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Author Topic: Diagnosis/treatment for someone: How do you get someone diagnosed?  (Read 1367 times)
colonel
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« on: October 10, 2008, 03:24:49 AM »

How do you actually get someone diagnosed with a mental illness? I've only experienced that happening because my friend attempted suicide and ended up in a psychiatric ward where she was assessed, but what if there isn't a huge enough event to end up sitting in a psych ward but something just isn't right. i'm pretty familiar with bp and mental illnes by now through my friend which is why I'm asking this. Basically the more i learn the more i can see signs of mental illness in a family member. Only problem is while I'm pretty certain there is an illness there, I don't have any official diagnosis. How do i get that especially when the person thinks they are perfectly justified. I've noticed there are a number of people on here that talk about undiagnosed loved ones how do you handle that you never really know for sure. i want to know. I need a reason behind all the sht and deliberate cruelty that goes on, one that i can say okay so she has an illness that's why she does that, not excuse it but understand it and know there is a reason behind it all. I want a diagnosis so it makes sense. I've never done this before where there is no medical file that says it all in black and white, with my friend it just happened, with my family member it's only a nagging thought in my mind and a feeling that what i see and deal with isn't normal.
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Auspicious
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« Reply #1 on: October 10, 2008, 05:29:55 AM »

Without legal problems or dramatic events, it pretty much has to be the person who wants help.

If they have symptoms that bother them, you might be able to suggest that they see their normal doctor about the symptoms. Their regular doctor might see the mental illness signs and refer them to a psychiatrist or psychologist.

There's a book you might (secretly) read called "I Am Not Sick, I Don't Need Help" about this topic.
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JoannaK
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« Reply #2 on: October 10, 2008, 06:18:47 AM »

Colonel, there is no way to get someone diagnosed if they aren't open to the idea.. unless they wind up in the mental health or legal system.   We have a review of the Amador book here on our site:

http://www.bpdfamily.com/message_board/index.php?topic=61716.0

And our Workshop on this topic:

http://www.bpdfamily.com/message_board/index.php?topic=76633.0
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GENERAL ANNOUNCEMENT

This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question.

Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board.

You will find indepth information provided by our senior members in our workshop board discussions (click here).

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« Reply #3 on: October 10, 2008, 07:39:54 AM »

This is an excellent book... and it characterizes meaningful therapy as a goal (not a given)... and getting there a process.

People seek help for problems that they perceive - not the problems we perceive.  They seek solutions that make them feel better - not us.

Anything you say should be how "help" would address the problem they see and are concerned about - and the outcome should be described in terms of how they will feel better.

If you are credible, trustworthy, and they believe you have their needs first - you might get there.



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K. Salters-Pedneault, Ph.D.
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« Reply #4 on: October 10, 2008, 10:12:26 AM »

Hi,
Totally agree with the posters above: unless they are forced into help by the legal or medical system (because of some mental health emergency or criminal act), then it has to be the person who wants to seek help.

But, it is possible to talk to them about this and maybe put the "bug in their ear" so to speak. You have to make the decision based on your relationship with them and how you think they will hear it. If they trust you and see you as someone who cares about them, they may get angry at first but after that reaction subsides may decide that your words held a grain of truth. If they don't trust you, they will probably just get defensive and not hear anything you have to say. If this is the case, I would recommend talking to someone they do trust and maybe that person can initiate the discussion.

Good luck,
K. Salters-Pedneault, Ph.D.
About.com's Guide to Borderline Personality Disorder
http://bpd.about.com
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JoannaK
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« Reply #5 on: October 10, 2008, 11:17:56 AM »

Thanks, Kristalyn!  Another resource that might help is our Workshop on Communication techniques:  There are better and worse methods of talking to someone who has bpd or a similar disorder.  SET (Support, Empathy, and Truth) is a good start.

http://www.bpdfamily.com/message_board/index.php?topic=69272.0

But, as the old adage goes, you may be able to lead a horse to water, but you can't make him drink.  Even if a person is required to seek mental health services due to a hospitalization or legal encounter, the person may not improve... unless he/she is ready to embrace treatment and recovery for him or herself... not because someone tells him/her that he/she must "recover".
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another_guyD
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« Reply #6 on: October 10, 2008, 11:29:56 AM »

Question?

  In the case of a PD, if a person is "forced" into help via legal or emergency,
does that necessarily mean that it will help the person? For a PD it seems that
the individual in question is less likely to be consistent, honest or even receptive to
treatment if they are forced...


colonel:
  The diagnosis is really not that useful in itself (I have found this out personally) legally or clinically.
If a person looking for help and actually wants to change is much more beneficial to them.

