Your Inner Struggles: Do You Have a Personality Disorder?

Q: Your Inner Struggles: Do You Have a Personality Disorder?

Hello everyone： Your courage to face your past and your efforts for yourself are truly admirable! Based on the situation you described, it seems that you may be experiencing physiological discomfort triggered by anxiety (such as hair loss, chest tightness, irregular bowel movemen

I am unsure if I have a personality disorder?

Hello, Doctor: I have been introverted and shy since childhood, and my early years were not happy.
Since I can remember, my parents have had a troubled relationship and argued daily.
When I was in elementary school, they abandoned me and separated from my brother, which left a significant shadow on me.
During my adolescence, although my parents reconciled, they continued to argue.
To escape my family background, I rebelled, misbehaved, abused drugs, skipped school, and became deeply involved in relationships, often giving my all and suffering greatly, which frequently caused my mother to break down.
There were instances of family members attacking each other with knives, and being taken to the police station became a norm.
After becoming an adult, my brother and I, due to our childhood separation, became strangers and found it difficult to communicate.
Both of us lack confidence, and I once hated being unable to move on, yet I deeply love them! This contradiction causes me great pain.
Although I am very self-conscious and introverted, I am also very competitive.
In my youth, I messed up everything, but after turning 23, I refused to continue this vicious cycle for the rest of my life.
I retook exams, entered a national university, and received a national scholarship to study abroad (to escape my family background).
After graduation, I wanted to stay abroad but was unsuccessful.
Upon returning to Taiwan, I found a job in a publicly listed company and successfully climbed the corporate ladder, earning a six-figure salary.
Although I appear to be thriving on the outside, it feels like there are other personalities living inside me.
At least two distinct personas exist within me; one acts like a mentor, forcing me to study hard and do good deeds.
My current achievements are largely due to their supervision.
When this persona appears, I become very diligent, but I clearly feel that this is not me.
This persona wants to win at everything, but I do not.
The other persona is filled with fear; whenever it surfaces, I lose control, become socially anxious, and feel intense guilt about everything.
At my core, I still feel very insecure and often doubt myself.
I believe I am merely being forced by the mentor within me, and I have never truly believed that I can accomplish anything well.
I have few friends and often feel that everyone dislikes me, which makes me hesitant to initiate social interactions.
Out of fear of being disliked, I often end up being a people-pleaser.
I can put on a facade in public, but when alone, I cry continuously, feeling extremely tense and fearful, often unable to control my descent into depression.
Although the mentor persona helps me face the outside world without major issues, my psychological problems are significant, and I feel clearly unwell.
I researched dissociative identity disorder online, but I do not lose memory during personality shifts; I merely retreat to observe the other personas.
Sometimes I can intervene in their actions, but other times I cannot.
I can separate my emotions from myself and remember my existence every moment of the day.
However, recently, friends have mentioned things I said previously, and I have no recollection of them.
During arguments with my boyfriend, I become like an outsider, calmly analyzing the situation, which makes him feel like I am a stranger.
I often forget things I resolved to do after a few attempts.
This has caused me some concern about physical symptoms; I have been experiencing significant hair loss, frequent chest pain and tightness, constipation and diarrhea, and my body has started to show signs of inflammation.
My body is unusually sensitive and painful to the touch, and despite numerous medical examinations, no cause has been found.
I worry that I might have a serious illness, which leads to extreme panic.
However, I sleep very well and do not suffer from headaches; I have always been able to fall asleep instantly, sometimes sleeping an entire day, feeling inexplicably fatigued.
I can manage my work, and the stress seems to be self-imposed.
Perhaps I have repressed too much because I can observe and analyze my own behavior but cannot control these symptoms.
This is truly painful.
I am uncertain about what illness I might have, and I kindly ask for your advice.
Thank you!

