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What Causes Anankastic Personality Disorder?

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Posted on Fri, 8 May 2015
Question: I have been diagnosed with ocd and or border line ankastic personality disorder. I havevhugevdebts and have make really reckless decisions impulsively. I get a crimal 30k in cash,purchased houses without looking at them. I can be confident and then extremely low in mood. I feel suicidal at this and I have been aggressive historically. I am extremely depressed at times obsessed with loyalty. I became obsessed with sex and when my marriage broke up I appeared to deal with it, then 4 or 5 years ago I was working looking after aterminally I'll man in his home when I was in tears and felt all my emotions and regret at loving my wife. All my thought were not in retrospect but as if it happened the day before. I an not a psychiatrist but people whom have known me along time say I have other mental disorder as do I. My mood can change quickly and my diagnosis does not fit with my imlusive and reckless actions. I have also stolen goods from shops . I can talk a lot and quickly.
doctor
Answered by Dr. Seikhoo Bishnoi (20 minutes later)
Brief Answer:
These symptoms don't suggest an OCD or anankastic personality disorder

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. You have been provisionally diagnosed with OCD or anankastic personality disorder by a nurse practitioner.

If we consider main issues from your history then you have history of multiple reckless decisions. You have mentioned rapid swings in your mood and behaviour in history you have provided. One time you remain confident and at other time you feel low in mood. You remain depressed and are obsessed with loyalty also. You also have history of suicidal behaviour. Due to obsessively excess sex the marriage broke up. The mood changes very quickly and you also have history of stealing goods from shops.

If we consider these symptoms then as per my opinion the diagnosis of either OCD or anankastic personality disorder is not appropriate though to make final diagnosis detailed evaluation is needed.

These symptoms like mood swings, talking excessively, history of obsessively excess sex, broken marriage, complaints of talking more, obsession of loyalty, depressed mood and then confident mood, history of wrong decisions etc are pointing toward some mood disorder and not towards personality disorder. In personality disorder individuals don't usually seek treatment by themselves and they always deny the problems. So we can rule out personality disorders easily. Your behaviour like making reckless decisions, mood swings, confident and then depressed etc can be explained easily by bipolar disorder especially in mania (irritable mania). Mood lability, mood swings, suicidal ideations etc all warrant evaluation by a psychiatrist for treatment.

Please consider consulting a psychiatrist for help. These symptoms respond well to treatment. Mood stabilisers will help to reduce your indecisiveness, talkativeness and other symptoms. These drugs will help to improve mood swings and you will feel good. Common mood stabilisers are Sodium Valproate, Carbamazepine, Lithium etc. Visit a doctor for prescription and start taking the drugs. These are safe to use and will help in better functioning. Try not to regret to your past life and try to correct your present life.

Thanks, I hope this helps you. Please provide more details about your symptoms so that I can comment with confidence. Feel free to ask a follow up. Take care
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Seikhoo Bishnoi (1 hour later)
Thank you so much for your help. Historically I have had intrusive upsetting thoughts so as stabbing myself in the leg, or have commiting some immoral act or related to contamination, however these thoughts have lessened with age.

My ex wife said my behaviour was almost as if i was a different man and she still thinks a great deal of me. I find it so ,so hard to forgive myself let alone understand. I know my mental health has affected my work history also I don't believe I lack interllect. I was a staff nurse for 17 years and found my mood could swing from one polar to the other.

I have low self esteem however sometimes grandious thoughts and behaviour. I attend counselling and keep being told I was unwell and should forgive myself. I reflect on past events and cannot recognise myself . I don't believe I have a personality disorder.. I do have insight however my mind feels tortured. I try to forgive myself and believe I was ill but my symptoms , behaviour, thoughts as you state just don't relate to the diagnosis.

I am told I am a good man but I don't feel that I am. Could I ask what constant dreams of heroism indicate if anything.

Interestingly I have a history of excessive work ridiculously such 30 night shifts i n a row. I am a perfectionist and accept ocd however I did not and do not believe it was ever my primary illness.

It means a great deal for me to understand however I do need to rebuild my life. I spoke to my gp whom stated getting a diagnosis would not help me and that I could see a number of psycitrists and get a different diagnosis. I explained having a correct diagnosis would enable me to receive the correct medication. Moreover my mental wellbeing is more important to me than my notes. I gave given up nursing as I recognised I could not manage the stress also the move from hands on care.

