Tag:

Irritability

Unstable Emotions

by Kristina Randle, Ph.D., LCSW February 13, 2021

written by Kristina Randle, Ph.D., LCSW

I’m not getting much help from my doctor: Ok so i have the following symptoms: depression (a lot); low mood; sometimes i feel i have too much energy and can actually feel the adrenalin inside my body running through my veins when i look in the mirror i mostly strongly dislike what i see but sometimes i feel almost amazed at the fact i look good (i feel big headed when this happens; i either have very little energy or way too much no in-between; i suffer from rapid speech all the time; I’m always losing my train of thought in the middle of a sentence or discussion; i get like itchy all over my body

I have OCD i have to count a lot and rhythmically and routinely do things, have things a very certain way, count my steps and so on. i find myself not just talking to myself but arguing constantly. as if im having a row with someone else but im playing both sides. it takes literally nothing to make me cry. i have a real problem accepting both praise and criticism. i feel constantly like a failure to myself others and family and my hcildren like im not worth the air i breath. altho i will do anything to make other people happy sometimes i fond myself having a total disregard for toher peoples feelings. not that i want to upset someone on purpose but more like im past caring. i get these sudden bouts of irritability which i take out on myself or my partner, not my children i have to add. this is really affecting my daily life and i just want it to stop.

Some of your symptoms are suggestive of bipolar disorder. Inflated self-esteem, being easily distracted, rapid or pressured speech, and irritability are characteristics of mania. A mania episode diagnosis, according to the DSM-5, requires that your symptoms be present for at least a week and last most of each day, are not attributable to some other physiological effect such as drug use or a medication side effect, and are causing you significant impairment in social or occupational functioning.

You also mentioned that you have OCD. OCD is an anxiety disorder. It does not seem as if your OCD symptoms are under control. People with OCD feel out of control and engage in counting and strictly adhering to routines in order to make themselves feel more in control. The rituals and routines are unhelpful and following them only makes your OCD worse. They may make you temporarily feel better but in the long run they reinforce your anxiety.

Arguing, having difficulty accepting both criticism and praise, feeling like a failure, possessing no regard for other people’s feelings, are not necessarily signs of any one particular mental health disorder but generally are signs of emotional instability. It’s possible that they are associated with your out-of-control OCD symptoms or perhaps bipolar disorder but without more information it’s difficult to determine the exact nature of these issues.

You are currently seeing a doctor but said he is unhelpful. If the help that you are receiving is ineffective, then consider seeing a new mental health professional. You can ask for a referral or simply find one on your own. Search for a mental health professional with whom you feel comfortable and who has a good track record of success. Choose a therapist who specializes in mood disorders. OCD and bipolar disorder are highly treatable with both medication and psychotherapy. Changing doctors might be just what you need to solve this problem. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

February 13, 2021 0 comments

Do I Have Borderline Personality Disorder or Am I Just Overreacting?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP February 11, 2021

written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

From Sweden: I apologize in advance as I know this question has been asked, but I feel like I have not gotten the answer I’m looking for.

What leads me to suspect I have at least traits of BPD:

-Impulsivity: I have been impulsive since I was a child.I binge-eat, (purge), I’ve had unprotected sex, impulsive romantic interests, I chose what I wanted to work with on impulse, it’s hard to stop the impulsivity, etc.

-Fear of abandonment: If my friends are short with me; if they don’t pay attention to me; if they text without smileys; if my girlfriend doesn’t reply to my texts fast enough; if people don’t laugh at my jokes, I’ll be convinced they’re leaving me. I’ve pulled and clung to my friend so she wouldn’t “leave”.

-Identity crisis: I have no idea what I want to do with my life (granted, I am only 18 years old!) but one day I want to work with something, the next day it’s something completely different. One day I’ll say I believe in something, the next day my view is changed.

