A person with borderline personality disorder (BPD) is acting out their intense pain, fear, and shame using primitive defenses they may have learned long ago. This can take many forms including self-destructive behavior, transient psychotic episodes, emotional and verbal abuse of others, splitting (see below), magical thinking (beliefs that thoughts can cause events), omnipotence, projection of unpleasant characteristics in the self onto others and projective identification (trying to elicit in others the feelings s/he is having).

The etiology of BPD is still unknown. Some believe it to be a true personality disorder caused by childhood trauma, however current research is showing that it is may be a highly genetic, physical brain disorder.

Evidence is showing that the hippocampus, a crucial limbic system component, suffers a significant size reduction in people with BPD. This may partly explain the memory problems associated with BPD, since the hippocampus is a critical location for memory.

Some new statistics
BPD affects one in 50 people and one in five of those people are admitted to psychiatric units in the U.S. One in every 10 people with BPD will die by suicide. Most people have not even heard of the borderline personality disorder.
-http://www.mhsanctuary.com/borderline/

BPD rarely exists without other diagnoses. Attention Deficit Disorder is the most common. Asperger's Syndrome, temporal lobe dysfunction (Described as a "spaceyness" or "medicine head" feeling in those with BPD. In fact BPD's more severe symptoms are likely a form of temporal lobe epilepsy.), Generalized Anxiety Disorder, Obsessive Compulsive Personality Disorder, Obsessive Compulsive Disorder, Attention Deficit Hyperactive Disorder, rejection sensitivity (along with dysthymia), Panic Disorder, and Cyclothymia are some of the many that are made in conjunction with BPD.


DSM-IV criteria



The DSM-IV gives these nine criteria; a diagnosis requires that the subject present with at least five of these.

Traits involving emotions:

1. Shifts in mood lasting only a few hours.

2. Anger that is inappropriate, intense or uncontrollable.

Traits involving behavior:

3. Self-destructive acts, such as self-mutilation or suicidal threats and gestures that happen more than once. The cuts have to be bloody, and the scars bright red; its sometimes the only way to express the indescribable pain and torment in my mind and soul, that I go through every day of my pathetic existence on this planet.

4. Two potentially self-damaging impulsive behaviors. These could include alcohol and other drug abuse, compulsive spending, gambling, eating disorders, shoplifting, reckless driving, compulsive sexual behavior. Sometimes I feel too much, instead of an empty hole, I'm bleeding to death emotionally. Alcohol slows everything back to numb again. Then the numbness scares the hell out of me and I do something just to remind myself that I'm alive again. Rinse, Repeat.

Traits involving identity

5. Marked, persistent identity disturbance shown by uncertainty in at least two areas. These areas can include self-image, sexual orientation, career choice or other long-term goals, friendships, values. People with BPD may not feel like they know who they are, or what they think, or what their opinions are, or what religion they should be. Instead, they may try to be what they think other people want them to be.

6. Chronic feelings of emptiness or boredom. A deep hole in my stomach. An emptiness that I don't know how to fill.

Traits involving relationships

7. Unstable, chaotic, intense relationships characterized by splitting. The self and others are viewed as "all good" or "all bad." People are either the best or the worst, no concept of middle ground. Something which is all good one day can be all bad the next, which is related to another symptom: borderlines have problems with object constancy in people -- they read each action of people in their lives as if there were no prior context; they don't have a sense of continuity and consistency about people and things in their lives. They have a hard time experiencing an absent loved one as a loving presence in their minds. They also have difficulty seeing all of the actions taken by a person over a period of time as part of an integrated whole, and tend instead to analyze individual actions in an attempt to divine their individual meanings. People are defined by how they lasted interacted with the borderline. In the same sense of constancy borderlines have "emotional amnesia", they are so completely in each mood, they have great difficulty conceptualizing, remembering what it's like to be in another mood.

8. Frantic efforts to avoid real or imagined abandonment.
Alternating clinging and distancing behaviors (I Hate You, Don't Leave Me). Sometimes you want to be close to someone. But when you get close it feels TOO close and you feel like you have to get some space.
Great difficulty trusting people and themselves. Early trust may have been shattered by people who were close to you. Many borderlines were abused at a young age.
Sensitivity to criticism or rejection. Feeling of "needing" someone else to survive Heavy need for affection and reassurance (Some people with BPD may have an unusually high degree of interpersonal sensitivity, insight and empathy)

9. Transient, stress-related paranoid ideation or severe dissociation.

Think rollercoaster. Think everyday as a hectic journey of nauseating ups and terrifying downs with no end in sight and no way of opting out. Mix it with a nearly non existent attention span and total lose of objectivity. Now imagine you are seeing it projected in front of you with no ability to intervene. This is for me at least the best attempt I can make of explaining what the last decade of my life has been like.

