Abuse

At the age of 5 I lost my father to suicide following the traumatic event I began to act out a lot more. Around age 7 I began to scream or cry and have extreme outbursts. Continuing on throughout my childhood I suffered repeated emotional and physical abuse from my mother. As well as being in a domestic violent home my needs were almost never met. I found myself taking care of myself and my brothers and constantly being on edge or in fear. As a child I was always changing my hair color as well as what sport or activities I liked. In my teen years the suicidal thoughts starting showing at age 14. In relationships I found myself to be extremely attached to the person being called annoying from how much I would text them or have the extreme desire to always be around them. My relationships have also always been intense. I notice I like to jump straight into another relationship if one ends. At around age 18 I started using drugs to numb the pain from my home life. Then moving in with my boyfriend and his mom only to experience more emotional abuse that lead me to a psych hospital. I was using these drugs to alter my personality I guess. To make myself more outgoing in a sense more fun to be around. My likes and dislikes seem to change almost everyday as well as my mood. Nothing about my emotions seem stable I can be happy one moment and for no reason become intensely angry. I also have a hard time focusing on one task at a time I am easily distracted. During the day I have to constantly find something to do to keep myself from feeling extremely bored or depressed. For example I will get up to get a glass of water but find myself vacuuming the whole house and cleaning my room. My sleep schedule has always been erratic I can sleep for 5 hours and still feel hyper. I am currently on prozac as my doctor thinks my only problem is anxiety. I have not been assessed at all since seeing this psychiatrist and my symptoms have been ignored. I almost feel crazy because I’m not sure what to believe are these feelings valid to others. I would really like to know what could be wrong.

Of course, it’s impossible to provide a diagnosis over the internet based on only a short letter. I would highly recommend undergoing a full assessment with a mental health professional. They will collect personal and psychosocial information about your life and interview you at length, which would help them to determine if a psychological diagnosis is warranted. There’s a tremendous advantage to conducting an in-depth interview as it allows the evaluator the opportunity to ask probing questions and to gauge an individual’s responses, observe body language and so forth. A thorough evaluation is the best place to start.

Although I cannot provide a diagnosis over the internet, I can provide some general feedback about your symptoms. In general, nothing you have described necessarily, fits borderline personality disorder. Rather, there may not be any one particular diagnosis that fully encompasses your symptoms. You lost your father to suicide at a very young age. That’s traumatic for anyone at any age but even more so for a child. It makes sense that you would begin acting out after the loss of your father. That is expected, especially given the absence of any intervention for the trauma of losing a parent to suicide. You were left to fend for yourself. Anyone would have struggled in that circumstance, most especially a young child.

Then, you had to deal with your mother repeatedly emotionally and physically abusing you. You stated that your needs were “almost never met.” You had to take care of yourself and your siblings when you were only a child. You lived, as you said, in a constant state of fear. There’s an enormous body of research that exists demonstrating the long-term damage of physical and emotional abuse on children. Studies show that children who were abused, sometimes develop posttraumatic stress disorder (PTSD). In these studies, children with PTSD, as a result of having been physically and emotionally abused, continued to experience elevated levels of stress even on “normal days” when nothing especially stressful was happening. In other words, their stress systems continued to be turned on even when they didn’t need to be. This creates a heightened sense of anxiety for a child, leaving them feeling uneasy, uncertain, and on edge. This may be what you had experienced and perhaps continue to experience.

At that point, as you got older, you began to do things such as dye your hair, experiment with drugs, and so forth. That’s fairly typical behavior among many teenagers but especially among those who lack support and guidance in their lives. You were doing the best that you could, given your difficult circumstances.

Fast forward to today. As you mentioned, you continue to experience problems but that’s not surprising given the fact that you seemingly have yet to try treatment. You spent some time in a hospital but typically hospital stays are short and are only meant to stabilize an individual’s acute mental state. Once the emergency has passed, hospitals typically discharge patients and recommend outpatient treatment for longer-term therapy.

My recommendation is counseling. Medication alone is not meeting your needs, as evidenced by the fact that you continue to have many distressing symptoms despite being on Prozac. You might benefit from dialectical behavioral therapy (DBT) which was developed as a specific treatment for borderline personality disorder but is also effective for other disorders. The key is to find a therapist you like and trust and with whom you feel comfortable. I always advise interviewing at least 4 to 5 therapists, over the phone, before beginning making a choice. Choose the one who you like the best. In this pandemic environment, your only therapy option may be by telehealth. Many people are finding it more convenient than traditional therapy.

All of the symptoms you have described are treatable. With the right help and guidance, you can overcome these issues. I wish you the best of luck. Please take care.

Dr. Kristina Randle