Q. About five years ago I was diagnosed with depression and then about a year ago I had the diagnosis of borderline personality disorder added. I agree with these diagnoses but I also have a couple questions. Every once in a while I will read things that will make me stop, reread, and read again because it sounds like me. Most recently it was an article about obsessive compulsive personality disorder. I read that it includes inappropriate perfectionism, difficulty making decisions, and some other things which I can't recall but they all had this 'life or death' feeling attached to them. I have always had an extreme habit of perfectionism. I will invite myself to perfect something of someone else's even. Any time I make something or do something it has to be absolutely perfect. If I am doing something that requires accuracy such as math I never trust someone else's answer to be correct. I must find the answer myself. I can't make decisions. I will leave a decision to the very last minute on most occasions and often the decision gets made for me simply because I have done nothing. That in itself ends up being the decision. The only time I make a decision to change something is when I do it impulsively. At the drop of a dime I will move halfway across the country because it seemed like a good idea at the moment. If I take the time to think about my decision I will end up doing nothing. And lastly, the thing I find to be very strange is that I have had a feeling since I was very young that when someone leaves my immediate environment it may be the last time I ever see that person. It's like my mind CANNOT let this feeling go. I must tell the people in my life who I love, that I love them every time I end a conversation on the phone with them or before walking out the door to go do something. I could never say "good-bye Mom" without adding "I love you". Never. I can't stand the thought of fighting with people I love because what if that is the last we speak?? Now, I could almost understand this fixation as an adult because at this point in life I have had numerous losses due to death.

Almost 3 years ago I lost my sister, brother in law and 3 nieces who I lived with for 3 years in a car accident. But, how do I explain this fixation as a child of approximately age 4 years old?? I very seldom fight with those I love, but when I do argue with them.....it gets bad. It's like all the little disagreements that I bit my tongue on for months all come out at once over one trivial thing. I lose it totally. And then until the situation is fixed I stress out in my head "what if that person dies and the last we spoke was a fight???" My head spins with these thoughts until the problem is worked out.

Is all this part of bpd? Is it something else? These 3 symptoms are the only ones I feel are related to each other. I have no other 'ritualistic' type behaviors like those I've read about with obsessive compulsive disorder. I apologize for the lengthiness of this. I tried to get my point across as quickly as possible. Any ideas you have would be greatly appreciated.

A. First of all, it is very difficult to know without a complete evaluation and assessment period what a person's diagnosis could be. You described many symptoms consistent with an anxiety disorder. Feelings of separation anxiety are common for many people struggling with anxiety and loss. In the same vein, people who are struggling with feelings of anxiety often times search through volumes of information to help them understand what they may be going through. Unfortunately, many of us have the tendency to find examples in our own life that are consistent with what we have read about certain disorders. This has the unintended effect of creating more anxiety for us because we then often think we have this other disorder on top of other concerns. I would suggest that you take time to sort through these ideas and concerns with a qualified mental health professional who can explore your history in detail, gain a full understanding of your situation, and then provide you with strategies to manage these feelings. By your description, you sound very insightful and therefore will likely benefit from the experience.

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