Pray

Hai and Assalamualaikum, I know it's been a while I don't write on the blog and I am sorry for that. I might not be replying to your comments for the last entries I wrote. I am trying my best to reply on by one and I hope you guys won't stop reading my entries. Thank you.

Today, I would like to share with you guys about today. I went to the counseling session as my depression is getting worse. As an introduction, on 2nd September 2019, I got into UiTM Pulau Pinang for the course of Civil Engineering Infrastructure. Things were hard for me since I told my parents about it. To be short, my boyfriend and I were never good until now. I keep blaming myself for whatever is happening between us.

After a few weeks in Degree, I tried to call Hospital Bukit Mertajam about my issue. The issue is I need to go home for an appointment at Hospital Putrajaya on 30th September. So, I went to Hospital Bukit Mertajam as they want me to give a referral letter and book an appointment date for me to check up. When I got there, I got lost because the hospital was so packed with people.

So, I went to the psychiatric section and gave the letter to a nurse. I was so nervous and anxious because I went there alone and only my new friends knew about it. It took like 15 minutes for my turn. The nurse asked questions and I was not taking any medicines because it is out of stock. The nurse consulted with a doctor and they gave me permission to collect the medicines at the pharmacy.

Currently, I am on my medication but still, it got worse. I decided to ask the counseling unit for the psychoeducation since my boyfriend and I was not in the good terms which trigger me a lot. So, my counselor asked me to do some tasks for myself to adapt in order to manage how to control myself not to self-harm and maybe other ways to help me someday.

I am texting my boyfriend about it and I don't know what will he respond since he won't reply to any messages I've sent. I want to make things right. Is there any chance for me to fix my relationship? Right now, I don't know what to write anymore, I am feeling so down. I am sorry everyone.

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How Borderline Personality Disorder Affects Relationship

Borderline Personality Disorder

People with borderline personality disorder (BPD) tend to have major difficulties with relationships, especially with those closest to them. Their wild mood swings, angry outbursts, chronic abandonment fears, and impulsive and irrational behaviors can leave loved ones feeling helpless, abused, and off-balance. 

Signs and Symptoms

Only a doctor or mental health professional can officially provide an official diagnosis of a personality disorder, but there are several key symptoms you can observe that might indicate a person has BPD. These include:

• Intense fear of rejection, separation, or abandonment
• Rapid changes between thinking someone is perfect to believing they are evil
• Risky behaviors including unsafe sex, gambling, drug use, or accumulating credit card debt
• Threats of suicide or self-harm
• Difficulty empathizing with other people
• Mood swings from euphoria to intense shame or self-criticism
• Frequently losing one’s temper

People with BPD are often terrified that others will leave them. However, they can also shift suddenly to feeling smothered and fearful of intimacy, which leads them to withdraw from relationships. The result is a constant back-and-forth between demands for love or attention and sudden withdrawal or isolation.

Another BPD symptom that particularly impacts relationships is called abandonment sensitivity. This can lead those with BPD to be constantly watching for signs that someone may leave them and to interpret even a minor event as a sign that abandonment is imminent. The emotions may result in frantic efforts to avoid abandonment, such as pleading, public scenes, and even physically preventing the other person from leaving.

Another common complaint of loved ones in borderline relationships is lying. While lying and deception is not part of the formal diagnostic criteria for BPD, many loved ones say lying is one of their biggest concerns; this can be because BPD causes people to see things very differently than others.

Finally, other symptoms of BPD, including impulsivity, self-harm, and dissociative symptoms, which can have an indirect impact on borderline relationships.

How to set and reinforce healthy boundaries

Talk to your loved one about boundaries at a time when you’re both calm, not in the heat of an argument. Decide what behavior you will and will not tolerate the person and make those expectations clear. For example, you may tell your loved one, “If you can’t talk to me without screaming abuse at me, I will walk out.”

