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Distressing Diagnosis…

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I am still finding the whole story of my diagnosis pretty distressing. Every time I think about it I feel like shit. More often than not I start crying. I am so ashamed, offended, frustrated, insulted, embarassed, disgusted, shocked; all of those and more. By diagnosing me with NPD, Dr M has labelled me as a horrible person, someone that no one would want to know. It hurts. I can’t stop hating myself for it.

I went and saw my GP, Dr N last week. I had written some notes for him outlining my thoughts on the diagnonsense issue, but when I went to pass him the notes, he said Dr M had written to him. For some reason I took that to mean she had actually told him my diagnosis and I withdrew my notes, but I realised later that she probably hadn’t given the detail. I wish I’d got him to read my letter anyway, but it’s a little late for that. Initially he tried to defend the suggestion that I had a personality disorder, mentioning that he had considered it in his differential dx when he first treated me back in 2008. He said that I shouldn’t worry about the diagnosis, diagnoses change and that it isn’t a personal attack. It was at this point that I managed to tell him, in between my tears, that it wasn’t the PD element I found particularly distressing but the narcissistic bit. I don’t think he knew which PD I had been diagnosed with until then. There was a look of surprise on his face and his attitude shifted. He was more receptive to my suggestions that the diagnosis was inaccurate, although he did defend Dr M. He suggested that she must have had reasoning for the diagnosis and that generally he trusted her, but he also agreed that she hadn’t known me very long. I said that I was scared of objecting and he finished my sentence for me, saying “because you’re afraid of it coming across as narcissistic”. I felt a little comforted that he understood this as it gave me hope that others would too. I do feel like I am trapped by this diagnosis, unable to complain for risk of compounding the issue. In the end, Dr N suggested that I sent Dr M a letter, ahead of my appointment this Monday as he didn’t really know what else to suggest. I agreed to do this and we sorted out the medication thing and that was it really.

I was generally a mess during the appointment. I couldn’t stop crying, which I think surprised Dr N a little. Despite the fact that I’ve seen him many times when I’ve been really low, anxious and generally at my worst, I very rarely cry. I can only actually remember one other occasion.

Usually I leave his appointments feeling a little better, but I went into this one with hope and left feeling pretty dejected. I do think he understood and was concerned, but I didn’t feel supported as such. I had hoped he would be able to help me in some way, although how, I do not know. I had hoped he would tell me he didn’t agree with the diagnosis, but I am not sure he would admit that, even if he wanted to. I guess that it’s probably not professional or wise to criticise a consultant’s opinion. I found myself losing all hope that this was something I could fight. I feel like I am fighting it alone and don’t know what to do. I had wanted to know there was someone on my side and I was disappointed that he chose to stay on the fence. I pretty much felt like giving up and resigned myself to the fact I am a horrible narcissistic person.

I got home and wrote the letter though. I found it hard to find the words and to keep it professional. I needed to stick to the facts and didn’t want it to become emotional. I wanted to be careful and not write anything that could be used against me, but even still I know that it doesn’t matter what I say, it could always be twisted into something else. I emailed it off to Dr M’s secretary and tried to forget about it, but no matter how hard I would try, it was haunting me. I felt physically sick with anxiety all weekend. I couldn’t face the thought of seeing Dr M again.

On Monday I saw Dr M. I didn’t get much sleep on Sunday, which is unsurprising really. I never get much sleep the night before appointments. My bloke came with me. In many ways I was uncomfortable with this, but I needed someone there. I was too scared to go alone.

She wouldn’t start the appointment with my email. She wanted to ask what I’d been doing and how my mood was and the usual. I found this hard when all I wanted was to get the diagnosis thing over and done with. I guess she did this to maintain control over the appointment.

We conceded that there had been a tiny bit of improvement in my mood. I have had the odd better day in the past couple of weeks, which I’d not had for some time before, but then the bad days are just as bad as ever. At times they are actually worse because anxiety has joined the depression. I have never really had a major anxiety problem before, but at the moment I am completely on edge. There is a churning anxiety there all the time and it flares up, leaving me feeling sick, shaky and tense. I think about things and suddenly my heart skips a beat, my chest gets tight and I feel this wave of unease washing over me. The diagnosis issue is the biggest trigger for this, but not the only one it seems. Sometimes it even happens for no conscious reason and this unnerves me even more.

