Neurodivergence and Emotional Dysregulation

Posted on by Astrid

Hi everyone. On Monday, I listened to an episode of the Navigating Adult ADHD podcast. It was on emotional dysregulation and it’s been on my mind ever since.

I don’t have a diagnosis of ADHD, but have wondered for years whether my emotion regulation issues are “just” autistic meltdowns, whether I have borderline personality disorder like my psychologist in the psychiatric hospital used to believe, or whether something else is going on. So far, I haven’t found a satisfactory answer and, with that, I have not found something that helps.

I tried a ton of medications but none truly helped me, except for maybe my antidepressant. That is, obviously my antipsychotic did lessen my emotional outbursts, but it didn’t do so in a pleasant way. In fact, I only felt irritability or I felt nothing. That’s not emotion regulation but being numbed down too much.

I tried dialectical behavior therapy, which I still believe could’ve been helpful if the clinician hadn’t been so horribly invalidating. I mean, there’s quite a world between going along with every single emotion I describe without question (which I realize could be counterproductive) and telling me, albeit implicitly, that my entire way of experiencing things is invalid. I haven’t been involved with DBT for long enough to know whether it in itself is invalidating or whether it was just the clinician being judgmental.

In the podcast, the speaker described six ways in which emotional dysregulation can show up. I related to all of them, though some more than others. For example, my low frustration tolerance is truly debilitating. So is my inability to calm down. I literally still fret over things that happened at the intensive support home and these influence how I react to my current staff. My spouse and I also regularly fight over both of our (but more so my) inability to let go.

The things I relate less to, interestingly, are things I see as relatively “positive”. For example, I do get slightly over-excited at times, but not to an extreme degree. Then again, the fact that I don’t experience it to an extreme degree, is probably why I see it as “positive”: after mulling over negative things for weeks, I’d love something to get overly enthusiastic about. In reality though, finding a new hobby and buying all the “needed” supplies within hours, isn’t actually good for me financially. I just wish I’d experience that rush of excitement. Then again, when, rarely, I do, it often leads to even lower lows afterwards.

I’m joining in with #WWWhimsy.

Youth to Midlife: At What Point is Personality Development Complete? #AtoZChallenge

Posted on by Astrid

Hi everyone. I’m cheating a little with my letter Y post in the #AtoZChallenge, because I’m not really talking about any Y topic. That is, my topic for today is personality development from youth to midlife.

Many people believe that someone’s personality development is more or less complete by the age of eighteen. This isn’t true. The last phase in emotional development, which covers people’s individuation from everyone else, isn’t complete until a young adult has reached age 25 or so.

Similarly, cognitive abilities such as executive functioning, which is important for impulse control, haven’t fully developed until a person is in their late twenties.

As such, can we say that someone is well and truly an adult by the age of 30? Not necessarily. After all, life experiences also contribute to adulting. This means that in today’s society, where people leave home later, many don’t start a family until they’re in their mid-thirties, etc., with respect to life choices, someone hasn’t truly faced the most difficult ones until they’re around age 40. Which is midlife whether you want it or not. Yes, Millennials like me might want to pretend to still be youthful, and this makes sense from a personality development standpoint, but we’ve most likely had (nearly) half our life behind us.

What does this mean if you want to work on personal growth? What does it mean when you’re struggling with a personality disorder? Personality disorders are said to start in early adulthood and be stable over time, but are they?

I try to see it as there being hope. People with certain personality disorders, such as borderline personality disorder, do experience improvement of their symptoms as they get older. In fact, when I was in my mid-twenties, my psychiatrist told me my dissociative and emotion regulation problems (which were at the time not diagnosed as BPD, by the way) would likely get better as I got older. So far, they haven’t, but then again I (hopefully) still have half my life ahead of me.

Shame and Guilt: How to Deal With Difficult Emotions #AtoZChallenge

Posted on by Astrid

Hi everyone. Today for my letter S post in the #AtoZChallenge, I want to talk about how to cope with hard-to-deal-with emotions such as shame and guilt.

First, what are shame and guilt? Shame is a complex emotion that usually arises when you think you’ve failed. Shame is not really focused on the specific action that causes you to feel bad about yourself, but rather it is focused on your identity. As a result, shame can cause you to feel inadequate or worthless.

