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Mental Health Disorder

A Brief Explanation of What I Feel/What Disorders I Believe I Have

by Holly Counts, Psy.D.
written by Holly Counts, Psy.D.

Hello! I’m mostly writing this to get feedback on issues I think I might have; I have suspicions. Sometimes I wake up with a knot in my stomach for no reason, or have trouble getting out of bed in the morning, and have trouble keeping calm in public (I’m more than certain I have generalized anxiety and depression – irritability, nervousness, sluggishness, upset stomach/nausea, panic in public situations). I’ve come out of an abusive relationship recently, and have severe anxiety attacks and panic when I think about my abuser, so I also believe somewhere mixed in with generalized anxiety, I have a case of PTSD-induced anxiety and anxiety attacks.

Another concern I have is that I might also suffer from Borderline Personality Disorder – I value loved ones dearly, but as soon as our usually brief friendship is over, I loathe them (and even within the friendship/relationship my opinions on them can change drastically daily); I occasionally drink, recklessly spend money, or harm myself in bouts of depression; I view myself very lowly and hate myself; I get mood swings daily (I get very, very angry at very small, inconsequential things, and the anger can last from an hour to maybe even a couple hours at a time, and my depression and anxiety can flare up at very small things also); I feel “empty” and “bored” quite often; in very strong cases of anxiety or paranoia, I suffer from disassociation.

Occasionally, I do have OCD-like symptoms, where things have to be done a certain way or said a certain way or written a certain way or else I feel very uncomfortable and can give me anxiety. It does happen every day, but it isn’t as detrimental to my everyday life as the anxiety and depression and suspected BPD. I know this isn’t a professional diagnosis, and I am looking into seeing a doctor, but it would be nice to get a second opinion until I can arrange a visit and get diagnosed. Thank you very much for reading. (age 20, from US)

I think the important thing for you is to focus less on what your diagnosis is and more on getting help, so I’m glad that you plan to make an appointment. From what you have listed here, you do have elements of all the diagnoses that you listed, but especially depression and anxiety. There’s also the possibility of bipolar disorder considering the mood swings and impulsive behaviors that you mentioned. However, having a thorough evaluation with a trained mental health professional will help you not only clarify possible diagnoses, but plan for the best treatment approach — which may include therapy and medication.

Most of us have elements of psychological and/or medical diagnoses, and the more we read about them, the more convinced we may become that we have them. But there are specific criteria that must be met to truly qualify for a disorder and the symptoms have to be severe enough to interfere with daily functioning. Luckily, that last criteria means most of us wouldn’t be diagnosed with everything we think we might. Hope this helps.

All the best,

Dr. Holly Counts

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Spontaneous Blushing A Symptom?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Ever since I can remember, I’ve always had a problem with blushing when I am the center of attention. It was so bad when I was growing up that even if a single person would talk to me for any length of time, I blushed or was terrified of blushing. I would obsess about not blushing so much while communicating with a person that I wouldn’t pay attention to anything the person said. This blushing problem has improved since I became an adult, but from time to time while engaging in conversation with anyone (especially men), I still get that anxiety and make excuses to end the conversation or anything to avoid the person seeing me blush. Blushing has always been a huge source of embarrassment for me. I want to know why I had and still have this problem and what I can do to change it. Is it a symptom of something?

I know of no mental health disorder in which blushing is a specific diagnostic symptom. While blushing is not a specific symptom of any one particular mental illness per se, it may be associated with social anxiety disorder. Individuals with social anxiety or social phobias feel particularly anxious in the presence of other people, especially when they are the center of attention. These symptoms seem to match your experiences.

Among individuals with social anxiety disorder, everyday situations can be fearful. Individuals with social anxiety often do not feel confident about themselves. Because of this, they tend to avoid the situations that make them anxious. In the short run, avoidance decreases anxiety but overtime, it can increase its severity.

Can social anxiety be treated? The answer is yes. Cognitive behavioral therapy (CBT) has been shown to be effective. CBT is a treatment that addresses both behaviors and thoughts related to anxiety. Generally CBT lasts for approximately 12 weeks but the length of treatment depends on problem severity. Some CBT therapists require clients to complete homework assignments such as recording your daily moods or feelings. Therapy sessions can be conducted individually or in a group setting. Another very effective treatment is exposure and prevention response (EPR) therapy. Usually, EPR is used to treat individuals with obsessive-compulsive disorder though it has been effective for other types of anxiety disorders.

