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Borderline Personality Disorder - Page 2

post #21 of 67
Thread Starter 
I wouldn't be surprised if I did suffer from PTSD, I don't feel comfortable writing my life story but it seems to have been one trauma after another. I also have a rather interesting family history full of mental issues.
post #22 of 67
I was going to say something along those lines. Complex PTSD and Borderline have a lot in common. I'm wondering how many of the people posting here experienced childhood trauma. I know I did. And the therapists I've seen addressed that fact, without giving me a specific diagnosis (though the last one was giving me stuff to read about complex PTSD). I can't understand why Borderline has such a bad reputation, if that makes any sense. If people (especially women) develop a constellation of symptoms and behaviors because they experienced a trauma (or a series of traumas), why is that so inexcusable? Why is BPD seen as more difficult to treat than other disorders?
post #23 of 67
^It's more difficult to treat because "Borderlines" are notoriously bat sh** crazy. If you relate to Borderline Personality Disorder criteria you know exactly what I'm talking about. It's pretty difficult to help someone who reacts impulsively with self injury, you know?

Quote:
Originally Posted by Vishapmama View Post
This is kind of a "garbage can" category for some groups of psychologists that means, essentially, that a female patient is difficult and particularly challenging to work with.
The demographics are about 3/4 women, right? As far as successful suicides go men blow women out of the water. They complete suicides at 5x the rate of women.

Is it possible that instead of going "bat sh** crazy" with suicide attempts and self-injury men instead live silently with the same psychological anguish & eventually terminate themselves?

"Bucket" terms are useful to quickly communicate the origins of someone's unease. It's not some anti feminisit conspiracy, you know? PTSD? Depression? etc

Anyway, I'm going to recommend again Marcia Linehan's book: http://faculty.washington.edu/linehan/

The politics of BPD aside, since you already feel you relate to the diagnosis pot, this book will help you understand, heal and change.




This is really important: What's important about correct diagnosis is that if somone is bipolar and prescribed antidepressants (as might be for someone who is "borderline"), the SSRI's can cause bipolar symptoms to be worse

So please, please be open & trust your instincts with any diagnosis. Moods are physical... if you have a mood disorder you'll literally feel enveloped physically. "Borderline" is your mind.
post #24 of 67
Quote:
Originally Posted by doublewhammy View Post
Complex PTSD and Borderline have a lot in common. I'm wondering how many of the people posting here experienced childhood trauma.

Yeah, they're pretty similar. It makes sense, doesn't it?
post #25 of 67
People who self injure can and are helped. Self injury does not make one crazy or unreachable, it merely means someone is hurting intensely. The fact is that people do recover from self injury. Its a reaction to internal pain, not an incurable disease. -Oubliette
post #26 of 67
Hi Carley. Do you know how and who has actually compiled the DSM-4? Mostly men who are interested in applying a medical model to problems of living that are often existential and cannot be reduced. It's geared more towards the requirements of insurance companies than the needs of people.

Yes, perhaps men are not adequately represented in the statistics because they are more successful at killing themselves. Perhaps not. Perhaps men who are living their lives in the aftermath of severely difficult, abusive family situations are more frequently given a different diagnostic label like "narcissistic personality" or "schizoid personality". Gender plays a huge role in how Axis-II diagnoses are applied, and hence I have cause to be wary. Some problems of living that people have can be narrowed down to organic causes. Others cannot. There is no viral antecedent to a Borderline Personality, and hence, no clearly defined path of treatment. This makes medically-minded mental health professionals feel helpless, anxious, and angry.