Guilt, on the other hand, is an emotional response to thinking you’ve done something wrong. It, unlike shame, is linked to the specific mistake you made and it as a result often prompts you to try to rectify it.

Put simply, shame is an emotion that prompts people to hide, whereas guilt prompts people towards justice.

How do you deal with shame and guilt? First, identify what shame feels like for you. For instance, where do you feel it in your body?

Then, identify your shame triggers. Shame and guilt are both triggered by specific events. However, shame often leads us to feel like we as people are flawed, rather than us having simply made a mistake. As such, we often lose sight of the specific situations that trigger us to feel shame. Try to identify these.

Then, identify and challenge the specific thoughts that cause you to feel like you’re altogether bad. Shame can be helpful in pointing out ways in which you’ve failed, but these mistakes do not make you a failure as a person.

Finally, right the wrong. Do what it takes to rectify the mistake you made that caused you to feel shame. For example, if you’ve damaged another person’s stuff, buy new stuff or give them money or whatever. At the very least, apologize. And do the work necessary to prevent you making the same mistake again. Going into hiding out of shame doesn’t do any good. Admitting your guilt and making amends does.

There are other difficult emotions I could’ve mentioned here, such as bitterness and anger (except that these don’t start with the letter S). These are in a similar way related to each other that shame and guilt are: while bitterness leads people to inaction, anger leads people to fight for what they believe in. Anger, of course, can turn to the extreme of rage and then be inappropriate, but in general it’s healthier to be angry rather than bitter. In every situation, it is recommended to watch for all-or-nothing thinking that can lead you towards hopelessness and self-defeat.

Growing Up Emotionally

Posted on by Astrid

Today’s Ragtag Daily Prompt is “when I grow up”. I’m going to be forty next year, so by most standards, I’m considered to have “grown up”. Only by the model that includes life experiences such as working, buying a house, etc., I’m not necessarily truly an adult. After all, though my spouse and I own a house together, buying it was mostly done out of necessity so that I could go into long-term care. I’ve never worked, not even had a side job as a teen.

That being said, in many respects I’m still young at heart. I know everyone my age says so to be cool, but I don’t mean it in a positive way. Rather, I mean it to say that emotionally I’m very vulnerable. Like I shared when discussing emotional development as it relates to intellectual disability (and autism) in 2023, on many subscales of the emotional development assessment used here in the Netherlands, I’m considered an infant or toddler. That doesn’t mean I can’t grow.

When I grow emotionally, I’d like to become more regulated. My psychiatrist used to say that I’d likely experience less emotional dysregulation after age thirty. I’m not sure that’s true in my case. In fact, I’m pretty sure it’s not true. The frequency and severity of my meltdowns has increased, though the duration has lessened significantly. I no longer experience outbursts that last all day. That, I mostly attribute to my staff’s proactive attitude.

I’d also like to be more independent. The problem with this, however, is the fact that my energy level varies significantly from day to day. Because of this, I hardly ever progress in my independence even though I might be able to. The reason is the fact that, if I do something independently once, my staff and others are going to expect me to always be able to do it.

Same for adaptability and emotional regulation: my abilities vary from day to day and sometimes hour to hour. I, for this reason, struggle to really make progress. That doesn’t mean I don’t want to.

Bulimia (Or Something Like It): My Relationship With Food and My Body (Revisited) #AtoZChallenge

Posted on by Astrid

Hi all and welcome to my letter B post in the #AtoZChallenge. Today, I’d like to share a more personal piece and describe my history of disordered eating and body image issues. After publishing this post, I saw I did a post on this topic in 2019 too.

I first started struggling with a negative body image when I was about thirteen. I remember writing stupidly specific worries in my diary about food and my weight, such as whether the nails I’d bitten off would cause me to gain weight. All the while, I didn’t realize that I was, in fact, pretty close to overweight if not overweight already from consuming enormous quantities of candy on weekends and daily sausage rolls at the school cafeteria.

I was lucky that I never became significantly overweight until around age 25. By that time, I had developed something at least bordering on bulimia: I ate a full 500g bag of candy, sometimes more, in one ten-minute sitting at least three times a week. I also purged, although I did that after regular meals as much as after bingeing.

