Diseases & Personality Disorders Answers

Hi Maddy,  As you wrote, mental health struggles affect not only the person who is experiencing them but also family and friends that care about them. The fact that you are reaching out with your question illustrates just how much you care for the wellbeing of your relative and the desire to help.  Try to create a safe non-judgmental space in which they can talk openly and honestly about what they are experiencing. Ask them how they are feeling and be open about your own experiences with mental health. Experiencing a manic or depressive episode can be quite scary to the person who is going through it especially, when as you said, they have not sought out help as of yet. Although you may not be able to understand their experience just the fact that you are trying to understand speaks volumes. Educate yourself as much as you can about things like Bipolar disorder, depression, and mania. There are books that have been written from the perspective of someone with Bipolar that can help provide insight into what the experience can be like. There are lots of resources online, but be sure that you are looking at well established sites such as official mental health agencies and governmental departments. If you can learn what some of their triggers are, this can help a lot as well. If for example, there are certain behaviors you notice before a manic or depressive episode that you are aware of, you could gently let them know in a way that reflects care and concern. Although there are many things that may be a trigger some common triggers include sleep disturbances, physical illness, stressors related to work, relationships or money, the death of a loved one or the end of something (such as graduation). Of course, these examples are not all encompassing. Triggers are as individual as each person is. Finding a balance between support and control can also be a bit of a tricky one. Often times, people with various mental health diagnoses experience overly controlling or critical behavior from friends and family. Ongoing communication and acceptance of one another's feelings is crucial for this. For example, talk with your loved one about how you feel in an open honest way at a time that is conducive for the conversation. If they are experiencing a low, that would not be a good time to talk about how you feel when they are depressed. A good conversation to have with them when you are both in a good head space would be to ask them what they need when they are experiencing a low (or a high). They may say that they need company or conversely they may let you know that they wish to be left alone. Remember that ultimately, each person is an expert on their own experience and knows best what they need. As long as the person is safe, if they request to have time alone, for example, one way that you can show them that you are supportive is by honoring their need.  Remain calm and provide support whether you are faced with a manic episode or a depressive episode. For example, sometimes during a manic episode people may see or hear things that are not there. This is often a time where we ask the question of "is it better for me to disagree with them and potentially cause further upset or should I just agree and potentially further fuel the belief further?" Stay calm and reassure the person that you are aware that what they are experiencing feels real to them. It's often helpful to focus on what they are feeling rather than confirming or challenging their sense of reality, which in those moments feels incredibly real for them. By supporting the person you are helping them to feel seen and heard.  A good place to start as far as getting a diagnosis is with a Primary Care Physician or General Practitioner. If possible try and go with your relative, with their permission of course, to the appointment in which the subject will be discussed. It can sometimes be helpful to have examples of some of the concerning behaviors that you have seen, especially if the person doesn't believe that they are ill. The best combination of treatment typically involves medication, therapy, and self-management. It goes without saying that while you are helping them and actively working on supporting them so that you can have a positive relationship, it is just as important to make sure you continue to focus on self care. Make sure that you are taking care of your own needs: physical, emotional, and spiritual, as this will benefit both you and them. You cannot help from an empty well and remember that the tool that you are looking to keep "sharp" is you.  Patience is another huge thing to remember when supporting your relative. Getting better takes time, even once the person is committed to treatment. Don't expect a quick recovery or a permanent cure. Be patient with the pace and be prepared for setbacks and challenges. Managing Bipolar is a lifelong process. Accept both your loved one's and your limits. Remember that they cannot control their moods or snap out of a depression. Neither depression nor mania can be overcome through willpower, self control, or reasoning. Remember that each and every day they are doing their absolute best. Some days their best may look like them not getting out of bed, while other days they will seem like they are completely fine.   Know what you need to be able to lend support and that sometimes you may need to simply step away. That is ok as well. Remember that ultimately, recovery is in the hands of the person, not yours. You can be there to support them and cheer them on but you cannot force recovery (or even being seen by a professional) on them. These decisions are ones only they can make

The two words to mindfulness: "Not Always So." Intellectualizing is probably your curse. You probably do sound nice and say the right things. I believe you probably understand the material and can apply it to the situation. I believe that what you explain yourself to be upfront. The neurodivergent self determines how you will interpret this answer and how to take in and store the information. All of that is the frontal lobe, higher level processing but what you need is to understand the lower level, the limbic system, and experience that moment at that time.  What I may suggest is to start experiencing therapy, if you continue. Stop answering or doing, and begin to notice and sit with what you are experiencing right now, for instance. You are having thoughts and judgments; you may not understand what I am saying because I am asking you to reflect, and there is no correct answer. You may be experiencing frustration as to the amount of time you wasted on writing this question, and it does not equate to what you thought was helpful for you. You may think that the person writing this answer does not understand neurodivergent individuals. There may be many things going on right now, and all through the lens through which you approach life, and I ask this. What are you feeling in your body?  What are your feet doing right now? Are your toes curled? Is your stomach tight? Are your hands doing anything? What do you smell and taste? Now, is there a thought to these questions, a judgment? Am I being coy with my response? Don't actually answer. There is no answer here. There is only what you are noticing objectively. Notice that you notice these things and practice sitting in them, not fixing or defining or trying to answer or summarize. Mindfulness will be your exercise now.  Now, you may have heard that and refer to practicing that and want to know how this could help you. I will answer, but you may question that. You are familiar with a certain association of thoughts to actions. A habit of this information applies to this thought. With that, you might think: How does this help me? How does being aware of myself and my surroundings help me? How can anything help, really? What is help, after all? There is no answer to your question because you are an intellectualizer; that is what you do. Your practice and, therefore, progress toward deep healing will be to sit with what you are experiencing and notice that you notice. Notice that there could very well be this childlike version inside of you screaming out as it is triggered, and yet, you want to understand the proper CBT format in which you should address it. You will sit with the uncomfortable parts and not tell anyone about them, not summarize or define them, sit there. Your therapist might ask, and you can articulate, but do so objectively, not giving what you associate it with or what you think it is from. Just notice and sit with them. Notice that. Now....notice that.  Your frustration is something to experience as well. You will want to leave because what is being asked cannot be intellectual. It is straightforward, in fact. Learn to sit with the parts of yourself that are triggered, and you will validate that person the trauma happened to and start to accept and then heal. 

