Presentation by Engineer Ishrat Hussain Mohammad Dubai. U.A.E. March 2014.
Borderline Personality and Muslims.
Muslims and Borderline personality disorder.
Islam and Borderline personality disorder.
Emotional control disorder.
The topic of this blog is Borderline personality disorder and Muslim community, this psychological disorder is such that the person who is suffering from this disorder is seen as normal person in the society and this is the biggest thing which is the cause of the trouble and sufferings.
Most of the time we assume that everybody in the society is normal and if somebody behaves abnormally then we and our society and even our police and the courts and legal system assumes that person to be normal and we treat with him like an ordinary normal person, the police and legal courts and judges punish these peoples, this is the worst case in the name of law and justice.
Actually there may be peoples around us whom we assume to be normal but they may not be normal, and one of these abnormalities is Borderline personality disorder.
The Borderline personality disorder is not madness, the person suffering from this disease is not idiot and stupid and he very often have high IQ, his intellect is intact, the only problem is in his emotion control mechanism, the sufferer cannot control his emotions, and this is not his fault, all this is due to the mental signal processing fault of his brain, and this leads him to behave in that abnormal manner.
And his sickness causes other sister disorders in him, such as avoidant personality disorder, dependant personality disorder and so on due to his psychological thoughts and consequences.
Now I will try to summarize the symptoms and details and characteristics of Borderline personality disorder in this blog.
Today all over in the world the Muslims are seen as terrorists and madmen, maybe there are some persons in us who might have done some nonsense due to their impulsivity and disease, we must not blame them but to understand them.

I am presenting data and information from various blogs and websites….
This is a long page where you will find solution and treatment to your problem, this disorder has cure and it is not madness and it is curable.
Read the symptoms and characteristics and the stories of BPD sufferers.
How common are borderline and narcissistic personality disorders?
According to the largest study ever conducted on personality disorders (PD) by the U.S. National Institutes of Health (NIH), 5.9% of the U.S. population has BPD (Grant et al. 2008) and 6.2% has NPD (Stinson et al. 2008). As some people fit both diagnoses, about 10 percent of the U.S. population has BPD and/or NPD.
Of the people meeting the criteria for a BPD diagnosis, 53 percent were women and 47 percent were men (Grant et al. 2008). Of the people meeting the criteria for NPD, 62 percent were men and 38 percent were women (Stinson et al. 2008).
Your partner could have either disorder—or both. Almost 40 percent of people with one of these disorders also have the other, according to the NIH study (Grant et al. 2008; Stinson et al. 2008).  Many more people have traits of a PD, but not the full disorder. Therefore, the number of people with some of these problems may be even higher.
(From Splitting: Protecting Yourself When Divorcing a Borderline or Narcissist by Bill Eddy and Randi Kreger)

What is borderline personality disorder?
According to the National Institute of Health, people with BPD often have highly unstable patterns of social relationships. While they can develop intense but stormy attachments, their attitudes towards family, friends, and loved ones may suddenly shift from idealization (great admiration and love) to devaluation (intense anger and dislike). Thus, they may form an immediate attachment and idealize the other person, but when a slight separation or conflict occurs, they switch unexpectedly to the other extreme and angrily accuse the other person of not caring for them at all.
With family members, individuals with BPD are highly sensitive to rejection, reacting with anger and distress to such mild separations as a vacation, a business trip, or a sudden change in plans. These fears of abandonment seem to be related to difficulties feeling emotionally connected to important persons when they are physically absent, leaving the individual with BPD feeling lost and perhaps worthless. Suicide threats and attempts may occur along with anger at perceived abandonment and disappointments.
People with BPD exhibit other impulsive behaviors, such as excessive spending, binge eating and risky sex. BPD often occurs together with other psychiatric problems, particularly bipolar disorder, depression, anxiety disorders, substance abuse, and other personality disorders.
People with BPD come in two commonly overlapping categories, and which type you're dealing with determines which struggles you will likely face. To be flip about it, individuals in the first category seek therapy and individuals in the second category provoke others to seek therapy.

Why do people with BPD act so differently?
People with BPD have similar thoughts and emotions, but their behavior differs depending on how they cope and what other co-occurring disorders might be present.
The overlapping types are lower-functioning conventional, higher-functioning invisible, and combination.
Characteristics of lower-functioning,"conventional" BPs:
They are driven by four primary fears:
1. Fear of being ignored
2. Fear of being belittled or publicity exposure
3. Fear of being abandoned
4. Fear of being dominated, includes fear of losing control over you, the other spouse, their money/assets, or themselves

1. They cope with pain mostly through self-destructive behaviors such as self-injury and suicidality. The term for this is"acting in."
2. They acknowledge they have problems and seek help from the mental health system, often desperately. Some are hospitalized for their own safety.
3. They have a difficult time with daily functioning and may even be on government disability. This is called low functioning.
4. If they have overlapping, or co-occurring, disorders, such as an eating disorder or substance abuse, the disorder is severe enough to require professional treatment.
5. Family members' greatest challenges include finding appropriate treatment, handling crises (especially suicide attempts), feelings of guilt, and the financial burden of treatment. Parents fear their child won't be able to live independently.
Because lower-functioning conventional BPs seek mental health services, unlike the higher-functioning invisible BPs we'll talk about next, they are subjects of research studies about BPD, including those about treatment.
Higher-functioning, invisible BPs:
1. They strongly disavow having any problems, even tiny ones. Relationship difficulties, they say, are everyone else's fault. If family members suggest they may have BPD, they almost always accuse the other person of having it instead.
2. They refuse to seek help unless someone threatens to end the relationship. If they do go to counseling, they usually don't intend to work on their own issues. In couple's therapy, their goal is often to convince the therapist that they are being victimized.
3. They cope with their pain by raging outward, blaming and accusing family members for real or imagined problems.
4. They hide their low self-esteem behind a brash, confident pose that masks their inner turmoil. They usually function quite well at work and only display aggressive behavior toward those close to them. Family members say these people bring to mind Dr. Jekyll and Mr. Hyde.
5. If they also have other mental disorders, they're ones that also allow for high functioning, such as narcissistic personality disorder (NPD).
6. Family members' greatest challenges include coping with verbal, emotional, and sometimes physical abuse; trying to convince the BP to get treatment; worrying about the effects of BPD behaviors on their other children; quietly losing their confidence and self-esteem; and trying—and failing—to set limits. By far, the majority of Welcome to Oz (WTO) members have a borderline partner.
BPs with overlapping characteristics:
Many BPs (perhaps a majority) possess characteristics of both lower-functioning conventional BPs and higher--functioning invisible BPs. Get Me Out of Here Author Rachel Reiland is typical of a BP with overlapping characteristics. When she insinuated she was going to shoot herself, her psychiatrist admitted her to a psychiatric hospital. Yet she held a job as a full-time mother and was active in church. Although she acted out toward her husband and psychiatrist, she was able to appear non-disordered toward most people outside her family.