In the six years that followed, I gained over 20kg in weight and, by the time I was kicked out of the psych hospital to live with my spouse in 2017, I weighed 80kg. At my height of 1.53m, this is quite far in the obese range.

Yet my body image wasn’t as much of a concern to me at the time. Yes, I hated the way I looked, but at the same time I was too careless and unmotivated to change my habits. I had stopped purging for the most part by the time I moved in with my spouse, although I still occasionally did it as a form of emotion regulation.

Now, I’ve been at a healthy weight for about a year. Don’t ask me how I got here, as honestly I don’t really know. I mean, yes, I’ve been supported by a dietitian since early 2022, but honestly I can’t quite say I follow her advice. I mean, okay, I no longer binge due to my food being locked away, but I do snack on “bad” foods all the time.

My body image, honestly, is still as screwed as it always was. I still swing between underestimating and overestimating my size, between hating my body and not caring about it. I still purge occasionally, though not really out of a wish to lose weight, but more out of a need to self-regulate.

Looking back, I don’t think I ever had a genuine eating disorder. I mean, I might’ve at one point met the criteria for binge eating disorder, but I’m not so sure about that. I think my disordered eating is really more a symptom of my emotion regulation difficulties.

#WeekendCoffeeShare (November 18, 2023)

Posted on by Astrid

Hi everyone. I have barely touched the blog lately, but it’s not because I’ve been uninspired. Rather, I’ve mostly been doing other things online. Before I abandon it altogether, I thought I’d write a post though. I’m joining in with #WeekendCoffeeShare. I’ve had my last cup of coffee for the day, but thankfully my assigned staff ordered my favorite soft drink, apple and peach-flavored Dubbelfrisss, so I’ll have that in a bit. If you’d like one too, join me. Let’s have a drink and let’s catch up.

If we were having coffee, first I’d talk about the weather. It’s been raining all day today and, though we were supposed to have a daytime high of 12°C, I don’t know when that was supposed to have been the case as it’s been around 7°C each time I looked at the weather on my Apple Watch. I haven’t been outside at all. I mean, I can bear the cold, but rain, yuck! I can tolerate it when it starts raining midway through a walk, but when it rains as I leave the house, I usually turn right around. Consequently, I didn’t meet my movement goal on my Apple Watch today at all. In fact, I’m pretty sure I hit an all-time low, but frankly, I don’t care.

The rest of the week, though we had some rain, it wasn’t constantly pouring. Though some days I needed to get out my winter coat, most days the daytime temperature wasn’t too cold either.

If we were having coffee, I’d cheat a little and tell you all about the meeting I had last week with my assigned staff, support coordinator, behavior specialist and my mother-in-law. Okay, who said you can only talk about the past week during a weekend coffee share? Maybe I did. Anyway, the meeting started out with my assigned staff complimenting me on how I do accept men and unfamiliar staff now. This rubbed me the wrong way, as the day prior he’d pretty much given me no choice, so what was I to do? I’ll see tomorrow whether they’ll go the full length and assign me a male staff for my ADLs (which is a big no for me), as then the female staff who normally always assigns me temp workers is working the morning shift with a male temp worker. Said temp worker is familiar with everyone here, but I am honestly quite sure she’s going to assign him to me for my morning routine anyway. Let me just say I’m going to throw a big hissy fit if this happens.

Other than that, the meeting went okay. We talked about my day schedule, which is okay in terms of how many hours of support I get but far from ideal in terms of how it’s cut up into small blocks. Since my ExtraCare (one-on-one) funding hasn’t been approved yet for next year, we’re waiting to see what happens to that to change anything. I’m pretty fearful the Care Office doesn’t consider every single moment the staff spend with me as ExtraCare, as, well, it isn’t, but the manager does. Oh well, we’ll see.

We also talked about my wish to start therapy again for my trauma-related symptoms. Upon further thought, I realized I need to work on stabilizing first before I start EMDR or whatnot. The behavior specialist is going to write an application. I am also going to work with my assigned staff on my signaling plan, which details how I can best be supported during each phase of emotional (dys)regulation.