Hi! Thank you so much for reaching out with your question.  I'm so sorry to hear that you struggled for awhile before you were able to get a definitive diagnosis.  On the one hand, a clear diagnosis can bring a sense of relief, and on the other hand, autism is a life-long challenge with no specific "cure," which can cause all sorts of emotions to pop up as you try to figure out how to manage things moving forward.  It sounds like you already have overcome some difficulties in your life since you mentioned being independent and on the right track with school at this time.  I don't doubt that you can do the same with the social aspect of your life as well.  It just may look different from other non-ASD peers. Here are some things that may be beneficial as you are learning about your strengths and your limitations with Autism: 1.  Gather as much support as you can from others.  The more you are able to find support in your family, friends, co-workers, classmates, therapists, school staff, etc, the more solid your foundation will be to move forward.  Remind yourself that you do have support and that you are not alone. 2.  Gather as much information that you can about your diagnosis from legitimate sources such as international, national or regional Autism awareness organizations.  The following are just a few resources: - Association for Science in Autism Treatment - Autism National Committee - Autism Network International - Autism Research Institute - Autism Society of America - Autism Speaks 3.  Many times, there are local meetup groups with others who also struggle with similar issues, such as socialization.  Some of these groups are in-person (contact local agencies for potential meetup or support groups), and some are online.  One example of these actually can be found through BetterHelp's groups which include social support groups and recently there was a group which explored neurodivergent patterns which can be helpful for individuals with Autism.  As difficult as it might be to reach out if social interactions cause anxiety, it may be well worth it in the end to identify strategies through a group of individuals with similar challenges.  One step at a time. 4.  You are not "just" your diagnosis.  There are so many other things about you that are worthy of developing and noticing.  I would challenge you to identify your strengths as well and to be mindful as you go throughout the day as to where you can apply your strengths, as well as where weaknesses pop up.  It may take a bit to come up with a good balance of socialization, independence, learning about yourself and being able to manage progress and setbacks.  But it is doable. 5.  Be patient with yourself.  Learning about your recent diagnosis can take some time and will take some perseverance in understanding how your brain works and what tools will/won't be helpful.  You may have to experiment with some intervention tools and strategies to improve upon your strengths and gather more information to help yourself.  You are a work in progress, and you can figure this out in the same way that you figured out how to become independent and to get on track with school.  Don't be afraid to ask for help from trusted supporters, or to reach out for help professionally to process what your diagnosis means for you and to explore potential strategies for becoming more successful in working through Autism-specific challenges. I hope this was helpful, and wish you the best of luck!   You got this!   

Thank you so much for asking this question and reaching out for help. You are definitely not alone when it comes to this problem.  In your question, you indicated that you lie in order to avoid conflict, possibly even perceived conflict. As Dr. Marks indicates, pathological lying is not a mental disorder but is identified as a behavioral disturbance. She explains that there is a difference between normal lying, prolific lying and pathological lying. She proceeds to define normal lying as the lying we engage in to spare another person’s feelings or getting out of something minor. Normal lying causes no or very little problems in a person's life. In contrast, pathological lying is a compulsive behavior that has no clear motive. On the other hand, prolific lying is defined as being deceptive for a purpose and leads to more complications in work, relationships and other areas of your life. At this point, it is important for you to take a moment and ask yourself if you are a person who is lying compulsively with no clear motive (pathologically lying) or if your lying is potentially prolific because your motive is to avoid being held accountable or to avoid engaging in any type of conflict.  Whether you identify as a prolific or pathological liar there are a few steps you can implement in order to change your behavior. First step, as always, is to admit that you have a problem. By reaching out for answers to your question you obviously understand that lying is a problem for you and may be leading to more complications in your life. The next step is to be accountable to other people in your life. You can choose one accountability partner or admit to everyone in your life that you are struggling with controlling a lying habit and need their help to change this behavior.  Of course, entering therapy to address the underlying causes of your lying as well as help keep you accountable will aid in creating change. Follow the creating accountability step with developing a list of  consequences you have experienced and will experience if you continue to engage in habitual lying. Write this list and post this list somewhere you see every morning and every night. By presenting yourself with this list twice a day you will be reminding yourself of the negative outcomes that will occur if you choose to lie that day. Journal about your progress each day. Identify where you feel you faltered and where you feel you succeeded. Create a goal to focus on the next day that will help you reduce your lying. Accountability is key - keep yourself accountable while also inviting others to hold you accountable. Commit to change every day while also acknowledging it will take time, struggles but, eventually, with attention and commitment to change you will succeed. 