~AgD
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Matt
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« Reply #7 on: October 10, 2008, 02:57:37 PM »

Here's an example - not at all unique as many other members here can attest:

My ex has exhibited BPD symptoms for decades.  She abused her first child, and he now, as an adult, suffers serious consequences from that, including very poor self-esteem and addiction.  She abused every man in her life, including me, and drove us all off.  She has been to jail and in the hospital because of her behavior.  A psychologist who did our custody evaluation gave us the MMPI-2 test, and the results went into his report, which stated that she has serious psychological problems and should get psychotherapy.  That became part of the court order when we were divorced.

But through it all she maintains there is nothing wrong with her - she doesn't have BPD or any other problem - it's all someone else's fault (mostly mine) - and the court order isn't binding.  She has seen a counselor a few times, but I assume she hasn't told the counselor the whole truth about her behavior.  No psychotherapy.

I think many other members can tell you the same thing:  Until someone acknowledges that they have a problem and need help, trying to force them to accept help is probably a waste of time or worse.

Matt
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jayvee
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« Reply #8 on: October 10, 2008, 05:47:29 PM »

Most BPDs are not ever going to admit they have any problems. It is always the other person's fault. The best I have to say is help yourself first. If you take care of yourself and work on understanding the BPDs behavior for what it is - mental illness - then that may be as good as it gets.   
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colonel
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« Reply #9 on: October 11, 2008, 03:00:31 AM »

Thanks for your replies, I'll look into getting a copy of that book. It's just so frustrating not being able to get them to see there is something wrong. The self doubt that maybe they're the normal ones and I'm crazy is hard to get around without an actual diagnosis. I want the diagnosis more for my own sanity, so that there is proof that their behaviour isn't normal and I'm really not satan's spawn like they try to convince me. I guess I want it for validation. Obviously i want her to get help and the chaos to stop as well. So very frustrating!
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Auspicious
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« Reply #10 on: October 11, 2008, 04:35:13 AM »

Thanks for your replies, I'll look into getting a copy of that book. It's just so frustrating not being able to get them to see there is something wrong. The self doubt that maybe they're the normal ones and I'm crazy is hard to get around without an actual diagnosis.

It is so frustrating, isn't it? I hope your family member will end up in treatment one way or another.

I still find myself dealing with self-doubt sometimes, and my wife is diagnosed.  As as a bonus I get to be accused of "always blaming everything on the illness."

I guess the diagnosis does help me some, but she's still perfectly capably of justifying any thinking or actions and making no connection at all to her diagnosis (and bitterly resenting any connection if it is suggested by others). And her justifications still sometimes generate self doubt in me.  So I guess what I'm suggesting is to not expect a diagnosis in itself to encourage your family member to take any responsibility (not that you were expecting that, just a thought).

Maybe the person will accept the diagnosis (a question in itself), but this or that specific bit of twisted thinking is perfectly justified, you see ...
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Matt
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« Reply #11 on: October 11, 2008, 10:26:46 AM »

I can definitely understand how you would want the diagnosis, to make things more objective and to validate that what you see is real.  I can tell you, though, as others have said here, that getting a diagnosis does not mean the BPD sufferer will begin to take responsibility for her behavior and get the help she needs.  It rarely works that way.  Getting the diagnosis might help you some, but probably wouldn't fix the problem.

You need to get validation from other sources.  First, from your own ability to see the behaviors and judge whether they are appropriate.  When my wife threw an iron at me, then gave me a very good reason why - because I wouldn't give her a check without first calling my bank to make sure it would clear - at first I almost got sucked into that logic - that it's OK to throw an iron at somebody if they don't do what you want them to.

But if you say it out loud - or share it with us here - it's easier to see how inappropriate the behavior is.  If I say, "My wife threw an iron at me", nobody asks, "Why did she do it?  Was it because you didn't do what she told you to?  Oh, then that's OK - she was right to throw an iron at you."  That's crazy logic, and nobody says that.  And nobody says, "Well she hasn't been diagnosed with BPD, so I guess it's OK if she throws an iron at you."

When I say her behavior out loud, everybody tells me what I already know - it's not appropriate, reasonable behavior.  With or without a diagnosis, IT'S NOT REASONABLE BEHAVIOR.

So...for you, Colonel, while I understand very well that a diagnosis would be a good thing to have, I'd suggest that you not dwell on it, but deal with the behaviors the best way you can.  Since it's a family member, I'm guessing you won't choose to abandon the person completely - a valid choice if it's a girlfriend for example.  But you may also not want to get too close to the individual and put yourself at risk.  Read more here, and share more when you are comfortable doing so, and I'm sure you'll get good ideas as to how you can move forward.

Best wishes,

Matt
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