Friday, November 28, 2014

Of Personality Disorders

I feel like there are a lot of things that I haven't finished yet! Ahhh. For now, case write up is finished... next I can focus on my second seminar on dissociative disorder, and then 2 case presentations that I have to write properly and then the long overdue my dad's power point slides on stress anddd the design for sisters tshirt.

Serves you right. Who told you to procrastinate, huh Nurul Ainn??!

Okay relax relax. Don't stress yourself out. Stress is not good. Take a deep breath in...and out. In...and out. Feel better now?

Okay cool.

Before I get back to work, I am going to tell you about...PERSONALITY DISORDERS!

Ehem ehem. Before we go any further, do you know what is personality?

Personality means the characteristic behaviour responses of an individual, based on his internal or external experiences. It is individualistic, unique, stable, hence making it predictable.

So when a person has personality disorder, it means that the person's behaviour deviates from the normal range of variation found in majority of people, resulting in significant impairment of adaptive functioning and/or personal distress.

How many types of personality disorders do we have?

Based on DSM-IV-TR, our fellow American psychiatrists have grouped the personality disorders into three clusters : Cluster A, Cluster B, Cluster C and Others.

I have drawn some pictures so that you can imagine better.

CLUSTER A : the odd and eccentric cluster.

These disorders involve the use of fantasy and projection and are associated with a tendency toward psychotic thinking. Patients may have a biological vulnerability toward cognitive disorganisation when stressed.

Source here

CLUSTER B : the dramatic, emotional and erratic cluster.

These disorders involve the use of dissociation, denial, splitting, and acting out. Mood disorders may be common.

Source here

CLUSTER C : the anxious or fearful cluster.

These disorders involve the use of isolation, passive aggression and hypochondriasis.

Source here


Other personality disorders are depressive, passive-aggressive, sadomasochistic, sadistic, self-defeating, personality disorder due to general medical condition and personality disorder not otherwise specified.

You can remember about these disorders by associating each one of them with people that you know of. Some of the examples our lecturer gave:

1. Histrionic - Kim Kardashian, who is such a drama queen and likes to draw attention to herself

2. Narcissistic - Kanye West, who thinks he is better than Taylor Swift, criticising her in public

3. Sadomasochistic - Christian Grey from 50 Shades of Grey ;)

I have some friends who fit some criterias of these disorders, so I just remember them when I think about Antisocial, Avoidant and Histrionic.

My friends think that I have some traits of Obsessive-Compulsive Personality Disorder. Hahhaa they are so funny. My best friend said that I used to be that severe. She mentioned the time when we were in foundation centre about 6 years ago. Even when I make single spelling/writing mistake on a piece of A4 paper, I would get a new paper and start writing again, from the start. I still do that even now, hahahaha shhh don't tell her. But it's only when I am doing my work alone, of course. 

Yeahh I admit, I was a bit of a perfectionist back then. But I dont fulfill those criteria for OCPD okayy. I only have some of the traits. Let's see how many do I have:

1. is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost - I only exhibit half of this criteria

2. shows perfectionism that interferes with task completion (eg. is unable to complete a project because his or her own overly strict standards are not met) - sometimes yes

3. is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity) - noo I still have time for my friends, and funn!  

4. is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification) - I dont think I am that inflexible

5. is unable to discard worn-out or worthless objects even when they have no sentimental value - I keep stuff that I like and throw away stuff too

6. is reluctant to delegate tasks or work with others unless they submit to exactly his or her way of doing things - hahahahha. okay this may be true. guilty as charged!

7. adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes - ohh I do spent a lot on shoes!

8. shows rigidity and stubbornness - a liiiitlee bit maybe

So out of 8, I only got at most three! We need 4 to diagnose OCPD, so I am not having this disorder yayy!! Hahahaha

Now you can diagnose yourself if you have any of these personality disorders!

Excuse me, I have to go take a shower and do my work work workk!!


Tuesday, November 25, 2014

Of Sleep and Clinic Patients

Tonight is like every other night when I don't feel like studying. Usually I end up reading magazine, or reading news on Facebook, or sleeping in this comfy bed. Ahh even now I feel like going to bed and stop writing this post, even though I just written a few meaningless sentences. Initially I planned on studying a bit, but now I don't feel like doing it.

I like sleeping. Especially when you are feeling tired from all the day work, sleeping feels like heaven! Or or, when you have some problems and you don't want to think about it anymore, you can sleep on it! Or when you miss someone so much that you wish you can go there and be with that person but you can't, then go to sleep! It's amazing how much a good sleep can do to you. Ahh I feel like sleepingggg.