SYNOPSIS
Emotionally Unstable [Borderline] Personality Disorder F60.3 - ICD10 Description, World Health Organization

Emotionally unstable [borderline] personality disorder is characterized by a definite tendency to act impulsively and without consideration of the consequences; the mood is unpredictable and capricious. There is a liability to outbursts of emotion and an incapacity to control the behavioural explosions. There is a tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or censored. Two types may be distinguished: the impulsive type, characterized predominantly by emotional instability and lack of impulse control, and the borderline type, characterized in addition by disturbances in self-image, aims, and internal preferences, by chronic feelings of emptiness, by intense and unstable interpersonal relationships, and by a tendency to self-destructive behaviour, including suicide gestures and attempts.
Borderline Personality Disorder - Diagnostic Criteria, American Psychiatric Association

An individual diagnosed with borderline personality disorder needs to show at least 5 of the following criteria:
• Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior here.)

• A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

• Identity disturbance: markedly and persistently unstable self-image or sense of self.

• Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating). (Note: Do not include suicidal or self-mutilating behavior here.)

• Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

• Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

• Chronic feelings of emptiness.

• Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

• transient, stress-related paranoid ideation or severe dissociative symptoms.
Like all personality disorders, emotionally unstable [borderline] personality disorder is a deeply ingrained and enduring behaviour pattern, manifesting as an inflexible response to a broad range of personal and social situations. This behavior represents an extreme or significant deviation from the way in which the average individual in a given culture relates to others. This behaviour pattern tends to be stable. It causes subjective distress and problems in social performance.
Core Features
Individuals with borderline personality disorder grow up being emotionally unstable, hostile and impulsive. The core features of this disorder are: (1) negative emotions(emotional lability, anxiety, separation insecurity, depression, suicidal behavior), (2) antagonism (hostility), and (3) disinhibition (impulsivity, risk taking). This disorder is only diagnosed if: (1) it begins no later than early adulthood, (2) these behaviors occur at home, work, and in the community, and (3) these behaviors lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Lack Of Social Skills And Personality Disorders
There are social skills that are essential for healthy social functioning. Individuals with borderline personality disorder lack the essential social skills of emotional stability,stable self-image, and social stability. They lack chastity and caution (that are also lacking in individuals with histrionic personality disorder), and lack control of anger(that is also lacking in antisocial personality disorder).
Social Skills That Are Lacking In Borderline Personality Disorder
SOCIAL SKILL LOW LEVEL HIGH LEVEL
Emotional Stability Emotional instability (emotions change rapidly and unpredictably) Having a predictable mood which does not quickly change
Stable Self-Image Unstable self-image Being certain about “who-am-I” and “where-am-I-going-in-life”; having meaning & purpose to life
Social Stability Social Instability (relationships are unstable, chaotic, and rapidly changing) Having a stable and peaceful social life
Chastity Desire for casual or illicit sex Avoidance of casual sex (“one night stands”) AND absence of intense desire for illicit sex
Caution Harmful impulsiveness (acting without forethought or concern for consequences) Thinking carefully before acting or speaking; being cautious
Control of Anger Hostility (often angry or hostile) Absence of anger or irritability in response to minor slights; absence of mean or vengeful behavior

Antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, and borderline personality disorder are so closely related that they are referred to as the "antagonistic" cluster of personality disorders.
Social Skills That Are Lacking In The "Antagonistic" Cluster Of Personality Disorders
PERSONALITY DISORDER LACKING LACKING LACKING
Antisocial Personality Respect (instead has disrespect) Responsibility (instead hasirresponsibility) Honesty (instead has dishonesty)
Narcissistic Personality Humility (instead has arrogance) Cooperation or Generosity (instead has being manipulative or greedy) Kindness (instead has callousness)
Borderline Personality Emotional Stability (instead hasemotional instability) Stable Self-Image (instead hasunstable self-image) Social Stability (instead has social instability)
Histrionic Personality Genuineness (instead has attention-seeking) Chastity (instead has desire for casual or illicit sex) Caution (instead has harmful impulsiveness)

Social Functioning
Individuals with borderline personality disorder have intense, unstable close relationships, which alternate between extremes of idealization and devaluation. They often make frantic efforts to avoid real or imagined abandonment.
Negative Emotion & Antagonism
Individuals with borderline personality disorder have marked negative emotions. They have frequent and intense experiences of high levels of a wide range of negative emotions (e.g., anxiety, depression, guilt/shame, worry). Antagonism: like many young teenagers, adults with this disorder have highly changeable moods and intense anger. Characteristically, these intense emotional episodes last only a few hours and only rarely more than a few days. The individual usually goes from one emotional crisis to another. Self harm and repeated, impulsive suicide attempts are seen in the more severely ill.

Borderline personality disorder is quite different from bipolar I disorder. The mood swings seen in borderline personality disorder seldom last more than one day. Mood swings in bipolar I disorder last much longer. Borderline personality disorder doesn't exhibit the prolonged episodes of decreased need for sleep, hyperactivity, pressured speech, reckless over-involvement, and grandiosity that are characteristic of bipolar I disorder.
Negative Emotion
o Emotions spiral out of control, leading to extremes of anxiety, sadness, rage, etc.
o Has extreme reactions to perceived slights or criticism (e.g. may react with rage, humiliation, etc.).
o Expresses emotion in exaggerated and theatrical ways.
o Emotions change rapidly and unpredictably.
o Feels unhappy, depressed, or despondent.