Another idea is a concept called “hyper-intension.” I’ve written about this concept in other answers but I think it may apply to you. The idea was written about by psychiatrist Viktor Frankl in his 1946 book Man’s Search for Meaning. He believes that when a person intensely focuses on their fear that attention may have the unintended consequence of producing or increasing the fear. In other words, a person’s fear is made worse by their intense focus on it.

The solution to this problem, Frankl says, is to apply a technique called “paradoxical intention.” Paradoxical intention means that you do the opposite of what you would normally do in response to a fear.

What is encouraging about your problem is that it has improved. The reason for this may be related to an increase in self-confidence. Another reason may be because you have trained yourself to be less anxious over time. There may be other explanations as well.

When you feel the blushing occur, I would encourage you to remain in the uncomfortable situation. If you force yourself to endure your anxiety it will diminish. Don’t avoid a situation because you think you may blush. As I mentioned earlier, avoidance could make your anxiety worse.

Also, keep in mind that while you may focus on the blushing other people may not notice. If you surveyed the other people present when a blushing episode occurred you would likely find this to be the case. Even if others did notice they most likely would not comment. Blushing does not necessarily have a negative connotation. In fact, some people may find it endearing.

If this is a problem that continues to bother you then I would encourage you to see a therapist. Because your fear is so specific (i.e. blushing) and it has improved over time, it may only take a few targeted therapy sessions to extinguish. I’d highly recommend it. I wish you well. Thanks for writing.

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My Mom’s Unique Disease

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hi. Well my mom has a very unique disease; and I am sure of it. It is unlike any other depression people have seen; she has been diagnosed as bipolar years ago but that really isn’t the case. I don’t know what to call her disorder. Her hands move according to what she says but what she says makes no sense at all. It is really really hard to explain. I have taken video of her and it can only be seen to be understood. We have tried time and time again, for years…..to get her help. But she isn’t dumb. When it came to her first psych exam, she acts completely normal. Says all the right things and is cleared. But as soon as shes home again – shes at it again at least 90% of the day. If anyone out there can help me, I can send you the video or post it up on you tube and give you a link. We don’t know how to get her help. She refuses and its making our lives miserable. She doesn’t shower – ever. She is just unique – and she is my mom and I want to help her. Please, someone help me.

Given only the symptoms that you have described, it is difficult to determine which disorder your mother may have. You mentioned that when she talks, her hands move according to what she is saying. This symptom is not a characteristic of any particular mental health disorder. I would need much more specific information regarding exactly what you mean when you describe her hands moving according to what she is saying. You also mentioned that she doesn’t shower. Again, this is a concerning symptom but it is not characteristic of any specific mental health disorder per se. Individuals who are depressed may not shower because they have a low level of energy but your overall description of your mother does not necessarily indicate depression. An individual may not shower if they are in the early phases of a psychotic episode but nothing you have written necessarily indicates that she is psychotic. You also wrote that she acts ‘normal’ in the presence of psychiatric professionals. What exactly do you mean by normal? Is she pretending or lying? Generally individuals who are experiencing genuine psychiatric symptoms can’t simply “turn it off.” It would also be interesting to know whether she showers before one of her scheduled psychiatric examinations.

This is a difficult issue because you cannot force anyone to seek help if they do not want it. Generally, the only way an individual can be forced into treatment is if they are displaying behaviors that are life-threatening. If you notice that your mother is not eating, along with not showering and displaying other disturbing symptoms you should call a local crisis team who can come in to your home and evaluate her condition. If she is unable to care for herself, then she may be admitted to the hospital even if against her will.

I would encourage you to contact local physicians or mental health professionals to ask their opinion of her symptoms. I do not believe that viewing the video is the best way to determine her diagnosis. A face-to-face interview with psychiatric professionals is the best way to proceed. You should continue to encourage your mother to be evaluated by medical and psychiatric professionals. The concern is that her odd behavior may possibly be an early sign of an untreated medical condition. Even if she continues to act “normal” in an evaluation setting, a good therapist should be able to pick up other symptoms. Also, at a doctor’s appointment you should report your concerns even if your mother is present in the room. She may become upset with you but it’s okay because it is necessary for her medical and psychiatric safety. I hope that she is able to get the help she needs. Please take care. I wish you well.

