Do I Have a Mental Illness?

Posted on by Astrid

Hi everyone. Several happenings today, including my reading today’s Friday Faithfuls post, made me think about the question whether I have a mental illness. Or should I say mental health condition? Is there even a difference?

People who know me, may be surprised at the fact that I even ask this question. I mean, of course! I spent nearly a decade in a psychiatric hospital. Then again, when I was first admitted, the psychiatrist deciding to admit me made it very clear that she wasn’t diagnosing me with a serious mental illness. I had a diagnosis of autism, of course, which though it is in the DSM and though here in the Netherlands it falls within the realm of psychiatry, isn’t technically speaking a mental illness. To be added to this diagnosis was adjustment disorder, which in short means an inability to cope with the stressors of daily life. Nowadays, people with this diagnosis alone don’t qualify for mental health services, let alone admission to a psychiatric hospital.

But once I was in the system, numerous mental health diagnoses which may fall under the realm of mental illness, were added. My first was impulse control disorder not otherwise specified, which I’m pretty sure was just a way of explaining away my meltdowns without admitting they were due to less than adequate care. I often wondered why they singled out impulse control as the only issue on which they gave me the vague “not otherwise specified” diagnosis. I guess it’s because, unlike my anxiety, depression, disordered eating, etc., my meltdowns did bother other people.

Then, several years later, came (complex) PTSD and dissociative identity disorder. These are mental illnesses, but they are caused by overwhelming circumstances, just like adjustment disorder.

Later came borderline and eventually dependent personality disorder. Finally, I was diagnosed with recurring depression in 2017.

All this to say, whether I have a mental illness or not, isn’t as straightforward as it may seem. I do know that my current care plan lists “mental health problems” as a general “diagnosis”. I honestly try not to care about the specifics of my diagnosis, but I’ve learned the hard way that the specifics can be used against me. For example, when I had the personality disorder diagnoses, I was kicked out of the psych hospital with almost no aftercare because of allegedly misusing care. I wish the higher-ups would look beyond the labels and at the individual.

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.

Narcissism, Narcissistic Personality Disorder and “Narcissistic Abuse” #AtoZChallenge

Posted on by Astrid

Hi everyone and welcome to my letter N post in the #AtoZChallenge. Today, I want to talk about narcissism and narcissistic personality disorder. I’ll also talk about the controversial topic of “narcissistic abuse”.

When looking up the definition of narcissism, several different descriptions come up, but an overarching theme is an extreme sense of self-importance. In psychoanalysis, narcissism is thought to be due to a person’s inability to distinguish themself from external objects. This is thought to occur naturally in infants but may also arise as a result of a mental disorder.

Narcissistic personality disorder (NPD) is defined by the American Psychiatric Association as a pattern of exaggerated feelings of self-importance, excessive need for admiration and a reduced capacity for empathy. Symptoms include:


  • A grandiose sense of self-importance.

  • Preoccupation with fantasies of unlimited success, power, beauty or ideal love.

  • Belief that they are special or unique and can only be understood by, or should associate with, specific people/institutions, usually those with high status.

  • Requiring excessive admiration.

  • A sense of entitlement, such as expecting especially favorable treatment or automatic compliance with their expectations.

  • Being interpersonally exploitative.

  • Lack of empathy: unwillingness and inability to identify with the feelings of others.

  • Often being envious of others or believing others are envious of them.

  • An arrogant, haughty attitude.


There is also an alternative model of describing personality disorders, which lists NPD as having two main criteria: grandiosity and attention-seeking.

There are two main subtypes of NPD: malignant and vulnerable. The malignant type is how most people see a classic narcissist, whereas those with the vulnerable type display more negative affect and shame.

As I look over the criteria of NPD, I can somewhat see why some people have called me “a little narcissistic”. I, after all, do see myself as unique and feel that I can only be understood by a handful of people. Unlike actual narcissists though, I don’t think of myself as “better” than others and, as a result, the people who will understand me are most certainly not high-status people.

Now on to “narcissistic abuse”. This is a term used to describe abuse, mostly psychological, perpetrated by people with NPD. However, it is more commonly used for any long-standing pattern of psychological abuse. As such, many people have come to call their toxic parents, partners or other abusers “narcs” even when these people don’t have a formal diagnosis of NPD. I’m not sure how I feel about this. On the one hand, it’s stigmatizing a mental disorder and also providing excuses for abusers (after all, they can’t help being a “narc”). On the other hand, well, it’s a major thing in abuse survivor circles and I need support regardless of what my abusers are or are not being identified as. I lean towards not believing in “narcissistic abuse” as its own thing.

