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Sat Apr 23, 2016, 02:26 AM

How to address issues very consistent with Avoidant Personally Disorder?

My official laundry list of psychatric DXes is Bipolar I and PTSD, though on Axis I Panic Disorder, Agoraphobia, and GAD have been floated around.

The only attempt to make an Axis II diagnosis was during a depressive episode when a hospital psychiatrist seemed to call all women who feel suicidal borderline (ignoring that I've experienced manic psychosis, and that makes Bipolar I pretty much the only disorder that accounts for my mood issues, that I was a self-admit for thoughts, not threats or actions, that everything admitted to honestly that gave any support to the diagnostic criteria for BPD only occurred during mood episodes, etc).

But I do recognise the patterns in myself for a different Axis II, in a different cluster -- Avoidant.

Essentially, I was bullied most of my life, I have ALWAYS felt socially awkward and inept, and the response I have to people who honestly say that some behaviors (like, I have a nervous laugh) bother them is to feel rejected beyond what I know I rationally should and want to withdraw. Tonight, my roommate decided to tell me that laugh drives him crazy, out of the blue, and my immediate response was to offer to move out if it bothered him so badly he felt he had to step away from his kids and go into my alone space just to tell me that I had bothered him earlier.

That's not a rational or healthy response, and I know it. But if people don't like me or how I am, I'd rather just be away from them, and he wasn't exactly elegant in his initial phrasing before explaining what it was that bothered him ("You drive me crazy in social situations".) I know my stupid side is going to remember this long after he got over it, be more nervous if he does have people over, which will make me laugh nervously even more... that cycle's been done so many times in the past it's pretty predictable now.

Or, alternatively, I'm going to hole up and make sure not to come out of my room when he has people over, because of fear I am going to embarrass him.... the hallmark of the personality disorder.

Does anyone who has issues like this have books they could recommend, or a way to bring it up to a therapist to get help without seeming like I found Wikipedia and went srlf-diagnosing? (I actually wanted to be a shrink for a long time before I realized I needed one more, which is sometimes threatening to MH professionals.)

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Reply How to address issues very consistent with Avoidant Personally Disorder? (Original post)
moriah Apr 2016 OP
charin Apr 2016 #1
No Vested Interest Apr 2016 #3
moriah Apr 2016 #5
No Vested Interest Apr 2016 #6
moriah Apr 2016 #7
No Vested Interest Apr 2016 #8
ReRe Apr 2016 #2
moriah Apr 2016 #4
steve2470 Apr 2016 #9
moriah Apr 2016 #10


Response to charin (Reply #1)

Sat Apr 23, 2016, 01:38 PM

3. I participated in this group 40-50 yrs ago.

It was very helpful to me at this time, both in the self-discipline it uses and in the support of other members.

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Response to charin (Reply #1)

Sat Apr 23, 2016, 05:43 PM

5. I'm a little nervous about "pay to get better" programs not directly with a doc, but....

... I will check it out.

I do participate in Adult Children of Alcoholics -- not to diss on Al-Anon Family Groups, but as an Alateen graduate I found much more of a home in ACA than Al-Anon. The focus in each group is very different -- Al-Anon continues to, despite their mission statement and actual teachings, focus on dealing with active or recovered alcoholics, where ACA focuses on reparenting yourself and getting past those times.

Particularly since my father is dead, and my mother's alcoholism is something that I already know I can't change and just try to love her and know she's not at fault... I am getting far more benefit from ACA's focus on acknowledging the past, looking at yourself, and working on improving yourself, regardless of your relationship or lack thereof with your family.

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Response to moriah (Reply #5)

Sat Apr 23, 2016, 09:41 PM

6. RecoveryInternational does not require payment as far as I know,

though they did ask for a "freewill offering" at the end of the meeting.
I never felt pressure for money, though that aspect could possibly vary by time and place.

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Response to No Vested Interest (Reply #6)

Sat Apr 23, 2016, 10:13 PM

7. Oh, website says membership is $30, that's why I was suspicious. Nt

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Response to moriah (Reply #7)

Sun Apr 24, 2016, 02:17 AM

8. If that is so, it's more recent since my time.

They would likely let you sit in on a session without membership, to see if it's right for you.

