Getting BPD diagnosis/treatment in Ireland

indiscipline · 26-11-2022 4:44pm #1

Hey all, I hope that I'm posting this in the right subforum.

I am a 19 year old male. In the past few years, I have been feeling a certain way which lines up with the symptoms of BPD/EUPD or cPTSD. I had a troubled childhood, which I won't detail, but would explain why I developed these tendencies. I know that I have a problem and I want to get treatment. I am a few months into college, and I have already started to fall behind on the course as I get too occupied with the things going on inside my head, and my overwhelming mood swings. My college has given me all the support they are able to and I am grateful for that, but I need further treatment.

I went to my GP and asked if I could be seen by some kind of psychiatrist to be assessed and to see if I could be assigned a counselor. She helped me submit an application to the HSE "mental health team", and a few days later I got a call that I was not eligible for an assessment. In a follow-up visit, she explained that they looked at my case and thought that there was not enough cause for concern to assess me. From what I understand, it seems like the only time they care about you is if you attempt suicide or threaten to hurt someone else. I would never do the latter but I think that the former is possible a few years down the line if I don't get treatment. And I don't want to wait until it gets that severe. I have phoned two private counselors in my area to see if I could see them for some time, but they both never followed up on giving me more details (time, place, etc.) after the first phone call where I briefly explained my situation.

It is my dream to get a diagnosis and start DBT. I hope that there is somebody on here who has been down this road before and could point me to where help is available. I live far away from Dublin (where most support seems to be). I could definitely go up there to get assessed if it would mean one or two psychiatrist visits, but I don't have the means to go up there every week for counseling/therapy.

Thank you for your time.

Gremlinertia · 26-11-2022 6:43pm

Would your gp resubmit and push for it?. I take it with college private healthcare is not possible?.

Wanderer78 · 26-11-2022 7:15pm

no real advice, but i find foxes youtube channel really good for personality disorders, look after yourself

https://www.youtube.com/user/lcruz71/videos

ive found college counselling services really good in the past, but its been a long time since ive received such services, is this an option for you?

nothing · 26-11-2022 8:14pm

Definitely check into counselling through the college, and see if they have any disability supports available (though without a diagnosis, these might not be available to you yet, some require a consultants letter). Also check if there are student services or advisors who might be able to point you in the right direction.

indiscipline · 26-11-2022 10:48pm

https://www.boards.ie/discussion/comment/119925333#Comment_119925333

https://www.boards.ie/discussion/comment/119925452#Comment_119925452

https://www.boards.ie/discussion/comment/119925633#Comment_119925633

Hi, thank you all very much for your responses. I should have included this in my original post, but I have already done counselling through college, and I've already done all my sessions (you only get a limited number). So I'm pretty much back on the streets again without any support at all.

My GP says that there isn't much that can be done at the moment, and there is no point in resubmitting the application at this time. She says that they would only look at my application if I threatened to hurt myself or others, or if I had like years of counselling behind me and saw no improvement. Come to think of it, I could probably see another GP and see what they have to say.

I agree, Dr. Fox's channel is great, but his videos and self-help books can only get me so far. Better than nothing, but I need an in person counsellor/therapist to help me out.

apache · 26-11-2022 11:22pm

I don't understand why you are not being seen publically by the HSE via a refferal letter from your GP. I'm in the same boat and got seen by a psychiatrist after about 3 months after my GP put a refferal in and am now on a waiting list for DBT. I'll check at my next appointment how long the wait is roughly for DBT. Only option is public route as it's not covered privately.

nothing · 27-11-2022 12:25am

Your GP could refer you to CIPC, which is free, but time limited (not 100% sure but I think it's 6 to 8 sessions)

https://www.hse.ie/eng/services/list/4/mental-health-services/counsellingpc/

There are also free services for those who have had abusive childhoods (including emotionally abusive, as well as physical, sexual, neglectful)

https://www.hse.ie/eng/services/list/4/mental-health-services/national-counselling-service/childhood-abuse-or-neglect-service-for-adults.html

Both have 6 to 12 month waiting lists, depending what part of the country you're in.

