Tag Archives: Psychology

The DSM-V Sucks: Self-Diagnosis?

I’m sure a bunch of people are the same as me. You think you’re fucked up in the head and start Googling what the hell your problem is. Do I have chronic depression? Am I bipolar? For fuck sake, do I have borderline personality disorder? This inevitably leads to the Wikipedia page of said symptom which also inevitably leads to you reading something like “[disorder] is recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a personality disorder” and if you obsessively do this enough you’ll notice every psychological issue in the world’s Wikipedia entry mentions the DSM-V, whatever the fuck that is.

But Wikipedia is full of links so if you obsessively read psychological issues you’ll also inevitably click the DSM link and already know what it is. If you don’t, it’s the American Psychological Association’s Diagnostic Manual for mental issues. Were talking anxiety, depression, substance abuse, mental disorders, and anything else you can think of. I see it as like a Bible of disorders/mental issues and also seemed like a book that would be a good reference to have on hand. I’m a huge fan of general use reference books such as this and it has the same appeal to me that a good set of socket wrenches or a multimeter has; you never know when you’ll need it!

Having the DSM-V is a dangerous thing though. It’s almost like an IRL Necronomicon as much as it’s the psychologist’s Bible where you have a bunch of dangerous information at your grasp that you’re probably too uneducated to properly use. Myself included because I have no fucking clue how a psychologist would actually use the damn thing. Do they reference it? Do they need to follow the clear steps for diagnoses or is it like a guideline? And what the hell are all the codes for?

Luckily I’m not too much of a dumbass to know that you’re not suppose to diagnose yourself or others with your own Amazon copy of the DSM-V. I’m not a trained psychologist or anything so know I can’t use the book to pretend to be one. But it’s a fucking pandora’s box of mental disorders and it’s impossible to read anything and not have the temptation to diagnose other people or especially yourself! It’s like the mental equivalent of looking up physical symptoms on WebMD. “Oh, I have a cough, shortness of breath, and…holy shit! I could have cancer? Fuck. Me.

(Fun Fact of Funness: Amazon obviously has copies of the DSM-V, but since it’s a textbook you’re going to be price-gouged like you’d expect. I originally found copies for over $100 which I wasn’t going to buy. But somehow, for some reason, I found this copy of it. Sure, it says “unknown binding” which sounds risky, but fuck, it’s a legit book! I was worried it would be loose-leaf pages or something, maybe a .pdf on a mini-SD card, but no, it’s a real soft-cover textbook. So if you want to buy your own copy of this book for 30% the cost of the “real”(hard-cover) version, click that fucking link. No I don’t get money for recommending this, it’s just such a good deal to be nearly unbelievable.)

Sadly I’m smart enough to buy it, think I know the proper use of it, believe I won’t misuse it, and whoops, pandora’s box is open and I’m wondering what disorders I and everyone else around me has.

Personality Disorders and Such

The DSM lists ten personality disorders. It’s tempting to think everyone has a disorder, but the whole idea behind a disorder is that it isn’t normal and is a hindrance to some degree in everyday life. Personality disorders aren’t like your zodiac sign or you Meier/Briggs personality type; you might not have one at all.

(Note about things being ‘normal.’ There is some controversy as to what a disorder is because it’s based off some nebulous idea of “normalcy.” Who’s to say what’s normal and what isn’t? Obviously some disorders are more ‘crazy’ than others, but where would you draw the line between ‘normal’ and ‘abnormal’? What seperates a disorder from a person simply being unique?)

That’s the first problem to solve: do I even have a personality disorder? To me, something seems off, but I’m not a psychologist and I only know myself so it’s impossible to gauge whether or not I’m ‘normal’ or if I have a disorder. Like I said, it’s not a good idea to diagnose yourself, but just for shits and giggles I wanted to take an educated guess at what disorders I could have.

There are ten personality disorders in the DSM-V. Just to rattle off a few: borderline, histrionic, obsessive-compulsive, antisocial, dependent, avoidant, and let’s not forget everyone’s favorite disorder narcissistic personality disorder!