Sometimes, most of the time, I think about what I have done, what my journey to adulthood was like and it scares me. It scares me that I could have gone through so much and suffered so much pain with no external influences at all. I have no one to blame no one to point the finger at and exorcise my demons into. No one but me and my flawed flawed reactions to external stimuli.

For years I trawled around doctors and shrinks and tried everything from acupuncture to Prozac. All of the drugs worked, worked for at least two weeks before the next cycle came back harder and blacker than ever before. Like a virus constantly evolving new strains it comes back worse and worse and goes up higher and higher. So now I have lamctial anti-epileptic mood stabilisers. They work to a certain extent; they have stolen my dreams and thrown me into this dazed version of life where all I can do is react, never act.

Would I go back to the temper tantrums and the dark hole I made my home? Never, in a million years. Sometimes I entertain thoughts that I could manage without all this chemical crap but then I look around and realise that all I would accomplish would be to make the people around me suffer again, even more.

So I am here following doctor’s orders and in retrospect I can say that yes, it is crippling illness but it has made me a much better person. I may over react and I may scream a little but at the end of the day I know where I am going, or at least in which direction I should be heading, I know who I am and what I am. Which is lot more than many other "normal" people could say.

Since the first time I found a web page describing Borderline Personality Disorder (last October, I think), I noticed a lot of similarities between how I felt and the symptoms.
 
That time last year I was feeling a lot more depressed, and when I tried an online self-test for BPD I ended up in the 'danger' category. Right now I guess I could get get away with describing myself as happy, which, on reflection, is a lot better than I expected I would be feeling now.  
Yet I still see a link between my behaviour and thoughts and the symptoms described above.
 
Although I don't notice at the time, if I look back on a day, I can usually see a lot of illogical mood shifts between being carefree and happy, to depressed and nearly suicidal. Usually, someone said something totally normal and innocent, and I took it the wrong way, and silently got angry, then decide its my fault and wonder what the point of living is.
 
And the main reason I'm feeling more relaxed is probably because I go out every Friday or Saturday night, and drown my sorrows with alcohol or cannabis.
 
At least I've managed to stop deliberately hurting myself (because I forced myself to throw away the blade i'd been cutting myself with). Infact, that's probably not the whole truth. I don't cut myself, but i still punch things, with the intent of hurting or cutting my hand. The thing is I don't know why I do it. I'm just fucked up.
 
Then again, I also see most of the symptoms of Asperger's Syndrome in myself. I always feel like I missed the class where we were taught how to interact socially. I'm hopeless at starting a conversation, and not much better at sustaining one. In a way that would make sense -- no one noticed I wasn't very good at making friends, and I was hiding away on IRC, and I got depressed. And even my dad once said to me how much more shy and withdrawn I became after my mum died. Not that I personally noticed it having a major effect on me, but I think it must have affected me somehow.
 
So either I'm a hyperchondriac or I've got some real issues. Heh, either way, I guess I've got problems.
 
Oh well. I'm done rambling on about how I feel now. At least it made me feel a bit better, even if I'm not too sure what use it is to Everything2.
The diagnosis made of Susanna Kaysen of Girl, Interrupted fame.

Another indicator of BPD, though not critical, is a history of sexual abuse.

A label for being rebellious, sometimes comforting the sufferer with the label, thereby questioning the desire to rebel. Perhaps the worst label doctors ever tried to stick on me. I'm more acknowledging of manic depression and suicidal tendencies (still a bit rash, though, IMHO). A few years ago it was dysthymia, so I guess I'm doing some mad psychiatric social climbing.

For me BPD means that I live in a society that does not give me proper outlets for self expression. It means that I have yet to find ways of self-regulation and that I a not always in control. Giving in is so painful, and this is what fuels the fight. It means that psychiatric disorders are not as romantic as we hype them up to be (Samuel Taylor Coleridge paid a mighty price for Kubla Khan), and that the ends do not always justify the means.

Having a psych disorder is like having the most intense love-hate relationship you can ever imagine because it is within yourself. The euphoria of mania is addictive and sometimes the only outlet for your creativity, but you live wondering whether or not you'll make it to the next cycle. Like a crazed Icarus, you fly into the sun drawn by it's energy, forfeiting the obvious: life.

BPD, to me, is not an excuse, probably because I refuse to honor it in the same way as I do manic depression. Perhaps psych disorders are, for me, more of an explanation of myself. My fallen muses and I act quite capriciously at times, butterflies not knowing the hurricanes we are stirring.