Do…

Calmly reassure the person with BPD when setting limits. Say something like, “I love you and I want our relationship to work, but I can’t handle the stress caused by your behavior. I need you to make this change for me.”

Make sure everyone in the family agrees on the boundaries—and how to enforce the consequences if they’re ignored.

Think of setting boundaries as a process rather than a single event. Instead of hitting your loved one with a long list of boundaries all at once, introduce them gradually, one or two at a time.

Don’t…

Make threats and ultimatums that you can’t carry out. As is human nature, your loved one will inevitably test the limits you set. If you relent and don’t enforce the consequences, your loved one will know the boundary is meaningless and the negative behavior will continue. Ultimatums are a last resort.

Tolerate abusive behavior. No one should have to put up with verbal abuse or physical violence. Just because your loved one’s behavior is the result of a personality disorder, it doesn’t make the behavior any less real or any less damaging to you or other family members.

Enable the person with BPD by protecting them from the consequences of their actions. If your loved one won’t respect your boundaries and continues to make you feel unsafe, then you may need to leave. It doesn’t mean you don’t love them, but your self-care should always take priority.

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How Bipolar Disorder Affects Relationship

Bipolar Disorder

Bipolar disorder is characterized by dramatic shifts in mood, energy and activity levels. These changes are so extreme that an affected individual may seem like a different person when they are up, as opposed to down. Everybody has moods, but bipolar disorder interferes with normal daily living.

If a person with bipolar disorder experiences major depressive symptoms, they may be less communicative during a period of depression. They may become tearful or feel hopeless and pessimistic. Having low self-esteem may feel less affectionate. It can be difficult for a person's partner to know what to say or do to help. They may feel rejected, mistaking symptoms as a lack of interest in the relationship.

The unpredictable symptoms and behaviors of a person experiencing bipolar disorder can shake up a relationship and may scare even the most supportive partner. These symptoms can include:

Mania (Type 1):

increased physical and mental activity

exaggerated optimism and self-confidence

excessive irritability, aggressive behavior

decreased need for sleep

rapid speech, thought

increased sexual behavior and spending

Depression (Type 2):

prolonged sadness

changes in appetite and sleep

irritability, anger, worry

pessimism, loss of energy

feelings of guilt and worthlessness

recurring thoughts of suicide and death

Tips For When Your Partner Has Bipolar

All relationships take work, and being in a relationship with a person with bipolar disorder is no different. A healthy partnership requires empathy, communication, and self-awareness. There are many ways to build a strong relationship with a partner who has bipolar, including by:

1. Learning about the condition

Learning about bipolar disorder can help a person understand what their partner is experiencing. Reading reputable, well-sourced health information websites can help give a balanced view of the condition.

2. Asking about triggers

Workplace stress or lack of sleep can trigger bipolar symptoms. Triggers are events or circumstances that could disrupt the mood state of a person with bipolar disorder. This could increase their risk of experiencing a manic or depressive episode.

Triggers could include dealing with a stressful work scenario, not getting enough sleep, or missing doses of medication. Not everyone with bipolar will have triggers, but if they do, they may have learned about them through their own experience with the illness.

Asking about personal triggers can help someone support their partner when those events or circumstances arise or help them avoid triggers. However, many mood changes can occur without triggers.

3. Asking about behaviors

Asking what behaviors are typical for a person with bipolar disorder during high or low periods can help someone recognize their partner's shifts in mood.

Learning which behaviors are usual for a loved one and which indicates a shift in mood can be very helpful. This enables the partner of a person with bipolar disorder to distinguish usual behaviors from bipolar symptoms.

4. Supporting treatment

To support a person's treatment plan, start by discussing what the plan involves. This may help reduce any anxiety in the relationship. While some people appreciate being asked about how their treatment is going, others may find it intrusive or paternalistic. It is crucial to talk about how best to support treatment and whether there are aspects of treatment that a person does not want to discuss.

