Some of My Disabilities: OCD and BPD

[RonPrice]

The handbook for mental health professionals lists different categories of mental disabilities and the criteria for diagnosing them. This handbook is published by the American Psychiatric Association. The DSM-IV, The Diagnostic and Statistical Manual of Mental Disorders(DSMMD), 4th edition, which was published in 1994, abandoned Freud for Kraepelin. Most psychiatrists these days use a model with combines behaviourism, cognitive psychology and pharmacological treatment. Some say that psychiatry has been at a pharmacological standstill for decades, although I think this is an extreme position. This manual, the DSMMD, is also the subject of much controversy, a controversy which my 70,000 word statement, the account of my disabilities, does not deal with.
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I have several disorders. One is obsessive-compulsive disorder(OCD) which is not excessively debilitating and, if chronic, it does not result in troublesome behavioural problems in my daily life. I see my OCD as a disorder that exists in a mild form as does my psychiatrist who goes so far as to say I do not even have OCD. OCD is a disease that has apparently exploded in prevalence in recent decades. I also suffer from Obsessive Compulsive Personality Disorder(OCPD) which I have discussed elsewhere in my account of BPD and which needs to be seen in the context of OCD.

The medical literature indicates that people who suffer from BPD experience ‘intermittent explosive disorder.’ This lack of control, this uncontrolled form of anger, is said to be a biologically driven symptom of hypomania or mania, at least the relevant literature strongly suggests that this is so. My sexual urges, I might add, still remained into later life. The interplay between two competing systems in the brain: the excitatory system and the inhibitory system which create, as one writer put it, an arousal template. As individual as a fingerprint, an arousal template is the total constellation of thoughts, images, behaviours, sounds, smells, sights fantasies and objects that arouse us sexually or arouse us in some other emotional way: visually, auditorily, inter alia. For me, these competing systems still competed into my sixties and had been competing virtually as long as I can remember. This framework of analysis based on an arousal template could be discussed in fine detail, but this is not the focus of my analysis of my BPD and its experience. It is, rather, a side issue, however pervasive an issue and however influential this issue has been in my life trajectory.

The word “explosive” was an appropriate one to associate with my anger episodes from the age of 18 until the age of 65 and with those temper tantrums I mentioned earlier in this account. But a mild anger, a more controlled anger, was a much more appropriate term than ‘explosive’ for this new emotional register after the age of 60. Once my new medication package of sodium valproate(NAVAL) and effexor was routinized and stabilized, by February 2009, any angry tendencies were ‘seriously controlled,’ although not entirely removed. If pushed, I could break out, so to speak. In the more than two years from February 2008 to October 2010, I broke out five times, getting angry at friends on four occasions, one very intensely making me decide to go back on my medication and kicking a dog twice, a dog which had bit my toes three times. I still had some work to do on that tiger in my tank!
--------MORE OF MY STORY IF DESIRED-------Ron

[OMFG!You'reActuallySmart!]

Originally Posted by RonPrice

The handbook for mental health professionals lists different categories of mental disabilities and the criteria for diagnosing them. This handbook is published by the American Psychiatric Association. The DSM-IV, The Diagnostic and Statistical Manual of Mental Disorders(DSMMD), 4th edition, which was published in 1994, abandoned Freud for Kraepelin. Most psychiatrists these days use a model with combines behaviourism, cognitive psychology and pharmacological treatment. Some say that psychiatry has been at a pharmacological standstill for decades, although I think this is an extreme position. This manual, the DSMMD, is also the subject of much controversy, a controversy which my 70,000 word statement, the account of my disabilities, does not deal with.

This is wrong. The DSM-IV-TR (text revision), is the one used currently and is published in 2000. The DSM-IV is not used clinically and sometimes not for research, although much of the information is identical. Also, DSMMD is not the correct abbreviation: it's the DSM. Your definition of the DSM is, well, for a very simplified manner, correct. Saying psychiatry has been at a pharmacological standstill, I would agree with you there.