Is your GP prescribing you anything to help with the mood swings? It does seem odd that the mental health team wouldn't even see you for an assessment, I vaguely remember when I was in college they had a psychiatrist who came once a month, might be worth exploring if your college has anything similar.

indiscipline · 27-11-2022 2:19pm

https://www.boards.ie/discussion/comment/119926348#Comment_119926348

Apparently they just looked at the referral letter and thought it wasn't severe enough. I thought that what I said to my GP was reason enough to at least assess me (incl. self-harm), but I guess not.

Please do let me know how long the wait for DBT is, if you remember to ask.

Good luck and take care.

https://www.boards.ie/discussion/comment/119926488#Comment_119926488

Thanks a ton, CIPC was one thing that my GP did refer me to on the first visit but I haven't heard a word from them since. CaPA is new to me so I'll try to read more about it.

My mood swings aren't random, they are always caused by something which I can always identify, so I think that DBT would work better than the conventional medications as I just need help managing difficult situations. Either way, I did ask about that and my GP said that only a psychiatrist can prescribe this kind of medication.

I would hope that if we had a psychiatrist come to the college on occasion, the support services would have already told me about it by now. But I'll try asking.

Sorry if I come off a bit snarky, I'm not trying to be, it's just one of those days. Thanks for the help.

nothing · 27-11-2022 3:42pm

Absolutely don't come off snarky at all. We're all told that if you need help, you just have to ask. But when you ask, it's either not available, there's a long waiting list or some other obstacle, mental health services in this country, especially public, are an absolute joke.

27-11-2022 4:01pm

Broadly speaking Mental Health services in this country have become inexcusably neglected at at time where challenges are ever increasing. It was better back in the 1970s when my father got quick access to good treatment for his depression. Nowadays the mantra is “talk about mental health” without actually providing a quarter enough resources to back it up. One may as well say “talk about cancer” and hope that’s enough for it to go away.

However, in somewhat more recent times, a relative of mine did access excellent mental health care at an over 65s clinic in St James Hospital where there was a superb team, and had a nurse visit her regularly at home until her issue was resolved by her being taught an excellent self-help strategy by said nurse.

There is no political will to improve Mental Health services, and when people try to access care they are far too often frustrated. Far too much the charity sector is relied upon for care. Imagine if access to cancer treatment was allocated much to the charity sector, there’d be uproar.

Ave Sodalis · 27-11-2022 4:07pm

Not at all snarky OP. I'm in that service and I wish every time I go that there was absolutely anything else I could go to instead. The dismissal doesn't end when you get through the doors. I was told ideation didn't count and not to bother mentioning it unless I had a plan in place. They're 10 minute sessions where you get talked at, over and down to. They ask questions and aren't interested in the answer. They then try to perform some sort of action that can be put down on paper as them "doing something". So far, they have tried to undo my PTSD diagnose (based on a few questions I couldn't answer due to a separate medical condition) whilst also trying to diagnose me with a PTSD related condition, tell me I'm not that bad because my anti-ds are only at x dose and when I went in the next time with a double dose (neurologist prescribed) tried to take them off me completely just to see, had students in the room without asking or even informing me. They scoff, sneer, dismiss, and are very clearly only there to collect a pay cheque because they're rotated out every few months. I have never come out of there feeling any better and the last time I left, I ended up having a panic attack so bad I left gouges down my own face.

I'm only there to get referred for CBT but because of the constant rotation of doctors, nobody knows what's going on there. One doctor even gave out to me for not going, rolled his eyes when I said I never got an appointment, and changed the topic when I pointed out they were supposed to be the ones sending me there.

It's shockingly bad, so if there's any other pathway, please take it.

apache · 27-11-2022 4:48pm

That's really bad Ave Sodalis.

I am doing something a bit underhand the past while. I was waiting ages for a psychiatrist's appointment and then got two together, private and public. The only reason I am attending public and saying nothing is because I am on a waiting list for DBT which I really need to do. I just do be in and out in 10 minutes and throw the prescription in the bin. I follow the private's one instructions but don't tell her about public. I see her more regularly obviously.

