How to get help with multiple dx's

I think after 20 years, I have finally learnt how to negotiate the mental health system a little. I only told them that I was Bipolar with PSTD and agreed with everything they said (whether I did or not). The liaison person said "it was an absolute pleasure to talk to me" and wished me "all the very best". I might have a chat to my pdoc if we can "lose" the diagnosis of borderline as I am instantly refused care when I mention it and it means my bipolar and ptsd aren't getting the treatment/management they need. It felt AMAZING to have the bipolar and ptsd addressed and not be turned away just because of the bpd. Other borderline's with multiple dx's might like to try this? and see how their quality of care varies? Admittedly it is only one time, but it still was the best response I've had from mental health in 20 years.
Jade

I know the feeling Living Well. I've gone through quite similar experiences with the mental health system but for me I was being treated as Bipolar first because they all just assumed I was bipolar when I was 15. Over the years everyone realized they were wrong about that and then they started diagnosing me with personality disorders, which is true but it also means I am no longer getting care except for a free clinic. If I had kept the bipolar diagnosis I might be getting better treatment but it would still be a lie.

I don't know, personally, I was having trouble because it all kept being called nothing but depression- and some of those other problems I was having (BPD problems) were just address with "oh, well that's a bit unusual". I felt like my BPD issues were being ignored in favour of me being depressed and "here's a referral go and have 5 sessions of CBT". I needed longer than 5 sessions to fix things. I found a new doctor and we've discussed BPD and I've been with the therapist for over 12 months now, and I've still only barely scratched the surface as far as progress goes. Maybe it's just that I've finally managed to find a good doctor and therapist who believe in the BPD stuff. My previous ones have been fairly useless to be honest- whether it was depression or BPD. I haven't come up against health professionals wanting to reject me because of the BPD so far (it's only early days though).

It's interesting how different the experiences are:

Hi AJ, I imagine you are prolly not Australian - here they avoid borderline's like the plague and then try to discredit the treating psychiatrist and dismiss bipolar diagnosis so they don't have to treat you either. I'm REALLY sorry that your change in diagnosis has brought you less care. Magic wand required for mental health care all over the world.

Lilyfairy, I'm so glad you got a great therapist! and are able to start treating the BPD. I don't know if you are interested but I found DBT really good (theoretically at least). The rolling out of it, and the application can be a bit dodgy, but I found it a great therapy all up.

Cheers

Magic wand required to fix mental health care? I want a magic wand to fix the mental health problem and make it go away forever. Unlikely though.

I haven't started any DBT- it's been discussed, but at the moment the main priority is to manage things on a week by week basis until we find the right meds for the depression, because until that happens I'm going nowhere and the DBT is going to be a waste of time. Don't get me wrong, I want to do the DBT and learn how to deal with everything more constructively, but the depression is really holding me back.

ajrocker8 wrote:If I had kept the bipolar diagnosis I might be getting better treatment but it would still be a lie.

After all this began to happen to me at the mere mention of the idea, I think I'll keep the lie as much as it bothers me to do so. For one, I need medications covered, I'd always have to pay full price. I benefit from medications generally given for Bipolar II,.. I've finally gotten back on my Lamictal recently.

As I have it now as far as anyone else is concerned I'm: Bipolar II, GAD, social anxiety disorder.

It is a bit soul-crushing to get the routine "when was the last time you went manic?" question and have to make some bulls--t up. The answer is "Hmm, let's see... it was,.. never!" I only go manic (it's more like 'nuts') from antidepressants, especially if taken without a moodstabilizer, and I've noticed that the moodstabilizers that work for me happen to be the ones indicated for BPD. Indicated, but not covered.

Edit: I should say that I seriously resent having to lie. I used to have little issue with it, but I believe a combination of getting older, and educating myself about borderline makes me feel ashamed -- that is, there I am a grown man lying my face off. At the end of the day though it's about getting what I need to get better and recover, but it also hinders that process in some ways at the same time. I really feel like I'm in a bind, all as BPD is yet to be fully respected as recognized. It pisses me right off.