We eventually got onto my letter and diagnosis. This part of the appointment is actually a bit of a blur now. I was too anxious and too upset to really take things in and I don’t actually think much was said. I was crying within moments of approaching the topic and at times the sobbing got the better of me. I couldn’t think. I couldn’t speak.

She said she was expecting my objections. It felt like she was saying “Look! I know what you’re like. Of course you’re going to write to me and object to the diagnosis. It just shows you’re narcissistic”. She may has well have. That’s how it felt.

I remember her trying to justify the diagnosis, saying that she hadn’t made it just on a few isolated examples, but that Dr S agreed that there was plenty of evidence. I tried to argue that she has barely had chance to know me and that considering I’ve not been well it would be hard to get a representative idea of my personality, but I don’t think it helped.

She pretty much counteracted everything I could say and I was losing the will to debate. It was a little like trying to swim upstream, with big sticks floating down the river towards you. You can see them coming and you know they are going to hurt when they hit you, but you can’t do anything to stop it. In the end, you just keep floating down river.

I tried to get my bloke to back me up and say it was ridiculous, but although he conceded he didn’t think I met the diagnostic criteria, he didn’t exactly add much weight to my argument. I almost felt that his near-silence only served to strengthen her opinion. I just felt helpless without anyone on my side.

At one point I asked her how she could diagnose any personality disorder so quickly and I suggested that she shouldn’t give the diagnosis until she was absolutely sure. She replied with “ohhh, I’m sure!”, said in that annoying way that implies you are ridiculous for even suggesting otherwise. This pretty much finished me off. The way she said it has echoed in my brain since and it doesn’t matter what happens to the diagnosis in the future, I’m always going to have those words telling me I’m a narcissistic cow running in the background.

She did however keep saying that she doesn’t think diagnoses are that important. I found this frustrating, because if that was the case I don’t see why she gave a diagnosis in the first place. There was no need to write it in my notes in big letters if it doesn’t matter. There was a lot of  discussion about how the diagnosis does or doesn’t matter and how it is or isn’t helpful, but I am not sure I was even following at the time.

I was asked what diagnosis I thought was accurate. What personality traits I felt were a problem. I didn’t really know what to say. At the time I could think of a few obvious ones, but I wasn’t thinking clearly. It’s something I have considered before, yet when called upon I went blank. I was also worried about saying anything too incriminating.

She asked if the diagnosis was really a problem or if it wasn’t helping. I agreed that it was making things worse, because I am so frustrated and upset by it. She said that she didn’t want to do anything that will make things worse and I know she does genuinely mean that. She told me that if it would make me feel better she wouldn’t specify the NPD. So now my diagnosis is going to say something like “moderate depressive episode” and “personality under investigation”.

On paper, I guess things are a little better. The horrible word is gone. I am back to a potential PD, but a non-committal one.  The problem is, it doesn’t change the way I feel or the way Dr M feels about me. The damage is done. I’ve been labelled as narcissistic and I am hurt and upset by it. I am still thinking about it far too much. I hate myself for it. I find myself thinking about what I’ve said and done and trying to work out if I’ve been narcissistic and if I have been in any way, then I beat myself up over it. I obsess over it and just use it as more and more evidence of why I am a crap, evil person and that I would be better off not being here.

I could go on. There is more I want to say, but I am pushed for time. Sorry all for cutting an entry short, yet again. Just too much going on, both in life and my head.

Hope everyone is well. xx

Edit: I tidied this entry up a bit. It was written when I was pushed for time and I didn’t exactly express myself too well in places. The strain of things is taking its toll in many ways.

Written by intothesystem

Wednesday, 10th March 2010 at 9:49 pm

12 Responses

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  1. She sounds like an awful person for a Psychiatrist, I really have no idea how you have to be feeling having this woman as your doctor… it’s no wonder you are feeling so devastated at the moment and upset over this. You prepare an email and it sounds like everything in it she fired back at you twice over, like you said ‘a little like trying to swim upstream’. I guess it didn’t help to have your other half there with you and feel little support from him, I suppose in a way he’s feeling a little helpless himself and wondering what the hell he’s suppose to do?