Speaking about sleep, based on what our doctor told us, almost every psychiatric disorders can present with sleep problems. For example, in schizophrenia, patients may have trouble in initiating sleep because they keep hearing voices. In anxiety patients, they will have trouble initiating sleep as well, because they are always anxious, anticipating on what's going to happen the next day. In post-traumatic stress disorder patients, they have trouble in maintaining sleep, because they keep having nightmares or flashbacks. For patients with melancholic depression, they will have early awakening as one of the symptoms. In bipolar patients, they have reduced need for sleep. They do not feel the need to sleep because in their mind, they have a lot of things to do and a lot of plans to be carried out. 

It is important for us to regulate our sleep. If our biological clock has been set to a specific pattern, our body will get used to it, and we will be able to do our daily activities effectively. I am advising myself as well, sometimes when there is a lot of work to do, you lost track of time, and push yourself to finish your work even though you know it's time for you to sleep.

Now putting sleep talk aside, I am going to tell you about the patients that we met in psychiatric clinic this morning, with Dr.Hanisah. Oh oh before that, here's a story. I went to the clinic and wanted to clerk a patient for my case presentation. I met with a couple, who both have psychiatric disorders! They were both Dr.Hanisah's patients. The husband is 51 years old, diagnosed with anxiety disorder. The wife, 30 years old, has bipolar disorder. They were very talkative and cooperative. The wife was really supportive of his husband, and remembered every single details about his husband's condition, like when was he started to become sick, what were his presenting symptoms etc. 

She talked like a normal person - you could never imagine that she can kill two people and had been arrested in jail because of that. Yeah, we were shocked when we heard about that from our doctor. The incident happened when she was in her manic state. She killed them by using a knife.

But but that's not the main story I wanted to tell you. It's this one. My friend Aida clerked this one female patient, in her 30s I think, who came with symptoms of mild depression. That was the first time coming to the clinic, accompanied by her husband. Here's the catch : Her depression was because recently, he caught her husband cheating on her! It's the same husband who was coming with her to the clinic! 

They had been married for 20 years (20 years can you imagine how long is that!) and they have four kids. The husband was having an affair with his office mate, a friend of his wife! The office lady had been to their house before! It started last year, when the wife noticed that the office lady was becoming close to his husband, but she never suspected that the two were a couple. It was until one month ago, when she confirmed her suspicion. She asked her husband's friends from office, and she got to know that his husband and the office lady had been going out for quite some time. 

And you know what? The office lady - she is already married as well!! But her husband lives in another city, and they have no kid. It's really sad, right? How can you not be depressed by that? Then I asked Aida, how come is she still staying with her husband? If it were me, I would have left him! And the husband - how nice of him to bring the wife to the clinic! And then Aida said that the husband still loves his wife and could not let her go. At the same time, he also loves the office lady. Pfftt. Guys. If he really loves his wife, he would never think of cheating on her in the first place!

Other than that, we met a 44-year-old male patient who was a drug abuser, his last intake was in August this year. He has a supportive wife and siblings. Even when he was using cannabis and methamphetamine, his wife still stays with him for 13 years! That was sweet. He presented with auditory and visual hallucination as well as persecutory delusion and delusion of control. When he was sick, he can see a big snake going inside his body.

And our last patients were a mother and her son. The mom is 46-year-old with anxiety disorder, while the son is 16 years old, having anxiety personality trait. When doctor interviewed the mother, who is a high-school teacher, she said that she had shortness of breath, giddiness, numbness of hands and legs. Those were the symptoms of a panic attack. She told us that she always get that when she thinks about her work. She had to take care of her school's koperasi account, and mark SPM students' papers. She is a workaholic and perfectionist, always like that since adulthood. She rarely take her family out for a holiday. 

We could see how she interact with her son at that time. Even though her son told us that he likes playing badminton and swimming, the mother kept saying that she thinks that it is better if her son starts to jog. Even if he does not like jogging, he can try it first and start from now. She was imposing her personal opinions on her son, and that's not healthy. When she asked her son if he has had any stress before, she made it sound like a teacher interrogating a student. Doctor told us later when they went out of the room, that they both need to address the problem in the way they communicate as well. A mother should give room for her children to choose what they want to do, and encourage them. The children should not do what the mother wants them to do. Yes, I totally agree with doctor. Let us children do what we like to do!

Anywayy, its getting late and I need to sleeeppp.

You have a good day, and take care of your sleep!

Ahh I want eggs. Fried rice with eggs.

Friday, November 21, 2014


Oh wow look at her beautiful dress and her glass shoes they are amazingg!!

When there is goodness, there is MAGIC! Can't wait to watch this movie!

And...this guy performed on Muzik Muzik (TV3) just songg

Anyway you have a good weekend!! 

Byebyeeee :D