16 March 2006

Family Update, More on Depression

So my grandfather went in to surgery on Tuesday. His surgery was delayed for whatever reasons. He came out of it ok. I haven't been to see him yet. I haven't really been out of the house. My car is in the shot -- the crankshaft pulley needs to be replaced (I hit a bump in the road that I didn't see). More money (that I don't really have) to spend fixing the car. I knew that there were going to be a few things wrong with the car when I bought it, but now it's getting to the point where the repairs are beginning to exceed my planning. Of course, this time it's probably due to something that I did.

So, my mother called me on Monday night. She told me that she needs my help because she's getting a divorce. This is her third husband. It turns out that she thinks that he's still married -- in Thailand (where he's from). She also thinks that he married her just to get citizenship (which he still has yet to get, although he did get his green card). So she wants me to come up to Hartford to help fill out the papers. Apparently, he's offering her $20k to get divorced. All of the finances are in his name, but my mother subjected herself to being denigrated by him for about a decade, and she took care of him and the homestead. From what I remember in law school, that's worth a bit more than $20k with no alimony payments.

Of course, my mother doesn't want alimony. She wants to get him deported, because she thinks that he had another child with his wife when he took a trip to Thailand last year. I don't have all the info yet -- I have yet to make it up to Hartford (the car's in the shop). But I'll find out. And I'll subject myself to my mother's co-dependence, paranoid, and anxiety disorders.

My Uncle has been visiting since Tuesday -- since my grandfather's surgery. He has some serious issues going on with his personality. He convinced one of the mental health hospitals where I received treatment that I have borderline personality disorder (BPD). I wholeheartedly disagree with that diagnosis. I might have some other kind of personality disorder, but I don't think I'm borderline. According to the DSM-IV (that's the Diagnostic and Statistical Manual of the American Psychological Association, Fourth Edition), one must have at least five of the following traits in order to be diagnosed with BPD:
  1. frantic efforts to avoid real or imagined abandonment.
  2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).
  5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  7. chronic feelings of emptiness.
  8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. transient, stress-related paranoid ideation or severe dissociative symptoms.
I've put the traits that I think I exhibit listed above in boldface, and I'm not even certain that I exhibit the ones I've marked out. For instance, with trait #5, recurrent suicidal behavior, I think, as I've said before, that my suicidal thoughts/behaviors have more to do with my surviving a fatal automobile accident than anything else. As for trait #4, I'll admit to that ... I do tend to be impulsive about spending, and I'm sure that some of my friends whom I've driven places will accuse my driving as being reckless. My past sexual behavior might be described as impulsive, and I might be guilty of binge-eating (I'll not eat for a day or two, because I'm depressed, or broke, or both, and then binge -- I'm not sure that this is typical binge eating, though, because I'm really just making up for a period when I wasn't eating but, then again, I don't know much about eating disorders).

I had a lengthly e-mail conversation with my friend Val (she's a Spiritual Counselor with a New York State Certification in School Psychology) about all of this. Here's what she had to say:
Peter, then what I'd diagnose you with (if it were something I had to do) would be Personality Disorder, Not Otherwise Specified. You do have a personality based disorder in my opinion but it does seem that you have a little of this and a little of that.
This is based on a self-assessment that I performed, by reading about all of the various personality disorders, the traits associated with each, and then doing a self-assessment to figure out which of those traits I exhibit. Basically, my personality can be considered to be pretty fucked up. Right, Val?

In my e-mail conversation with Val, I also wrote about my past suicidal behaviors, and why I don't think they should be counted as one of the traits for BPD, and why I don't think I have BPD in general:
Looking back on things, I can see that I've had major depression/chronic depression for a very long time. However, the only time I didn't want to live was when I was 17 and tried to commit suicide because I realized that I was gay. But I got over that, and became an activist instead. Ever since then, I've been depressed, but I didn't want to do. I always had the "fight" in me, if you know what I mean.

Until, at least, my car accident four years ago. Ever since then, I've lost that "fight" -- that spirit. For the two years after my accident when I was trying to kill myself, I was taking a LOT of painkillers (opiates). I was in a total fog. The reason that I didn't succeed in killing myself then, I attribute to the fact that my mind wasn't working correctly [basically, I was in a major fog].

In terms of me wanting to kill myself, it has a lot to do with the fact that I'm in a lot of physical pain. I don't want to go back on the opiates. I take a LOT of Aleve (like 8-12 pills a day -- the bottle recommends no more than three) for the pain, which helps, but doesn't get rid of it completely. The pain that I have is only going to get worse (much of it comes from the arthritis). I've had more than one orthopaedic surgeon tell me that fusing the joint (meaning I'd lose all mobility in the ankle, as opposed to the 20-25% that I now have) will help alleviate that pain but won't get rid of it completely, especially since some of my pain is from neurosis.

Without that pain, I might just be depressed. But with the pain, and the depression, I lose energy, I lose my will to stick around. I saw my grandmother and what pain did to her -- I don't want to end up like her. If I could figure out how to do it right now, I would. But unfortunately, I'm not sure, and I don't want to make another "attempt" and have some fucking idiot tell me I'm just doing it for attention. Really, I'm not. If I wanted attention, I'd do something else. I'd spend more time with people. As it is, I'm avoiding everything.

Recently I was discussing my car accident with a friend from the hospital and she mentioned that it's very common for people in severe accidents to not remember a thing -- that's it's part of post traumatic stress disorder. That got me to thinking, the fact that I can't remember anything, and that I lived and the other driver died, and that I've only really been suicidal since after the car accident -- I think being suicidal is more related to PTSD than to borderline personality disorder.
One of these days, I'll post the rest of that e-mail conversation ... the part where I pick out which attributes of which personality disorders I see myself as having.

Back to my depression ... I think I'm in, or heading into, a double depression. Too much shitake going on in my life these days. I did manage to get in touch with someone who works for WJCS today. He took my information and will get back to me about getting back into treatment. One step closer, right? Hopefully it won't be too long now....

In the meantime, check out some books at Amazon.com on personality disorders and the DSM-IV: