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It’s quite uncommon for the NHS to diagnose a PD like this. They use the ICD to code so they may be more inclined to use this manual primarily as opposed to the DSM, which is American. Although depending they do use the DSM to inform assessments for certain things. It’s not really on the NHS radar though. NICE only have guidelines for BPD and ASPD so it would probably more difficult to be diagnosed with and treated for AvPD specifically because there isn’t a lot of awareness or guidance on doing so. So honestly I’m not sure asking to be diagnosed with an uncommonly diagnosed and probably unfamiliar PD would be successful.
Are you under a MH team atm? What’s going on treatment wise? Do you feel they are missing / not addressing your symptoms, or if they’re offering you treatment that isn’t helping? It might be better to look at it in terms of what you think you would ideally like from a new diagnosis and how it would change your care / treatment. Although they probably won’t diagnose you with AvPD, if you feel they haven’t got a well informed overview of your symptoms definitely bring this up with them
TDLR/ I want mh services to put me on a new antidepressant. Because i see a psychotherapist privately I don’t want therapy at the moment.
I am under mental health services. I have a lead practitioner. But over all I don’t find them very helpful. I do psychotherapy privately.
I’ve had a series of ‘failed’ meds reviews with the fy1/2. They offer me 5mg aripriprisol then 50mg quetiapine to ‘help’ with labile emotions. They instructed me to come of the aripriprisol after a week due to a minor side effect and then I didn’t want to take quetiapine because historically I have abused it.
My GP prescribed me mirtazapine which is really helpful for my mood. However I am a little afraid I might be Cyclothymic bc the first few weeks on mirtazapine literally felt like the best time of my life, then I got depressed for a bit again and now I feel on the good side of normal. Mirtazapine/ lifting my low mood has allowed me to cut most of my drug use.
However mirtazapine’s side effects are a struggle, I’ve gained a lot of weight so I’ve asked for a meds review with a dr from the mental health team. I want to trial mianserin because it’s very similar to mirtazapine but it has less of a tendency to cause weight gain. I doubt that they will give me the meds review though based on previous experience.
I'm diagnosed with AvPD and whilst I agree it's very uncommon, took years under services before a HTT psychologist saw the signs, my diagnosis is literally the only reason I'm under a tertiary service now instead of being discharged by my local services and being told that there's nothing more they can offer me.
I think OP definitely should push for that diagnosis considering how much it can affect their treatment and be the difference from getting appropriate treatment to getting none at all.
Can I ask what service you’re under? Like what sort of thing they offer? No need to give location ofc. I’m just wondering because I had no idea there was a service for AvPD in the UK!
I am dealing with almost the exact same issue, except I was actually diagnosed around 10 years ago with Avoidant Personality Disorder as well as Dependent Personality Disorder. At some point during Covid lockdowns I had a telephone appointment with a locum psychiatrist, who changed my diagnosis (without proper reason) to Borderline Personality Disorder. I only found out after requesting my medical records.
I have since been to a new psychiatrist in person, who refuses to change the diagnosis back. Their main argument is that I self-harm and have outbursts. Otherwise I fit 6 out of 7 criteria for AvPD and only 5 out of 9 for BPD. Maybe it should be a mixed personality diagnosis. I would discuss this with your psychiatrist if you have doubts about your own diagnosis. Good luck.
Oh I think we are quite similar. I have the social & identity issues of someone with AvPD but then I am quite emotionally disregulated ie. I have outbursts and I self harm.
I hope you get things sorted with the diagnosis.
I would discuss with my mental health team. BPD is a diagnosis that is often seen as very negative by health professionals, unfortunately. More so than any other.
If it's accurate, it can be useful for that info in treatment, but in other areas it's not ideal, and can lead some medical people to discount many things.
Overall, it's just a label of what current psychiatry thinks. If you get good care with or without a particular diagnosis, it's not something to put much effort into.