Originally Posted by RonPrice

I have several disorders. One is obsessive-compulsive disorder(OCD) which is not excessively debilitating and, if chronic, it does not result in troublesome behavioural problems in my daily life. I see my OCD as a disorder that exists in a mild form as does my psychiatrist who goes so far as to say I do not even have OCD. OCD is a disease that has apparently exploded in prevalence in recent decades. I also suffer from Obsessive Compulsive Personality Disorder(OCPD) which I have discussed elsewhere in my account of BPD and which needs to be seen in the context of OCD.

If you psychiatrists doesn't say you have OCD... then you cant have a mild version of which you don't have. Anytime people say they have a mental disorder but their psychiatrist says otherwise, then to me, they don't have it.

Originally Posted by RonPrice

The medical literature indicates that people who suffer from BPD experience ‘intermittent explosive disorder.’ This lack of control, this uncontrolled form of anger, is said to be a biologically driven symptom of hypomania or mania, at least the relevant literature strongly suggests that this is so. My sexual urges, I might add, still remained into later life. The interplay between two competing systems in the brain: the excitatory system and the inhibitory system which create, as one writer put it, an arousal template. As individual as a fingerprint, an arousal template is the total constellation of thoughts, images, behaviours, sounds, smells, sights fantasies and objects that arouse us sexually or arouse us in some other emotional way: visually, auditorily, inter alia. For me, these competing systems still competed into my sixties and had been competing virtually as long as I can remember. This framework of analysis based on an arousal template could be discussed in fine detail, but this is not the focus of my analysis of my BPD and its experience. It is, rather, a side issue, however pervasive an issue and however influential this issue has been in my life trajectory.

The word “explosive” was an appropriate one to associate with my anger episodes from the age of 18 until the age of 65 and with those temper tantrums I mentioned earlier in this account. But a mild anger, a more controlled anger, was a much more appropriate term than ‘explosive’ for this new emotional register after the age of 60. Once my new medication package of sodium valproate(NAVAL) and effexor was routinized and stabilized, by February 2009, any angry tendencies were ‘seriously controlled,’ although not entirely removed. If pushed, I could break out, so to speak. In the more than two years from February 2008 to October 2010, I broke out five times, getting angry at friends on four occasions, one very intensely making me decide to go back on my medication and kicking a dog twice, a dog which had bit my toes three times. I still had some work to do on that tiger in my tank!
--------MORE OF MY STORY IF DESIRED-------Ron

This is very insightful and I have three questions. First, which form of bipolar disorder do you have? I notice you mention hypomania and mania but did/do you have other experiences, such as with depression or was it restricted to hypomania and mania? Second, noticing your reference to the arousal template, along with other terminology such as excitatory and inhibitory systems, do you teach/taught biology, psychology or chemistry, or something else? Lastly, noticing your signature, you say you were/are a teacher (hence my previous question), so how did bipolar disorder affect your teaching ability?

[Invert]

BPD could be Borderline Personality Disorder also, so I agree, you need to clarify that one.

I have several disorders. One is obsessive-compulsive disorder(OCD) which is not excessively debilitating and, if chronic, it does not result in troublesome behavioural problems in my daily life.

The psychological and medical profession, and even the DSM that you mention, tend to consider a disorder as being required to effect the well being of your life/cause distress, or interferring in it. If it is not debilitating or troublesome, it is unlikely it is severe enough to be deemed a disorder, rather you have some obsessive compulsives habits. In fact in the criteria for OCD it includes:

C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.

[Unicorn ♥✿]

Do they let people with OCD etc teach ?

[OMFG!You'reActuallySmart!]

Originally Posted by Smiley:)

Do they let people with OCD etc teach ?

Why wouldn't they? As long as it's under control so it's not causing distress to oneself nor limiting the teaching ability, doesn't really matter. It could actually be considered discrimination if they don't let anyone with OCD teach simply because they have OCD.

[BECCALICIOUS!]

I have a teacher who has severe dyslexia. In a way, this could be considered "worse" than being a teacher with OCD because a teacher is expected to maintain an image of almost perfection, especially when it comes to simple tasks such as correct spelling. Using that logic, if there are dyslexic teachers, why can't there be OCD ones?