If we were having coffee, lastly I’d share about my dietitian’s appt on Wednesday. It went pretty well. I am currently at a healthy weight and within the weight range I agreed upon with her. She did finally admit she doesn’t know why I’m not gaining weight when I’m having quite a lot of food in excess of my food plan. I honestly currently have far too many other things on my mind to care about this too. I mean, yes, I’m scared, but I’m scared for a lot of other reasons too.

How have you been?

Getting Older, Being Happier?

Posted on by Astrid

Today’s prompt for Friday Faithfuls is aging. I used to think aging was scary. Even at the early age of four, I didn’t want my classmates to sing in a birthday song that I was growing up.

Then, a few years ago, I heard an episode of All in the Mind, an Australian psychology radio show (I listened to it as a podcast), about aging. In it, people were discussing the positive aspects of getting older and mentioned that, for people who got to age ninety or beyond, the happiest age they’d ever been in their entire life was 82. How they got to such an exact number, I don’t know, but I’ve since clung to that number. It helped that my assigned day activities staff at my old care home always said she was going to live to age 93. Since she is eleven years older than me, we had this inside joke about the two of us meeting up near the end of our lives when she was 93 and I was at my happiest ever, ie. 82.

There actually is, or so the people on the show said, some logic behind older people being happier than younger people. The reason is the fact that the amygdala, one of the parts of the brain responsible for registering fear, shrinks as we age.

Also, many people become more resilient as they experience more of life. Whether this is a biological, social or psychological thing or more likely a combination of all three, it does mean older people may be generally happier than those in their twenties and thirties, for example. Borderline personality disorder, also known as emotionally unstable personality disorder or emotion regulation disorder, of which I have some traits, tends to lessen as people get older as well. This lessening of symptoms usually starts in a sufferer’s early thirties. Indeed, though I cannot say I’m necessarily happier now that I’m nearly 37 than I was ten or twenty years ago, I am generally more emotionally stable.

#WeekendCoffeeShare (April 24, 2022)

Posted on by Astrid

Hi everyone on this last Sunday afternoon of April. Can you believe that we’ll be in May this time next week already? I certainly can’t. The weather’s okay: sunny and about 16°C. I can’t wait for higher temperatures though. Anyway, I’m joining #WeekendCoffeeShare today. I haven’t had my afternoon coffee yet, but am likely going to take a break while writing this post to have it. You can have a cup as well. The staff are also trying to get me to try some type of drink that sounds much like what Americans call Kool-Aid: a powdered substance (sugar-free or so I’m told) that you add to cold water and that then creates the flavor of juice. I’m pretty sure I’d prefer plain water though. Anyway, we have this stuff in the apple-flavored variety, so if you’d like a drink of that, get yourself one. Let’s have a drink and let’s catch up.

If we were having coffee, I’d tell you that this week, I’ve been experiencing quite the rollercoaster ride of emotions. Due to a number of triggers, I got to doubt once again whether I want to stay in my current care home forever and, on Thursday, I more or less decided that I at least want to discuss the possibility of looking for another place. I have no idea whether a voluntary move is even possible and it’s certainly not something I’m looking to decide on quickly. My assigned home staff E-mailed the behavior specialist and manager to see if they can discuss the possibilities and process with me.

If we were having coffee, I’d share that I also experienced quite a bit of emotional dysregulation recently. I am having some major flashbacks and identity confusion. It looks like a new factive alter (an alter based on a real, outside person) may have formed recently.

If we were having coffee, I’d tell you that tomorrow, I’ll finally be discussing lowering my antipsychotic dosage with my nurse practitioner. I’ll most likely take the first step sometime in early May. Even though I’m not feeling at my best right now, I want to move forward with it.

If we were having coffee, I would share that I did enjoy doing some polymer clay work recently. Mostly, I just mixed colors. Like I said before, last week, I got the Fimo Professional true colors six-pack, which comes with a mixing chart, from the day center. I love it! My mother has her birthday on Thursday and I’m fully intending on making her a tulip out of polymer clay with all colors I mixed myself.

If we were having coffee, lastly I’d share that I went to Lobith yesterday. It was good being with my husband once again. We got Domino’s pizza and had orange tompouces (a Dutch-specific pastry) in honor of King’s Day on Wednesday. This morning, my husband went out to the local bakery to buy us croissants. Yum!