-Emotional instability: Sometimes I have intense mood swings where I am very frustrated/irritable and then laugh and cry hystercally without any warning. During those times, I talk too fast, and I make no sense. I say things I don’t mean. And I can be cruel. Other times, I feel empty.

-I idealize people when I first meet them and then after a while, without warning, I have this intense anger and hatred toward them. It’s over trivial things, too. I will “hate” my girlfriend for nothing and I’ll be moody/passive aggressive or quiet around her and then other times I will be completely in love with her and never want to break up with her.

-I took the tests on this site and both of them tell me BDP is [severely] likely.

Things that lead me to believe I do not have [traits of] BDP:

-My friends say I’m overreacting
-I am not paranoid
-My relationships have been intense and quick, but not unstable in the sense that we fight a lot.
-I have difficulty controlling my anger SOMETIMES, like most people I would think
-I perceive people with BPD to be more unstable than I am (perhaps this is ignorance on my part)

Does it look like I have traits of BPD or am I overreacting?

Thank you for asking. It looks like you have done your homework on BPD. While it would be inappropriate for me to make a diagnosis, the important thing is that you have identified the symptoms that cause concern. It is important to remember that you have the same collection of indications whether or not you are overreacting on a regular basis — or meeting the criteria for BPD. A diagnosis can be helpful in finding the right treatment, but often a list of symptoms doesn’t fit neatly into a categorized diagnosis. I think the best way to move forward is to make an appointment with a psychologist or psychiatrist. He or she will be able to help put together a treatment plan for the symptoms, which is the main goal.

Wishing you patience and peace,
Dr. Dan

February 11, 2021 0 comments

My Spouse Can’t Handle Change

by Holly Counts, Psy.D. January 23, 2021

written by Holly Counts, Psy.D.

My husband and I have been together 11 years. I started to write this letter because we can’t agree on moving into a new house. As I began writing I realized it is about much more than whether we move or not. My husband cannot handle change. No matter the situation, he gets completely overwhelmed, starts thinking about the worst possible outcome, and stresses himself out.

The current situation is that we started talking about moving 2.5 years ago. He was overwhelmed by that idea, said I was moving too fast, and couldn’t we compromise. He wanted a date way in the future, maybe we could meet in the middle. Life threw us a curve during that time frame where selling the house wasn’t an option, so I dropped it. After that situation passed we would discuss moving occasionally, but the timing wouldn’t be right, so I would drop it. Now we have started discussing it, the timing is right from a housing market standpoint. We found a house that we both love. He seemed finally to be in on it, so I start moving forward with getting our house ready to sell and he immediately became overwhelmed to the point that he makes himself ill. He says it is all going too fast, and can’t we wait another month. My point of view is that we have been discussing this for over 2 years, when you move, it can go fast, and the things that overwhelm him will still be there in a month, but the house may not.

In all fairness I do need to mention that his mother is terminally ill, and has been for sometime. I know that weighs on his mind. If he wasn’t always like this and it was just because of his mom, I would back off. But I know that with him it will never be a good time. It wasn’t a good time 2+ years ago, it isn’t a good time now, at some point his mom will pass and it won’t be a good time, then he’ll be getting ready to turn 50 and that will stress him out. He just keeps putting up new barriers. I don’t know how to help him. I know better than to think I can change him. I don’t know how to live in a state of paralysis because everything overwhelms him. (age 41, from US)

You are probably correct in thinking that your husband will always have a reason why “this isn’t a good time” if he has difficulty dealing with change. Some folks hate change and avoid it all costs and some folks hate the status quo and are always looking for excitement. It can be difficult to be married to either personality type, if they tend toward the extreme end.

It sounds like you have tried backing off and giving him time, but now that you are ready to move forward he is digging in his heals again. I’m sure that his mother’s illness is a huge stressor and could be wearing on him a great deal, however, focusing on getting your house ready to sell and looking forward to new surroundings could be a nice distraction, if he could reframe the whole situation.