Antagonism
o Intense anger, out of proportion to the situation at hand (e.g. has rage episodes).
o Often angry or hostile.

Borderline Traits
As well as having unstable emotional functioning and unstable interpersonal functioning; individuals with borderline personality disorder have a poorly developed, orunstable self-image, often associated with excessive self-criticism, chronic feelings of emptiness, and dissociative states under stress. Thus the main characteristic of this disorder is its instability. It has been argued that, rather than being a personality disorder, this disorder is just a delayed, unstable state of normal personality development. Individuals with this disorder appear to be having a developmental delay in passing through the emotionally turbulent phase of adolescence. Thus, in their twenties, they have the maturity of a young teenager.
Borderline Traits
o Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior.)
o A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
o Identity disturbance: markedly and persistently unstable self-image or sense of self.
o Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating). (Note: Do not include suicidal or self-mutilating behavior.)
o Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
o Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
o Chronic feelings of emptiness.
o Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
o transient, stress-related paranoid ideation or severe dissociative symptoms.

Borderline Coping Styles
o Feels misunderstood, mistreated, or victimized.
o Blames her own failures or shortcomings on other people or circumstances; attributes her difficulties to external factors rather than accepting responsibility for her own conduct or choices.
o Gets into power struggles.
o When upset, has trouble perceiving both positive and negative qualities in the same person at the same time (e.g. may see others in black or white terms, shift suddenly from seeing someone as an angel to seeing her as a devil).
o Becomes irrational when strong emotions are stirred up; may show a significant decline from customary level of functioning.
o Has little psychological insight into her own motives, behavior, etc.
o Is unable to soothe or comfort herself without the help of another person (i.e. has difficulty regulating her own emotions).
o Tends to “catastrophize”; is prone to see her problems as disastrous, unsolvable, etc.
o Tends to hold grudges; may dwell on insults or slights for long periods.
o When distressed, tends to revert to earlier, less mature ways of coping (e.g. clinging, whining, having tantrums).
o Relationships tend to be unstable, chaotic, and rapidly changing.

NOTE: These borderline traits and coping styles would be considered to be "normal" for many young adolescents. The majority of these young adolescents mature in their late teens and lose these borderline features. However, in normal development, it is not uncommon for these borderline features to persist into early adulthood; however it is less common for these borderline features to persist into middle adulthood. Thus the question is, for adults who still have borderline features, what factors prevented these individuals from maturing and losing these borderline features?

It should be also noted that most of the coping styles seen in borderline personality disorder are also seen in antisocial, histrionic, and narcissistic personality disorders.
Disinhibition
In adulthood, individuals with borderline personality disorder are disinhibited. Like young teenagers, adults with this disorder often do impulsive, harmful activities (e.g., over-spending, reckless sex, substance abuse, reckless driving, binge eating). They want immediate gratification, and act without consideration of future consequences. In personality measurement, disinhibition is the opposite of conscientiousness. Research has shown that conscientiousness (or "grit") is even more important than intelligence inpredicting scholastic and vocational success.
Disinhibition
o Tends to act impulsively (e.g. acts without forethought or concern for consequences).

Effective Therapies
A number of psychological treatments are partially effective for borderline personality disorder, but all lack robust evidence of their effectiveness. Dialectical behavior therapy (DBT) and general psychiatric management have been shown to be equally effective. Individuals with this disorder usually suffer from 2 or more psychiatric disorders. Thus,2 years after therapy, even though two-thirds achieve diagnostic remission and significant increases in quality of life, 53% are neither employed nor in school, and 39% are still receiving psychiatric disability financial support. Pharmacotherapy can exert a modest beneficial effect on some core traits of borderline personality disorder.
These emotionally unstable individuals need a long-term mentor to establish a stable, supportive relationship in which clear and consistent boundaries are established. This mentor must have the patience and strength to withstand the patient's many crises and limit-testing episodes. Communication should always be clear, honest, optimistic and directed towards teaching more mature coping skills. This mentor could be a primary care physician, or some other qualified therapist.
Ineffective Therapies
Vitamin therapy, nutritional supplements, and special diets are all ineffective in the treatment of personality disorders.
Which Behavioral Dimensions Are Involved?
The ancient Greek civilization lasted for 1,300 years (8th century BC to 6th century AD). The ancient Greek philosophers taught that the 5 pillars of their civilization were:wisdom, courage, community, moderation, and justice. Psychiatry named the opposite of each of these 5 ancient themes as being a major dimension of psychopathology (i.e., irrationality, negative emotion, detachment, disinhibition, and antagonism). (Psychology named these same factors the "Big 5 dimensions of personality":"intellect", "neuroticism", "extraversion", "conscientiousness", and "agreeableness")
Borderline Personality Disorder: Negative Emotions, Disinhibition and Antagonism
      Wisdom vs Irrationality: N/A
      Courage vs Negative Emotion:
? Separation anxiety, depressed mood, suicidal behavior
? Separation or divorce are common; close relationships are unstable, intense
      Community vs Detachment: N/A
      Moderation vs Disinhibition:
? Harmful impulsiveness, emotional instability, lacks meaningful life purpose & goals, unstable chaotic social life
      Justice vs Antagonism:
? Physical violence



Prevalence
The prevalence of borderline personality disorder is about 1.6% of the general population. It is seen in 20% of psychiatric inpatients. About 75% of these individuals are female.
Course
Borderline personality disorder is usually worse in the young-adult years and then it gradually decreases with age. In outpatient mental health clinics, after about 10 years, about half of individuals with this disorder no longer meet the full criteria for borderline personality disorder.
Familial Pattern
If individuals have borderline personality disorder; their first-degree biological relatives are 5 times more likely to have this disorder. These relatives also have an increased risk of having substance use disorders, antisocial personality disorder, and depressive or bipolar disorders.
Complications
Completed suicide occurs in 8%-10% of individuals with borderline personality disorder. Self-mutilation (e.g., cutting or burning), suicide threats and attempts are very common. Recurrent job losses, interrupted education, and broken marriages are common.
Comorbidity
Personality disorders are an overlooked and underappreciated source of psychiatric morbidity. Comorbid personality disorders may, in fact, account for much of the morbidity attributed to axis I disorders in research and clinical practice. "High percentages of patients with schizotypal (98.8%), borderline (98.3%), avoidant (96.2%), and obsessive-compulsive (87.6%) personality disorder and major depressive disorder (92.8%) exhibited moderate (or worse) impairment or poor (or worse) functioning in at least one area."