Hi. The reason your daughter takes her anger out on you is because she can. Everything is about her, and she doesn't take ownership of her behaviors or actions. Hopefully she is in therapy to work on this. You cannot help her change her behavior because with her diagnosis, it is all about her and she does not like boundaries. She doesn't have them and she especially will not respect anyone else's boundaries. As long as she can do what she wants, she will continue to show a lack of respect for others. To help yourself, you need to set boundaries - which is not an easy task. She will fight this every step of the way. You cannot change her. You can only work on yourself to modify your behaviors. The challenge is setting them one boundary at a time. The bigger challenge is maintaining the boundary, because your daughter and others will not like this new boundary. This is difficult because your daughter does not like boundaries and will do everything she can to get you to give up and go back to things as they were. Most people are not comfortable with change. They especially do not like it when they do not get their way. Her lack of respect for you and others is no surprise. She will always continue this behavior because she can, since it appears that no one has challenged her. This is because if you tried and she didn't back down, it was just easier to give in. No one is comfortable constantly fighting. It is tiresome. It is much easier to give in then stand by your boundaries that might be best for you. You are her parent and you love her. You also want her to be happy and give her the best you can. But you also must take care of yourself.  This is exhausting, but necessary for your own mental and physical status. Stress can be harmful to your overall health. Taking care of ones self is necessary to then care for others too. Hope this is helpful and maybe I will get to work with you. Take care. Terry

Hello Arabella, Thank you so much for sharing your story.  It sounds like you have been through a lot and you are still in a place where things are hard for you in life.  I will try and do my best with the information provided, I can't clinically diagnose you since I would have to do a complete in-person assessment, but I can offer you some feedback.  It could be possible that you do have Borderline Personality Disorder(BPD).  Some of the clues that you have provided in your summary of behaviors, do sound like they align with this personality disorder.  Individuals who have BPD often have difficulty with thinking positively about themselves, others, and have difficulty managing stress, emotions, and behavior in a healthy controlled way.  They often have self-image issues, managing their emotions (very extreme and intense feelings and responses to things), and have a history and pattern of unhealthy relationships. They often act very impulsively and can have a fear of abandonment or rejection. Overall, they have difficulty coping and managing through stressful events and experience intense feelings and reactions to things.It seems like you have a lot of things that are happening right now, past trauma, unresolved issues, and difficult maintaining and regulating your emotions and moods.  A licensed therapist would be able to help you navigate through all of this, work through these issues, and help you obtain coping skills needed to start feeling better. There also seems to be a lot of trauma that you experienced as a child and it would be good to work through these issues as you make be easily triggered and your inner child starts to act out.  This probably would explain why you regress to the behavior you display towards your mom.  There also may be some post-traumatic issues and events that are still unresolved from your childhood. I would highly recommend that you find a licensed therapist that can help you during this time and they can clinically assess you and provide you with the best treatment regarding any diagnosis you may be experiencing. 

Hello Riley, Thank you for the vulnerability and entrusting your question to this platform. It sounds like the obsessiveness that you can experience with certain people in your life leads you to cling to a person so tightly that it pushes the person away and that it also leads you to feeling not cared for, etc. Without enough context or more information it is hard to determine what leads you to cling to these people in your life. I highly encourage you to look into meeting with a therapist who can help you explore and get to the root of why you respond this way towards certain individuals. A therapist can also help you to engage in a treatment modality called Dialectical Behavioral Therapy that is very successful at treating symptoms like the ones you have mentioned in your question. Regardless of formal diagnosis or not, Dialectical Behavioral Therapy is highly effective at teaching skills such as emotion regulation and interpersonal effectiveness. Learning to regulate your own emotions might help you to rely less on any one person to get your emotional needs met and free you up from relying too heavily on any one person and ultimately putting strain on those relationships. There are many therapists here on the platform, through your insurance, or in your community who are skilled at using Dialectical Behavioral Therapy and other techniques to help you have more fulfilling relationships. Your relationships don't have to continue to fall into the same patterns; there is help to break the cycle. If starting therapy is not right for you at this time there are also some great workbooks and tools that you can use to do self work in the meantime. If you search for DBT skills for example on any search engine you will likely find helpful worksheets and other resources without even needing to purchase anything.  I do, however, highly encourage working with a professional as they will be able to point out patterns, distortions, etc. that can be hard for you to identify yourself and can help you to gain insights into why you respond the way you do. Regardless of which route you take, I do believe you can find stability in your relationships. I wish you the best, and thank you again for entrusting us with your question. Take care. 