5. Creating a support plan

Creating a support plan is a useful way for a partner to learn how to help a person with bipolar when they are unwell. This might include planning activities, making a list of useful contacts, such as a trusted relative or therapist, and making adjustments to a daily routine.

A support plan reassures both partners that they will know how to respond to a very high or low period. This can reduce anxiety around the idea of the person with bipolar becoming unwell.

6. Communicating feelings

High or low periods may be emotional for both partners. For this reason, open communication is crucial. A partner should explain how the behavior of a person with bipolar makes them feel, without judging them or stigmatizing the condition. Talking openly can be a powerful way to reduce the negative impact that certain behaviors may have.

7. Practicing self-care

It is vital for the partner of a person with bipolar disorder to support their own mental health by practicing self-care. Through self-care, a person can strengthen the relationship. It can also improve their ability to care for their partner.

Some ways a person can practice self-care when their partner has bipolar disorder include:

1. talking to a friend or family member about relationship issues
2. practicing a hobby
3. getting regular exercise
4. seeing a therapist
5. not being the partner's only support
6. practicing stress-relieving techniques such as mindfulness or meditation

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How Dysthymia Affects Relationship

Dysthymia

When I am depressed, the tendency to let the dark side of my situation will fill into the relationship of us, my family and friends too. People who suffered from depression ni have higher levels of suffering the pain, anxiety and sadness. They will feel the relationship is less satisfactory and become unusually upset when problems in the relationship happen. 

They more likely to blame their partners when things go wrong, and they tend to shut down emotionally instead of reach out and connect. Their partners, in turn, feel more emotionally burdened and distressed themselves.

Just as depression and relationship satisfaction are linked, so is anxiety and distress in the relationship. Being in a poorly functioning relationship may make you more susceptible to the experience of anxiety which, in turn, can lead relationship quality to worsen.

You might be a sunny optimist, happy and relaxed, but if your partner casts a negative light on your interactions, this will take its toll on your mood and relationship satisfaction.

Men who experience anxiety may seem to be more rejecting to their partners and because women are typically more sensitive to rejection, in turn, can cause them to question and doubt their relationship’s quality. I know you've been anxious when we were together but I accept you anyway.

This shows why it is hard for us to have a healthy relationship.

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Hari Terakhir

Hai and Assalamualaikum, today I want to share with you guys about hari terakhir appointment saya di HOSHAS. Untuk makluman semua, seperti yang saya dah bagitahu sebelum ni dekat entries yang ada label #mentalhealth, saya menghidap penyakit kemurungan, iaitu dysthymia (klik untuk info lebih lanjut), bipolar mood disorder type 2 in depressive mood and borderline personality disorder. Jadi, bagi sesiapa yang tak tahu pasal jenis - jenis kemurungan, saya akan buat entry pasal bipolar and borderline nanti. Buat masa sekarang, saya nak fokus dengan final dulu.

Unit Kesihatan UiTM Jengka

Tepat pukul 8 pagi, saya dah terpacak depan unit kesihatan, kitaorang kat sini panggil Medec. Nak tahu tak, Medec UiTM ada sediakan pengangkutan secara percuma untuk pesakit - pesakit dari UiTM ke hospital berdekatan. Caranya, korang bawak je buku temujanji pesakit dekat Medec. Then bagitau je medical assistant (MA) yang bertugas, nak buat permohonan pengangkutan ke hospital sekian sekian. Nanti MA akan isikan form sambil rujuk buku temujanji korang. Tapi permohonan ni hanya valid untuk seminggu sebelum tarikh appointment korang.