Parental Behaviors Which Increase The Risk Of Developing A Personality Disorder
Research has shown that genetic, environmental, and prenatal factors all play important roles in the development of personality disorder. Recent research has also shown thatlow parental affection and harsh parenting increase the risk of a child later developing a personality disorder.

"Low affection" was defined as: low parental affection, low parental time spent with the child, poor parental communication with the child, poor home maintenance, low educational aspirations for the child, poor parental supervision, low paternal assistance to the child's mother, and poor paternal role fulfillment. "Harsh parenting" was defined as: harsh punishment, inconsistent maternal enforcement of rules, frequent loud arguments between the parents, difficulty controlling anger toward the child, possessiveness, use of guilt to control the child, and verbal abuse.
Setting Goals In Therapy
Questions To Ask When Setting Goals
In The Past Week:
o WHO: was your problem?
o EVENT: what did he/she do?
o RESPONSE: how did you respond to that event?
o OUTCOME: did your response help?
o TRIGGER: what did you do that could have triggered this problem?
o GOAL: what life skill(s) do you have to work on? (from checklist)
Example Of Setting Goals In Interviewing A Person With Borderline Personality Disorder
In The Past Week:
o WHO: was your problem?
"My husband."

o EVENT: what did he/she do?
"My husband is always angry at me, and is turning our children against me."

o RESPONSE: how did you respond to that event?
"I stand my ground and yell back at him."

o OUTCOME: did your response help?
"No, my kids can't take all this fighting. I think our marriage is nearly over."

o TRIGGER: what did you do that could have triggered this problem?
"Ever since my husband found out about my affair; he's been impossible to live with."

o GOAL: what life skill(s) do you have to work on? (from checklist)
"I want to work on: (1) Social Stability ("having a stable and peaceful social life"), and (2) Stable Self-Image ("being certain about “who-am-I” and “where-am-I-going-in-life”; having meaning & purpose to life")."


Rating Scales
• Borderline Disorder Rating Scales

Treatment
• Borderline Disorder Treatment Guidelines
• Borderline personality disorder: treatment and management. - National Institute for Health and Clinical Excellence (NICE); 2009
• Borderline personality disorder: treatment and management. "One study assessed the cost effectiveness of manually-assisted cognitive therapy (MACT) versus treatment as usual (TAU) in a sample of 397 people with recurrent deliberate self-harm participating in a UK-based randomised controlled trial (RCT). MACT was found to be slightly less costly than TAU, but this difference was non-significant. MACT was more effective than TAU in terms of proportion of people with a repeat self-harm episode (39% in the MACT group versus 46% in the TAU group); again, this finding was not statistically significant".
• DBT Self-Help - Dialectal Behavior Therapy self-help website
• Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up "Both treatment groups showed similar and statistically significant improvements on the majority of outcomes 2 years after discharge. The original effects of treatment did not diminish for any outcome domain, including suicidal and nonsuicidal self-injurious behaviors. Further improvements were seen on measures of depression, interpersonal functioning, and anger. However, even though two-thirds of the participants achieved diagnostic remission and significant increases in quality of life, 53% were neither employed nor in school, and 39% were receiving psychiatric disability support after 36 months."
Borderline Personality Disorder
Is your partner either loving or hateful? Peaceful or raging? Gloriously happy or depressed? "Black" or "white" with no grey middle ground? One exasperated non-BP said that if by some chance he didn't make an unforgivable error one day, his wife would probably rage at him for being too perfect.

A personality disorder is a severe disturbance in the characterological constitution and behavioural tendencies of the individual, usually involving several areas of the personality, and nearly always associated with considerable personal and social disruption.

Personality disorder tends to appear in late childhood or adolescence and continues to be manifest into adulthood. It is therefore unlikely that the diagnosis of personality disorder will be appropriate before the age of 16 or 17 years. General diagnostic guidelines applying to all personality disorders are presented below; supplementary descriptions are provided with each of the subtypes.


