Nursing Student Afraid I Have Mental Illness

[Nurse Beth, MSN]

Dear Nurse Beth,

This may be a bit of a read but I have a question about mental health.

I am 20 years old and have been in college since I was 17! I am in a nursing program now and realizing I have a possible borderline personality. I see a definitive 3 personalities within myself, they are all me. I only talk to myself when I'm alone/day dream when alone. It hard to tell how long I've had this because of my ADHD diagnosis, I always seemed to day dream. I thought this occurred with everyone. This doesn't interfere with my social skills or life. I seem to always day dream and talk to myself when I'm alone and not busy for periods over 30 minutes (never in public or at work).

I already work in healthcare and am great with patients.

I have been diagnosed with ADHD and taken all kinds of stimulants since childhood!! I hate them and can function well as a student without them since adulthood. I hate taking medications they have always made me feel depressed and I'm typically extroverted. I don't want a new diagnosis.

I'm very concerned about my career since I've been working so hard to be a nurse and s/s of schizophrenia/borderline have developed after years of working so hard. If they do not interfere should they be reported?

I see the big section on applications asking about inpatient care and worry that it will prevent me from being hired if I am diagnosed. I have worked so hard and care deeply about my future in nursing.

Will this keep me from being successful? Will it limit me from working in trauma or the OR if diagnosed?

---

Dear Have s/s of schizophrenia/borderline personality,

You have been diagnosed with ADHD and you are self-diagnosing yourself with schizophrenia and borderline personality disorder. These are very different disorders.

If you are having symptoms suggestive of schizophrenia (auditory hallucinations, break from reality) you need to see a doctor as soon as possible for a diagnosis and treatment. However, you are high functioning and most people with schizophrenia are not high functioning without the proper treatment.

You also say you have three different personalities which is not characteristically typical of either disorder. Borderline personality disorder often affects relationships, and makes it hard to regulate your emotions.

You are extroverted, have a job, are great with patients, and are in nursing school. You do sound anxious, but again, you need a diagnosis to see if your fears are grounded.

As far as employment, you do not have to disclose your medical history unless you are asking for work accommodations. Some states do ask for medical history when applying to the board for licensure.

I wish you the best and truly hope you do not have a serious and chronic neuro-biological medical condition.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[operations]

I do not mean to diagnose, but I suspect the student may have anxiety disorder related to her past ADHD diagnosis (she seems to "fatalize" here different personality states and have some obsessive/distractive thoughts without any apparent psychosis). I think nursing is high stress and can exacerbate any kind of MH disorder. I would greatly advise her to get reevaluated. It isn't going to harm her career to get help, and there are many options for her to choose from of she didn't like the ADHD meds. Especially since untreated anxiety disorder can lead to panic attacks, which can in fact be disabling and far more difficult to treat. That I know from experience.

[Timbal]

This sounds more like psychiatric hypochondria. You are mentioning 4 different diagnoses here.

1: Confirmed ADHA that you have been treated for in the past.

2: Borderline Personality Disorder: includes mood instability which can cause unstable relationships (intense anger, anxiety, depression lasting minutes or days), frequently includes self-harm behavior (cutting, deliberate injuries to self), may have bulimia/anorexia with the accompanying distorted self-image. Individuals with this disorder are surrounded with drama, and can be paranoid. Either everything that goes wrong is someone else's fault, or everything is your fault, and that 'blame' can change in the same conversation.

You have given no symptoms indicating that this diagnosis is a possibility, but instead immediately state you have different personalities.

3: Multiple personality disorder (Dissociative Identity Disorder) - Frequently stems from severe childhood abuse, either mental, physical, or sexual. Characterized by the presence of two or more 'identities' that are unaware of the others. Identity changes can last minutes, days, or weeks at a time.

You state you see definitive personalities in yourself. Key to D.I.D. is NOT being aware of other personalities.

4: Schizophrenia - Involves loss of contact with reality, although it feels 'real' to the individual. Hallucinations - seeing, hearing, smelling or touching things that other people do not. Delusions of persecution or paranoia - government conspiracy, feelings of being followed, thinking people are 'out to get you'. Delusions of grandeur - I personally have met "the queen of America", "the President" more than once, multiple "gods", and even 8 or 9 "satans". CIA and FBI agents also seem to end up in our mental health facility while "under cover".

You clearly state you are daydreaming or talking to yourself. Schizophrenics do not talk to themselves. They are talking to other people that they perceive to be present. Is someone else asking you who you are talking to or what you are looking at? Hallucinations do not occur only when you are alone. Someone would notice abnormal behavior.