Hi Phoenix22 and thank you for asking me your question about changing your thought patterns and decreasing mood swings. You mentioned that your mood swings have become more frequent and more difficult to moderate after you had your second chid about two years ago. From your description, it sounded that you were not having mood swings from feeling "high" or manic to then shortly afterwards experiencing a swing in your mood to severe depression. I am not trying to diagnose you and without conducting a diagnostic interview in person, would not be able to diagnose you with anything. In any case, my first thought, when reading the title of your question was that you were experiencing Bipolar Disorder. While psychotherapy can be helpful in decreasing severity and frequency of  mood swings in a person with Bipolar Disorder, the most important issue first would be to consult a psychiatrist to figure out which medication combination would work best. After that, therapy could be useful. You mentioned being diagnosed with Borderline Personality Disorder. If this diagnosis predates the birth of your second child, then I would want to be certain that the doctor treating you evaluated you for Post-Partum Depression, to ensure the diagnosis is correct and to rethink medication choices.  Your symptoms do sound to be consistent with Borderline Personality Disorder and assuming this is the case, it could be helpful to read about Cognitive Behavioral Therapy (CBT), particularly exercises that discuss and teach you how thoughts lead to emotions and together, these influence actions and behaviors. In addition, it would be helpful to learn about cognitive distortions which often cause us to believe that situations are much worse than they really are and happen as automatic thoughts. It could be helpful to determine which of the types of cognitive distortions influence your thoughts and emotions the most and from there, you could modify these distortions and automatic thoughts so that your thoughts are not as severely negative and then you would have less negative emotions and thoughts influencing your daily actions and behaviors.  If you were in therapy, I would also introduce Dialectical Behavioral Therapy, (DBT) the only therapy approach to lead to reliable improvements in better mood regulation in individuals with Borderline Personality Disorder.  DBT involves several modules in which a person learns to make decisions and settle disagreements only when you can approach these issues from what is called a "Wise Mind". The wise mind is not under the influence of alcohol or drugs, it is calm and able to assess all aspects of a problem and incorporate the information needed to come to an informed decision or resolution. DBT also teaches mindfulness mediation which teaches a person to be present in the here and now and not worrying about things from the past and future. Another of the core modules of DBT teaches the many activities and methods a person can engage in to help them tolerate distress, or deal with pain and other unpleasant variables without resorting to impulsive and destructive actions and behaviors. The final core module teaches Interpersonal Effectiveness. This is exactly as is sounds, how to relate to other people while remaining calm and civil as well as communicating effectively. Some versions of DBT have additional modules that are helpful, however the ones that I have mentioned here will be found in any article or book on Dialectical Behavioral Therapy. The information from Cognitive Behavioral Therapy can usually be found online with persistent searches. I wish I could come up with a single book on CBT to suggest, however all the ones that I have are written either with a lot of clinical language or written academically and would be like text books and not of help to you. As for DBT, much can be found on the internet, although an even better source would be one of the Dialectical Behavioral Therapy workbooks. There are several available and they have information and lessons that are easy to understand and are printed and bound like spiral notebooks so that you can make copies of the worksheets in the book. The worksheets are helpful because they go over lessons and ask you to think of personal examples and answer questions from the viewpoint of the personal situation that you chose at the beginning of the worksheet. Along with those suggestions, I think it is important for you to see a therapist who is well versed in DBT as soon as you are able. I hope this information gives you a helpful place to start and I wish you the best of luck and a great life, Daniel Boyle Downey, LCSW

It sounds like you're feeling a lot of confusion, you recognize that what you are doing isn't working, yet you can't seem to find a way to make the choices that you want to make. This is a place many people find themselves in and feel like it is impossible to get out of, but the important thing to remember here is to take things in baby steps.  There are a number of questions that need to be covered here. First of all, you have a question about a potential diagnosis of bipolar which seems to potentially underly much of your behavior. For that, you would need to meet with a provider for a diagnostic interview or psychiatric intake, typically done by a psychiatrist or psychologist.  There does tend to be genetic predispositions with certain types of mental health disorders; however, just because it runs in your family doesn't mean you have bipolar disorder.  Sometimes, growing up in a situation where certain behaviors are the norm leads to others adopting those behaviors as their own. Once the individuals realize it and get out of the situation, they can make changes that are more within their personal norms and feel more comfortable.  When we find ourselves avoiding tasks that we know we need to do there are a few different ways to handle the situation. First of all, working on your mindset and realizing that saying yes to one thing means saying no to another. As you sit down or head out to do something, ask yourself first, "If I do this, what am I saying no to?" just making a habit of stopping and thinking about the choices that you are making, while it may not fix everything immediately, is a step in the right direction. It is important to remember that you have been living in this pattern for a long time, so even making the decision to change is the first step, but the steps to follow must be made in small manageable chunks where you can easily see success so your brain will see the reward and then want to continue making those changes.   Create a system that only asks for small changes of yourself, instead of focusing on the large changes that you are wanting to make overall. If you want to start a regular exercise routine, think about when is the time that you will be best motivated to do something, and instead of making a large goal like: I will go to the gym and workout for an hour at this time; start off with something that is just activity that you like it may be just committing to 15 minutes walking in the neighborhood, or 15 minutes dancing in the living room. Once that 15 minutes becomes a habit then increase it and gradually it will become something you look forward to and you won't have to fight yourself to get it to happen.  For budgeting, creating space between you and spending you money so you have to think about it helps with starting to get in the habit of saving.  An example may be setting up a savings account that you don't have easy access to from your checking account. This ensures that savings are only used for emergencies or for the purpose the money was set aside for.  With relationships, if you find yourself in an on-again-off-again situation; it's important to sit down and ask yourself why that is the pattern you are following. Are you comfortable and happy when you are alone? If not, then you will find yourself compromising your own happiness and goals in relationships, and they will be unpredictable and potentially border on toxic for both of you.  It's important to be happy and content with who you are before you add in the complications of a relationship with another person.  You have a lot to unpack here and if you try to focus on everything at once, it will be overwhelming. It's important to pick one or two areas of focus and take small steps in those areas, make those small things a habit before you try to take on anything else. 

