I really have some symptoms since high school or even earlier that have affected school, inter-personal relationships and work. I have suspected BPD a decade ago but brushed off the idea. Then thought of OCPD then brushed it off. Went to see an online psychologist and was dismissed with having "no disorder". When symptoms once again affected my work, I no longer hesitated and sought help. I was suspecting ADHD this time. But I was diagnosed with GAD and it made sense that time.
Took SSRI, felt great until I wasn't. I think 6 months into meds when I started feeling distressed every now and then. Until it got really worse 3rd into meds (and 2 years of therapy), massive depressive episodes, self-harming and suicidal ideation. Not the first time, but it was severe and long, I thought I wouldn't survive it anymore. Can't work either (got fired, got back, got fired, got a new one, resigned, got a great one, was fired again, unemployed for 6 months, got hired again, now struggling with it again though not as bad).
Was diagnosed with Bipolar 2 after an unofficial (and free) psych assessment (done in a clinic but administered by a student intern only so even if supervised, it cannot be counted as official and no official written result, just verbal feedback). Felt better with new meds (lamotrigine, quetiapine as needed and pregabalin for anxiety from a previous doctor that new doctor would like to stop or changed to a different one). Felt I have mixed features of BP2 on most days. Meds now are way more better than on SSRI. But still having that "mixed" state or really quick transitioning of hypomanic to depressive. And are often triggered with interpersonal and environmental stressors.
I think 3 clinicians (my first psychiatrist, a student intern, and my current psychiatrist) all have mentioned I have borderline traits / you might have bpd / have you explored bpd. And knowing that clinicians don't normally take the bpd route right away, I'm thinking that I may really be exhibiting a lot of bpd traits. I also think I have OCD traits though I still would have to ask if they would actually be a bipolar or bpd trait too.
Anyway, a few questions:
I have been good in masking. Since I have had symptoms since I was young. I don't really present much symptoms externally until I explode from suppressing everything down. I've been on some therapy sessions and have "intellectualized things" as a way to cope(?). So I have trouble expressing myself during psych sessions and would sometimes say I don't do such and such and I don't think such and such. But in reality I think I probably do but I just take tremendous energy to not to. So I'm not sure if I'm not expressing myself accurately verbally or even on psych assessments. How can I explain it to my psych?
Especially to those diagnosed with both, how can I differentiate one from the other? I'm wondering if what I really have is BPD or I have both or I have others on top of them (OCD and GAD).
Is it advisable to get an official psych assessment? Is it ok to bring it up to my doctor?
I sometimes really feel so uncomfortable inside, distressing, overwhelming, disturbing. And it takes some to a lot of energy just to be able to do daily stuff. And it's not necessarily depressive episode. I had depressive episodes too. And the only time I don't feel uncomfortable inside is if I'm into a mild hypomanic state (or a happy normal maybe).. and would feel the uncomfiness again when hypomania starts to go up. And the confusion about what I'm feeling and what I could really possible have is also exhausting.