Dr. Kristina Randle

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Wife’s Issues Harming Children

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I am fairly convinced that my wife has some degree of bi-polar disorder. She goes into fits of rage over any question about her, her parents or upbringing. She constantly belittles me and talks bad about my family to the children.

It has escalated in recent years with her attempting to push me, going into 20 minute tirades where she brings up everything that I had done over the last 12 years and her drinking has increased. She drinks to the point that she is carried out of neighborhood parties with the children crying out of embarrassment then blames me. Those who dont tolerate it are ‘fake people’ but the others are ‘true friends’ and she has been going out and staying out all night this past month.

What is of greatest concern is that her explosions have increasingly come in front of the children resulting in them crying hysterically and her threatening to ‘kick me out’. She yells at them and then goes into a dialog of how much she does for them and how lucky they are.

It is very stressful but I need confirmation that this is what I am dealing with and how do I proceed?

It’s unclear whether your wife has bipolar disorder. Emotionally she is unstable but it might be due to her drinking. The fact that she is drinking makes it difficult to determine if a mental health disorder is present or if her drinking is the main problem. It may be a combination of both but I cannot make that determination based on this short letter.

What is clear is that your wife’s drinking is excessive and is causing a great deal of distress for your marriage and for your children. Both you and the children are subjected to her tirades. It’s abusive, unacceptable and something needs to change.

Encourage her to seek psychological treatment or inpatient rehabilitation if necessary. If she is unwilling to seek treatment, then you must take action. This might include seeking psychological help for yourself so that you know how best to deal with your wife or temporarily moving out of the home. Your children should not be subjected to your wife’s tirades. It most certainly frightens them and it’s abusive.

You may also want to consider an intervention. By this I mean you and members of your family come together as a group and ask your wife to seek help. During the intervention, members of the group describe how her behavior is affecting them and ask her to receive help. Perhaps she would be willing to seek help if she knew how her behavior was negatively affecting friends and family.

I can confirm the fact that there is a problem but I cannot determine the precise problem that is causing your wife to behave in such an unstable manner. Utilize the help of mental health professionals to assist you in dealing with your wife and children. I firmly believe that trained mental health professionals can give you the best advice about how to proceed. I wish you the best of luck. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Childhood Schizophrenia?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I wonder if it is possible I had some form of schizophrenia as a child. I remember very little until I was 10 years old, and even between the ages of 10 -18 there are whole areas of my life that I do not remember. Family members have told me of situations that occurred during this time and I have no memory whatsoever of them. I remember there were things I felt, heard and saw that I didn’t tell anyone about. There were times that I felt like if I let go of my thoughts for a minute, I would go away and somebody else would take over. Those episodes stopped when I got into my teens. Is it possible I had schizophrenia or DID and went it undiagnosed? (I did enter therapy for a while in my 20’s.)

Many children and young adults have undiagnosed mental health disorders but in the case of schizophrenia, the symptoms generally don’t vanish in adulthood. Theoretically it’s possible, especially if individuals undergo intense therapy, but usually it does not happen that way.

The majority of individuals who ultimately develop schizophrenia first begin to experience symptoms in late adolescence and those continue into adulthood. Schizophrenia among children is rare. None of the symptoms you have described in your letter would lead me to believe that you had schizophrenia as a child. Having had a mental health disorder as a child cannot be ruled out but schizophrenia would not be, in my estimation, the most likely possibility.

Having been in therapy might have prevented the development of a severe mental illness.

You also inquired about having dissociative identify disorder (DID). The average age of onset for DID is between the ages of five and 10. A common symptom of DID is gaps in memory. Simply having memory loss, however, is not indicative of DID. Many individuals who never develop DID have difficulty recalling childhood memories.

Memory loss is also associated with trauma. Trauma is correlated with DID but one can have endured traumatic events without developing DID. Repressed trauma might be another explanation for your gaps in memory.

You may have had an undiagnosed mental health disorder as a child, such as DID, but it is difficult to know with certainty. One would have to conduct a thorough analysis of that time in your life, which might include interviewing your family members, former friends, former doctors, accessing historical medical or mental health records, etc.

You did not mention whether you currently have troublesome symptoms. If so, that might lend support to the idea that you had a mental health disorder as a child.

Consider consulting a mental health professional who could assist you in thoroughly investigating your mental health history. You may ultimately find that gaining definitive answers to your question may not be easy but it is worth the effort. I wish you the best of luck.