Kaunter Medec

Sementara  tunggu driver datang, saya tunggu kat dalam Medec. Driver tu saya tak pasti dari Hal Ehwal Pelajar (HEP) or Hal Ehwal Akademik (HEA). Tapi borang yang kita isi itu, Medec mohon untuk tempah driver untuk ke hospital yang kita appointment. So,  sebab tu kena tempah awal sebab takut takde driver atau takde yang nak hantar dan sepanjang kita tempah driver tu, MA sendiri kata, kita tempah dulu, kalau driver takde, kena pergi naik pengangkutan sendiri. Biasanya, saya dengan boyfriend drive naik kereta sewa kawan, around RM50++ (inclu. minyak)

Nombor Giliran untuk mendaftar

Around 8.45 pagi, saya sampai la kat HOSHAS tu. Dari Bandar Pusat Jengka ke HOSHAS lebih kurang 45 minit cemtu. Mula - mula kena pergi dekat kaunter macam biasa ambik nombor giliran. Tunggu giliran untuk daftar biasanya ambik masa around 10 - 15 minit. Bila dah sampai giliran tu, kena bagi kad IC and bayar RM5. Pastu akan dapat nombor giliran untuk jumpa dengan doktor.

Nombor giliran untuk jumpa doktor

Bila dah dapat nombor, kita bagi buku temujanji dengan nombor tadi dekat kaunter klinik pakar psikiatrik. MA dekat situ akan suruh kita timbang berat ambik blood pressure, pulse rate dan MA lain akan catat kat nombor tadi. Then pass balik kat MA kat kaunter. Lepas tu kena la tunggu sampai giliran kita around 15 - 20 minit jugakla.

Ruang ke bilik appointment

Sementara tunggu tu, saya baca nota yang saya bawak sebab lusa dah nak exam tapi diri sendiri masih tak sedar lagi. Rasanya kena penangan last paper syndrome haha. Tapi sebolehnya nak try aim subject tu dapat A sebab lecturer dah baik hati nak kasi carry marks yang tinggi. Saya dapat 36/40 kut. Untuk final exam, tinggal lagi 60%.

Bilik Appointment Doktor

Tiba giliran, saya masuklah dengan perasaan gemuruh sebab sejuk satu, sebab bila jumpa doktor je saya rasa macam kena serious. Tak boleh main - main. So nervous la kan?? lol Doktor tanyalah macam mana perkembangan saya, macam mana effect ubat dekat saya. Saya bagitau semua benda, pesanan untuk semua, jangan pernah sesekali menipu or tak bagitau perkara sebenar sebab doktor nak nilai diri kita dengan ubat yang doktor bagi. Pastu saya minta doktor buatkan surat rujukan untuk pindah hospital ke Putrajaya memandangkan ini appointment terakhir dekat HOSHAS. Lupa saya nak bagitau, saya nak tukar Hospital bukan sebab HOSHAS ni tak best, cumanya saya dah habis diploma dekat UiTM Jengka. So, saya kena dapatkan rawatan di Hospital yang berdekatan dengan rumah iaitu Hospital Putrajaya. 

Nombor Giliran nak ambik ubat

Sementara tunggu tu, saya main je phone haha sebab ramai sangat orang, saya jadi gemuruh sebab saya sorang - sorang je. Memang macam - macam ragam ada. Kalau dulu boyfriend teman, bolehla borak - borak ke apa. Tapi gentle, hospital memang sejuk nak mati. Haha hari terakhir appointment baru nak reti pakai sweater bila datang. Selama ni pakai tshirt nipis je. Ish ish.

Ubat Seroquel XR 300 mg

Doktor naikkan dose ubat saya dari 200mg ke 300mg sebab saya mengadu saya makin gemuruh sekarang berbanding dulu and susah nak tidur. Pastu doktor sarankan saya untuk makan dalam pukul 6 petang sebab even kat wad pon pesakit akan makan dalam waktu tu. Cuba korang tengok harga ubat tu. It's freaking RM 402 / 30 biji. Sumpah mahal nak mampos! Saya berterima kasih gila - gila dekat kerajaan sebab banyak spend duit dekat perubatan apa semua. Like kita bayar RM 5 je setiap kali appointment and kita dapat ubat harga beratus. Kalau beli sendiri memang tak mampu la. Itulah, kita semua kena banyak belajar bersyukur bila dah ada kemudahan macam ni.