I can only afford free clinics anyway. Well they're not free, they're public, but none of them really 'do' BPD. I live on disability at the moment so there's no way I have access to any higher/rarer/overly-specialized care.

Anyway, I've come to realize that there are some people who can do without meds, and there some people who need meds and/or benefit from them so greatly that there's no getting around taking them. That is to say, I'm in the latter category.

I went in for generalized anxiety, answered some questions and was assigned a DBT group + individual counseling. It was as if they didn't want to tell me any Dx, just wanted to get me doing "something". My doc knows I hate medications, I'm only taking a HRT for an autoimmune disorder currently. I asked my counselor at one point if I had BPD and she said no diagnoses have been made. Quite the hush hush process... as most of you have experienced.

It seems like a moral issue, like AJ has said. It's good there is a way for you to stay covered for the bipolar and work with your therapist on BPD issues. I don't have much experience in the mental health system in the US as I got out of it in my teens but from what I've read on here it can be challenging to find the right treatments. DBT was helpful for me even though it was not run well. I still look over the materials and may try another group someday.

Best

PS meant to mention, BPD was diagnosed when I was 12 yrs old. No one has mentioned it to me in a clinical setting since then.

i've had trouble getting treatment from the NHS. i don't know if i have ANY PD dxes from them, let alone dual dxes. i wouldn't think i would cause last time i was involved with any NHS psychiatrists who could actually dx, i was technically too young for PD dx, but then again i was also too young to be put on any of the (then) experimental medications they used on me.

people linked with assesments i spoke to recently pretty much said i had a PD but it "wasn't causing mental illness". didn't give me any idea of what, but IMHO that's a pile of $#%^ cause PDs can cause a hell of a lot of pain and chaos in people's lives to the same point other mental illnesses can, so i feel like that's pretty unfair. they also tried to imply triggered mood swings (or mood swings in general) weren't mental illness if they were in reaction to stuff, or had psychological causes

I also got dxed bipolar as a teenager, later on i saw a psychologist who didn't give me any feedback at all. she made lots of notes about me. she prescribed me antidepressants that made me worse, and had to quit cold turkey cause i became addicted to them which made me feel very ill (but so did the meds even a short while after if i missed one dose ). (she was was also a qualified dr.) i know she was trying to help with my mood problems and didn't mean to make them worse, but no one even tried to help me with anything else. it turned out she was in communication with the college i went to and all sorts, stuff that i was told was meant to be confidential wasn't. i feel like i was treated like they should just keep an eye on me (but did nothing to intervene) or prod and poke me like something in a test tube. i feel the system has failed me at every point it is supposed to help people.

I applied to see my medical notes and read them, but the notes from the psychologist i saw weren't in there. so I don't know if any dxes were made or not. All I know is when i met a boyfriend and was happy about it, she agreed to allow me to not have to see her any more.

as far as i KNOW i honestly don't have any formal NHS dxes - but i know there are notes about me that were either never filed (meaning no problem) or that i have no access to. I don't know what's in my notes tho. not surprisingly my head is all over the place with stuff like this, one day i'll say i want help, the next i'll turn round and make excuses. when i try to get help from the NHS, i struggle with transferrence to a point that has made really getting anything out of it very difficult - and they haven't really managed to work with that transferrence, or maybe i have just been too "difficult" for them to manage to, idk. maybe i expect too much.

If i wanted meds, that would be easy, but nothing so far suggests meds are going to help much! - i understand they can give people a helping hand and that might be true if i spent loads of time trying them all out, but they are not going to cure me of anything. therapy etc is harder, cause how do you do therapy while lying? you can't really! i'll get there anyway, with or without that help, but sometimes i do wish i did get genine help and support from the health service. and at the same time they don't do much to earn my trust. (someone please tell me if i sound crazy or saying this stuff! lol)
i guess i could try to be honest as possible while avoiding certain issues, or connections between issues, but again that makes things difficult too - i would say its extremely hard to get the help you need without being totally honest.