Yes, everyone daydreams. Yes, people talk to themselves. That is normal, healthy behavior.

MH RN x 15 years.

[Kooky Korky, BSN, RN]

As a student, I thought I had every disease we studied.

That is not to put you down in any way. If you think you should see a doctor, please do that.

I wouldn't advise reporting anything, especially without a valid diagnosis.

Please get any care you think you need.

[Kooky Korky, BSN, RN]

This sounds more like psychiatric hypochondria. You are mentioning 4 different diagnoses here.

1: Confirmed ADHA that you have been treated for in the past.

2: Borderline Personality Disorder: includes mood instability which can cause unstable relationships (intense anger, anxiety, depression lasting minutes or days), frequently includes self-harm behavior (cutting, deliberate injuries to self), may have bulimia/anorexia with the accompanying distorted self-image. Individuals with this disorder are surrounded with drama, and can be paranoid. Either everything that goes wrong is someone else's fault, or everything is your fault, and that 'blame' can change in the same conversation.

You have given no symptoms indicating that this diagnosis is a possibility, but instead immediately state you have different personalities.

3: Multiple personality disorder (Dissociative Identity Disorder) - Frequently stems from severe childhood abuse, either mental, physical, or sexual. Characterized by the presence of two or more 'identities' that are unaware of the others. Identity changes can last minutes, days, or weeks at a time.

You state you see definitive personalities in yourself. Key to D.I.D. is NOT being aware of other personalities.

4: Schizophrenia - Involves loss of contact with reality, although it feels 'real' to the individual. Hallucinations - seeing, hearing, smelling or touching things that other people do not. Delusions of persecution or paranoia - government conspiracy, feelings of being followed, thinking people are 'out to get you'. Delusions of grandeur - I personally have met "the queen of America", "the President" more than once, multiple "gods", and even 8 or 9 "satans". CIA and FBI agents also seem to end up in our mental health facility while "under cover".

You clearly state you are daydreaming or talking to yourself. Schizophrenics do not talk to themselves. They are talking to other people that they perceive to be present. Is someone else asking you who you are talking to or what you are looking at? Hallucinations do not occur only when you are alone. Someone would notice abnormal behavior.

Yes, everyone daydreams. Yes, people talk to themselves. That is normal, healthy behavior.

MH RN x 15 years.

Believing there are conspiracies is not necessarily delusions. Remember: Being paranoid doesn't always mean there's no reason to be.

[Timbal]

Believing there are conspiracies is not necessarily delusions. Remember: Being paranoid doesn't always mean there's no reason to be.

A person with schizophrenia does not realize the delusion. They believe it to be very real. Do you work in mental health? If you do, you know what I am saying. If you do not, then how many people do you know that are fearful of their very lives every single day?

I am not saying if you think you are in danger, ignore the feeling. Everyone gets that feeling once in a while, but NOT every day.

As I originally stated above, schizophrenics experience unrealistic, unfounded fears that impact their lives negatively, and that is what this discussion is about.

paranoid

par·a·noid

adjective

The definition of paranoid is being suspicious, having illusions about being followed or persecuted, or about being afraid or distrustful of others.

Paranoid dictionary definition | paranoid defined

[spotangel, DNP, RN, NP]

Chill! Many ADHD kids talk and answer themselves! I should know as my oldest child in college does it! There is an anxiety component and a feeling of doubt about yourself. That said get a neuropsychological evaluation. They are great at getting to the bottom of any issue.If you get a diagnosis ask if there is any kind of recommendation for college life. Those reports help you to get accommodations in school like extra time for tests, quiet environment ,note taker etc. All luck and don't be hard on yourself ! You got this! Cheers!

[Fed_RN14]

If you are legitimately concerned you have mental health issues, please see a specialist to confirm this. Much of what you are describing are personality quirks. I don't think anyone makes it through nursing or medical school without some self diagnosing. Heck, I was once convinced I had HIV because I was so tired and getting sick frequently. (Because I was a stressed out working student). I'll tell you the same as I'd tell a patient- talk to a doctor. A psychiatrist in this case. Let the experts do the diagnosing.

[mircats]

I have BPD, and it has no effect on my ability to care for pts. Unless you are unsafe to practice, there is no need to report it. As for being at uni since you were 17 - it took me 6 years to complete a 3 year degree. Not a big deal, unless you make it one.