Applying an Axis II diagnostic label is just not helpful to the patient. In all my years of practice, I have never once heard a mental health professional refer to someone as "borderline" in a way that reflects some empathy, or even certainty as to how the individual might be helped. What it usually means is that the patient is most often a female (or gay man) who comes from a history of severe abuse, neglect, or deprivation; that the individual has a tendency to act out interpersonally; that the cookie-cutter so-called "empirically-driven" 10 to 30 therapy sessions that insurance will pay for are probably not going to get to the core of the problem; and that in many ways, as a clinician you are going to be frustrated in your inability to hold and contain the patient's affective states. Furthermore, the "medical model" that the psychological professions have been trying to fit into just doesn't work well with the problems of living that have come to be associated with Axis II personality disorder diagnoses. For Axis-I issues (mood disorders, depression, bipolar, and so forth), you can give a pill or tweak medications to alleviate symptoms. There are different things one can "do". While a mood disorder can often accompany a "personality disorder", and symptoms of depression and anxiety can be lessened, the fact of the matter is that there aren't easy solutions for the difficulties in living, working, and loving that develop in the aftermath of a difficult, abusive upbringing.

Here's a link to an excellent, albeit difficult-to-read (due to content, not writing style) article on the History of Child Abuse by Lloyd de Mause:

http://www.psychohistory.com/htm/05_history.html

In it, de Mause clearly states his belief that Borderline symptoms are sequellae of particular kinds of early psychological injury, and that throughout history, what are now labeled personality disorders have existed and have taken the particular guises of particular temporal and cultural contexts.

As I wrote earlier, the upcoming version of the Diagnostic and Statistical Manual will have many changes in the Axis II diagnostic criteria. It just simply doesn't work as it currently is.
post #27 of 67
http://www.time.com/time/magazine/ar...870491,00.html

I read this article a while back, and found it to be disturbing.
post #28 of 67
Thread Starter 
Quote:
Originally Posted by Carley View Post
^This is really important: What's important about correct diagnosis is that if somone is bipolar and prescribed antidepressants (as might be for someone who is "borderline"), the SSRI's can cause bipolar symptoms to be worse

So please, please be open & trust your instincts with any diagnosis. Moods are physical... if you have a mood disorder you'll literally feel enveloped physically. "Borderline" is your mind.
Thank you for your post. For some of my problems I feel I can get a grip on it. Like the self injury, I haven't cut since before I met my husband, but they're have been rages where I've scratched myself or hit my head against a wall. For my moods, the rage to depression to just plain numbness, I feel like I have no control over it. I can mentally acknowledge that I have no reason to be so angry/anxious/depressed/want to hurt myself and see that but my head won't let me out of the feeling. I feel trapped in my head and at the will of my emotions.
post #29 of 67
Thread Starter 
Quote:
Originally Posted by Breathless Wonder View Post
http://www.time.com/time/magazine/ar...870491,00.html

I read this article a while back, and found it to be disturbing.
I found it comforting? There were some disturbing parts but the overall picture made me feel comforted in knowing if that is the problem I can get better.
post #30 of 67
Quote:
Originally Posted by Carley
Moods are physical... if you have a mood disorder you'll literally feel enveloped physically. "Borderline" is your mind.
Carley,

As someone who has a set of symptoms that fit with either complex PTSD and BPD, I can tell you that when you say mood disorders are physical and you feel enveloped but that borderline is in your mind, that is wholly incorrect. And even dismissive of BPD. Whether the original dysfunction is chemical or emotional, the result is the same; a chemical war in the body, which overtakes the whole person, mind and body.

Quote:
Originally Posted by Carley
I think for a motivated person, Borderline Personality Disorder can be easily "fixed" & moved on from.
It isn't just a matter of wanting therapy and then going to therapy to "solve" BPD/PTSD. You can REALLY want to get better, but are unable to for years. Decades, even. It almost places the blame upon the individual afflicted with BPD to say that they could get better if they REALLY wanted to, and if they aren't getting better then what? I guess they didn;t want it bad enough?