Hi alittleblue, I'm glad you are taking the initiative to try to understand yourself better. First off a true narcissist does not really care that they are a narcissist. As a matter of fact, they generally would never think there was anything wrong with them. There are different types of narcissism but all have the common thread that there is manipulation present. What stands out to me is you stating that you felt scared in the relationship that you mentioned. I would urge you to dig deeper to find out what was the basis of that fear? Were you afraid you would be hurt? Or afraid you would be wrong? Or something else altogether?  People can certainly have some traits of narcissism without being diagnosed with a disorder. We all have varying levels of extraversion, agreeableness, consciousness, etc. The fact that you care enough to ask and that you have an awareness that you feel you need to keep your ego in check is a really hopeful thing because you can absolutely have successful and thriving relationships if that is what you are seeking. One can have a large self preservation instinct but still care about those around them. I would be curious to learn more about your past and your experiences to truly discover what has lead to this level of pride you feel that you have. You mentioned handling intense situations poorly because you assumed you were correct. Do you feel like you factored in the feelings of the other person or people or were only concerned with being right and having things go your way? It seems like you care how this is affecting a particular relationship in your life and if you are able, you could discuss this with that person and hold yourself accountable for your actions at the same time.  This is true of any situation within a relationship. Have things always felt this way within your relationships or was there a time where your relationships played out differently? These are all questions to ask yourself and to potentially process through with a professional therapist. From your question it sounds like you may feel there is an issue with how much you put yourself above others, or perhaps you are just trying to get to the root of the issue. Either way, people can lead successful lives even when struggling with tendencies of narcissism. I encourage you to work through these things with a therapist on the platform or elsewhere in order to assist you with understanding your own values and how you can live a life that aligns with those values.    Best of luck to you.

Hello, So of course I wouldn't be able to give you a diagnosis based on the information you provided or without meeting with you in person, but I'll give you some of my thoughts. There are a number of features often seen in Borderline Personality Disorder, and "explosive" moments can be one, as well as rapid mood shifts. However, there are several other mental health disorders that also would fit with these as well.  If I were to assess you for a mental health disorder, I would want to take a look at your life history first of all. The most common "ruleout" I would make before looking at a Borderline diagnosis is Posttraumatic Stress Disorder. It is very common for those who present with "explosive" behaviors to have a history of trauma. When this trauma has not been addressed in therapy, there can be a wide range of unhealthy behaviors that result. In fact, the majority of the clients that I meet with who have previously been diagnosed with Borderline Personality Disorder I end up giving a diagnosis to of Posttraumatic Stress Disorder. There are also mood disorder, such as Bipolar Disorder, that could apply, although I find that this is often also overdiagnosed. There is also Intermittent Explosive Disorder which involves, as the name implies, occassional violent, aggressive behaviors. I woudl also want to look at any substance use history (even if it is not occurring presently).  Above all else, I'd want to look at what your life looks like in general. For example, if you are dealing with a lot of stress and a lack of self-care, that could certainly explain those feelings of detachment and some explosive episodes. If you're feeling trapped, dealing with a lot of guilt, having difficulty coping with grief, etc., these are all potential explanations for what is occurring. There can even be medical factors that could be playing a role, such as some vitamin deficiencies. Borderline Personality Disorder tends to be fairly inflexible. You can work on the symptoms, and it is possible for them to go away, but as a personality disorder it tends to be more inflexible than some other mental health disorders. From personal experience I've seen many clients who are convinced they have Borderline Personality Disorder or another personality disorder work on issues that are resulting in their maladaptive behaviors and by doing so no cope much more effectively. In other words, they probably never had Borderline Personality Disorder in the first place. So, here are the two most important points I want to make: One is that the diagnosis really doesn't matter. Even if you did receive the Borderline Personality Diagnosis (which I would perhaps ignore unless it was done very carefully and by collecting a considerable amount of information, as it is often misdiagnosed), the problem isn't the diganosis--the concern is your well-being and your behaviors. Getting a diagnosis really doesn't fix anything, and if it's an incorrect diagnosis, it can definitely do more harm than good. I secondly want to strongly encourage you to give mental health treatment a try, whether you choose to participate in therapy on this platform or reach out for help elsewhere. The symptoms you're experiencing can be addressed, but we would want to dig deeper into what is causing them. If you would like to participate in therapy, or even if you just have further questions for me, please don't hestitate to ask. No matter what the diagnosis is, it's very likely that with some help your mental health can improve. Take care. Nick 

Thank you so much for your question. Coping with Borderline Personality Disorder (BPD) can be very challenging. BPD is characterized by the difficulty in being able to regulate one's emotions. Emotions can be felt more intensely for extended periods of time for people who are diagnosed with this condition. These challenges in healthy mood regulation can lead to impulsivity, poor self-image, conflict in interpersonal relationships, and intense emotional responses to stressors.  I am going to answer this question from two main perspectives of (1) a person with a confirmed diagnosis from licensed mental health professions and (2) a person without a confirmed diagnosis. I would also encourage you to contact your benefits provider to find out what kind of behavioral health care coverage you have because oftentimes if you have assistance for medical coverage, the benefits plan will account for mental health as well.  (1) If you have already received a diagnosis of Borderline Personality Disorder (BPD) from a licensed professional, the next step would be to try to get engaged with treatment services. Psychotherapy has been proven to be very effective in the treatment of BPD as it addresses the emotional dysregulation associated with the disorder. You can check to see if there are any providers that your insurance may cover that offer Dialectical Behavioral Therapy (DBT) and/or Cognitive Behavioral Therapy (CBT). -DBT focuses on teaching coping skills to help fight destructive urges, regulate emotions, improve relationships, and practicing mindfulness. -CBT focuses on helping to reduce negative thinking and the behaviors associated with BPD by learning effective coping strategies. Sometimes medication-assisted treatment can be effective with the combination of psychotherapy which usually requires a prescriber. Some things you can do on your own include: -Connecting with others through support groups (in-person or online) -Taking care of your physical health (eating balanced meals, getting adequate rest, stress-relieving activities like meditation or yoga) -Avoid the use of mood-altering substances like alcohol and drugs as it can exacerbate symptoms of BPD   (2) The first thing a person would benefit from doing if they suspect they have BPD is to get assessed by a licensed mental health professional, preferably one who specializes in personality disorders. It is important to not self-diagnose because these professionals are trained to look for symptomatology and potential causes of these conditions. A licensed professional with be able to help a person navigate the mouse appropriate level of care.   For more free resources please check out these sites below: https://www.nhs.uk/mental-health/conditions/borderline-personality-disorder/treatment/ https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Borderline-Personality-Disorder/Overview https://www.borderlinepersonalitydisorder.org/consumer-recovery-resources/