Freud’s Theory of Personality #AtoZChallenge

Posted on by Astrid

Hi everyone. For my letter F post in the #AtoZChallenge on personal growth, I want to talk about Sigmund Freud’s theory of personality.

According to Sigmund Freud (1856-1939), the human personality consists of three main components: the id, the ego and the superego.

The id refers to sexual and aggressive drives that, Freud claims, are fully unconscious. More broadly, it refers to the drive for pleasure and the drive to avoid discomfort. This is the only part of the personality that Freud thinks is present from birth. As such, an infant cannot delay their need for gratification. For instance, when they are hungry, they are not able to keep themselves from showing this.

The ego is the part of the personality, both unconscious and conscious, that helps regulate the id and express our impulses in a way that’s acceptable in the real world.

The superego, which doesn’t start developing until a child is about five-years-old according to Freud, is the part of the mind that allows a person to distinguish right from wrong. This part includes the conscience, which is the part of the mind responsible for signaling that something is “bad”, as well as the ego ideal, which holds the person’s ideas of what is desired of them or what is “good”.

Healthy personality development can only happen if there’s a balance between the id, the ego and the superego, that is, if the ego is capable of moderating the other two parts of the personality. As such, if a person has an overactive id, they are thought to become impulsive or otherwise antisocial. On the other hand, if a person has an overactive superego, they will become overly judgmental. Freud actually claimed that pretty much all mental illnesses are down to imbalanced personality development.

Freud describes several stages of personality development, which are all related to the way the child interacts with their body. For instance, the first stage is called the oral stage, in which a baby discovers their environment through their mouth.

It has been nearly twenty years since I read about Freud. Back then, I only saw how Freud’s theory was wrong on so many levels and particularly judgmental, especially towards women. For instance, Freud reasoned that women have a less well-developed moral sense than men. This is obviously not true.

However, now that I read up on Freud’s theory, I can see certain parallels between Freud’s thoughts and the modern ideas of emotional development. For example, behavior signaling pleasure or discomfort is still strongly associated with Anton Došen’s first stage of emotional development. This is not, for clarity’s sake, meant to defend Freud, whose theory is not only grossly outdated but also horribly anti-woman, like I said. I guess this is a case of the saying that a broken clock is right twice a day.

Codependency and Emotional Dependence #AtoZChallenge

Posted on by Astrid

Hi everyone. For my letter C post in the #AtoZChallenge, I wasn’t really sure what topic to pick. I could go with cognitive functions, but without explaining personality typologies first, this wouldn’t make sense. Since I chose the broad topic of personal growth for my theme, I could however choose a topic that isn’t necessarily related to personality. IN this post, I’m talking about codependency.

What is codependency? In a narrow sense, it refers to certain behaviors exhibited by individuals in a close relationship with an addict. The addict is, in this sense, dependent on a substance (or behavior) and their partner is codependent, as in “second-degree dependent”.

I used to understand codependency as involving just enabling behaviors. For example, a codependent person might be manipulated into giving the addict access to their drug of choice. In this case, a person buying alcohol and giving it to an alcoholic, is codependent.

Actually though, codependency isn’t just the direct enabling of an addiction. It also happens in abusive relationships in which neither of the parties involved is an addict. For example, a person staying with their partner in spite of domestic violence, could also be seen as codependent.

Codependency, as such, is more related to being emotionally dependent on someone else despite them being in some way toxic. It could also be seen as compulsive caregiving.

For clarity’s sake, though their are certain individual traits that make someone more susceptible to becoming codependent, codependency is at least as much an attribute of the relationship as it is of the individual.

How can you heal from codependency? The first step is to set healthy boundaries. This means that boundaries are not so weak that they allow others to use you as a doormat and not so rigid that you end up self-isolating. Of course, what boundaries you set, depends on the person you’re setting boundaries with. For example, you may want to go no-contact with an abuser, but keep a supportive friend close by.

Another step in the healing process is to recognize yourself as a unique individual separate from the addict or abusive person you’re codependent on. And, for that matter, separate from everyone else in the world. This means learning about and validating your own preferences, wants and needs. As you learn to be more aware of your own individuality, you’ll start to develop greater emotional independence.

Healing from codependency will ultimately help you have healthy relationships with the people around you.

I am not currently in an abusive relationship and don’t have any close relatives who are addicts. As such, I am not really codependent on anyone at the moment. However, being that I grew up in a dysfunctional family, I do share some traits of emotional dependency. I was at one point also diagnosed with dependent personality disorder (DPD), even though my psychologist at the time only chose that diagnosis to make it look like I was misusing care. She actually claimed that I was perfectly capable of asserting myself, which people with DPD definitely aren’t.

