8 years ago I was told by a psychiatrist, face to face, that I had dysthymic disorder (or dysthymia), which is a 'time-limited' form of depression but is dismissed by many as 'not as bad as clinical depression'. I couldn't understand it because I'd had severe depressive episodes on and off since I was a teenager (undiagnosed, largely) and knew there was something else at play, but couldn't figure it out for myself. At the time I was having psychotherapy on the NHS, which lasted a year. I then picked up again with a private psychotherapist whom I'd seen briefly before the NHS bumped me up the waiting list. I continued to see him weekly, sometimes twice weekly, for the next 7 years.
During that time I did a fair amount of counselling training. I showed some aptitude, passed all my courses, and did some reasonably successful placement work. But once my training had come to an end I began to struggle with certain interpersonal aspects in the workplace - my old problems rearing their ugly head again, basically, which a diagnosis of dysthymia doesn't even begin to account for. I struggled on for a while but gave it all up this July.
Earlier this year my psychotherapist moved away, which was a blow. That, and other factors, drove me back to community mental health services via my GP. At my screening with them I was told they had me down as suffering a variety of conditions: depression, generalised anxiety and PTSD. This was news to me! And I mean that in the sense that I didn't disagree with that for one moment, but they'd never told me they'd diagnosed me with those conditions. Following a second assessment soon afterwards, this time with a doctor, I was sent a care plan. The official diagnosis was Borderline Personality Disorder (Emotionally Unstable type). I had mixed feelings about that. On the one hand, I felt sad that my difficulties were viewed as fundamentally part of me, rather than a type of mental illness that one could conceivably heal from with time and decent treatment (like some forms of depression, for example). Just felt like a judgement on me, rightly or wrongly. On the other hand, it made such a lot of sense and I felt partly vindicated for my interpersonal struggles and handicaps. But the real shocker was to come.
Not long after that letter came I had to reapply for my ESA. I gathered together paper medical evidence going back to 2009, and while glancing over a psych report/care plan from 2010 I noticed it said Axis I: Dysthmic Disorder, Axis 2: Emotionally Unstable Personality traits!! I was shocked and saddened. It felt like if someone had verbally communciated that to me at the time, and described its implications, I'd have made some very different choices as a result, and would have understood my situaton better. Knowledge is power, after all, and yet for years I'd been showing traits of someone with EUPD but felt that I was just a difficult person who sometimes made others unhappy rather than someone who medically struggled with their feelings and relationships.
I've reflected on this a lot since the summer. I remember my private guy asking me a couple of times what the CMH diagnosis had been, and when I said "dysthymia, basically" he looked really puzzled. Now I know why. He knew his shit, but he didn't want to undermine the psychiatrist's authority, I suppose. Ironically, for a while I had a private client with a diagnosed personality disorder, and also a client at a voluntary agency I was in placement with whom we suspected had BPD. I discussed them with my therapist occasionally (because of the personal impact that work was having on me at times) and he must've known that it was a case of the blind leading the blind! In fact he even took a book off the shelf one day, opened it a page that had a pithy summative phrase for EUPD - "My misery is your command" - and was probably waiting for the spark of self-recognition to catch fire in me, lol.