Hello, I understand that you are having difficulty with gambling and urges to gamble that have caused negative consequences in your life.  Your question of can someone help you stop gambling, I would say yes, there is professional help, but you must ultimately be the one who is ready to make the changes necessary to combat the urges to gamble.  With proper psychoeducation, a solid support system, and learning/practicing techniques, you should be able to exercise improved self-control over these urges over time.  However, changes don't happen immediately or overnight and require dedication and some work on your end.  There is not a professional who can do the work for you, but a therapist can stand beside you and offer support and opportunities to learn.  Oftentimes, the urges to gamble have roots in a desire for instant gratification and the feeling that you get when you do win money from gambling.  The "high", the chase, or intensely pleasurable feelings you get from participating in gambling, the risk, the thrill, and sometimes the winnings are what you seek.  This is the feeling that you would potentially focus on in therapy and try to identify ways to replicate parts of it in other healthy activities.  Support is crucial.  There are Gambling Anonymous groups that focus on the 12 steps which many find helpful.  The group format with others who share your struggle can instill a feeling of belonging and help keep you accountable.  Gambling Disorder is the only addiction disorder outside of substance use disorder that has made it into the DSM V (Diagnostic and Statistical Manual of Mental Disorders fifth edition).  What that indicates to clinical mental health professionals, is that this disorder should be treated in a similar treatment modality as with other addictive behaviors.  Behavior modification, emotion regulation, and healthy habits that become long-term life changes can be achieved with psychotherapy and the motivation of the individual seeking help.  Better Help is a platform where individuals do not receive diagnoses but therapists provide their expertise and non-judgmental listening ears to allow people to learn about themselves and find solutions to their problems.  So, in short, yes, gambling is something that you can be helped with.  You are brave to reach out and admit that this has become a problem in your life.  I wish you the best of luck on this journey!  

Bipolar Disorder is a diagnosis whose symptoms create an erratic and sometimes create gret chaos in the person's life who has the diagnosis but also in the lives of those who regularly come into contact with them.  What seemed fine two or three sentences ago can just as suddenly turn dangerous and lead to a hospitaliztion as you notice.  It can also just as quickly destroy the peaceful setting of a wedding and create forever negative memories of something that should be beautiful and wonderful.  It is, however, as you probably already realize something that is difficult to manage.  Setting boundaries is healthy but it can be difficult to navigate the emotions of another person who is hearing or receiving the boundary setting.  The timing of setting boundaries needs to be chosen with the greatest of care.  It seems that you have been managing this dilemma for a while and would like some guidance. It would be important for you to share how the person diagnosed with Bipolar Disorder has been affecting your life.   You say that this happened 3 years ago so I would ask that you prepare a time line of how she affected your life prior to the diagnosis and since the diagnosis.  No piece of information is too miniscule.  They are all very important to resoling your dilemma and determining how to begin setting boundaries.  Please be as specific as you can concerning any past interactions and attempts to work with her mental health symptoms.  What was successful and what was not successful?  Are you aware of the National Alliance for the Mentally Ill a/k/a NAMI?  There are many groups throughout the United States and they provide resources at their websites and meetings that are educational and supportive.  You can reach then at www.nami.org.  You may find that their availability is limited to or heavily internet or virtually focused today.  That would be a good resource whether virtual or in person.  Bipolar Disorder is best managed through a combination of counseling and medication.  Medication is going to be generally a lifelong situation as it is a chronic disease much the same as diabetes or heart disease.  She will decompensate from time to time so finding successful responses to her symptoms that you can use on a regular and steady basis.  This is likely to reduce the chaos and change for you.  Read a good book on Bipolar Disorder. The best writer I know is Kay Jamison who wrote An Unquiet Mind and who is a medical professional diagnosed with Bipolar Disorder.  You will find that a search of "Bipolar Disorder" on Amazon will produce family books for those who love a family member diagnosed with Bipolar Disorder.