It’s interesting to discover that I show signs of nearly all the ten disorders. None seem clear enough that I can label myself with one but each one has traits that seem fitting. I have the selfishness of someone with narcissistic personality disorder, but seem to lack the lack of empathy and powerful ego that is characteristic of the disorder. Everyone has a little bit of paranoia floating around in their minds, and the same is true for me, but this probably doesn’t mean I have paranoid personality disorder. The mood swings I seem to have sound terrifyingly similar to borderline disorder, but lack the angry outbursts and unstable relationships that categorize those with borderline. I can’t make my own decisions very well, and this sounds like someone who could have dependent personality disorder, but probably not because I don’t fit the rest of the traits. Oh, and the need to be in control like those with obsessive-compulsive personality disorder (not to be confused with the stock OCD), but once more I lack the rest of the symptoms or traits to actually be diagnosed with it.

Around this time I’m starting to feel even more fucked up, wondering if I’m a borderline/narcissist/antisocial and a few other terrifying ones. You can have more than one disorder! Strangely, I’m also wondering if I don’t have any actual disorders and, holy hell, what if I’m normal! Somehow that seems worse in a way. Like none of the drama that plays out in my mind is special or notable because it’s just typical life bullshit that everyone experiences and that maybe I’m blowing it all out of proportion. And this sounds like something a narcissist would say…

Then I stumbled upon one of the lesser known and “boring” personality disorders: avoidant personality disorder. I’d never heard of it before. But reading the traits gave me that horrible sinking feeling that things were a bit too truthful and were hitting a bit close to home. Sure, I read about narcissistic personality disorder and found a few things that sounded like me, but the rest were a stretch. But APD? Holy fuck. I seemed to have nearly all the traits of that disorder. These people avoid others unless they’re certain they are liked. These people are very insecure and have fragile egos and don’t take criticism well. They’re needy and always searching for approval  I read towards the end of the section and then shut the book. My adventure of reading about personality disorders was taking a turn for the worst. Here I was reading about disorders and fantasizing about what it would be like to have them, wondering what people I know (if any) might have them, but reading about APD took me out of mild curiosity into serious self-introspection. It was like I was reading a person critique about my personality. I stopped reading, laughed, closed the book, and said, “Oh, wow. That’s enough of the DSM for tonight. Yikes…”

I’ll probably write about possibly having avoidant personality disorder sometime soon because there’s a lot to unpack here. It sounds so close to who I am and how I feel and it’s like another layer of the proverbial onion has been exposed. But until then, maybe use some caution when you bust open your own personal copy of the DSM-V for ‘casual reading’ purposes. Things can get a bit dark and too real when you least expect it. But still it’s a good reference to have on hand and I highly recommend it.

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Getting Help Sucks

Last week I decided that I should probably go see a therapist. For most of the week and for various reasons I felt as though I was on the verge of a total mental meltdown. It was especially terrible while at work with me nearly going home early because I couldn’t deal with being there. I was antsy, jittery, and my body had sort of a nervous hum to it, like the hum of a fluorescent light bulb if that makes sense. I was shaking and bzzzzzz constantly. Just a total feeling of being on edge and ready to lose it all. My mind was in overdrive thinking (mostly worrying) about a wide range of things where it was impossible to not think about them. I was utterly depressed. I felt lonely. I felt hopeless. I felt like a loser, like everyone probably hated me and only dealt with me to be nice. Despite me knowing that I was overreacting, it’s hard to get yourself to actually internalize it. I knew I was being fearful, scared, and irrational with no way to actually think rationally about things.

It was in this rare mental state that something snapped and I realized something obvious but difficult to admit: I was not happy. Life was not enjoyable. Like at all. Something was not working. I felt on the precipice of something very dark and scary. My drinking had picked up again. I was anxious and terrified of everything. Day after day was a struggle against the dread of existing. And that probably isn’t how a person is supposed to feel. Certainly isn’t how a person is supposed to feel. I admitted to myself that I needed to go see someone about my mental state.

So how did that go? Well, I don’t know. I still haven’t went because getting help fucking sucks.