Please forgive me for going on but I have a slipped disc at the moment, yet mental pain is far worse. I want to get correctly medicated a live my life with some quality. Warm regards, XXXXXXX

doctor
Answered by Dr. Seikhoo Bishnoi (21 minutes later)
Brief Answer:
These symptoms don't suggest any personality disorder

Detailed Answer:
Hello again and thanks for updating your history

Even if we include the upsetting thoughts and self stabbing in thighs still I would keep some mood disorder as first diagnosis. During childhood a lot of individuals show some unexplained behaviours which usually occur due to some underlying or unconscious anxiety.

Repeated episodes of mood change in front of wife, some instances of grandiose behaviour and thoughts, constant dreams of heroism (most probably due to hidden grandiosity), history of working continuous 30 days in a row (related to increased work efficiency or risk taking behaviour of bipolar disorder), obsessive punctuality etc all are pointing more towards mood disorders especially bipolar.

After reading your history I don't think you have some personality disorder. Please don't worry about mis-diagnosis, and if possible try to take opinion from one good psychiatrist only. Opinion of a single psychiatrist would be better for you an this will also increase compliance to treatment. With proper drug therapy your symptoms will start reducing and you can then lead a normal life.

Thanks, I hope this helps you. Still have more uncleared things please don't hesitate to ask again.

Take care
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Seikhoo Bishnoi (24 minutes later)
I wanted to thank you. My metal health historically has cost me a great deal. It is hard to make people understand how mental health has such an impact on all aspects of our lives. I could not afford to get the help and support without your services. Again I truly appreciate your help and advise. Once I get some money together I would like to see you for a consultation however I don't know if this is possible. Warm regards XXXXXXX
doctor
Answered by Dr. Seikhoo Bishnoi (6 hours later)
Brief Answer:
Mental illnesses cause huge effects on social, personal and financial life

Detailed Answer:
Hello again XXXXXXX Thanks for asking a follow up

I can understand your problem. A lot of individuals suffering from mental illnesses loss huge money because of loss of proper occupational functioning, losses at personal and social front and also a lot of money go in treatment of illness. All these contribute in huge financial loss. Please visit a doctor nearby for confirmation of provisional diagnosis and start taking treatment. Its never too late. With treatment your symptoms will improve.

Thanks, I hope this helps you. Take care
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5193 Questions

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What Causes Anankastic Personality Disorder?

Brief Answer: These symptoms don't suggest an OCD or anankastic personality disorder Detailed Answer: Hello thanks for asking from HCM for your health related queries I can understand your concern. You have been provisionally diagnosed with OCD or anankastic personality disorder by a nurse practitioner. If we consider main issues from your history then you have history of multiple reckless decisions. You have mentioned rapid swings in your mood and behaviour in history you have provided. One time you remain confident and at other time you feel low in mood. You remain depressed and are obsessed with loyalty also. You also have history of suicidal behaviour. Due to obsessively excess sex the marriage broke up. The mood changes very quickly and you also have history of stealing goods from shops. If we consider these symptoms then as per my opinion the diagnosis of either OCD or anankastic personality disorder is not appropriate though to make final diagnosis detailed evaluation is needed. These symptoms like mood swings, talking excessively, history of obsessively excess sex, broken marriage, complaints of talking more, obsession of loyalty, depressed mood and then confident mood, history of wrong decisions etc are pointing toward some mood disorder and not towards personality disorder. In personality disorder individuals don't usually seek treatment by themselves and they always deny the problems. So we can rule out personality disorders easily. Your behaviour like making reckless decisions, mood swings, confident and then depressed etc can be explained easily by bipolar disorder especially in mania (irritable mania). Mood lability, mood swings, suicidal ideations etc all warrant evaluation by a psychiatrist for treatment. Please consider consulting a psychiatrist for help. These symptoms respond well to treatment. Mood stabilisers will help to reduce your indecisiveness, talkativeness and other symptoms. These drugs will help to improve mood swings and you will feel good. Common mood stabilisers are Sodium Valproate, Carbamazepine, Lithium etc. Visit a doctor for prescription and start taking the drugs. These are safe to use and will help in better functioning. Try not to regret to your past life and try to correct your present life. Thanks, I hope this helps you. Please provide more details about your symptoms so that I can comment with confidence. Feel free to ask a follow up. Take care