ALSO

BPD is a garbage can diagnosis for the most part. The only real use it has is for one shrink to tell another shrink shorthand, that they have a PITA for a patient. If someone is diagnosed with PTSD they are seen as a person with a reaction to a horrible situation, and needs help. If someone is dx with BPD, they are a pain in the butt and will be turned away by many psychologists as untreatable. And like "hysteria," there are misogynistic undertones to the diagnosis.
post #31 of 67
Quote:
Originally Posted by Oubliette8 View Post
People who self injure can and are helped. Self injury does not make one crazy or unreachable, it merely means someone is hurting intensely. The fact is that people do recover from self injury. Its a reaction to internal pain, not an incurable disease. -Oubliette

As a person who hasn't self-injured in 10 years I'm well aware complete recovery is possible, both with self-injury and ALL of the other dis ease summarized by Borderline Personality Disorder.

11-17 years prior, however, I thought "noone understood me." I would cut, threaten or attempt suicide or later, insist on being institutionalized to "protect myself" if the "wrong thing" was said. A therapist or social worker who told me I had the power to stop cutting would give me a "reason" to act out.

Pretty impossible. One has to be motivated to recover. Sometimes it takes people a long time to "get the net" & meanwhile they go bat sh** crazy when they're "set off."
post #32 of 67
Quote:
Originally Posted by geekgolightly View Post
I can tell you that when you say mood disorders are physical and you feel enveloped but that borderline is in your mind, that is wholly incorrect. And even dismissive of BPD. Whether the original dysfunction is chemical or emotional, the result is the same; a chemical war in the body, which overtakes the whole person, mind and body.


BPD is a garbage can diagnosis for the most part. The only real use it has is for one shrink to tell another shrink shorthand, that they have a PITA for a patient.

If someone is dx with BPD, they are a pain in the butt and will be turned away by many psychologists as untreatable. And like "hysteria," there are misogynistic undertones to the diagnosis.

There are physical symptoms of the stress and anxiety when someone "has" BPD or PTSD. They are physically different from the mood actions of a mood disorder. Someone with BPD has pain that can be healed. Someone with a mood disorder cannot be healed. They have the moods no matter how many therapy sessions. They have the moods no matter how healed they are, no matter their circumstances. That's not dismissive, it's true.

& yeah, some psychologists don't want to treat someone summarized by "Borderline." Psychologists are human too. They might have their own sh** when it comes to "Borderline." Maybe their Mommy had it & they wouldn't be able to treat it without their sh** interfearing. They have the right to choose patients. If that's too much for their practice they refer. Hence, some psychologists specialize in BPD. Some specialize in PTSD. Some work in county hospitals. Again, humans with different experiences/interests.

http://dictionary.reference.com/browse/dia
http://dictionary.reference.com/browse/gnosis

If you're symptoms are summarized as "Borderline" then you can relate to why someone would consider your actions a PITA. If you're not a PITA and want to recover it will be apparent.
post #33 of 67
Quote:
Originally Posted by Vishapmama View Post
Hi Carley. Do you know how and who has actually compiled the DSM-4?


What it usually means is that the patient is most often a female (or gay man) who comes from a history of severe abuse, neglect, or deprivation; that the individual has a tendency to act out interpersonally; that the cookie-cutter so-called "empirically-driven" 10 to 30 therapy sessions that insurance will pay for are probably not going to get to the core of the problem; and that in many ways, as a clinician you are going to be frustrated in your inability to hold and contain the patient's affective states.

For Axis-I issues (mood disorders, depression, bipolar, and so forth), you can give a pill or tweak medications to alleviate symptoms. There are different things one can "do".
1) yeah, I know all about it. DSM/psychaitry/pharmaceutical industry was my area of interest in college.

2) Yep, that's exactly what it means. I don't blame anyone for not wanting to take on a Borderline patient. Do you? How effective would treatment be if the phsycologist treating wasn't into it? I'd much rather find someone who takes interest hence willing to try different treatments (like DBT)

3) Exactly.


Have you heard of DBT? Marcia Lenihan? There are clearly people interested in developing effective treatments - hence effective treatments are out there.

Psychologists who don't keep up with modern research aren't worth persuing unless one believes are desires an "old school" treatment. The same to medical doctors. I don't see any conspiracy here. I see people.
post #34 of 67
I just read the time article.