You’d think the main difficulty in actually getting help is admitting that you need or want help, but this is only the initial part of the challenge. Once you finally admit that you need help, you actually need to find someone. And holy hell is that another shitty adventure all on its own.

The fact is that mental health issues are still stigmatized in the United States (maybe the world, I don’t know) and it’s very difficult to find someone you can open up to between family and friends. After you admit you want to find help, it greatly helps if you have a support system who can support your choice to find someone. I think I’m pretty lucky in regards to having friends and family to talk to, but other people? It’s terrifying to put myself in someone else’s place who has no support. If a person like that did admit they needed help, there isn’t anyone to support them along the way. Finding help is solely on them, and that is terrifying. Everyone needs a support system.

So knowing that you want help, now what? You find someone to go see. How do you do that? Once again it’s up to you to do most of the work. There are no mental health “general practitioners” to go see, no one to recommend you to someone, you have to find them your own. And mental health is different from general health. If you have a physical problem any doctor should be able to help, or at least point you in the right direction to someone who can help, but with mental health? It seems there needs to be a good relationship between therapist and patient and sometimes people just do not bond or feel comfortable with others, even if there is no outward reason to feel so. I guess I’m trying to say finding someone for mental health issues isn’t as easy as going to your insurances’ provider finder, typing in your address, and going to the first place you find. You need to do research and research is not something the depressive person is actually up to doing.

One of my friends directed me to psychologytoday.com. You can search for therapists/counselors/psychologists/psychiatrists in your area. (What are the differences? More on that shortly) This helped a ton as you can still search by insurance providers and you can read their profiles/treatment techniques/see what their specialized in, but there were still too many to choose from! I didn’t want to start limiting my choices based on stupid shit like how friendly they look or if they’re young or old. It seems like I could miss a good person to go see by using such pointless criteria. And once again a person in this mindset probably isn’t the best at taking the initiative or being motivated to continue the search.

And there’s always the question about who exactly I should go see. Therapists and counselors are kinda the same thing (I think. But one has more schooling? I don’t know.) while psychologists have more schooling or something. I think the psychologists are meant for people who have more clinical disorders who might need specific treatments. And psychiatrists? Apparently they can prescribe medicine. (Also, let’s not forget the fact that psychologists and psychiatrists are both spelled similarly and are equally difficult to type. The psych- is so fucking clunky to type out, try it for yourself. Every time I write one of those I get a big, squiggly red line under it.) I don’t really know and if anyone wants to clear these distinctions up feel free to correct me in the comments. I don’t know if my case is serious enough to require a psychiatrist or if I just need someone to talk to, like a therapist. Being depressed means you don’t fucking know. So if I don’t know, how am I going to know who to see? I’m just trying to stress again that a person in a depressed state probably doesn’t want to research the intricacies and differences between certain mental health professional’s titles, schooling, and specialties. It’s daunting at a time you don’t want to face anything daunting.

I think that’s about it (so far). I feel that admitting you have a mental health problem should be the primary key to finding assistance. It should be your ticket to freedom, sort of like a call to 911 in a medical emergency is enough to get help. The emergency room doesn’t require you to select a pulmonologist or a cardiologist because they figure out what is wrong with you and find a person to treat you. With mental health? Nope. It’s up to you to find someone even though you’re as confused as you could ever be. You need to go through a mostly bullshit, confusing, and complex process mostly by yourself to actually find someone to see. It’s a pain in the ass even if you weren’t in a shitty mental state, and being in one only makes things harder.

We have a ton of work to do in the US and probably the world at large in regards to mental health. I’m almost certain that a massive amount of people quietly go about their lives abusing drugs or whatever or hiding behind hobbies, entertainment, and other things to keep busy so they don’t break down. Putting on a mask and struggling in silence. Like everyone is dealing with something and even if some look like they’re fine many might be close to their breaking points without showing any outward signs of it. There is no clear way to get help, no clear way to talk about how you feel or to be open about it, and maybe people turn to suicide as a way to ask for help because mental health is so stigmatized. If you do admit to get help, good job on you. Congratulations, it’s probably the hardest thing to admit! Hang in there. But it’s still going to be a pain in the ass finding someone to go see.