Lots of Symptoms: Am I a Hypochondriac?

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Reader’s Question

For a while now I’ve wondered if it’s possible that I have BPD (Borderline Personality Disorder). I know a diagnosis wouldn’t be possible over the Internet but I would just like to know if you think I should seek some further help.

I’m 17 years old; a junior in high school. I don’t have many close friends. I’m not sure if it’s because of my fear of abandonment. My family tells me I’m selfish and moody, and I tend to have self-destructive behavior such as cutting, burning, experimenting with inhalants and being willing to have sex without thinking about the consequences. I’m not a very emotional person but I do have mood swings, usually lashing out at family. I’ve contemplated suicide several times, planning it all out down to the day, but never go through with it because of embarrassment. I’m currently going through a small bout of ED. I’m limiting my calorie intake to 400 a day.

I don’t know if I’m molding myself to fit the symptoms — feeling desperate to find myself, since I have no idea who I am — or if I’m just a hypochondriac.

Psychologist’s Reply

I am glad you wrote, as you have mentioned a number of things that cause me to have concern for your safety, such as substance use, impulsive sex, self-harm, suicidal ideas and plans, and calorie restriction.

You may already know some of the negative effects that risky behavior (e.g. inhalants, unprotected sex) can have on your health, but I will reiterate them. The National Institute on Drug Abuse (NIDA) states about inhalants, “irreversible effects can be hearing loss, limb spasms, central nervous system or brain damage, or bone marrow damage. Sniffing high concentrations of inhalants may result in death from heart failure or suffocation (inhalants displace oxygen in the lungs).” Inhalants, with repeated use, may cause enough brain damage that you are unable to learn new things or have difficulty carrying on simple conversations (NIDA).

Similarly, with sex, it is wise to be cautious about when, who, and why. Impulsive or unprotected sex can potentially lead to health risks such as sexually transmitted disease. Unplanned pregnancy, regret, and social/relationship problems (e.g. peer rejection or bullying) are other potential negative results of sex when it is not approached with careful consideration.

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Although it is not uncommon for teenagers to be curious about and experiment with alcohol, sex, and even substances, it is important to consider the risk of these behaviors.

Hypochondriasis is usually excessive worry or preoccupation about one’s physical health; a significant, obsessive concern that one has a serious physical illness that has not yet been diagnosed. Although this does not match what you report, I do hear you asking whether your concerns about your mental health are warranted or overblown. You mentioned suicidal ideation and plans as well as self-harming behaviors, which are not necessarily typical parts of the teen years. Often these behaviors are a response to stress or trauma or a way of coping with difficult feelings or events. You are right, I cannot diagnose you with BPD or anything else over the Internet. However, I would recommend meeting with a mental health professional to anyone who has specific suicidal plans and a history of self-harm. You have been able to observe these behaviors in yourself and have done at least some research, it appears, on criteria for various disorders. A mental health professional helps people sort through what problems or experiences are most important to address and offer assistance in finding healthy ways to cope.

You said that you have no idea who you are. When the immediate symptoms are resolved and you are safe and stable, therapy can also be a place to explore who you are and who you want to be. Without knowing you at all, I guarantee that you have many strengths, talents, and interests that define you as much or more than the symptoms and problems you described here. My hope is that you will start to define yourself in terms of those aspects of yourself as well.

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