[RonPrice]

Many psychiatric disabilities, if not all of them, are complex and, in the end and for many people, the professional is the place to go for help.

The questions you have raised in the above thread are good ones and I will try and answer them in the paragraphs below.

1. My form of bipolar disorder:
2. My experience of depression:
3. The affect of my disability on my job as a teacher:
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In one study of 60 patients with BPD, 23 (38%) fulfilled the diagnostic criteria for at least one personality disorder. Those personality disorders most commonly were: narcissistic, borderline, antisocial, avoidance disorder and obsessive-compulsive. In my case the obsessive-compulsive personality disorder(OCPD) and post-traumatic stress disorder(PTSD) have been the most dominant and especially after the age of 60. I have also logged many years of depression. The presence of these disorders sometimes make BPD symptoms more intense and more difficult to treat and they appear to increase the risk of suicide, but not in my case. I will deal with suicidal ideation later in this account of my chaos narrative(but not in this post). This account is about BPD and by a person with BPD and it only ventures into these several other psychiatric illnesses and personality disorders to a limited extent and only from time to time when it seems relevant. ------------------
I was diagnosed with a mild schizoaffective disorder in the autumn of 1968. After six months(6/68-11/68) in four different psychiatric wards and hospitals I was eventually released. I have also been taking the anti-depressants luvox(fluvoxamine-2001) and then effexor (venlafaxine-2007) for depression. The side-effects from these anti-depressants which I have manifested in the years 2001 to 2010 are: sleepiness, fatigue and weight gain. Less common side-effects that have been manifest in my day to day life include: gas, difficult or laboured breathing, some loss of touch with reality, neck pain, vertigo, diarrhoea, heartburn, abnormal dreams, unusual tiredness and social withdrawal symptoms.
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The luvox and effexor have helped decrease the intensity of the depressions which I had been experiencing late at night for 20 years. The sense of relief from the intensity of that late-night depression was a source of positive energy, a wonderful injection of spirit and joy into my life. The significance of the depressed phase of BPD has been markedly underestimated not only by those familiar with BPD but by the wider society. Bipolar depression accounts for most of the morbidity and mortality due to this illness.
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Except on rare occasions when I let the veil down and ‘come-out,’ as they say, the majority of those I meet are left in the dark as to my illness and, for the most part, this does not trouble me. Even then, after some degree of 'coming-out,’ the understanding of others is limited. I know from many years of experience of BPD that there is little public understanding and much stigmatization of my condition, inspite of many changes and improvements in society and much destigmatization for/of the mentally ill. This is one reason I utilize the internet to: (a) tell my story and (b) help others at over 100 sites on the world-wide-web. I certainly did not let my employers know of my BPD. Due to the stigmatization of mental illness---even now--most sufferers stay in the closet if they want a job.-Ron Price, Tasmania

[OMFG!You'reActuallySmart!]

Originally Posted by RonPrice

In one study of 60 patients with BPD, 23 (38%) fulfilled the diagnostic criteria for at least one personality disorder. Those personality disorders most commonly were: narcissistic, borderline, antisocial, avoidance disorder and obsessive-compulsive. In my case the obsessive-compulsive personality disorder(OCPD) and post-traumatic stress disorder(PTSD) have been the most dominant and especially after the age of 60. I have also logged many years of depression. The presence of these disorders sometimes make BPD symptoms more intense and more difficult to treat and they appear to increase the risk of suicide, but not in my case. I will deal with suicidal ideation later in this account of my chaos narrative(but not in this post). This account is about BPD and by a person with BPD and it only ventures into these several other psychiatric illnesses and personality disorders to a limited extent and only from time to time when it seems relevant.

Can you please provide a link to the study or tell me the authors or the name of the study? I would like to look at the study and I do have access to many scientific journals of all parts of the world.