• Splitting Black
BPD is sometimes referred to as the Relationship Disorder because that's where it usually manifests itself. In this post, I'm going to talk about the phenomenon known as "splitting black" or as I like to call it, turning to the Darkside.
Indicators of BPD - from BPD Central
• Is someone you care about causing you a great deal of pain?
• Do you find yourself concealing what you think or feel because you're afraid of the other person's reaction or because it just doesn't seem worth the horrible fight or hurt feelings that will follow?
• Do you feel that anything you say or do will be twisted and used against you? Are you blamed and criticized for everything wrong in the relationship - even when it makes no logical sense?
• Are you the focus of intense, violent, and irrational rages, alternating with periods when the other person acts perfectly normal and loving? Does no one believe you when you explain that this is going on?
• Do you feel manipulated, controlled, or even lied to sometimes? Do you feel like you're the victim of emotional blackmail?
• Do you feel like the person you care about sees you as either all good or all bad, with nothing in between? Is there sometimes no rational reason for the switch?
• Are you afraid to ask for things in the relationship because you will be told that you're too demanding or that there is something wrong with you? Are you told that your needs are not important?
• Is the person always denigrating or denying your point of view? Do you feel that their expectations of you are constantly changing, so you can never do anything right?
• Are you accused of doing things you never did and saying things you never said? Do you feel misunderstood a great deal of the time, and when you try to explain do you find that the other person doesn't believe you?
• Are you constantly being put down? When you try to leave the relationship does the other person try to prevent you from leaving in a variety of ways (anything from declarations of love and promises to change to implicit or explicit threats)?
• Do you have a hard time planning anything (social engagements, etc.) because of the other person's moodiness, impulsiveness, or unpredictability? Do you make excuses for their behavior or try to convince yourself that everything is okay?
Right now, are you thinking,  "I had no idea that anyone else was going through this."
Thoughts that may indicate BPD - from BPD Central
Does this person:
• Alternate between seeing people as either flawless or evil?
• Have difficulty remembering the good things about a person they're casting in the role of villain?
• Find it impossible to recall anything negative about this person when they become the hero?
• Alternate between seeing others as completely for them or against them?
• Alternate between seeing situations as either disastrous or ideal?
• Alternate between seeing themselves as either worthless or flawless?
• Have a hard time recalling someone's love for them when they're not around?
• Believe that others are either completely right or totally wrong?
• Change their opinions depending upon who they're with?
• Alternate between idealizing people and devaluing them?
• Remember situations very differently than other people, or find themselves unable to recall them at all?
• Believe that others are responsible for their actions-or take too much responsibility for the actions of others?
• Seem unwilling to admit to a mistake-or feel that everything that they do is a mistake?
• Base their beliefs on feelings rather than facts?
• Not realize the effects of their behavior on others?
Feelings that may indicate BPD - from BPD Central
Does this person:
• Have trouble observing others' personal limits?
• Have trouble defining their own personal limits?
• Act impulsively in ways that are potentially self-damaging, such as spending too much, engaging in dangerous sex, fighting, gambling, abusing drugs or alcohol, reckless driving, shoplifting, or disordered eating?
• Mutilate themselves-for example, purposely cutting or burning their skin?
• Threaten to kill themselves-or make actual suicide attempts?
• Rush into relationships based on idealized fantasies of what they would like the other person or the relationship to be?
• Change their expectations in such a way that the other person feels they can never do anything right?
• Have frightening, unpredictable rages that make no logical sense-or have trouble expressing anger at all?
• Physically abuse others, such as slapping, kicking, and scratching them?
• Needlessly create crises or live a chaotic lifestyle?
• Act inconsistently or unpredictably?
• Alternately want to be close to others, then distance themselves?  [ Examples include picking fights when things are going well or alternately ending relationships and then trying to get back together. ]
• Cut people out of their life over issues that seem trivial or overblown?
• Act competent and controlled in some situations but extremely out of control in others?
• Verbally abuse others, criticizing and blaming them to the point where it feels brutal?
• Act verbally abusive toward people they know very well, while putting on a charming front for others?
• Can they switch from one mode to the other in seconds?
• Act in what seems like extreme or controlling ways to get their own needs met?
• Do or say something inappropriate to focus the attention on them when they feel ignored?
• Accuse others of doing things they did not do, having feelings they do not feel, or believing things they do not believe?
Additional Traits Common to People with BPD - from BPD Central
People with BPD may have other attributes that are not part of the DSM definition but that researchers believe are common to the disorder. Many of these may be related to sexual or physical abuse if the BP has experienced abuse earlier in life.

Pervasive Shame:  The all-pervasive sense that I am flawed and defective as a human being. It is no longer an emotion that signals our limits; it is a state of being, a core identity. Toxic shame gives you a sense of worthlessness, the feeling of being isolated, empty, and alone in a complete sense. Non-BPs share this characteristic.

Undefined Boundaries:  People with BPD have difficulty with personal limits-both their own and those of others. Non-BPs share this characteristic.

Control Issues:  Borderlines may need to feel in control of other people because they feel so out of control with themselves. In addition, they may be trying to make their own world more predictable and manageable. People with BPD may unconsciously try to control others by putting them in no-win situations, creating chaos that no one else can figure out, or accusing others of trying to control them.

Conversely, some people with BPD may cope with feeling out of control by giving up their own power; for example, they may choose a lifestyle where all choices are made for them, such as the military or a cult, or they may align themselves with abusive people who try to control them through fear. Non-BPs share this characteristic.

Lack of Object Constancy:  When we're lonely, most of us can soothe ourselves by remembering the love that others have for us. This is very comforting even if these people are far away-sometimes, even if they're no longer living. This ability is known as object constancy.

Some people with BPD, however, find it difficult to evoke an image of a loved one to soothe them when they feel upset or anxious. If that person is not physically present, they don't exist on an emotional level. The BP may call you frequently just to make sure you're still there and still care about them. [One non-BP told us that every time her boyfriend called her at work, he introduced himself using both his first and last name.]

Interpersonal Sensitivity:  Many individuals have noticed that some people with BPD have an amazing ability to read people and uncover their triggers and vulnerabilities. One clinician jokingly called people with BPD psychic.

Situational Competence:  Some people with BPD are competent and in control in some situations. For example, many perform very well at work and are high achievers. Many are very intelligent, creative, and artistic. This can be very confusing for family members who don't understand why the person can act so assuredly in one situation and fall apart in another.

Narcissistic Demands:  Some people with BPD frequently bring the focus of attention back to themselves. They may react to most things based solely on how it affects them.
Common "games" between BPs and Non-BPs - from BPD Central
Feelings Create Facts:

In general, emotionally healthy people base their feelings on facts. If your dad came home drunk every night (fact) you might feel worried or concerned (feeling). If your boss complimented you on a big project (fact) you would feel proud and happy (feeling).

People with BPD, however, may do the opposite. When their feelings don't fit the facts, they may unconsciously revise the facts to fit their feelings. This may be one reason why their perception of events is so different from yours.

Splitting: I Hate You - Don't Leave Me

People with BPD may have a hard time seeing gray areas. To them, people and situations are all black or white, wonderful or evil. This process of splitting serves as another defense mechanism. Peter, who has BPD, explains: "Dividing the world into good or evil makes it easier to understand. When I feel evil, that explains why I am the way I am. When you are evil, that explains why I think bad things about you."