HOSHAS

Terima kasih saya ucapkan kepada staff - staff HOSHAS yang banyak berjasa kepada orang ramai. Daripada saya masuk wad orthopedik dulu sebab patah tangan sampai la saya pergi ke bahagian psikiatrik. Semuanya selesa dan layanan doktor, MA dan staff lain pon mesra. Cuma tandas haha biasalah orang ramai guna jadi takdela selesa sangat. Saya sarankan korang yang nak pergi ke HOSHAS, gunalah tandas depan jabatan X-ray. Sumpah bersih gila and wangi. Akhir kata, terima kasih kepada doktor kerana sudi berhempas pulas tenaga dan berbakti pada negara walaupon diri sendiri pon tak terjaga tapi sanggup jaga pesakit sendiri. Saya doakan semua terbaik dunia akhirat.

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DYSTHYMIA VS DEPRESSION

Hello, Assalamualaikum everyone, today I'd love to share with you guys about Dysthymia. I'll talk about it based on what I've understood. Of course, it won't be a wronged info, I was diagnosed with it. So I'd love to discover it. 

9 TYPES OF DEPRESSIONS

1. Persistent Depressive Disorder (Dysthymia)
2. Major Depressive Disorder (MDD)
3. Postpartum Depression
4. Seasonal Affective Disorder (SAD)
5. Psychotic Depression
6. Premenstrual Dysphoric Disorder (PMDD)
7. Destructive Mood Dysregulation Disorder
8. Substance/Medication-Induced Depressive Disorder
9. Bipolar Disorder (BP)

So, for today, I'd share with you guys about Dysthymia and MDD since both of them are kinda related. For bipolar disorder, I'll share with you next time. The rest, I'm not sure when will I share, since I don't know much about it, but I'll try my best to share with you!

DYSTHYMIA

A form of continuous long-term (chronic) depression. Patients may lose interest in regular daily activities, feeling discouraged, less productive, and inferior and inadequate feelings. This feeling lasts for years and may disturb your relationship, school, work and your daily activities significantly. Dysthymia is typically defined as a chronic but less severe form of major depression. It has many similar symptoms to other forms of clinical depression.

MAJOR DEPRESSIVE DISORDER

Depression, known as major depressive disorder (MDD), is a common medical illness that negatively impacts the way you think, feels, and acts. This may lead to emotional and physical problems that can interfere with your ability to function at home and work.

DIFFERENCES BETWEEN DYSTHYMIA AND MDD

• PDD is used to describe a person who experiences clinically significant depression over a long period of time. 
• The level of depression is usually not severe enough to meet the criteria for MDD.
• People with MDD have a normal mood baseline when they're not experiencing depression.
• People with PDD experience depression all the time and don't remember or know what it feels like not to be depressed.
• For a diagnosis of MDD, symptoms must last at least 2 weeks.
• For a diagnosis of PDD, symptoms must have been present for at least 2 years.

DYSTHYMIA SYMPTOMS VS MDD SYMPTOMS

The symptoms of MDD and PDD are basically the same, sometimes differing in intensity. They include:

• Feeling sad, empty, tearful or hopeless
• Responding to even small matters with anger or frustration
• Losing interest in normal daily activities such as sports, sex or hobbies
• Sleeping too little or too much
• Responding to even small tasks with a lack of energy
• Losing appetite or increasing food cravings
• Losing or gaining weight
• Feeling guilty or worthless
• Having trouble making decisions, thinking, concentrating and remembering

To oversimplify, the symptoms of Dysthymia might be less intense or debilitating, but they're continuous and long-lasting.

DOUBLE DEPRESSION

Even though Dysthymia and MDD are separate conditions, people can have them both at the same time. If you’ve had PDD for a number of years and then have a major depressive episode, this is referred to as a double depression.