How have you been?

What Recovery Means to Me

Posted on by Astrid

Yesterday, one of the daily word prompts here on WP was Recovery. I didn’t see it till it was already time for me to go to bed, so I’m writing about this word today. Today, I am sharing with you what recovery from my mental health conditions means to me.

First, there are a few things recovery doesn’t mean to me. Recovery isn’t the same as being happy all the time – that’d be an unrealistic goal. It also isn’t the same as independence. I don’t intend on ever living independently again and there are few things with respect to life skills I’d really still want to learn.

Recovery does mean no longer being scared when I’m able to do something independently. Currently, I constantly expect people to overestimate my abilities, so when I can do something independently, I think people will expect me to do it all the time.

Similarly, recovery means no longer being afraid of my feelings, both good and bad. Affect phobia is a thing, you know? I currently tend to dissociate from my feelings a lot. I also often counter joy or sadness with anger, because that’s the easiest emotion for me to express.

Recovery means having a relatively stable sense of self. I don’t necessarily want to integrate all alternate parts of my personality, although it’s okay if it happens spontaneously. We do want to achieve cooperation among ourselves. This also means being able to accept the seemingly opposite sides of me.

Recovery means, as a result of the above, no longer needing to rely on negative coping strategies such as self-harm, rage or impulsive behavior. I will no doubt still have times when I indulge into an unhealthy habit such as overeating or buying stuff I don’t need. That’s okay, since I don’t think total self-control is a realistic goal. I just don’t want to use these as coping skills when feeling overwhelmed, and I no longer want to engage in self-harm at all.

Lastly, recovery means no longer expecting people to abandon me if they know the real me. Currently, I have such a negative self-image that I believe any positive aspects of me are a façade and at the core I’m so wicked no-one should want to be associated with me. Overcoming this is probably the hardest thing to achieve, as expectation of abandonment is such an ingrained thought pattern. I really hope to someday stop seeing myself as one giant manipulator though.

In addition to the word prompt, I am linking up with #LifeThisWeek and #SeniSal.

Working On Us Prompt: Coping With Crisis

Posted on by Astrid

Today, I’m once again joining in with Beckie’s Working On Us Prompt. This week, the topic is to write a narrative of what works for you when facing a panic or anxiety attack, manic episode or other crisis. I don’t get panic or anxiety attacks much or mania at all, so I’m going to describe what works for me when I’m in an emotionally dysregulated crisis.

Like I’ve said before, I have BPD (traits). These are also known as emotion regulation issues. I also experience complex PTSD symptoms. Both can cause me to suffer emotional outbursts. In addition, I can get severely overloaded due to my autism. This can cause me meltdowns, which in some ways are similar to BPD outbursts. In fact, I’m not 100% sure my BPD diagnosis is correct given that autistics, particularly women, are often misdiagnosed as BPD.

Anyway, I usually notice an outburst coming on when I experience an increase in sensory reactivity. I also often start to experience a decrease in my language abilities. I start to stutter or can only make humming noises and repeat the same phrases. My staff at day activities say that when in this state, my communication abilities resemble those of a toddler. It is interesting, in that we have only one toddler alter. When I can’t do something to calm down, I may progress to a full-blown state of meltdown, in which I become angry and sometimes aggressive or self-injurious.

What helps me when I’m in such a state, is to physicaly remove myself from the situation. This is hard though, as often it feels as though everything that happens around me is important. Usually, my staff help me by clarifying what’s important and what is not.

Of course, now that I still live independently, I don’t always have a staff member available to help me sort through a crisis or make suggestions on how I can cope. I, however, have a phone number of a psych hospital I can call in a state when I’m close to a crisis. They can’t do much but listen to me and try to offer advice, but it’s definitely been helpful in some situations. The mental health team that treats me also has a staff available on the phone for crisis intervention during office hours.

Sometimes, when I’m in a really bad crisis, I take my PRN lorazepam. However, I have some experience with it being overused on me in the psych hospital. Like, whenever I’d react to a sound in an irritated tone of voice, staff would tell me to take a lorazepam rather than helping me to figure out what was causing me overload. This has really gotten me weary of PRN medication.