In honor of the egg donor’s birthday, and extra post this week.

What is Comorbidity?

I don’t usually trust Wikipedia as a primary source, but this definition fits my thoughts on multiple diagnoses.

“In medicinecomorbidity is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases. The additional disorder may also be a behavioral or mental disorder.

In medicine, the term “comorbid” can be either medical condition(s) existing simultaneously but independently with another condition; or it can indicate a related medical condition or conditions. In psychiatric diagnoses it has been argued in part that this “‘use of imprecise language may lead to correspondingly imprecise thinking’, [and] this usage of the term ‘comorbidity’ should probably be avoided.”” – from Wikipedia

11+ Diagnoses Become 1 Primary with a Secondary diagnosis

Between 2004 and 2007, I was diagnosed with 11+ different mental illnesses including:
  • clinical depression
  • 5 different anxiety disorders
  • mild agoraphobia
  • anorexia nervosa
  • a variety of other phobias
  • panic attacks
  • obsessive/compulsive disorder
  • and an anger management issue.

I wish I could remember all of the names, but I can’t. What frustrated me the most at this time was that they kept giving me these labels because I did not fit any of the mental illness categories exactly.

Symptoms like hallucinations and dissociation were evidence of a psychotic disorder; but they couldn’t call me something I wasn’t.  And I wasn’t psychotic.  The psychologists and psychiatrists kept treating each condition as something separate.  I began to believe I really was crazy.

Between 2004 and 2014, I had visited 3 therapists (1 psychologist and 2 LISCWs), 2 partial programs with teams of mental health providers and 3 psychiatrists, and 11 private psychiatric professionals (psychiatrist and psychiatric nurse).  The therapists kept recommending medication to make the symptoms go away.  The psychiatrists kept giving me medication – increasing doses or changing medications – until they got frustrated and gave up on me because nothing worked.  I take the medication and get sick.  The symptoms go away, and I become a catatonic zombie.  I stop taking the medication and become independent again.  The symptoms come back worse than before.

Ironically, it was an academic advisor in graduate school who figured out my correct diagnosis: complex post traumatic stress disorder.  The academic advisor was a domestic violence survivor and in the process of getting out of the relationship when we met.  She recommended the book Trauma and Recovery by Judith Herman to read.  That was the first turning point in my recovery.  I realized that everything I had remembered was the driving factor in my diagnoses.

Then I learned that each diagnosis can be its own disorder or symptoms of a more complex mental illness like post traumatic stress disorder and personality disorders.

Lessons Learned from Multiple Diagnoses

Along with medicine, the therapists helped me by teaching me strategies to rebuild my internal sense of self – the foundations based on my values, beliefs, and self-trust.  My problem was and continues to be that I do not trust anyone until they have proven themselves to me with their actions.  This can take a while or not happen at all.  The trust issue and pressure to stop going from the sperm donor caused the first therapy relationship to break up.

I still go into every potential relationship knowing that, unless I feel both emotionally and physically safe, it’s going to be temporary.  I met my closest friend during my junior/senior year in college.  We reconnected a few years later through a mutual friend and have remained friends since then.  Up until 3 years ago, I waited for the moment when something one of us said or did would break up our friendship.  Even now, when I or one of my parts are having a particularly difficult time, we wonder when all of the people in our support network are going to stop being supportive – either they walk away or I walk away.

The voluntary programs taught me that everyone, even mental health providers, has an agenda.  Maybe not a conscious one, but definitely an agenda / purpose driving their approach to helping others.  The first time, a program helped for two reasons:

  • 1)I learned that I wasn’t alone
  • 2) there were people in the world who could accept an eccentric, weird, individual with “unique perspective of yourself and the world” (paraphrasing my program clinician)

The second program taught me that I wouldn’t get anything out of groups unless:

  • 1) I trusted the clinicians to do their jobs
  • 2) the people around me to be supportive, respectful, willing to speak up and help other clients in the group, and accepting of others.

And even though I didn’t get the same kind of assistance as the first time (different people working in the program), I learned to trust my instincts.  By observing the people in the program, I learned about my values and what I want in any kind of relationship.  The people in the program (clients and clinicians) reminded me of people in my family and circle of friends.  The same family and friends whom I was considering a permanent separation from.  Not knowing I had Dissociative Identity Disorder made things even more difficult.  I didn’t remember interactions with other clients or understand why they treated me different from moment to moment.

The other part was my “unique perspective” because I was in a different recovery place than the others.  I couldn’t relate to anyone.  And the more I talked, the more I felt separated from them.  The other clients started to resent me and avoid me – partly my fault because I was obviously cautious and had mood swings from dissociation/switching; partly theirs for feeling frustrated/angry/upset with me because they couldn’t be where I was – which caused tension whenever I was in a group or tried to connect with others.  The clinicians were not happy with me because I was too assertive and knew more about the coping techniques they tried to teach us than they did.  This was routinely said by clients in groups where the clinicians and moderators could hear.

That’s when the subtle condescension and shaming started.  And not just with me, but with other clients too.  The whole atmosphere made me uncomfortable.  And it was only after I learned about shame that I realized why I felt uncomfortable and not inclined to trust anyone in the program.  But the month off from work gave me time and perspective; two things I needed to make the final decision to walk away from my family and current relationships.

Conclusion

Anniversaries bring up a lot of stuff.  Remembering the past is not a waste of time if one learns from those experiences.  Today is my mother’s birthday.  Sometimes she is referred to as the egg donor.  Most of us prefer not to attribute the word “mother” to her, but old habits are hard to break.  I and my parts always get stuck in memories and feelings before, during, and after her birthday.

I think about her and get angry.  I think about her and promise myself not to spend time around people who act in similar ways towards themselves and others.  I think about her and feel proud that I am able to choose who to spend my time with even if that means having a very limited social circle.   I think about her and wonder if she can still hide her craziness without me there to take the blame.

Most important, I think about her and feel relief that we are not in each other’s lives.

When I think of now, I wish that all survivors and their connections are able to find supportive, compassionate, knowledgable mental health providers who can offer them the correct diagnosis and options for symptom management instead of having to go through what I did.

Advertisements