Dr. Kristina Randle

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Could I Develop Borderline Personality Disorder From Being Around My Ex?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I believe I have spent the last 3 years in a relationship with a man who has borderline personality disorder. Can i actually begin to get the same disorder. I’m finding myself behaving in ways and feeling things I’ve never felt before in my life. I feel like I’m loosing my mind at times, we are in process of separation and I’m showing signs of the disorder it’s very scary.

A You believe that you have symptoms of borderline personality disorder but you did not provide any details. Generally speaking, however, I do not believe that it is possible to develop borderline personality disorder simply because your partner (or soon-to-be ex) has the disorder. It is theoretically possible that you are beginning to recognize that you may have borderline personality disorder. Perhaps it took interacting with someone with that disorder for you to be aware of your own symptoms.

There is a rare mental health disorder called shared psychotic disorder (or folie à deux). It is a delusional disorder in which two or more people, who share a close emotional bond, exhibit the same symptoms. To be diagnosed with this disorder, an individual would have to meet the following criteria, according to the DSM:

  • the development of a delusion in the context of a close relationship with another individual in which it has been established that they have a delusional disorder;
  • with regard to content, the delusion is similar to the individual who has an established delusional disorder; and
  • the psychiatric disturbances are not better accounted for by another psychotic disorder, physiological problem or substance abuse.

The more likely scenario is that you are reacting to your partner’s behavior but without more specific details it is difficult to know with certainty.

Individuals with borderline personality disorder are commonly involved in what the DSM terms “stormy relationships.” In other words, they have significant difficulty in relationships. It is one of the hallmark traits of the disorder. Individuals with borderline personality disorder strongly desire connecting with others but often act in a manner that drives people away. A popular book written on the subject called I Hate You Don’t Leave Me: Understanding Borderline Personality Disorder by Jerold Kreisman and Hal Strauss, describes this trait and others associated with the disorder. I would highly recommend it. It offers valuable insights into why individuals with borderline personality disorder act the way they do.

Kreisman’s newer book Sometimes I Act Crazy also has received good reviews. In addition, I would recommend any book written by Marsha Linehan. She and several colleagues recently wrote a book called: Loving Someone With Borderline Personality Disorder: How To Keep Out-Of-Control Emotions From Destroying A Relationship.

If you continue to be concerned about your reaction to the breakup, then you may want to consult a therapist to help you get through this difficult time. The therapist can determine if you have borderline personality disorder or are experiencing a reaction to your partner who has a mental health disorder. It is an important distinction. If you would like to write back and be more specific about your symptoms, I may be able to better answer your question. I wish you the best of luck. Please take care.

Dr. Kristina Randle

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Worried About My 20-Year-Old Grandson

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

My grandsons personality has changed in every way in last two years. he used to be loving, & caring, now he is unsociable, & uncaring. He has no remorse. He seems to be real caring when things are going the way he wants them to. Spaced out and distend when he is just sitting around. If anyone tries to talk to him he dosn’t let them finsh he already knows the answer. He is depressed. I have tried to get help for him, but he is twenty so he has to agree befor I can make make an appointment to see a doctor. Now the big problem is Feb 1 my little dog is missing. I’m very upset about is. My grandson said, to me it is just a dog get another one. Two week later his mothers dog is dead. He said he just fell over dead. he was the only one home. Again he said it is just a dog, what is the big deal.

then a week later his mothers other dog is dead, again he is the only one home. And says he dosn’t know what happened she was just dead. Then three weeks later another dog of mine is missing. He said that the dog was in the back yard when he left.He dosn’t show any kind of concern at all. The only thing he can say about any of them is they are just a dog go get another. I would like some advice PLEASE HELP! Thank you, Waters.

Dear Waters, I understand your concern. This is a troubling and complicated situation. There are two main reasons why your grandson’s personality may have changed. The first is the development of a mental health disorder. If you and I were meeting in a traditional counseling setting, I could gather many more details and offer an opinion about a possible diagnosis. I currently do not have enough information to know what, if any, diagnosis he may have.

The second possibility is that he is using drugs. The use of drugs can drastically alter an individual’s personality and behavior. I would recommend searching the home for drug paraphernalia.