Tag, You're It: A Game of Projection

Some people with BPD who act out may use a more complicated type of defense mechanism - we've named it "Tag, You're It"- to relieve their anxiety, pain, and feelings of shame. It's more complex because it combines shame, splitting, denial, and projection.

People with BPD usually lack a clear sense of who they are, and feel empty and inherently defective. Others seem to run away from them, which is lonely and excruciatingly painful. So borderlines cope by trying to "tag" or "put" these feelings onto someone else. This is called projection.

Poof! I'm perfect again!
Projection is denying one's own unpleasant traits, behaviors, or feelings by attributing them (often in an accusing way) to someone else. In our interview with Elyce M. Benham, M.S., she explained that projection is like gazing at yourself in a hand-held mirror. When you think you look ugly, you turn the mirror around. Voila! Now the homely face in the mirror belongs to somebody else.
Sometimes the projection is an exaggeration of something that has a basis in reality. For example, the borderline may accuse you of "hating" them when you just feel irritated. Sometimes the projection may come entirely from their imagination: for example, they accuse you of flirting with a salesclerk when you were just asking for directions to the shoe department.

The BP's unconscious hope is that by projecting this unpleasant stuff onto another person-by tagging someone else and making them "it" like a game of Tag - the person with BPD will feel better about themselves. And they do feel better, for a little while. But the pain comes back. So the game is played again and again.

Projection also has another purpose:

Your loved one unconsciously fears that if you find out they're not perfect, you will abandon them. Like in the Wizard of Oz, they live in constant terror that you'll discover the person behind the curtain. Projecting the negative traits and feelings onto you is a way to keep the curtain closed and redirect your attention on the perfect image they've tried to create for themselves.

How can people with BPD deny that they are projecting when it is so obvious to everyone else? The answer is that shame and splitting may combine with projection and denial to make the "Tag, You're It" defense mechanism a more powerful way of denying ownership of unpleasant thoughts and feelings.

Some adults who enter into relationships with borderlines feel brainwashed by the BP's accusations and criticisms. Says Benham: "The techniques of brainwashing are simple: isolate the victim, expose them to inconsistent messages, mix with sleep deprivation, add some form of abuse, get the person to doubt what they know and feel, keep them on their toes, wear them down, and stir well."

Everything Is Your Fault:

Continual blame and criticism is another defense mechanism that some people with BPD who act out use as a survival tool. The criticism may be based on a real issue that the person with BPD has exaggerated, or it may be a pure fantasy on the borderline's part.

Family members we interviewed have been raged at and castigated for such things as carrying a grocery bag the wrong way, having bed sheets that weighed too heavily on the BP's toes, and reading a book the BP demanded they read.

One exasperated non-BP said that if by some chance he didn't make an unforgivable error one day, his wife would probably rage at him for being too perfect.

If you object to the criticism or try to defend yourself, your loved one may accuse you of being defensive, too sensitive, or unable to accept constructive criticism. Since their very survival seems to be at stake, they may defend themselves with the ferociousness of a mother bear protecting her cubs.
» When the crisis has passed and the person with BPD seems to have won, they may act surprised that you're still upset.
Borderline Personality Disorder FAQs - paraphrased from BPD Central
• What does BPD stand for?

BPD stands for "Borderline Personality Disorder."
• Is BPD common?

More than six million people in the USA have a BPD disorder, and these people greatly affect the lives of at least 30 million others.
• Why is BPD a problem?

BPD can lead to suffering for both the BP and those whose lives they affect [non-BPs, or simply "nons."] BPD is linked to high conflict; divorce; suicide; substance abuse; child abuse; physical, sexual, and emotional abuse; eating disorders; estrangement from family members; and much more.
• I need some support for what I'm going through?   No one understands.

The people in cyberspace understand. They've all been through it. Many have had experiences very similar to yours. Join one of the cyberspace mailing lists [they're like online support groups], you'll get support from people who care. There are separate groups for people with borderline partners, children, and parents. There are also groups for people WITH BPD.
• Is there hope for people with BPD?   Can they recover?

Yes. The Stone New York State Psychiatric Institute did an outcome study of 206 BPD clients admitted between 1963 and 1976 who spent three months or more in inpatient unit. Follow-up study showed:


o Two-thirds of sample patients now in their 30s and 40s were rated as "good" or "recovered" on the Global Assessment Scale, a tool used by clinicians.
o In this and other studies, "good" outcomes were related to the following: "likableness, candor, perseverance, talent and attractiveness, high IQ, and obsessive traits." [We didn't come up with this...we're just reporting it.]
o Poorer outcomes were related to the following: "more [on the 'BPD' scale] anger and moodiness, continued substance abuse, sociopathy [innate 'meanness'], history of parental physical abuse and incest."
o About 9% of BPD patients kill themselves.
o BPD patients can get better, but it's slow. Every single recovered BP I have talked to had these things in common: Helpful, but not 100% prevalent, was:
o Significant others who were supportive and caring and enforced boundaries and made it clear which behavior they would not tolerate. Often, this provided the BP with the motivation to get better. This is not a formal study. It is only from anecdotal experience.
• What can I do to make the BP in my life seek treatment?

Think about something that is very, very difficult for you to do. Lose 25 pounds. Change careers. Overcome poor self esteem. Think about how hard this has been for you to do, even though you may want to do it very much.

Now... imagine that you didn't want these things. What are the chances that you would lose the weight, get a new job, and buy a book on self-esteem? Pretty low.

Recovery from BPD is a hard thing to do. For the borderline (BP) it may involve facing horrible childhood abuse or deep-rooted feelings of shame. People with BPD feel stigmatized. The only way through it is to want it very, very badly.