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Response to moriah (Original post)

Sat Apr 23, 2016, 05:27 AM

2. Get to your therapist and talk about this...

... like yesterday. Bring the subject up to her/him (therapist) just like you have in this OP. Print it out and take it with you. Or mail it to your therapist before your next appointment. My initial advice would be to get the Hell away from that cruel SOB. I don't know of any books off the top of my head, but you know there HAS to be tons of books on PTSD cases, understanding PTSD, etc. Do you have a decent library near where you live? Hit the stacks, girl. You will find yourself and some help there somewhere. Good luck.

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Response to ReRe (Reply #2)

Sat Apr 23, 2016, 05:15 PM

4. He really wasn't trying to be a jackass, or cruel.

In fact, he's a friend I've had since teenage years, and when I was assaulted and the PTSD became disabling, he took me in when I had no other place to go. When my SSDI hit, I moved out quickly and tried to live on my own, but I am not capable of it anymore -- don't take care of myself, slip into worse depression, become even more of a social recluse.... and also my check just isn't enough to live on my own and still pay my car payment.

So he asked me to move back in, paying actual rent.

I was then able to afford a shrink that was decent and listened to me regarding both my Bipolar I and PTSD and how I reacted to meds, etc. He's a Medicare opt-out and older, but a VERY good doctor and recognized my system simply cannot tolerate most of the newer drugs used for Bipolar due to being medicated incorrectly during my manic psychosis -- they treated it as schizophrenia and ignored the beginning symptoms of NMS for several days, just giving me stronger dopamine antagonists and combining them, until I finally entered the full muscular rigidity and rhabdomylosis stage. As a result I don't tolerate even newer drugs that antagonize dopamine well.)

He also recognizes that antidepressants can cause rapid cycling in Bipolar depression rather than how they react in MDD, so he had me go over every antidepressant I had been on and how I reacted, we found the only one that ever actually did anything (Prozac), and we went with just 10mg along with a slow Lamictal titration and 1.5 mg of clonazepam for mood stabilization. Very old-school treatment, but it's working. (I also get a very small prescription for public panic attacks of 1mg Xanax, but it's the kind of thing where I still have the one refill written left and have to get it filled before it expires next month.)

So I know my roommate cares about me as a person, but even so, if I embarrass him or he doesn't like how I act, my instinct is not to cling, think of him as a bad person, think he was intentionally trying to hurt my feelings, etc (the Borderline response -- either they're great or they're bad, but please don't leave me!)... it's instead to want to withdrawal, go away, try not to let it make me slip into the self-esteem issues that feed my depression but still be more inclined to see it as him probably being correct that I suck socially...

To push people away.

Which I know is me, not him. As I said, he's a decent person overall and was venting. He's probably forgotten about it.

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Response to moriah (Original post)

Thu Apr 28, 2016, 07:07 PM

9. since I am (and was) a MHP.....

It never bothered me when someone self-diagnosed but maybe I'm the exception to the rule. I would at least discuss it with them and give my official diagnosis if I felt it was therapeutically appropriate.

Use the non-technical words. Avoidant is a nice fancy word for very very shy, in that you avoid possible human interactions. I'm no expert on Avoidant, but yea, use the non-technical words. No therapist will object to that, guaranteed. Also, no psychiatrist, clinical social worker or psychologist will object either, guaranteed. Shrinks (psychiatrists) like to get into territorial pissing matches over words, so yea, just avoid that nonsense.

My $0.02, hope it helped.

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Response to steve2470 (Reply #9)

Thu Apr 28, 2016, 11:47 PM

10. I may not meet the criteria fully, but the sad part is I didn't start out shy.

You know how some kids are obviously naturally shy as toddlers... that wasn't me. Dad actually felt the need before I was three to tell me if we got pulled over by a police officer, that I was supposed to "pretend like I was one of those kids who didn't talk to strangers".

But with school came bullying, by third grade I was already in therapy for how badly I was reacting to it, fourth grade came with two concussions and a broken arm in the same year from other children on the playground, and 5th grade was my first total school refusal that led to Mom not being able to get me to go back. We did finally find a very small, private school for kids who were GT, and a year there gave me the confidence to attempt public school again and even finally stand up for myself when someone threatened me physically vs the reaction that so fed the bullies.

Then 7th came around, the girl who broke my arm was at the same school as me, a teacher had a nervous breakdown, and so the physical bullying escalated again with no safe space. I convinced Mom to homeschool me, and by then had been sent a modem and gotten on the Information Dirt Road. Truthfully, the Internet is the closest I want to come to people who I don't already know well and know that they are accepting of me.

Of course, life doesn't allow that easily.

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