Borderline Personality Disorder

Life on the border... between neurotic and psychotic

Borderline Personality Disorder often occurs with at least 1 other mental disorder. The most common are mood disorders like Bipolar disorder (manic depression), OCD (obsessive-compulsive disorder), eating disorders, other personality disorders (includes Avoidant, Antisocial/Psychopathic, narcissistic, etc.), substance abuse or related disorders, Attention deficit disorder (ADD), and Attention deficit hyperactivity disorder (ADHD).

Facts and statistics

  • Sadly, about 10% of individuals with BPD will successfully complete suicide. For borderlines suffering from mood disorders, the rate is even higher.
  • The good news is that those who make it to their 30s and 40s usually experience increased stability.
  • BPD affects about 2% of the general population, 10% of people seeing outpatient psych. doctors, and 20% of patients in hospitals. Many borderlines will be hospitalized at some time during the course of the illness.
  • There is an increased risk of Borderline Personality Disorder among those with relatives with the disorder as well as those with Antisocial/Psychopathic Personality Disorder, subsstance-related disorders, and mood disorders.

MORE FACTS:

Famous borderlines:

  • Zelda Sayre Fitzgerald- author of "Save me the Waltz" (her autobiography), dancer, artist and wife of writer F. Scott Fitzgerald. She was said to be unusual. She nursed until she was 4, twirled and danced in public, and underwent heavy ballet training as an adult.However, she ended up spending most of her adult life in and out of hospitals and treatment and was originally diagnosed with schizophrenia and manic depression before being diagnosed with borderline personality disorder.
  • Susanna Kaysen - author of "girl, interrupted" the story of Susanna's stay in a psychiatric hospital as a late teen. She is also the author of many other books. Look her up!
  • Princess Diana

I have heard that there are many famous writers and artists that were borderlines. I will post them when I find out who they are!

What distinguishes Borderline from the other personality disorders?

  • Antisocial/Psychopathic Personality Disorder and Borderline Personality Disorder both share the trait of manipulation. But those with Antisocial Personality Disorder manipulate to gain profit and material gratification. Borderlines manipulate to gain the power and concern of other people.
  • Although Histrionic Personality Disorder consists of rapidly-shifting emotions, manipulative and attention-seeking behavior, Borderline Personality Disorder is distinguished by self-destructive behaviors, anger, and a feeling of deep emptiness.
  • Schizotypal Personality Disorder and BPD can both cause paranoid illusions and ideas, but those in BPD are far more transient.
  • Paranoid and Narcissistic Personality Disorders share with borderline the angry reaction to minor stimuli, but borderlines are distinguished by self-destructiveness, impulsivity, and abandonment issues.
  • Dependent Personality Disorder and BPD are both concerned with abandonment issues. However, while individuals with Dependent Personality Disorder react with increased submissiveness, urgently seeking a replacement relationship, borderlines react with anger and feelings of emotional emptiness. Additionally, borderline can be distinguished by its pattern of unstable and intense relationships.

What can friends and family do?

The best thing to do is stay informed, RESEARCH THE DISORDER, and be as patient and supportive as you can. Never give up, keep trying, because BPD affects everyone, not only the person with the illness. If necessary, talk to a professional who can give you tips of dealing with your significant other/friend/relative with the illness, or join a support group. It is important to take care of the person with the illness. But is important to take care of yourself too. Recommended reading can be found at http://www.mhsanctuary.com/borderline/bkindex.htm

Copy and paste the address into the address bar at the top of the screen.

RECOMMENDED READING

It is VERY important not only for borderlines, but also anyone involved with them to very well understand the disease! Read up! Just go to the library and check out a book!! Just do it! Recommended reading can be found at

http://www.mhsanctuary.com/borderline/bkindex.htm

Borderline Personality Disorders are traditionaly difficult to treat, However some new drugs have been approved for the treatment of several symptoms of the disorder.

Epival or Divalproex Sodium has been used to treat Epilipsy, Migrane headaches and the manic portion of Bi-Polar disorder. Doctors have found some success in treating the anxiety, aggression and unstable moods of Borderline patients with Epival. Patients taking this drug should be monitered closely and Epival serum levels taken regularily as to prevent blood toxicity.

Seroquel or Quetiapine is an anti-psychotic drug that is being used to treat Borderline patients to control the semi-psychotic aspects of the disorder and has been approved as a alternative to traditional anti-anxiety medications such as Ativan, Diazapam and other minor tranquilizers, as it is non addictive.

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