Quote:
Originally Posted by Vishapmama View Post
There is no viral antecedent to a Borderline Personality, and hence, no clearly defined path of treatment. This makes medically-minded mental health professionals feel helpless, anxious, and angry.
"Therapeutic advances have changed the landscape. Since 1991, as Dr. Joel Paris points out in his 2008 book, Treatment of Borderline Personality Disorder, researchers have conducted at least 17 randomized trials of various psychotherapies for borderline illness, and most have shown encouraging results. According to a big Harvard project called the McLean Study of Adult Development, 88% of those who received a diagnosis of BPD no longer meet the criteria for the disorder a decade after starting treatment. Most show some improvement within a year."

"It was Linehan who changed all that. In the early 1990s, she became the first researcher to conduct a randomized study on the treatment of borderline personality disorder. The trial — which showed that a treatment she created called "dialectical behavior therapy" significantly reduced borderlines' tendency to hurt themselves as well as the number of days they spent as inpatients — astonished a field that had come to see borderlines as hopeless"


http://www.time.com/time/magazine/ar...870491,00.html


I think this is an awesome article. I don't see how hope and effective treatments could be disturbing. Goes to show how different all people are. One person reads this article & sees hope. Another reads this article & sees a reason to be disturbed. Perception, motivation etc.
post #35 of 67
Quote:
Originally Posted by Right of Passage View Post
For my moods, the rage to depression to just plain numbness, I feel like I have no control over it. I can mentally acknowledge that I have no reason to be so angry/anxious/depressed/want to hurt myself and see that but my head won't let me out of the feeling. I feel trapped in my head and at the will of my emotions.

That is exactly how Bipolar disorder is different from "Borderline." You can't talk yourself out of a bad mood. It's physically there no matter your will.

When I was unmedicated I remember watching my daughter play & crying. My mood was so depressed yet my mind was so appreciative of my daughter. It's totally physical, it's not in your "Mind" it's in your Brain. My mania was paranoid and crazy. I could talk myself out of wild antics, but I would pace around my house shaking like Parkinsons from the physical Mood of mania. I could literally not sit down. I would physically jump and shake.

The moods of Bipolar disorder cannot be "snapped out of." One can talk themselves out of suicide or behaviors, but the moods will still cycle. Someone with Bipolar disorder is physically enveloped in a Mood regardless of anything but the proper medication. Therapy is for behaviors and patterns of thoughts. Someone with Bipolar disorder must change their behaviors and patterns of thoughts, but unless medicated they will continue to be physically overtaken by moods.
post #36 of 67
Quote:
Originally Posted by Carley View Post
There are physical symptoms of the stress and anxiety when someone "has" BPD or PTSD. They are physically different from the mood actions of a mood disorder. Someone with BPD has pain that can be healed. Someone with a mood disorder cannot be healed. They have the moods no matter how many therapy sessions. They have the moods no matter how healed they are, no matter their circumstances. That's not dismissive, it's true.
You didn't mention physical symptoms, you said it was all "mental." There are certainly other physical symptoms than "stress and anxiety."

It's true that "all" ptsd's and bpd's have to do is some therapy and then they are "healed." Isn't it also true that "all" a bipolar has to do is take some pills and then magically they are better.

Or is that too dismissive?

Quote:
& yeah, some psychologists don't want to treat someone summarized by "Borderline." Psychologists are human too. They might have their own sh** when it comes to "Borderline." Maybe their Mommy had it & they wouldn't be able to treat it without their sh** interfearing. They have the right to choose patients. If that's too much for their practice they refer. Hence, some psychologists specialize in BPD. Some specialize in PTSD. Some work in county hospitals. Again, humans with different experiences/interests.
I think you might be idealizing the reaction that psychologists have to BPD. It is rare that the negative reaction is related to something personal. It's that BPD patients are extremely difficult to treat and it is the rare therapist indeed who is willing to take it on wholeheartedly.

