Friday, February 1, 2013

Borderline Personality Disorder

In the beginning of February 2013, my psychiatrist diagnosed me with Borderline Personality Disorder. My heart sunk. I had no idea what that actually meant for me. At first I was scared. And angry that I had yet another thing wrong with me. But he reassured me that he wasn't trying to chase down a new diagnosis. Rather he explained that the more I know about what is wrong with me, the more I can help myself. And as he described certain actions and words - "red flags" I had been throwing for months - it actually made sense. And it made me feel a little better in a way. Because there were some things I was feeling that weren't quite covered by the criteria of Bipolar Disorder. Such as the loss of my personal identity, the extreme internal agitation & rage, the self harm (cutting), impulsivity & suicidal tendencies, and so forth.. Knowing this information has given me a little insight into why I do certain things, how to avoid certain triggers & impulses, etc. It sucks that I have something like this wrong with me, but I really feel like knowing this is a blessing too. Gives me something to work with. This is just a basic background knowledge. I will elaborate more on my personal experiences in a separate blog entry.

For anyone unfamiliar with BPD, Mayo Clinic :
Borderline personality disorder (BPD) is a mental health disorder that generates significant emotional instability. This can lead to a variety of other stressful mental and behavioral problems.
With borderline personality disorder, you may have a severely distorted self-image and feel worthless and fundamentally flawed. Anger, impulsiveness and frequent mood swings may push others away, even though you may desire to have loving and lasting relationships.
Borderline personality disorder affects how you feel about yourself, how you relate to others and how you behave.
Signs and symptoms of borderline personality disorder may include:
  • Impulsive and risky behavior, such as risky driving, unsafe sex, gambling sprees or illegal drug use
  • Awareness of destructive behavior, including self-injury, but sometimes feeling unable to change it
  • Wide mood swings
  • Short but intense episodes of anxiety or depression
  • Inappropriate anger and antagonistic behavior, sometimes escalating into physical fights
  • Difficulty controlling emotions or impulses
  • Suicidal behavior
  • Feeling misunderstood, neglected, alone, empty or hopeless
  • Fear of being alone
  • Feelings of self-hate and self-loathing
When you have borderline personality disorder, you often have an insecure sense of who you are. Your self-image, self-identity or sense of self often rapidly changes. You may view yourself as evil or bad, and sometimes you may feel as if you don't exist at all. An unstable self-image often leads to frequent changes in jobs, friendships, goals and values.
Your relationships are usually in turmoil. You may idealize someone one moment and then abruptly and dramatically shift to fury and hate over perceived slights or even minor misunderstandings. This is because people with borderline personality disorder often have difficulty accepting gray areas — things seem to be either black or white. 

And the website : 
What is borderline personality disorder?
Borderline personality disorder is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed borderline personality disorder as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.
Because some people with severe borderline personality disorder have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name "borderline personality disorder" is misleading, a more accurate term does not exist yet.
Most people who have borderline personality disorder suffer from:
  • Problems with regulating emotions and thoughts
  • Impulsive and reckless behavior
  • Unstable relationships with other people.
People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.
According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have borderline personality disorder in a given year.
Borderline personality disorder is often viewed as difficult to treat. However, recent research shows that borderline personality disorder can be treated effectively, and that many people with this illness improve over time.

What are the symptoms of borderline personality disorder?

According to the DSM, Fourth Edition, Text Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms:
  • Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived
  • A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
  • Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices)
  • Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
  • Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
  • Intense and highly changeable moods, with each episode lasting from a few hours to a few days
  • Chronic feelings of emptiness and/or boredom
  • Inappropriate, intense anger or problems controlling anger
  • Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.
Seemingly mundane events may trigger symptoms. For example, people with borderline personality disorder may feel angry and distressed over minor separations—such as vacations, business trips, or sudden changes of plans—from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative meanings than people who do not have the disorder.

Suicide and Self-harm

Self-injurious behavior includes suicide and suicide attempts, as well as self-harming behaviors, described below. As many as 80 percent of people with borderline personality disorder have suicidal behaviors, and about 4 to 9 percent commit suicide.

More on BPD Suicide :

Unfortunately, suicidal behaviors and completed suicides are very common in individuals with BPD. Research has shown that around 70 percent of people with BPD will have at least one suicide attempt in their lifetime, and many will make multiple suicide attempts. People with BPD are more likely to complete suicide than individuals with any other psychiatric disorder. Between 8 and 10 percent of people with BPD will complete suicide; this rate is more than 50 times the rate of suicide in the general population.

Why is Suicide so Common in BPD?

There are several factors related to BPD that may explain why suicide is so common.
First, BPD is associated with very intense negative emotional experiences. These experiences are so painful that many people with BPD report that they would like to find a way to escape. They may use a number of different strategies to try to reduce the emotional pain (e.g., deliberate self-harm, substance use), including suicide. Also, BPD is a chronic condition; it usually lasts for years. Conditions that are more chronic may lead to more risk for suicide since they do not tend to get better quickly without treatment. This may leave people with BPD feeling that there is no other way out, despite the fact that there are now effective treatments available for BPD.
BPD is also associated with impulsivity, or a tendency to act quickly without thinking about consequences. This may be another reason that suicide is common in BPD; individuals with BPD may engage in suicidal behaviors in a moment of intense emotional pain without fully considering the consequences.
Finally, BPD often co-occurs with substance use. The use of drugs or alcohol is a risk factor for suicide alone. However, substance use issues combined with BPD may be a particularly lethal combination; substance use can lead to even greater impulsivity. And, people who are using substances have access to a means for overdose.

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