Receiving a solid diagnosis can be a positive step in helping you gain clarity and direction when tackling mental health issues.  In episode 262, I received a question from a listener who was determined not to use their diagnosis as an excuse, wanting to be proactive in moving forward and ensuring their mental health doesn’t negatively impact their family’s life. In this post, I dive deeper into this and look at how you can use your diagnosis as a stepping stone to a more positive future.

The Question

Hey Dr. Duff, I’m new to the podcast, but I’m using it to help me on my personal journey of growth and I think it’s a very wonderful podcast.

I’m currently struggling in a lot of aspects of my life. I come from an emotionally neglected childhood and I don’t think my emotional maturity matches my age (29). I believe I have BPD, but in my limited interactions with a psychiatrist, my diagnosis was depression and anxiety. Frankly, I don’t want to use my diagnosis, whatever is the right one, as a crutch, and I just want to be “normal”. How can I work to get my anxiety, mood swings, depression, invasive negative thoughts, distrust, and controlling behaviors under control? I don’t want these behaviors to damage my two children or my relationship with my wife any more than they already have and I feel stuck in a rut.

Hi! Great question. I appreciate you wanting to take personal responsibility here.

First off, I want to address the diagnosis part with you. In a situation like yours, I think it can be super valuable to arrive at a good solid diagnosis. This is not a crutch or a scapegoat to blame things on. Rather, it can really help to clarify what is going on and why things work the way that they do for you. I am working with someone in therapy right now that was actually in a very similar boat. They basically had the depression and anxiety diagnoses, which were true, but definitely not the whole story. There was an inkling that they may have had BPD but nobody diagnosed it. Once we started working together, we dove into the criteria and came to the conclusion that they do indeed have BPD. This has really helped to direct treatment and has clarified why things have happened the way that they have for them in the past.

So, if you’re open to it, meeting with a good psychologist that has experience in personality disorders might be a really smart thing to do here. And as I said, the point is not to use the diagnosis as a crutch or an excuse. This is something that should help you to guide your own efforts. To target things more effectively.

Embrace therapy

If this is indeed a personality disorder, this is a bit different than the “top-level” symptoms of anxiety. There are certain aspects of your personality that you may need to accept will be there, but you need to change the way in which you use them or react to them. I feel like a broken record, but you should definitely be looking at therapy here. All of the things you listed, like anxiety, mood swings, controlling behaviors, etc. are going to be much more easily worked on with the help of an experienced professional. You’re going to need to start noticing patterns both in current circumstances and in the past. There are probably consistent triggers that you have that are probably rooted in relationships – a common one would be the feeling of being abandoned or left out. Other ones might be the feeling of not being heard. Once you can recognize those triggers, you may not be able to always avoid them, but you can at least be aware of them and work to intervene somehow. Like when you recognize that a common trigger is happening, that could be a cue for you to take a 5-minute break, to pull out your journal, to use a guided meditation, or to simply not make any solid decisions. There are some practical things like this that can be very helpful.

There are also tons of strategies for your more top-level symptoms like anxiety, which I’ve talked about at length in a number of places. If you haven’t yet, starting to practice a nice breathing exercise that you can use to calm your physiological response in the moment would be very helpful. You are also going to want to start keeping track of conflicts or difficult moments so that you can go back later and break them down either on your own or with the help of a therapist/someone you trust. Once you are able to identify and challenge some of those patterns, you can work toward trying things in a different way. Experiencing success in a new way of doing things is what will help you start to have a “corrective emotional experience”.

Dive deeper into your past

But beyond this, you are going to need to dive into the past. To look at attachments to your care figures, to look at traumas that you have experienced, to see where these patterns came from in the first place. That’s where therapy comes in. It sounds like you are resolved to do something about this and I wouldn’t be surprised if some change has already started occurring. The more you pay attention and the more you try, the more you are going to benefit.

Just remember that you may have a tendency to be all-or-nothing for a while and then flip the other direction. Try to resist that urge. What is called for here is not just intensity, but measured consistency and commitment over time. That is what will make a difference for you.

You got this!

You can listen to this on Episode 262 of the podcast! 

Thank you for the great question!

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