If possible, you should take the deceased dogs to a veterinarian. The veterinarian may be able to determine a cause of death. Knowing the cause of death could help you determine if your grandson is to blame. This would be very important information. In addition, until you can determine the cause of the missing and deceased dogs, you should not bring any more animals into the home. It is not be fair to bring animals into a home where they may be killed.

His behavioral changes are becoming a very serious problem for you and others living in the home. In addition, his lack of compassion for the missing and deceased dogs is very disconcerting. Coupled with his change in personality, these two traits are major red flags. Having him in the home may be dangerous.

As you said in your letter, you cannot force someone to get help if they don’t want it. If your grandson refuses help, then this may require action on your part. You may need to confront your grandson about his behavior but before you do, you may want to consult a therapist. A therapist could help you determine the best way to approach your grandson.

You may also need to contact the local authorities. If your grandson is killing animals in your home, then there is a chance he may kill other animals in the neighborhood. Animal cruelty is a punishable offense. Individuals can and have gone to jail for such a crime. Animal cruelty is also a sign of an individual who is deeply disturbed. I understand that you may not want to call the authorities to report your grandson but it may be the only way to stop his disturbing behavior.

I wish you the best of luck. Please take care.

Dr. Kristina Randle

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Confused About What’s Wrong in My Life

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

As of a few months ago (2 or 3) i’ve been feeling really bad. actually it’s been a really long time since i felt not so good about life, but it got worse around this time. i decided to take to googleing my possible problems when my friends started saying they think i’m bipolar, because i have periods of extreme niceness and other occasions of being really mean or down in the dumps… sometimes i feel like everyone thinks i’m ugly and dumb and other things, and other times i feel like i’m totally awesome.

i told my mom that my friends think i’m bipolar and she said “yeah right” and just blew it off. she’s bipolar by the way. i also asked my dad and he said i’m kinda acting depressed more than bipolar, but niether of them really know what’s going through my head. sometimes i have totally random mood swings that i don’t tell anyone about, so that’s probably an important thing to say. another thing is that sometimes i feel like life really sucks and is pointless (not suicidal tho), and other times i feel happy and loved. it’s kind of 50-50 on which one of those i feel like though.

Bipolar disorder may be a possibility but only a psychiatric evaluation could determine this for certain. Sometimes individuals experience problems but don’t have a diagnosable mental health disorder.

You are having difficulty regulating and understanding your emotions. Many people can relate to this especially if they have never received proper emotional guidance from parents or mentors. Managing and understanding emotions are skills that can be learned. If an individual lacks a healthy model for dealing with their emotions effectively, then maladaptive reactions may develop. This may in part be the cause of your current difficulties.

A major problem is that when you experience “random” mood swings you do not let others know. You keep it to yourself. Perhaps this is due to fear. You may not want others knowing how you feel. Sharing that type information can make an individual feel vulnerable. Another possibility is you want to talk but you believe that others are not interested in what you have to say. Your mother did not take you seriously when you expressed the possibility of having bipolar disorder. If you feel shunned by your family, then your reluctance would be understandable.

I would suggest having another discussion with your mother. Inform her that you wrote to Psych Central. It may help to underscore the seriousness of your concerns. You should also discuss with her the possibility of seeing a therapist. If she has had positive experiences with the mental health system, then she may be open to you seeing a mental health professional. In the meantime, here are some suggestions that you might want to utilize when trying to regulate your emotions:

• Keep a journal. Journaling can help release pent-up emotions. It also serves as a record of your feelings. After a week or two of continuous journaling a clear pattern may emerge. For instance, if you notice that you feel anger after interacting with a particular relative then it may explain the source of your feelings. Analyze what happened just before a particular feeling emerged.

• Label your emotions. Journaling can help with this. When you feel a particular way write down precisely what is happening and try to give it a name. This might help you further clarify your emotions.

• If you’re feeling overly emotional leave the situation if possible and allow yourself at least 10 minutes of quiet time. During this time alone, try to relax. Breathe deeply and attempt to emotionally stabilize. Try to answer the question “What just happened?” This would be a great time to record your feelings in your journal.

• Attempt to maintain an even emotional keel at all times. It is not healthy to allow yourself to be overly happy or overly sad. Don’t react impulsively without taking time to think through a response. When we feel emotional we may say or do things that are not rational or that we may later regret.

I hope this answer helps. I wish you the best and please consider writing back and letting us know how you are doing. Please take care.

Dr. Kristina Randle

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