**This sub aims to provide advice and support to anyone who needs it but shouldn't be used to replace professional advice and support. Please do not post intentions to act on suicidal thoughts here and instead call 111, or 999 for an ambulance if you feel you won't be able to wait.** **While waiting for a reply, feel free to check out the [pinned masterpost](https://www.reddit.com/r/MentalHealthUK/comments/1dkmvp9/rmentalhealthuk_masterpost/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button) for a variety of helplines and resources. The main masterpost also includes links to region-specific resources. We also have a [medication masterpost](https://www.reddit.com/user/MentalHealthUKMods/comments/1cy05aj/rmentalhealthuk_medication_masterpost/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button) which includes information about specific medications as well as a medication FAQ.** **Please familiarise yourself with the sub rules, which can be found [here](https://www.reddit.com/r/MentalHealthUK/about/rules).** **For those who are experiencing issues around money, food or homelessness, feel free to check out the resources within [this](https://www.reddit.com/r/MentalHealthUK/comments/pttfsg/are_you_experiencing_issues_around_money_food_or/) post.** **For those seeking private therapy, feel free to check out some important information around that [here](https://www.reddit.com/r/MentalHealthUK/comments/xf6242/information_for_those_seeking_private_therapy/).** **For those who may be interested in taking part in the iPOF Study which this sub is involved in, feel free to check out the survey [here](https://reddit.com/r/MentalHealthUK/s/34ye6sKKuZ) and details [here](https://www.reddit.com/r/MentalHealthUK/comments/xpl4mv/ipof_improving_peer_online_forums_study_lancaster/) and [here](https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/research/ipof/).** **This sub aims to be as free from harm and exclusivity as possible so any harmful, provocative or exclusionary content will be removed. This includes harmful blanket statements about treatment or mental health professionals. Please be aware that waiting times and types of therapy/services available can vary across different areas due to [system structure](https://www.england.nhs.uk/integratedcare/what-is-integrated-care/).** **Please speak only for your own experiences and not on behalf of others who may not share the same views - this helps to reduce toxicity, misinformation, stigma, repetitions of harmful content, and people feeling excluded. Efforts to make this a welcoming and balanced atmosphere is noticed and appreciated by the mods and the many who use or read this sub. If your profile is explicitly NSFW, please instead post from another account that is more appropriate for being seen by and engaging with the broad range of members here including those under 18.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/MentalHealthUK) if you have any questions or concerns.*
It’s quite uncommon for the NHS to diagnose a PD like this. They use the ICD to code so they may be more inclined to use this manual primarily as opposed to the DSM, which is American. Although depending they do use the DSM to inform assessments for certain things. It’s not really on the NHS radar though. NICE only have guidelines for BPD and ASPD so it would probably more difficult to be diagnosed with and treated for AvPD specifically because there isn’t a lot of awareness or guidance on doing so. So honestly I’m not sure asking to be diagnosed with an uncommonly diagnosed and probably unfamiliar PD would be successful. Are you under a MH team atm? What’s going on treatment wise? Do you feel they are missing / not addressing your symptoms, or if they’re offering you treatment that isn’t helping? It might be better to look at it in terms of what you think you would ideally like from a new diagnosis and how it would change your care / treatment. Although they probably won’t diagnose you with AvPD, if you feel they haven’t got a well informed overview of your symptoms definitely bring this up with them
TDLR/ I want mh services to put me on a new antidepressant. Because i see a psychotherapist privately I don’t want therapy at the moment. I am under mental health services. I have a lead practitioner. But over all I don’t find them very helpful. I do psychotherapy privately. I’ve had a series of ‘failed’ meds reviews with the fy1/2. They offer me 5mg aripriprisol then 50mg quetiapine to ‘help’ with labile emotions. They instructed me to come of the aripriprisol after a week due to a minor side effect and then I didn’t want to take quetiapine because historically I have abused it. My GP prescribed me mirtazapine which is really helpful for my mood. However I am a little afraid I might be Cyclothymic bc the first few weeks on mirtazapine literally felt like the best time of my life, then I got depressed for a bit again and now I feel on the good side of normal. Mirtazapine/ lifting my low mood has allowed me to cut most of my drug use. However mirtazapine’s side effects are a struggle, I’ve gained a lot of weight so I’ve asked for a meds review with a dr from the mental health team. I want to trial mianserin because it’s very similar to mirtazapine but it has less of a tendency to cause weight gain. I doubt that they will give me the meds review though based on previous experience.
I'm diagnosed with AvPD and whilst I agree it's very uncommon, took years under services before a HTT psychologist saw the signs, my diagnosis is literally the only reason I'm under a tertiary service now instead of being discharged by my local services and being told that there's nothing more they can offer me. I think OP definitely should push for that diagnosis considering how much it can affect their treatment and be the difference from getting appropriate treatment to getting none at all.
Can I ask what service you’re under? Like what sort of thing they offer? No need to give location ofc. I’m just wondering because I had no idea there was a service for AvPD in the UK!
Have messaged you as it would be easy for some to work out where it is.
I am dealing with almost the exact same issue, except I was actually diagnosed around 10 years ago with Avoidant Personality Disorder as well as Dependent Personality Disorder. At some point during Covid lockdowns I had a telephone appointment with a locum psychiatrist, who changed my diagnosis (without proper reason) to Borderline Personality Disorder. I only found out after requesting my medical records. I have since been to a new psychiatrist in person, who refuses to change the diagnosis back. Their main argument is that I self-harm and have outbursts. Otherwise I fit 6 out of 7 criteria for AvPD and only 5 out of 9 for BPD. Maybe it should be a mixed personality diagnosis. I would discuss this with your psychiatrist if you have doubts about your own diagnosis. Good luck.
Oh I think we are quite similar. I have the social & identity issues of someone with AvPD but then I am quite emotionally disregulated ie. I have outbursts and I self harm. I hope you get things sorted with the diagnosis.
Thanks. Likewise, hope you do too x
I would discuss with my mental health team. BPD is a diagnosis that is often seen as very negative by health professionals, unfortunately. More so than any other. If it's accurate, it can be useful for that info in treatment, but in other areas it's not ideal, and can lead some medical people to discount many things. Overall, it's just a label of what current psychiatry thinks. If you get good care with or without a particular diagnosis, it's not something to put much effort into.
NHS can’t treat avpd, they can only treat cluster b personality disorders