Hi there. I'm sorry that you are struggling with the symptoms that you are experiencing. I can imagine that it is overwhelming and distressing for you. What I would like to do for your question is to give you a better sense of what BPD is in contrast with Bipolar Disorder. From what you described, it is highly likely that you have just BPD. BPD often mimics or appears like Bipolar Disorder. The difference between the two is with respect to the length of time and severity of the symptoms. For Bipolar Disorder, people often experience grandiose ideas, impulsivity secondary to those ideas, high levels of energy, and a decreased need for sleep. These symptoms occur together and are for a specific period of time therefore considered a "mood episode." With BPD, the symptoms are more pervasive and difficult to control in your day-to-day. The symptoms do include: difficulty with maintaining relationships because you go back and forth between "idealizing" to "hating" them; fears of abandonment; self-harming behaviors to help with alleviating emotional pain; frequent and intense experiences of suicidal ideation and/or gestures; impulsive behaviors (the goal being to alleviate emotional pain or to "fill the emptiness"); difficulty with managing your temper/anger outbursts; frequent and intense moodiness/mood lability; fleeting paranoia when you are under a lot of stress; lack of an identity/poor self-esteem (you often build your relationships with others by being a chamelion/blending in so that you are not rejected and feel like you belong but don't have a strong sense of self); and, chronic feelings of emptiness (which fuels impulsivity, self-harming and clinging to relationships even if they are unhealthy). Self-harming is one of the more "classic" or telling symptoms of BPD. When a person is experiencing bipolar disorder, they may become impulsive and also, during that episode, struggling with insight whereas when you are experiencing symptoms of BPD, you are aware of what is occurring but you have difficulty managing how you feel because it is so overwhelming. Can people have both? Absolutely, but there is generally a period of time when if Bipolar symptoms are under control that you are better able to see if BPD symptoms are still occurring or if they have stopped. I hope that this is helpful.

Alzheimer’s is a degenerative disease that has multiple negative symptoms throughout its progression, most of which affect the brain and subsequently affect other areas of your body.  The most commonly known symptom associated with Alzheimer’s is memory loss.  Due to the degenerative nature of this disease, the effects on the brain are more subtle in the beginning.  You may notice a slight increase in forgetfulness; usually, small items are easily forgotten.  But the frequency will be increased.  As the severity increases, more important things may be forgotten, like where you live, who your family is, or even what year you are in.  Oftentimes this process can have a major impact on our emotional health; those facing this disease may become easily overwhelmed, confused, and agitated, leading to increased symptoms of depression. In the later stages of Alzheimer’s, when the progression has become more severe, individuals will begin to lose the functioning of their physical body.  They become incontinent, resulting in the person soiling themselves.  Their muscles become weaker, making it more challenging to do simple tasks like cleaning up after themselves or lifting/carrying items that normally would not have been challenging for them.  At this point, they may require an aide or other person to assist in caring for their daily activities.  Unfortunately, their brain functioning continues to deteriorate, so they may forget who they are trying to help them and become combative with their helpers.  Also, their mood will be more labile; you may see these individuals become easily tearful, which is usually related to the negative feelings associated with losing their ability to function at a “normal” capacity.  They may also lose their appetite or even forget if they ate, which would only worsen the symptoms listed above.  At this point, there is no “cure” for Alzheimer’s.  Some medications help slow the progression so that someone with this diagnosis can live out their lives with normal functioning for as long as possible.  Research also supports that exercise and good nutrition helps to prolong the inevitable progression of Alzheimer’s.  So if this is something that has genetic influence, then it is best to take good care of your body. 

Mental health professionals rarely determine that one factor causes a mental health disorder; rather, experiences can put a person at a higher risk of experiencing a mental health disorder. Therefore, rather than ask whether bullying causes Obsessive Compulsive Disorder, it makes more sense to think about whether bullying increases or contributes to one’s chances of developing the symptoms consistent with Obsessive-Compulsive Disorder. There is evidence that a person who experiences bullying may be at a higher risk of developing Obsessive-Compulsive Disorder. This makes a lot of sense if you think about what bullying is. When a person is bullied, they are placed in a situation where they have little control over it. He may not feel safe in places where he should feel safe, such as at school, and efforts to seek help to stop the bullying may be ignored, only further contributing to the sense that he has limited control over his circumstances. There is a link between trauma (and bullying can absolutely be traumatic, even if the individual does not experience significant physical harm) and Obsessive Compulsive Disorder, likely in part because, with Obsessive Compulsive Disorder, the individual obsesses about controlling their environment and/or body. Unfortunately, in trying to control so much, they often lose a sense of control over his ability to make decisions.   Bullying and trauma are also linked to several other mental health disorders, including substance use disorders. By abusing substances to control feelings, the person may temporarily feel more control over his life (although this substance often leads to much less control). A person who experiences bullying may also be more likely to obsess over control of food intake (which can result in eating disorders) or inflict pain on oneself (self-mutilation). An article by Fugen Neziroglu, Tania Borda, Sony Khemlani-Patel, and Brittany Bonasera entitled The Roles of Bullying and Victimization in OCD and BDD: An International Sample can provide additional reading for someone interested in the link between bullying and OCD (as well as Body Dysmorphic Disorder). In conclusion, recognizing that bullying can be correlated with higher rates of Obsessive-Compulsive Disorder and other disorders can be beneficial if we help the survivor of bullying receive the necessary treatment and take practical measures to prevent bullying. There is absolutely no debate that the experience of bullying as a child can increase a person’s risk of various mental health disorders.  

