relationships, and intense emotional responses to stressors.  I am going to answer this question from two main perspectives of (1) a person with a confirmed diagnosis from licensed mental health professions and (2) a person without a confirmed diagnosis. I would also encourage you to contact your benefits provider to find out what kind of behavioral health care coverage you have because oftentimes if you have assistance for medical coverage, the benefits plan will account for mental health as well.  (1) If you have already received a diagnosis of Borderline Personality Disorder (BPD) from a licensed professional, the next step would be to try to get engaged with treatment services. Psychotherapy has been proven to be very effective in the treatment of BPD as it addresses the emotional dysregulation associated with the disorder. You can check to see if there are any providers that your insurance may cover that offer Dialectical Behavioral Therapy (DBT) and/or Cognitive Behavioral Therapy (CBT). -DBT focuses on teaching coping skills to help fight destructive urges, regulate emotions, improve relationships, and practicing mindfulness. -CBT focuses on helping to reduce negative thinking and the behaviors associated with BPD by learning effective coping strategies. Sometimes medication-assisted treatment can be effective with the combination of psychotherapy which usually requires a prescriber. Some things you can do on your own include: -Connecting with others through support groups (in-person or online) -Taking care of your physical health (eating balanced meals, getting adequate rest, stress-relieving activities like meditation or yoga) -Avoid the use of mood-altering substances like alcohol and drugs as it can exacerbate symptoms of BPD   (2) The first thing a person would benefit from doing if they suspect they have BPD is to get assessed by a licensed mental health professional, preferably one who specializes in personality disorders. It is important to not self-diagnose because these professionals are trained to look for symptomatology and potential causes of these conditions. A licensed professional with be able to help a person navigate the mouse appropriate level of care.   For more free resources please check out these sites below: https://www.nhs.uk/mental-health/conditions/borderline-personality-disorder/treatment/ https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Borderline-Personality-Disorder/Overview https://www.borderlinepersonalitydisorder.org/consumer-recovery-resources/