I also agree that as a spouse, you can’t change him. You can try to understand and empathize. You can try to develop a strategy that takes into account his anxiety or resistance. But, you can’t change his personality or life-long patterns of thinking. What you can do is request that he seek help. He may benefit from medication to help with any possible anxiety or depression that could be an underlying issue, but most importantly, I would suggest that he seek counseling. In this case, both individual and couples therapy would be the best approach. Having a therapist or mediator in the room will help you approach an old conversation in a new way, hopefully aiding a mutually satisfying resolution.

All the best,

Dr. Holly Counts

January 23, 2021 0 comments

My parents don’t like me like this, and neither do I

by Dr. Marie Hartwell-Walker July 22, 2011

written by Dr. Marie Hartwell-Walker

From England: I’m 14. It’s only recently that things have changed, I live in quite a poor family, yet I have the basics of a teenager, a laptop and phone etc. I have always known that I’m never going to get what I would really like, but for once I thought that I would be happy. My mum told me that I would never be able to get an iPhone, but instead i could get a cheaper brand of phone, but still a smartphone. I was so happy, but then one morning, I started shouting at her for the smallest things and she refused to get me a phone, but never told me I wasn’t getting one. I was then told I wasn’t able to get a dress for the first party I would be going to in years. The next day at school we were exchanging texts, and I have never repeated the phrase “I hate you”, so many times. I appreciate what I have got, I’m not spoilt, but I’m not me. My mum refuses to believe that it’s hormones, she says that I no longer love her. I have been crying at school and at the slightest thing, eg. I had English for my first lesson. I have no idea what’s happening to me, and my mum doesn’t want to know me, my dad also. My friends don’t understand and they simply go on about how their home life is great. I’m finding this really hard to deal with, I feel like everything is different and no one will treat me the same any more. Am I having a mid-life crisis or something? I don’t understand what I’ve done and what to do about it.

No. You’re not having a mid-life crisis (you haven’t even hit a quarter-life yet). What you have hit is puberty. Different people respond to the hormonal shifts of adolescence in different ways. Some girls act as you do. If your mum didn’t have the same reactions to puberty when she was young, she might not understand that it’s your hormones that are talking, not you, when you go off.

I strongly suspect that your moodiness and irritability have to do with adjusting to the emotional rollercoaster that often comes with changes in body chemistry during the teen years. You might tell your mum I said so. It’s clear to me from your letter that you do love your family and want very much to show your appreciation and respect for your parents. You are as surprised and upset about your own behavior as they are. A book that you and your parents might find helpful is: I’m Not Mad, I Just Hate You!: New Understanding of Mother-Daughter Conflict by Roni Cohen-Sandler. If that doesn’t give you enough help, you might want to see a counselor who specializes in working with teens and their families. You need to learn some new ways to manage your feelings. Your parents need to learn some new ways to work with you so you all come out of the teen tunnel as friends.

I wish you well.
Dr. Marie

July 22, 2011 0 comments

Sleep deprived, not bipolar

by Dr. Marie Hartwell-Walker July 10, 2011

written by Dr. Marie Hartwell-Walker

When I was 7 my mom died of lung cancer,she was 43. Now I’m 13 and my dad has a girl friend and she moved in and my dad barely talks to me anymore. So I feel so lonely so I think that’s where it all started. I ALWAYS feel sad and hopeless. I have no changes in weight which is good. My sleeping patterns change during the school year I don’t go to bed till at least 3:00 am and I wake up at 6. Then the next night it’s the opposite. I think about death but I don’t consider it because I’m way to scared and my best friend keeps me alive. But yet at other times I feel happy and have a high self esteem. I also sometimes have good energy and not that tired. My speech is okay like sometimes I can’t talk right. I’ve had one breakdown in January. My stress levels are very high and I do have some anxiety but not that bad. I always think something is my fault and I always think that people are talking about me and really aren’t my friend. I also tried cutting and starving myself but I chickened out. I have back pains when nothings causing it and I sometimes get headaches too for no reason. My aunt is bipolar so I’m wondering if I can also be/get bipolar sometime in my life. I have high fatigue and some irritability.Sometimes I can get angry and people don’t know what I’m angry about and sometimes I don’t either. I also go to therapy and I’m not on any form of medicine. So please help me. Thanks.

