Dear Dr. Archer,
My psychiatric profile is complex and elusive. According to one doctor, I suffer from chronic major depression and general anxiety. According to another, I have cyclothymic bipolar disorder and atypical borderline personality disorder.
My most recent psychiatrist thinks there are too many diagnoses in my medical history and refuses to make another, though he has said some symptoms resemble OCD.
Meanwhile, I'm seeing a very liberal minded psychoanalyst who thinks psychiatric diagnoses are just labels, but I disagree with her on the grounds that these labels are attached to complex theoretical frameworks that help us better understand associated groups of symptoms and their underlying causes.
Here's a snapshot of my personality:
1) extreme emotional fragility
2) daily episodes of intense obsessive ranting and extreme rage
3) very low self esteem, self hatred, self mutilation
4) fragile narcissism, unstable grandiose self image
5) antisocial hostility when extremely frustrated or made to feel inferior
6) desperate attempts to avoid being enslaved (refusal to work menial jobs)
7) extremely narrow vocational focus and unwavering intolerance to all other alternatives
8) suicidal ideation, suicide experiments, suicide threats
9) excruciating phobia of any workplace involving humiliating work (i.e., all jobs except college teaching)
10) sexual paraphilia (coprophilia -- feces fetish)
11) disabling perfectionism, obsessions, tics, compulsions
12) fear of daylight, fear of responsibilities, fear of stress, fear of fear, panic attacks
13) virgin until age 27
14) constant state of anxious tension and dread
Now I'd like to balance this horrible list of vices with some of my virtues:
1) high intelligence (Ph.D. candidate, performance pianist -- both undermined by perfectionism)
2) man of many passions with an unquenchable thirst to learn fascinating new subjects
3) storehouse of theoretical knowledge
4) desire to mentor others, capable of profound empathy, when not angry
5) passionate love of beauty
6) passionate devotion to my chosen vocation -- research, literature, teaching college/university
So, what's wrong with me?
Look, I know you spent a lot of time writing in to me, but I can’t make a diagnosis based on your list of symptoms.
One school of thought in the psychiatry community is that rather than make diagnoses, it would be better to focus on treating symptoms as we know that certain meds work for certain symptoms regardless of the diagnosis they are associated with.
Dr. Steven Stahl is a leader in this type of thinking, and although his books are written for mental health professions, as a smart Ph.D. candidate, you may find them enlightening and interesting.
If ever you feel suicidal, Craig, you MUST go to your local hospital ER to get help. Bottom line: Find one doctor you like and feel comfortable with, and stick with him as you work together to resolve your symptoms.
Never give up hope, Craig. As Ralph Waldo Emerson said, "Our greatest glory is not in never failing, but in rising up every time we fail." Good luck.