    Have you thought anymore about making an appointment to see Dr G?

    Alison

    Wednesday, 10th March 2010 at 10:32 pm

  2. Sending lots of hugs.
    You’re not a horrible, evil, or narcissistic person, you just have a doctor that’s made a (shit) assumption based on the few times she’s met you. She sounds awful, is there any way you could request a change or even a second opinion? Thinking of you xx

    thesunshinediaries

    Wednesday, 10th March 2010 at 11:06 pm

  3. That sounds crap. You really are in a pickle when they PD you as can’t argue it without re-enforcing. I had that when BPD was branded about though evntually they changed mind when saw my symptoms over longer time.

    la reve

    Wednesday, 10th March 2010 at 11:43 pm

  4. Oh honey, you’re not a horrible person, the shrink is. Can you ask to see a different psychiatrist? I would insist on it if I were you, not just because of the diagnosis, but because of the difficulty in your working relationship with her.

    Karita

    Thursday, 11th March 2010 at 12:24 pm

  5. You do not come across as the narcissist in this situation. Ahem. That is all.

    la

    Thursday, 11th March 2010 at 4:53 pm

  6. Comfort wishes for you. I don’t think you are a horrible person. I’m really sorry your doctors ar enot taking you seriously. Can you ask to be referred for a second opinion re the diagnosis? I don’t know about your rights in the UK, but in the Netherlands you have the right to one.

    Astrid

    Thursday, 11th March 2010 at 6:50 pm

  7. i have to say that Dr M sounds like a patronising old cow! I’m not surprised you feel so terrible – not only are you dealing with your crippling depression but you are being subjected to an attack on your personality by somebody who is supposed to help you.
    Please forgive me if you have already answered these questions but i wondered:
    1. What evidence has dr m cited to back up her dx?
    2. What role has dr s had in the dx?
    3 What support do they propose to put in place for you since they have made this dx?
    4. why did your gp initially question pd as a differential dx?
    i do think that you would benefit from a second opinion – maybe through the dr that dx you with bipolar?
    thoughts are with you x

    starrunner

    Friday, 12th March 2010 at 7:14 pm

  8. Fuck. I would be in bits. I think starrunner is right- you deserve clarification on this, proper clarification, a damn fucking explanation and some treatment as a person who is distressed by this.

    I don’t know what to say, but I hate the sound of your Dr. Bollocks to this- it’s a label, you were the same person before, and you’re pretty cool and it doesn’t change that.

    The Secret Life of a Manic Depressive

    Sunday, 14th March 2010 at 6:30 am

  9. Of course Dr M sounds like an awful/horrid/patronising person. That’s how ITS has described her!!!

    It’s quite a distance from reality though.

    As someone who has actually met Dr M, she seems nice and is trying hard. For one – she’s fitting ITS into her diary herself every fortnight (a damned sight better than the 4 month gap between CMHT appointments).

    As far as I can tell, ITS’s problem with Dr M is just the NPD diagnosis. In my opinion this isn’t 100% accurate, but it’s not as far away as ITS makes out.

    OH

    Monday, 15th March 2010 at 9:49 am

  10. *hugs*

    I agree with the others – if you can, please seek a second opinion. I am not surprised at all that you’re distraught over this; it’s horrible. Again, I agree with the others – she’s the nasty party in all this, not you.

    Please take care of yourself. xxx

    Pandora

    Monday, 15th March 2010 at 12:51 pm

  11. Just another thought – i’ve just been reading up on the proposed DSM v and it seems that there are only 5 different diagnosed PD’s and Narcissistic isn’t one of them. I wonder what happens when a dx fails to exist?!?

    starrunner

    Monday, 15th March 2010 at 2:29 pm

  12. […] a comment » My last post, Distressing Diagnosis… was a little on the rushed side and basically unfinished when I posted it. I knew if I didn’t […]


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