Hopefully the wait for the course isn't too long, the next appointment I go to I should have a better idea. As I said I feel that I am being underhand and lying and using the public and I am. But for a chance to do this course I have to. The private dosen't cover it. I tell myself the appointment is just for 10 minutes and they don't care. It's all just a box ticking exercise.

Best of luck indiscipline

nothing · 27-11-2022 4:57pm

The constant changing of doctors is because they get in training doctors for a 6 month rotation, same as a lot of other outpatient clinics, so you could be lucky and get one that listens, or you could get one who's only there as a box ticking exercise. If you can find out who the consultant is over the clinic, you can insist on seeing them - though there's no guarantee. It would at least give some continuity of care, which is a huge issue imo. A significant number of them don't even read back your chart before seeing you (and I can't blame them as some of the handwriting is illegible).

Jequ0n · 27-11-2022 5:05pm

Word of well meant advice: don’t focus too much on the diagnosis and therapy form. You seem to have made up your mind to some degree and you will be disappointed and possibly react badly when you don’t get the affirmation.

You are right to seek professional advice and a diagnosis this way, but you need to keep in mind that this will take time. You will not be assigned a DBT place right away even if you have BPD.

I’m not saying this to drag you down, but I think this will take longer than you hoped. Good luck to you on this journey.

apache · 27-11-2022 5:34pm

I'm probably building DBT up to be this wonderful thing that is the answer to all my prayers. Has anyone done it? Did they find it useful?

It might not be the answer but surely it can only be helpful.

Wanderer78 · 27-11-2022 5:55pm

https://www.boards.ie/discussion/comment/119928060#Comment_119928060

never done it, but i continually hear great things about it, so im sure it has helped many globally, but im sure it has its limitations also

nothing · 27-11-2022 6:04pm

https://www.boards.ie/discussion/comment/119928113#Comment_119928113

It's proven to work well for some of the bpd elements, particularly suicidal ideation and anger issues. Some mental health teams think its the be all, end all of bpd treatments. Though they also seem happy to throw just about anyone on the course, which then means there's longer waiting lists.

Wanderer78 · 27-11-2022 6:07pm

https://www.boards.ie/discussion/comment/119928141#Comment_119928141

im aware it was originally designed for bpd alone, so those with the disorder should really be prioritised, and we all know, our mental health services are simply completely fcuked, this seems to be a global problem also, but id imagine some countries are better than others

apache · 27-11-2022 6:08pm

https://www.boards.ie/discussion/comment/119928141#Comment_119928141

Ah I have a better understanding now. Thanks nothing.

nothing · 27-11-2022 6:20pm

https://www.boards.ie/discussion/comment/119928147#Comment_119928147

I'm no expert, I've only managed 1 module as I wasn't in the right head space for it at the time, currently on the waiting list again. It's tough going, and I *think* I read that it's most effective after 2 rounds (a bit over a year total I think)

Wanderer78 · 27-11-2022 7:05pm

https://www.boards.ie/discussion/comment/119928182#Comment_119928182

heard about the 2 rounds thing also, i does come across as an intense form of therapy, but i guess it needs to be for the type of disorders its designed for, as long as it helps i guess

apache · 27-11-2022 7:22pm

How long is the course? How long is the waiting list roughly, months, years?

I'm not too sure of the difference between DBT and CBT. I'd say a lot is to do with your frame of mind. You'd want to be in an open place and accepting of it to help which is not always easy.

nothing · 27-11-2022 7:58pm

DBT is a very specific course which includes elements of CBT, it has 4 modules; mindfulness, emotional regulation, distress tolerance and interpersonal relationships, and iirc its approximately 8 weeks per module (1 per skill, iirc). It's a group setting, usually once a week for 2 hours, though I'm not 100%. CBT is more usually done one on one, and I'm not sure that it's as strictly set out as DBT.

Getting BPD diagnosis/treatment in Ireland

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