You cannot make someone want this, any more than someone can make you want to change yourself. It has to come from within.
• I'm concerned about my children and the effects of my spouse's behavior on them. What should I do?
This is a very serious issue that is discussed in a chapter of Stop Walking on Eggshells (1-888-357-4355 or 1-800-431-1579). Here are some hints:
o Join a non-BP list with active topics of discussion.
o If the BP is acting abusive, remove your children from the situation temporarily. Take them out for a walk or ice cream. If your BP is consistently abusive to your children, determine your legal rights, especially if you are a man.
o Be a consistent oasis for your kids. Follow through. Do what you say you will.
o Tell your children that no one has the right to abuse them. Try to help them understand that mom or dad's behavior is not about them. Tell them this every time you see them being abused.
o Become involved in your children's life. Nothing is more important. Have fun with them. Create good memories. Listen to them. Respect their feelings. Take them seriously. Believe them.
o Do not make excuses for abusive behavior. Do not tell yourself things like, "The kids will probably turn out OK, they'll just learn some hard lessons early in life." Do not excuse the borderline for their abusive behavior just because they have BPD.
o Don't throw up your hands because tackling this problem makes you uncomfortable. Fight for your children's mental health. Ask yourself, "What would I do if a stranger was acting this way toward my child?" Then, do what needs to be done as long as it is within your legal right.
o Stop taking the borderline's actions personally. Rage, screaming, verbal abuse, self-mutilation, blame, criticism, and all the other things that make life difficult are not about you at all. It's part of the BPD.
o Do some good things for yourself and your body. Have some fun. Take a walk. Stop drinking or abusing drugs, if you are.
o Join a non-BP list.
o Learn all you can about BPD.
o Learn to take care of yourself.
• My therapist doesn't seem to know very much about BPD.   What should I do?

Your therapist is very typical. If you read the entire BPD Central site, you may know more about BPD than the average therapist. In addition, your therapist may suspect BPD, but not have mentioned it.

The reasons for this are complex. For right now, trust your instincts. If your therapist doesn't seem to be helping, listen to your feelings. Learn all you can about BPD and interview potential therapists.
Off-Site Links:
• BPD Central
• Facing the Facts - When a loved one has Borderline Personality
[ Life on Eggshells © by BPD Central. Thank you for making this information available. ]

Borderline Personality Disorder - A Clinical Perspective
Borderline Personality Disorder (BPD) is an extremely complicated disorder to understand. BPD describes a constellation of symptoms that can present as any one of 357 different manifestations ranging from low functioning BPD, (those that self-injure or attempt suicide) all the way to the high functioning (those appear normal and even successful but have a history of turbulent relationships with loved ones and family members). ~ BPDResources.net

People with BPD often have an unstable sense of who they are. That is, their self-image or sense of self often rapidly changes. Relationships are usually in turmoil.

Borderline personality disorder is often a devastating mental condition, both for the people who have it and for those around them.

Perhaps shaped by harmful childhood experiences or brain dysfunctions, people diagnosed with borderline personality disorder live in a world of inner and outer turmoil. They have difficulty regulating their emotions and are often in a state of upheaval. They have distorted images of themselves, often feeling worthless and fundamentally bad or damaged.

And while they yearn for loving relationships, people with borderline personality disorder typically find that their anger, impulsivity, stormy attachments and frequent mood swings push others away.

Over the last 10 years, increasing awareness and research are helping improve the treatment and understanding of borderline personality disorder. At the same time, it remains a controversial condition, particularly since so many more women than men are diagnosed with it, raising questions about gender bias.


Although definitive data are lacking, it's estimated that 1 percent to 2 percent of American adults have borderline personality disorder (BPD). It occurs in about one in every 33 women, compared with one in every 100 men, and is usually diagnosed in early adulthood.

Contrary to lingering perceptions, emerging evidence indicates that people with BPD often get better over time and that they can live happy, peaceful lives.


Signs and symptoms

Borderline personality disorder affects how people feel about themselves, how they relate to others and how they behave.

People with BPD often have an unstable sense of who they are. That is, their self-image or sense of self often rapidly changes. They typically view themselves as evil or bad, and sometimes they may feel as if they don't exist at all. This unstable self-image can lead to frequent changes in jobs, friendships, goals, values and gender identity.

Relationships are usually in turmoil. People with BPD often experience a love-hate relationship with others. They may idealize someone one moment and then abruptly and dramatically shift to fury and hate over perceived slights or even misunderstandings. This is because people with the disorder have difficulty accepting gray areas — things are either black or white. For instance, in the eyes of a person with BPD, someone is either good or evil. And that same person may be good one day and evil the next.

In addition, people with BPD often engage in impulsive and risky behavior. This behavior often winds up hurting them, whether emotionally, financially or physically. For instance, they may drive recklessly, engage in unsafe sex, take illicit drugs or go on spending or gambling sprees. People with BPD also often engage in suicidal behavior or deliberately injure themselves for emotional relief.

Other signs and symptoms of borderline personality disorder may include:

* Strong emotions that wax and wane frequently
* Intense but short episodes of anxiety or depression
* Inappropriate anger, sometimes escalating into physical confrontations
* Difficulty controlling emotions or impulses
* Fear of being alone


Causes

As with other mental disorders, the causes of borderline personality disorder are complex. The name arose because of theories in the 1940s and 1950s that the disorder was on the border between neurosis and psychosis. But that view doesn't reflect current thinking. In fact, some advocacy groups have pressed for changing the name, such as calling it emotional regulation disorder.

Meanwhile, the cause of BPD remains under investigation, and there's no known way to prevent it. Possible causes include:

- Genetics. Some studies of twins and families suggest that personality disorders may be inherited.

- Environmental factors. Many people with borderline personality disorder have a history of childhood abuse, neglect and separation from caregivers or loved ones.

- Brain abnormalities. Some research shows changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly.

Most likely, a combination of these issues results in borderline personality disorder.


Risk factors

Personality forms during childhood. It's shaped by both inherited tendencies and environmental factors, or your experiences during childhood. Some factors related to personality development can increase the risk of developing borderline personality disorder. These include:

- Hereditary predisposition. You may be at a higher risk if a close family member — a mother, father or sibling — has the disorder.

- Childhood abuse. Many people with the disorder report being sexually or physically abused during childhood.