I’m very sorry you’re having such a hard time. I hope you are talking honestly with your therapist about what you’ve written here. We therapists wish we were mind-readers but we’re not. If people don’t tell us their thoughts and feelings, there isn’t much we can do except guess. With most appointments lasting less than an hour, we’d like to get right down to business and use the time well. It’s up to you to bring up important issues right away.

My guess is that you are still grieving your mom. Your dad is moving on before you are ready to. You feel like you’re losing him too. He’s caught up in a new relationship and is probably unaware that you are feeling left out of his life. If that weren’t enough, you are at an age when your body is adjusting to becoming an adult. It’s normal to feel moody and to have ups and downs but that doesn’t make it any easier.

My biggest concern, though, is your sleep patterns. Of course you have fatigue. Of course you are irritable. You absolutely need 8 – 10 hours sleep a night to be physically and mentally healthy. There is a reason for your headaches. It’s lack of enough sleep. It’s also possible that the “breakdown” was related to sleep deprivation. Same thing with the anxiety and moodiness and speech problems. I very much doubt that you have bipolar illness. I’d at least want to rule out all these other sleep-related issues before considering it.

Please talk to your therapist about ways to get your sleep cycles back where they should be. It’s obvious that you are intelligent and know how to research things on the Internet. Look into sleep disorders and how they are treated and you may also be able to help yourself.

I don’t know enough to comment on whether you need medicine (although I doubt it). But I absolutely do know that you need sleep!

I wish you well.
Dr. Marie

July 10, 2011 0 comments

Do I Have Adult ADD?

by Julie Hanks, MSW, LCSW February 24, 2011

written by Julie Hanks, MSW, LCSW

I’m a student receiving my Masters degree. Within the past two years I’ve felt my body and mind change significantly in many ways. I feel extremely anxious when doing tasks (even small ones like packing/unpacking a suitcase). This is the same with grocery shopping or attempting my homework. I then push everything aside and get nothing done. My habits of cleanliness such as my apartment have declined because I refuse to motivate myself to clean. I’ll find myself in the kitchen then in the bedroom for some reason the randomly in the bathroom, ultimately accomplishing nothing. I get distracted by TV a lot and it impedes my homework. I also feel pressured on what to do when I finish my masters and feel like I’m too lackadaisical to even search for jobs. My relationship with my boyfriend is also affected by this in that I’ll freak out on him, refuse sex, and find him at the mercy of which high or low I’ll be on. I’ll also find myself drinking and smoking cigarettes more often to avoid doing work or tasks. I feel like I have adult ADD due to these symptoms and have spoken with my mother, who revealed she believes she has it as well but was never properly diagnosed. I would like to know what to do and what would happen if I see a psychiatrist.

Next time you talk with your mom ask her if she recalls you having similar attention problems in elementary school. While your symptoms do sound a lot like adult ADD, it’s important to determine whether you experienced these symptoms during childhood or whether they are new. If all of your symptoms are recent, it’s very unlikely that you have ADD. If they’ve been going on for years, it’s more likely that you have have ADD.

There are other possible explanations for your recent changes in your behavior and emotions. Depression or anxiety disorders often emerge in young adulthood and symptoms are similar to what you’re describing – difficulty concentrating, irritability, lack of motivation. ADD is often associated with other mental health conditions as well, so there may be a combination of issues that you’re struggling with.

Your idea about getting an evaluation by a psychiatrist is right on target! An evaluation will provide a clear diagnosis and suggest course of treatment to help you manage your symptoms. Your doctor will likely recommend medication or psychotherapy, or a combination of both.