Renren, 30~39 year old female. Ask Date: 2018/08/26

Dr. Wang Yazhen reply Psychiatry

Hello everyone: Your courage to face your past and your efforts for yourself are truly admirable! Based on the situation you described, it seems that you may be experiencing physiological discomfort triggered by anxiety (such as hair loss, chest tightness, irregular bowel movements, pain, etc.).
This aspect can be addressed by seeking psychiatric help for appropriate medication to alleviate these symptoms.
However, considering your history, the past traumas related to family and interpersonal interactions still have a significant impact on you.
The feeling of having multiple personalities often arises as a defense mechanism developed to cope with emotions that may be overwhelming.
Therefore, during conflicts, you might find yourself unexpectedly calm instead of feeling sad, as you detach from the situation.
I recommend engaging in long-term psychotherapy to gradually unpack your issues and reintegrate your experiences.
This approach will likely be beneficial for you!

Reply Date: 2018/08/26

More Info

It sounds like you are experiencing a complex interplay of emotions and behaviors that may be indicative of underlying psychological issues. Your narrative suggests that you have faced significant challenges throughout your life, particularly in your childhood, which has likely contributed to your current struggles with self-identity, self-esteem, and interpersonal relationships.
From what you've described, it appears that you may be grappling with symptoms that could align with several psychological concepts, including aspects of personality disorders, dissociative experiences, and possibly even traits associated with borderline personality disorder (BPD). The presence of different "personas" or aspects of your identity, such as the "mentor" who pushes you to succeed and the fearful part that holds you back, suggests a fragmentation of self that can occur in response to trauma or chronic stress.

Understanding Your Experiences
1. Childhood Trauma: The tumultuous environment you described during your formative years, including parental conflict and feelings of abandonment, can have profound effects on emotional regulation and self-perception. Children who grow up in unstable households often develop coping mechanisms that may not serve them well in adulthood, such as dissociation or the creation of alternate identities to manage overwhelming feelings.

2. Dissociation and Identity Fragmentation: Your ability to observe your behaviors from a distance, as if you are not fully in control, points to dissociative experiences. While you mentioned that you do not lose memory during these shifts, the feeling of being an observer suggests a level of dissociation that can be common in individuals who have experienced trauma. This can manifest as feeling detached from oneself or one's emotions, which can be distressing.

3. Self-Esteem and Identity Issues: The internal conflict between your self-perception and the "mentor" persona indicates a struggle with self-worth. You seem to oscillate between feeling capable and driven, thanks to this mentor, and feeling inadequate and fearful when that part of you is not dominant. This duality can lead to confusion about your true self and what you genuinely want or feel.

4. Social Anxiety and Fear of Rejection: Your fear of social interactions and the belief that others do not like you are common symptoms of social anxiety disorder. This can lead to avoidance behaviors, where you might prefer isolation over the risk of rejection, further exacerbating feelings of loneliness and depression.

Recommendations for Moving Forward
1. Seek Professional Help: It is crucial to engage with a mental health professional who can provide a safe space for you to explore these feelings and experiences. A therapist trained in trauma-informed care or dialectical behavior therapy (DBT) might be particularly beneficial, as these approaches focus on emotional regulation and self-acceptance.

2. Journaling and Self-Reflection: Keeping a journal can help you articulate your thoughts and feelings, providing a clearer picture of your internal struggles. This practice can also help you identify triggers for your different personas and how they influence your behavior.

3. Mindfulness and Grounding Techniques: Practicing mindfulness can help you stay connected to the present moment and reduce feelings of dissociation. Grounding exercises, such as focusing on your breath or engaging your senses, can help you feel more anchored in your body and less overwhelmed by your emotions.

4. Building a Support Network: While it may be challenging, try to cultivate relationships with people who are understanding and supportive. Sharing your experiences with trusted friends or family members can help reduce feelings of isolation.

5. Physical Health Monitoring: Given your physical symptoms, it may be beneficial to consult with a healthcare provider to rule out any underlying medical conditions. Stress and anxiety can manifest physically, and addressing these symptoms holistically is essential.

Conclusion
Your journey toward understanding and healing is unique, and it is commendable that you are seeking clarity about your experiences. Remember that change takes time, and it is okay to seek help along the way. By addressing both the psychological and physical aspects of your well-being, you can work toward a more integrated sense of self and a healthier emotional state.

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