I have wonderful in-laws, both of whom are psychologists and you should hear the crap they say about borderlines. It's horrific. And they do it in front of me! I know they don't see me as one of those patients, as I am for the most part healed, but it's very difficult to hear two wonderful, competent and usually empathic people sit and discuss how awful this patient population is and make fun of the things that they do.



Quote:
If you're symptoms are summarized as "Borderline" then you can relate to why someone would consider your actions a PITA. If you're not a PITA and want to recover it will be apparent.
If someone attends therapy, they want to recover. How difficult the road will be to recovery depends upon the degree of the trauma and the steps which have already been taken. The difficulty of the patient has nothing to do with the desire to be healed.
post #37 of 67
Quote:
Originally Posted by Carley View Post
That is exactly how Bipolar disorder is different from "Borderline." You can't talk yourself out of a bad mood. It's physically there no matter your will.

When I was unmedicated I remember watching my daughter play & crying. My mood was so depressed yet my mind was so appreciative of my daughter. It's totally physical, it's not in your "Mind" it's in your Brain. My mania was paranoid and crazy. I could talk myself out of wild antics, but I would pace around my house shaking like Parkinsons from the physical Mood of mania. I could literally not sit down. I would physically jump and shake.

The moods of Bipolar disorder cannot be "snapped out of." One can talk themselves out of suicide or behaviors, but the moods will still cycle. Someone with Bipolar disorder is physically enveloped in a Mood regardless of anything but the proper medication. Therapy is for behaviors and patterns of thoughts. Someone with Bipolar disorder must change their behaviors and patterns of thoughts, but unless medicated they will continue to be physically overtaken by moods.

The moods of borderline can not be snapped out of. I have watched my son doing normal toddler things and KNOW they are normal toddler things and have screamed at him. I have watched my son happily play and I have wanted desperately to join in and play with him and just be happy, but have been absolutely physically unable to do so. I know, I can see myself and how ridiculous it is for me to sit there like a lump, but I can not help the way I feel. I would walk around the house shaking over a simple statement my husband made (No, I don't want to go take a nap with you right now) , and fight to very strong desire to get a knife and cut my heart out, hysterically crying, hands shaking unable to do anything except cry and vomit. And all the while watching myself from the outside thinking that I was being ridiculous, but my BODY was trapping me into those emotions. I could not stop myself. I have to cycle out of it just like I cycled in it.

And I definitely do not have bipolar. I was med free then, took some wellbutrin for a while and therapy (again) and finally was able to get the worst of it out of my body. I weaned from wellbutrin about a year and a half ago and have not had any episodes since. It was the right time for therapy, with the right therapist, and all the prior steps I had taken to healing helped me get to that point.
post #38 of 67
Carley, yes. I know Dr. Linehan's work, and while I do not practice DBT or any other type of "BT", I know it is helpful for some individuals with particular symptom profiles and at particular times in their lives. I would not advise anyone to refrain from entering DBT treatment, or any other treatment or activity with the intention of feeling better and living full, happy, productive lives.

And yes, I do work with women who have what can be described as the full spectrum of "Borderline" features. I welcome these women and I find working with them challenging as well as profoundly rewarding.

I guess what I'm saying is that, regardless of what is done to help with dysfunctional behaviors, thoughts, and moods, unless the underlying trauma is addressed, there is enough compelling evidence that the symptoms will likely re-emerge at stressful times in life, transitions, losses, major changes, etc.
post #39 of 67
Quote:
Originally Posted by geekgolightly View Post
You didn't mention physical symptoms, you said it was all "mental." There are certainly other physical symptoms than "stress and anxiety." ... Or is that too dismissive?

It's that BPD patients are extremely difficult to treat and it is the rare therapist indeed who is willing to take it on wholeheartedly.