Like I said, codependency is at least in part defined by the relationship, whereas DPD is a diagnosis meant for an individual. It doesn’t, however, take into account the fact that many adult children of dysfunctional families will end up showing (co)dependent behaviors in other relationships too.

No Longer Defective #Bloganuary

Posted on by Astrid

Today’s daily prompt for #Bloganuary is to share about your biggest challenges. At one point, I believe I wrote on this blog that my biggest challenge ever is my poor distress tolerance. Right now, I’d like to take it to a deeper level and say that my two biggest challenges are basic mistrust and a sense of being defective. I think the sense of being defective is even worse. This stems from my being an Enneagram type Four – or my being a Four is a result of my sense of defectiveness. In fact, the most distressed Fours are called “Defectives”. The healthiest are called “Appreciators”.

Being an externally-oriented Four – I’m undecided as to whether my instinctual variant is Social or Sexual -, I commonly blame others, be they in my past or present, for my sense of defectiveness. Now it is true that my parents commonly alternated between idealizing and devaluing me, that I was severely bullied in school and that I suffered numerous other traumas. That’s an explanation. It’s not an excuse.

There’s a thing I forgot to list when writing my not-quite-resolutions for 2024 earlier today: to work on personal growth more. I mean, honestly, I’m pretty stable where it comes to the most severe of (C-)PTSD symptoms. I do still get nightmares and flashbacks, but they do not ruin my day nearly everyday. Rather, my main issues are probably clinically classified as personality disorder symptoms, shameful as that feels to me to admit. I may or may not need a therapist to work on those, and if I do need one, I may or may not be able to find one. I can, however, work on exploring my issues on my own. I want to stop seeing myself as defective and start moving towards becoming the appreciator I know I can be.

Brain Injury As It Relates to Intellectual and Developmental Disabilities #AtoZChallenge

Posted on by Astrid

Hi everyone. We’ve arrived at my letter B post in the #AtoZChallenge. I struggled with what topic to choose for this letter, but eventually settled on brain injury. As you will find out, this type of disability has a kind of controversial relationship to intellectual and developmental disabilities. After all, many people view an intellectual or developmental disability as necessarily present from birth. The American Association on Intellectual and Developmental Disabilities (AAIDD), however, considers an intellectual disability as having originated before the age of 22. In the Netherlands, the age of onset cut-of for an intellectual disability care profile in the Long-Term Care Act is 18. As such, people who acquired a brain injury in childhood affecting their ability to learn, are diagnosable as having an intellectual disability.

With respect to other developmental disabilities, such as autism, the diagnostic waters get even muddier. I, for one, was diagnosed as autistic at age 20 despite having suffered a brain bleed as an infant. Then, ten years later, the diagnosis was removed again because apparently a brain injury no matter how early on precludes an autism diagnosis. However, I could not be diagnosed with acquired brain injury-related neuropsychological or behavioral difficulties either, because these would have required a clear before/after difference. Besides, I am blind too, so most neuropsychological testing isn’t possible on me. As a result of this, I ended up with just a regular personality disorder diagnosis. Now I’m not 100% sure I don’t have a personality disorder, but it’s certainly not all there is to me diagnostically.

In the Dutch care system, people with acquired/traumatic brain injury usually fall under physical disability service providers, unless they have really severe challenging behavior. In that case, they usually either end up in an intellectual disability facility or a psychiatric hospital. There are a few specialist mental health units for people with brain injury, but these are treatment-based, not living facilities. There are also nursing home units for people with brain injury, but these cater towards people over 65.

The Wednesday HodgePodge (July 20, 2022)

Posted on by Astrid

Hi everyone. I haven’t posted in a few days, because I was too tired from the heat. It’s still quite hot here, but I feel okay now. Today, I’m joining the Wednesday HodgePodge. Here goes.

1. Last time you drove more than 100 miles from your home? Where did you go?
I don’t drive, but I’m assuming riding in the passenger seat counts too. That being said, the last time my husband drove more than 100 miles with me in the car, was probably eight years ago when we went on a short vacation to the Black Forest in southern Germany. We drove in our Kia Rio, which we later found out deserves its acronym, “killed in action”, because shortly after that trip, the car crashed on the highway and my husband could just about move it onto the shoulder before it completely malfunctioned. We thought we had the problem fixed, but it developed the same problem that had caused it to crash back then again half a year later. Needless to say we sold that car. We’re thinking of going back to the Black Forest this September, but my husband has a really small car now, so he might want to replace that one first.

2. Something that drives you batty?
WordPress’ ever-increasing number of ads on free sites. I hope at least that, since I have a paid plan, they aren’t displaying on mine.