You answered the questions by giving further information on yourself but it doesn't address them directly, so I want to know if what I have interpreted from your response is correct or incorrect. From the last paragraph you gave, I take it that OCD does not impair your teaching ability. The confusing thing is, you said how it doesn't impair you much at all, which is problematic because one criteria of ALL (or almost all) of the psychiatric conditions is significant distress in your life and impairing function.

When you mentioned schizoaffective disorder and side-effects of the medications, what are the abnormal dreams you had? I've never taken such medications and I've read it as a side-effect but I've not had the chance to know what the dreams are like. There's a good chance your dreams may differ from someone else with those side-effects so I understand your answer wouldn't be universal but nonetheless, you're very articulated so I assume your answer would be detailed. How do these abnormal dreams compare to your normal dreams?

[lauri]

borderline personality disorder one of the symptoms is mood swings just like bipolor disorder

[OMFG!You'reActuallySmart!]

The medical model doesn't lend itself very well to psychiatry. The medical model uses the symptoms manifested to localize the area of the body affected by the illness or pathogen. For psychiatry, this falters because the brain isn't the focus of study in psychiatry, rather the behaviour is or the mind is. Disorders of the brain don't fall in the realm of psychiatry, they are for neurology and certain fields of psychology. The mind is something that is difficult to locate as it depends on how you resolve Descartes' mind-body paradox. Although psychiatry by definition is a medical field, the medical model isn't that effective.

[Bibliophile]

Can you please keep this thread on topic and refrain from debating as much as possible.
Thank you.

[RonPrice]

Thanks for that sensible advice,Atelophobia.--Ron in Tasmania
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I will, though, add a little more on OCD and BPD(bipolar disorder)....not to debate but to provide more of my experience....for what it is worth.-Ron
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In a list of ten basic symptoms of obsessive-compulsive personality disorder(OCPD), I possessed six symptoms rated at 5 or above on a 10 point scale in January 2010. I will not list these symptoms of OCPD here since this narrative and analysis is a focus on BPD, but readers can easily google them if they are interested. Wikipedia is an informative source for information on OCPD. The pattern of behaviours for my OCPD has been highly diverse rather than stable over the years as far back as my childhood and has become more dominant, as I say, in my late adulthood, the years after the age of sixty on a new medication regime of an anti-depressant and a mood stabilizer which I will discuss in more detail later in this story. People with OCD are ridden with anxiety. This overstates my level of anxiety. By contrast, people with OCPD tend to derive pleasure from their obsessions or compulsions. This is the case with me.
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The primary symptoms of OCPD are: (i) a preoccupation with details, rules, lists, order, organization, and schedules; (ii) showing a perfectionism that interferes with the completion of a task, (iii) excessive focus on being productive with time and (iv) excessively devoted to work and productivity to the exclusion of leisure activities and friendships. People with OCPD, when anxious or excited, may tic, grimace, or make noises, similar to the symptoms of Tourette syndrome or do impulsive, and unpredictable things. Children are sometimes born with a genetic predisposition to OCPD, but may never develop the full traits. Looking back to my early childhood there is some evidence that I had OCPD. The literature suggests that much depends on the context in which such children are raised. Since anxiety, trust and everyday routines of social interaction are so closely bound up with one another, it is easy to understand how the rituals of day-to-day life become a type of coping mechanism.
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In my retirement years, 1999 to 2010; and disability and old-age pension years, 2001 to 2010, my cyclothymia or full-blown BPD(bipolar disorder), was treated. Whatever label I give to the BPD I suffered after the age of 55(in 1999), this BPD was characterized by: lack of interest in socialising(after 2 hours of interaction), except to a minimal extent, the need for a very large amount of sleep(only 8 hours), not wanting to get out of bed(not as bad as in my youth), difficulty in holding down a regular job(not that it matters now at the age of 66), relationship issues and financial troubles. The death wish and associated feelings continued, as they had done since 1980 but, with the new meds, the Black Dog was not as black. I managed my BPD during these years reasonably well and was able to provide a decent standard of living to my wife and I due to: (a) the pensions I received and (b) the house I had paid-for as well as the small retirement bank-balance that got us through my years 55 to 65. That's enough for now.-Ron
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