I have wonderful in-laws, both of whom are psychologists and you should hear the crap they say about borderlines. It's horrific. And they do it in front of me! I know they don't see me as one of those patients, as I am for the most part healed, but it's very difficult to hear two wonderful, competent and usually empathic people sit and discuss how awful this patient population is and make fun of the things that they do.

I summarized. I'm definitely not dismissive. Remember, I too had a traumatic childhood, lived for years with a "Borderline Personality" AND I have Bipolar I Disorder. Clearly I'm hitting a nerve... let me see if I can better communicate my perspective (i.e. I'm not trying to "change your mind" I think the dialogue is interesting) via analogy.

Alcoholism, like Borderline Personality Disorder, is a disease (a dis ease) that is a culmination of psychological & environmental factors & probably a genetic disposition. Treatment requires the alcoholic to feel "their life has become unmanagable" and desire to change. They have physical symptoms of withdrawl and physically compelled to drink. They have to have the will to stop drinking.

It's a rocky road. They might not get sober right away. They might not stay sober. They might have 3 years sobriety under their belts only to slip back into drinking. They must always examine their thoughts from the perspective of an alcoholic. Having an "Addictive Personality" or "Codependant Personality" means they have to be careful in certain situations or they'll act in ways that are detrimental to themselves. Through behavior modification, however, they can move beyond the pain and live whole lives.

In the end it's up to them; not their family, not their sponser, not their doctor. It's not easy, but it's true. How difficult the road will be to recovery depends upon the degree of the trauma, the steps which have already been taken and the will of the individual.

Parkinsons, like Bipolar Disorder, is a neurological disease that causes a mood disorder. Its cause is neurological, probably some gene or genetic mutation. Treatment with medication, theraputic support, sleep, nutrition etc can alleviate symptoms but there is no cure. No amount of will, medication, therapy, sleep, nutrition will make Parkinsons go away. It takes will to survive and live with any degenerative disease (such as Bipolar disorder and Parkinsons), but the will doesn't make the disease go away.


This isn't apples to apples here. The two get confused because they have similar symptoms, but clearly they are completely different animals.

The physical symptoms of Parkinsons are caused by a neurological disease. The physical symptoms of alcoholism are caused by alcoholism.


Do you believe it's possible for situations to have both tragic and humorous qualities? Is it possible for people to have empathy and fustration?

Psychologists are no different from the rest of us except that they listen to the rest of us talk about our problems. You clearly recognize how extremely difficult a "Borderline Personality" is to treat. Can you have empathy with the people who have chosen the occupation to try? I can't imagine. I think Linehan is some kind of saint.



I'm Bipolar & was "borderline" since I was about 9. I've done some pretty outrageous things, and in retrospect most of them were pretty hillarious. I definitely would have laughed at myself behind my back in ADDITION to having empathy.


The man who lives next door to me is a drunk. I feel really bad for him... he's seriously imparied. However, he can also be hillarious. He's simultaneously tragic and humorous. Too bad for him.
post #40 of 67
Quote:
Originally Posted by geekgolightly View Post
The moods of borderline can not be snapped out of.

but my BODY was trapping me into those emotions. I could not stop myself. I have to cycle out of it just like I cycled in it. And I definitely do not have bipolar.

I weaned from wellbutrin about a year and a half ago and have not had any episodes since. It was the right time for therapy, with the right therapist, and all the prior steps I had taken to healing helped me get to that point.

In your first sentance you're saying the moods of borderline cannot be snapped out of, and in your last sentance you're saying that you have snapped out of it.

You felt your life had become unmanageable, you sought treatment, you stuck with treatment and now you're healed. Your doctor prescribed you an anti-depressant to help manage your physical symptoms while you worked through the underlying cause of your dis ease.

I understand you're eager to compare your "Cycling" with the cycling of Bipolar Disorder, but pathologizing yourself & taking the responsibility and accountablity out of your actions of isn't going to help your path to wellness. It's really a detriment.


ETA: I don't know a mom who hasn't yelled at her kids for doing normal kid stuff. People are people, no matter how "crunchy" you aspire to be... you know?
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