Be gentle with yourself, dear 😘

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The Truth #1

Assalamualaikum, hari ni saya baru je lepas buat cookies, walaupon I made them alone (with Ajin's help but not so much help). I am kinda proud of myself but I am not sure how I feel. It is kinda irritated and tired. None wants to help me. Like I have to ask for help, but not everyone is willing to help. I hate this kind of situation where I do need help but none is helping me. Apa - apa pon, I just made it. Tutup cerita. Tak nak panjang - panjangkan isu yang tak penting ni. 

So, saya nak bercerita tentang one of my secrets that I have been keeping from anyone. This secret is like 1 month of letting none knows. It takes a lot of guts to write this but I want to make a clear statement to everyone around me that I am like this because I am mentally sick. I try my very best to overcome the hardness that I have been through. It is going to be a long story.

On 30th April 2019, I was diagnosed with persistent depressive disorder (dysthymia), bipolar disorder type 2 and borderline personality disorder at HOSHAS, Temerloh. I was accompanied by Supi (one of my friends, she had an appointment too). I will try my best to explain those and for the detailed one, I will post a new entry. Before I was diagnosed, I want to tell you guys how to get diagnosed to make it clear for you guys. I hope it will give you an awareness of mental health.

2 weeks before an appointment, I had a hard time with my boyfriend which makes my situation gets hard for me to handle. I have been cutting myself with anything that could make arm and wrist bleeds. I would not suggest you guys to google for it. It might trigger your mind or anything. After the hardship happened, I broke up with my boyfriend as actually I pushed him away. I could not think well since I have been depressed for a long time.

First thing I thought of when I broke up, I wanted to make myself better. I told myself, it is time for me to seek help from the professional. It was very hard for me to tell something that I have been keeping from anyone. Even my family, my friends. I was having a hard time since I was 11 or 12 something. I have been cutting since I was 11. It got worse when I am in secondary school.

I went for counseling in UiTM at KMK. It was on Monday, at around 2pm with Puan Anita. I said I want to have a consult about how to control my anger and about mental health. She asked a few questions and at last, I got the courage to tell that I have been self-harming. She asked me to show where did I do it. I had to show her and I cried while showing it because it was hard for me to open up. Nizam is the only person that I have been opening up.

I was asked to take a DASS test which I have taken for thousand times. For those yang tak tahu apa itu DASS, it stands for Depression, Anxiety, Stress Scales. The result of it was as I expected. Puan Anita terus make a phone call to Medec (klinik yang ada dekat UiTM) as it needs to be checked up. She said I have to immediately go to Medec right away after the counseling session is done. At that time, I had to skip a class for meeting a doctor at Medec.

Masa jumpa doctor kat Medec tu, sumpah anxious gila sebab I do not know what will happen next, it is not something I have planned for. Masa sampai sana, I met my old friend, Haris. We talked for a while, he was there for time slip with a medical assistant. He asked about what am I sick, but I could not tell him the truth. I felt bad actually, what can I do to make me less uncomfortable about it. I am sorry to everyone that I have lied to.

Meeting the doctor was fine but I hate it when everyone talked to me about me being a suicidal or doing self-harm has things to do with Iman or whatsoever. I really hate it when they want to relate doing such things could go to hell and stuffs. Personally, to me, for those who were suffering, did not have much choices as they are mentally unstable. They really cannot make good decisions. That is similar things to me. I really hope people out there, mind the little things that you do might trigger their irritating moods or thoughts. Please, think of something that would put you in their shoes.

The Medec has made my first appointment with a psychiatrist at HOSHAS. It made me a bit thrilled since it is my time to recover my mental health. I will continue sharing with you guys about my journey in the next post. Anything you want to know, you may comment down below or chat in the chatbox. Let me know the question in your head. I will be ready to answer those.

For those who are struggling, I pray you will be strong to face the world even if you are alone.

It is okay to feel unstable. It is okay to be confused. It is okay to hide from the world. It is okay to get a help. It is okay to not be okay. It is okay to feel whatever feelings you have. Your mental illness is not your personal failure. I love you guys.

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