3. Do you feel like you’re “on track”? For what?
In my blogging life, I don’t feel as though I’m “on track”, but maybe that’s just my feeling. I mean, I really would’ve wanted to write at least as much this year as I did in 2021 and, up till the month of June, I was keeping up nicely. Now though, I’m not.

Similarly, I have a ton of craft projects waiting for me to finish them. Not that there’s a timeline for those to keep track of, but it does sort of feel as though I’m losing track anyway.

4. Your favorite car snack(s)?
Licorice and winegums (gummy candies).

5. Something you’ve done recently “on the fly”?
Nothing really. I plan most of my activities at least some time in advance. That being said, I do buy things impulsively at times. Does that count? In that case, going to Action (a budget store) in town and buying some random craft supplies last Monday. The trip into town was planned, and I had sort of planned to go to Action too, but I hadn’t planned to buy any of the things I ended up buying.

6. Insert your own random thought here.
Yesterday, I had a review with my nurse practitioner from mental health and the behavioral specialist from my care facility. I could rant about it here, but I’m not going to. Instead, I’m going to say that, after it, I finally concluded that, screw it, I’m ready to face whatever it takes to get real help for whatever it is I’m facing mental health-wise, be this trauma-related or a personality disorder or whatever.

Because I’d Had a Stroke…

Posted on by Astrid

I couldn’t possibly be autistic, my psychologist said, because I’d had a stroke as an infant and that somehow precluded a diagnosis of autism. Never mind that autism is genetic and said stroke supposedly didn’t change my genetic makeup to make me neurotypical. I, however, had to be diagnosed with acquired brain injury-related behavior change instead, but then again I couldn’t either, because I was too young when I sustained the stroke for my behavior to be considered as having changed either; after all, a six-week-old infant hardly shows any behaviors that would be considered significant in an adult. For this reason, I ended up with just some regular personality disorders, specifically dependent and borderline PD. Never mind that these have their onset in early adulthood and I’d shown symptoms since childhood. As it later turned out, my psychologist’s reason for changing my diagnosis had nothing to do with logic and everything with her wish to kick me out of care.

This post was written for the Six Sentence Story link-up, for which the prompt word is “stroke”. It isn’t completely factual, in the sense that, though my psychologist kept referring to what happened to me at six weeks of age as a stroke, it was actually a brain bleed. That doesn’t change the rest of the story though.

What If I Lose My Care?

Posted on by Astrid

Today’s prompt for the Weekly Prompts Wednesday Challenge is fear. More specifically, the organizers ask us to consider whether we ever worry about the “what if’s” of a situation without looking at the positive present. Fear, for me, takes many forms, including post-traumatic stress, in which I relive the past. However, it also includes worrying about the future indeed.

Specifically, I worry about losing my support. Of course, this is a realistic worry in a sense, in that my one-on-one support has only been approved until sometime in late 2023. However, right now it’s only May 2022 and a lot could happen between now and then.

This worry also takes unrealistic forms. For example, sometimes I’m convinced that the psychologist from the psychiatric hospital who diagnosed me with dependent personality disorder to “prove” that I was misusing care, will find out that I’m in long-term care and will report me for care fraud. If she does and if the authorities follow along with her allegation, I will not just lose my one-on-one, but all my long-term care and will essentially be required to move back into independent living with my husband.

In a sense, the fact that this “what if” is my worst fear, does prove sort of that I do have dependent traits. However, dependent personality disorder or dependency in general is not the same as misusing care. After all, I never disputed my psychologist’s claim that I wished to be cared for. What I disputed, is her claim that this wish is unfounded, in that I don’t really need this care.

In a similar fashion, recently I’ve had “what if’s” in my head about moving to another care home. What if the staff there expect me to be much more independent than I am right now? In a sense, one reason I want to move to another care home is to have a better quality of life, a broader perspective. This may include greater independence. But I don’t want to be forced into it.

I am reminded of a question on a personality test I had to fill out for my autism re-assessment back in 2017. The agree/disagree statement went something like this: “Being left behind alone is my worst fear.” I didn’t know how to answer it back then, as I thought at the time that being in serious pain would be worse, so I ticked the “Disagree” box. Then again, at the time, I hadn’t experienced significant time being left to my own resources in at least nine years. Now, I would certainly tick the “Agree” box even though I know it was a red flag for dependent personality disorder. I don’t care.

What if I lose all my care and am left to my own resources? During the same assessment, I had to answer a question about how difficult it would be to stay on my own for a couple of days. I ticked the “Very difficult” box, not the “Impossible” box that I would have ticked now. Then again, if my husband had stocked up on food and I had my computer and phone with me, would it literally be impossible? Hmmm, well… emotionally, yes, it would be.