Awareness Mindfulness allows us to be aware of our present conditions. We may notice that we are holding onto tension that we did not realize we had, or we may notice maladaptive thoughts of which we had not been fully aware. Mindfulness allows us to appreciate what is in front of us. A common mindfulness exercise is to slowly eat something, such as a raison, and appreciate its texture, smell, and the transformation of flavors. Because so many of us live busy lives, we may focus too much on what is behind us or ahead of us and not enough on what we are thinking and feeling at that very moment. We may notice our concentration improves as we can focus more completely on tasks in front of us. Acceptance Another key component of mindfulness is acceptance. Because mindfulness focuses on the hear-and-now, it can be useful to reduce worry about possible future events. Additionally, if we struggle with thinking about a past event, mindfulness can reduce the guilt, grief, resentment, etc., of whatever past event occupies our mind. Many problems identified by those in therapy can involve trying to control something that cannot be controlled while failing to control something that the person does have control over. Because mindfulness can help us to become more aware of what we can control and accept what we cannot, we may feel empowered while also feeling that we can let go of the thoughts and feelings that are unhealthy for us. With acceptance, there is more opportunity for gratitude and peace. A New Way Of Living By achieving greater awareness and acceptance, we may notice several positive changes in our lives. For one, we may sleep better because we worry less about the future and focus less on the past. Mindfulness strategies can be helpful for those with mood disorders, anxiety disorders, and even those with chronic pain, and you may notice that your mental health improves. Mindfulness is also linked to increased creativity (artists will often practice mindfulness techniques for inspiration). While mindfulness may be challenging for someone not used to it at first, it can quickly become an enjoyable part of your daily life.   

To determine the best course of action when diagnosed with Bipolar Disorder, it is necessary to speak with mental health professionals, as symptoms of Bipolar Disorder can vary widely with regards to severity. Those with Bipolar I Disorder may require hospitalization until the person is stable, which is often unnecessary with Bipolar II Disorder. An important point to make before discussing treatment options is that Bipolar Disorder is sometimes misdiagnosed. Make sure you receive a thorough evaluation by a mental health professional you trust. If it has been a long time since being diagnosed with Bipolar Disorder, be open to the fact that you may receive a different diagnosis now. Since those with Bipolar Disorder will experience depressive episodes and manic or hypomanic episodes, treatment may vary depending on the current episode. Cognitive Behavioral Therapy is effective in treating Bipolar Disorder. The therapist will help you to recognize the cognition associated with your depressive episodes and, by using cognitive restructuring, change the way you think. Because those experiencing a manic episode may feel agitated, euphoric, or out of control, your therapist may help you learn mindfulness strategies and coping skills. Your therapist may also help you develop a routine and stick to it, as having a structured schedule can be important for those with mood shifts. Additionally, the therapist may include your family in therapy, as your communication and overall relationship with them may be affected. If you abuse substances, helping you get and stay sober will be extremely important, as drug and alcohol use can make the symptoms of Bipolar Disorder far worse. Your therapist may encourage you to participate in additional social activities to have additional support and be more active when feeling depressed.  Rather than only treating the episodes when they occur, there are preventative measures that your therapist can help you take to minimize these episodes. Many people who have Bipolar Disorder, especially those who have frequent or intense manic episodes, can benefit considerably from psychotropic medications. Mood stabilizers, including lithium and Depakote. Antipsychotic medications, such as Abilify, are also sometimes used if the client is not experiencing psychosis. In addition to the mood stabilizer, your doctor may also prescribe an antidepressant that can reduce the frequency and severity of depressive episodes. It is very important that you take these medications as prescribed, as stopping them without consulting your doctor can be catastrophic even if you are feeling well. Overall, there are several treatment options for Bipolar Disorder, with Cognitive Behavioral Therapy combined with other treatment modalities probably the most common experience. Communicate with the mental health professional what is and what is not working for you. Fortunately, various approaches can be effective, so although it can take trial and error, most people with Bipolar Disorder benefit significantly from therapy.

Counseling is a joint effort between a client and a counselor; wherein professional counselors support clients in identifying goals and potential solutions to problems. Emotional turmoil, difficulty communicating, issues like anxiety, depression, and even schizophrenia can be addressed with the support of a counselor. Counselors work with clients to improve communication and coping skills, support health self-esteem, behavior change, and overall mental wellbeing. Counseling comes in many forms. Individual counseling is one on one counseling. Couples counseling helps couples address relationship issues and strengthen bonds. Family counseling supports families in addressing areas of difficulty that they may encounter. Group counseling usually involves a counselor working with 8 to 10 people on the same or similar issues. At some point in life, everyone experiences a bump in the road. These challenges may be changing careers, navigating the end of a relationship, recovering from substance use, working through anxiety, managing stress, or learning to live with a mental health condition like depression, bipolar disorder, or something else. Counseling is a treatment that considers the individual and their unique circumstances when creating treatment plans. There are also many areas of specialty that counselors may work within: grief, addiction, relationships, and more. The research support for counseling as a viable treatment makes it extremely important. There are many modalities, theories of treatment, and interventions. Counselors receive training in multiple methods or their preferred methods and are ethically bound to use treatment modalities that have scientific research support as being helpful. Some common modalities utilized are cognitive behavior therapy or CBT, dialectical behavior therapy or DBT, EMDR or eye movement desensitization and reprocessing, biofeedback, ACT or acceptance and commitment therapy, person-centered therapy, and more. Counseling has been researching proven to treat anxiety, depression, obsessive-compulsive disorder or OCD, attachment disorders, posttraumatic stress disorder or PTSD, personality disorders, and more. While medical approaches and treatments with medication can be helpful, they may not be the first choice for every person or appropriate. Medication adherence and outcomes are often improved by therapy (also called counseling). Counseling empowers clients with skills that can last a lifetime and support them as they work through problems in ways that are best suited to their needs and preferences, making it a unique and important treatment option. For more information on the counseling profession and its many branches, visit the American Counseling Association website or the National Board for Certified Counselors.