If you’ve never had a psychiatric or mental health evaluation, it’s natural to be a little nervous because you have no idea what to expect. When you set up an appointment with a psychiatrist, he or she might give you some questionnaires to fill out before the appointment. During your appointment he or she will perform an in-depth interview with you. Medical or psychological testing may also be recommended. In addition to your evaluation and psychotherapy, you and your boyfriend may want to consider couples counseling to help repair any damage to your relationship.

You are in a stressful time of life full of transitions and important decisions – graduate school, serious relationships, career choices. These can be exciting and incredibly stressful. Make sure you’re taking care of your basic needs by getting adequate sleep, eating well, and engaging in regular recreation and exercise. No matter what your diagnosis, all of these lifestyle choices will help you manage your symptoms and will contribute to your overall health and happiness.

Take good care of yourself.

Julie Hanks, LCSW

February 24, 2011 0 comments

No Support But Need Help

by Kristina Randle, Ph.D., LCSW January 4, 2011

written by Kristina Randle, Ph.D., LCSW

I am a 28 year old single mother of two who lives with her parents. I graduated from college in 2008 but have not been able to find a job at all. I don’t have anybody at all. I had to move in with my parents because my ex was abusive. I have been suffering from depression for about three years. I can’t go and talk to someone because I have no money or insurance. I have insomnia and have been hallucinating. I find myself being irritable and lashing out in anger. I haven’t bathed in about a month. I’m afraid to go outside and I stay in my room in bed all day. I have constantly thought about death everyday, I like to cut myself. My parents get mad at me because they do not want to hear what is going on with me.My dad attacked me one day and my mother called the cops on me. I am so lonely. I just cut all my hair off today. I feel so lost and incapable of doing anything at all. I hate myself and my life. I want to always kill myself. I can’t get a job because I don’t have enough work experience. I don’t know what to do or where to turn. Help me! I feel like I’m drowning. I feel guilty and like a failure in life. I feel out of control. My brother tells anybody who will listen that I don’t do anything and am lazy. I can’t get over the only man I have ever loved and he dumped me 3 years ago and is married. I’m just a wreck. I feel like I’m crazy.

You should strongly consider going to the hospital immediately. You currently are having suicidal thoughts. You are also unable to care for yourself at this time. This is evidenced by the fact that you have not showered in a month and cannot leave your bedroom. Other very concerning symptoms include: hallucinations, insomnia, extreme anger and irritability, cutting, hopelessness and the lack of a support system. It seems as though your home environment may be significantly contributing to the problem. The hospital could provide a much needed reprieve from an unstable and unsupportive home environment.

You should go to the emergency room and report all the symptoms that you wrote about in this letter. Even if you do not have health insurance, given your symptoms, you are likely to be admitted. The hospital has an obligation to admit individuals who pose an imminent danger to themselves or to others. Once in the hospital, you can work with a doctor who can prescribe medication that will help to decrease your symptoms. You will also have the opportunity to work with a therapist and a social worker. The social worker can assist you with a comprehensive aftercare plan including follow-up care, the acquisition of health coverage, housing assistance, as well as any other practical and immediate needs that you may have.

If you do not wish to go to the hospital, then call your local community mental health center (CMHC) and ask for their assistance. They can provide similar services to that of a hospital social worker. CMHCs also have therapists on staff who can provide counseling. You can also call the local health department and ask what type of services may be available to individuals who do not have health insurance.

The CMHC or the local health department may be of assistance with regard to locating mental health services but I would recommend more immediate assistance. It is important to recognize when immediate help is appropriate. Given your symptoms, I would advise that you go to a hospital for an evaluation. Call 911 if you feel that you cannot get yourself to the emergency room. You need and deserve help. I hope you’re able to get the help that you need. Please take care.

Dr. Kristina Randle

January 4, 2011 0 comments

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