- Neglect. Some people with the disorder describe severe deprivation, neglect and abandonment during childhood.


When to seek medical advice

People with borderline personality disorder often feel misunderstood, alone, empty and hopeless. They're typically full of self-hate and self-disgust. They may be fully aware that their behavior is destructive and be distressed about it. Impulsivity may cause problems with gambling, driving or even the law. You may find that many areas of your life are affected, including relationships, work or school.

If you notice these things about yourself, talk to your doctor or a mental health provider. The right treatment can help you feel better about yourself and help you live a more stable, rewarding life.

If you notice these things in a family member or friend, talk to them about seeing a doctor or mental health provider. But keep in mind that you can't force someone to seek help. If the relationship has you unduly distressed, you may find it helpful to see a therapist yourself.


Screening and diagnosis

Personality disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with borderline personality disorder, someone must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

The DSM criteria note that people with BPD have a pattern of unstable relationships, self-image and mood, as well as impulsive behavior. These typically begin in early adulthood.

For BPD to be diagnosed, at least five of the following signs and symptoms must be present:

* Intense fears of abandonment
* A pattern of unstable relationships
* Unstable self-image
* Impulsive and self-destructive behaviors
* Suicidal behavior or self-injury
* Wide mood swings
* Chronic feelings of emptiness
* Inappropriate anger
* Periods of paranoia and loss of contact with reality

A diagnosis of BPD is usually made in adults, not children or adolescents. That's because what appear to be signs and symptoms of BPD may go away with maturity.


Complications

Borderline personality disorder can damage many areas of a person's life. Relationships, jobs, school, social activities, self-image — all can be negatively affected. Repeated job losses and broken marriages are common. Self-injury, such as cutting or burning, can result in scarring and frequent hospitalizations. Suicide rates among people with BPD are very high, reaching 10 percent.

In addition, people with borderline personality disorder may have other mental health problems, too, including:

* Depression
* Substance abuse
* Anxiety disorders
* Eating disorders
* Bipolar disorder
* Other personality disorders

Because of their risky, impulsive behavior, people with BPD are also more vulnerable to unplanned pregnancies, sexually transmitted diseases, motor vehicle accidents and physical fights. They may also be involved in abusive relationships, either as the abuser or the abused.


Treatment

Treatment for borderline personality disorder has improved in recent years with the adoption of techniques specifically aimed at people with this disorder. Treatment includes:

- Psychotherapy. This is the core treatment for BPD. Dialectical behavior therapy (DBT) was designed specifically to treat the disorder. Generally conducted through individual, group and phone counseling, DBT uses a skills-based approach to teach people how to regulate their emotions, tolerate distress and improve relationships.

- Medications. Medications can't cure BPD, but they can help associated problems, such as depression, impulsivity and anxiety. Medications may include antidepressant, antipsychotic and antianxiety medications.

- Hospitalization. At times, people with BPD may need more intense treatment in a psychiatric hospital or clinic. Hospitalization can also keep them safe from self-injury.

Because treatment can be intense and long term, people face the best chance for success when they find mental health providers with experience treating BPD.


Self-care

Living with borderline personality disorder can be difficult. You may fully realize that your behaviors and thoughts are self-destructive or damaging yet feel unable to control them. Treatment can help you learn skills to manage and cope with your condition.

Other things you can do to help manage your condition and feel better about yourself include:

* Sticking to your treatment plan
* Attending therapy sessions as scheduled
* Practicing healthy ways to ease painful emotions, rather than inflicting self-injury
* Not blaming yourself for having the disorder but recognizing your responsibility to get it treated
* Learning what things may trigger angry outbursts or impulsive behavior
* Not being embarrassed by having this condition
* Getting treatment for related problems, such as substance abuse
* Educating yourself about the disorder so you understand its causes and treatments better
* Reaching out to others with the disorder to share insights and experiences

Remember, there's no one right path to recovery from BPD. The condition seems to be worse in young adulthood and may gradually get better with age. Many people with the disorder find greater stability in their lives during their 30s and 40s. Their inner misery may lessen and they go on to sustain loving relationships and enjoy meaningful careers.

I Love My Borderline Personality Disordered Partner - How Do I Make this Work?
It takes a great deal of strength to be in a BP relationship and not be emotionally injured by it. As you cannot escape the natural human impulses to "recoil when raged" upon or "be overly protective" when idealized, it really important to have other outlets / escapes to keep yourself grounded

Strength: It takes a great deal of strength to be in a BP relationship and not be emotionally injured by it. A person in a weak emotional state, who feels wounded/abused, or depressed is likely to be consumed by the relationship, confused by the intense rages and idealization, and finding their self worth in decline. If you chose this path, you've got to be very strong and very balanced.

Realistic Expectations: A person with BPD is emotionally underdeveloped and does not have "adult" emotional skills - especially in times of stress. If you are in this type of relationship it is important to have realistic expectations for what the relationship can be in terms of consistent respect, trust and support, honesty and accountability, and in terms of negotiation and fairness, or expectations of non-threatening behavior. It is important to accept the relationship behavior for what it is - not hope the person will permanently return to the idealization phase, not accept the external excuses for the bad behavior, and not hope that changing your behavior will improve things.

Accept the Role of "Emotional Caretaker": According to Kraft Goin MD (University of Southern California), "borderlines need a person who is a constant, continuing, empathic force in their lives; someone who can listen and handle being the target of intense rage and idealization while concurrently defining limits and boundaries with firmness and candor". To be in this type of relationship, you must accept the role as emotional caretaker - consistently staying above it.

~ Maintaining routine and structure
~ Setting and maintain boundaries
~ Being empathetic, building trust, even in difficult times
~ Don’t tolerate abusive treatment, threats and ultimatums
~ In crisis, stay calm, don’t get defensive, don't take it personally
~ Don’t protect them from natural consequences of their actions - let them fail
~ Self-Destructive acts/threats require action

And at the same time, its important to understand that you and your behavior cannot rehabilitate anyone - you can only mitigate the situation. Rehabilitation requires an individual's deep personal commitment, consistently, and over time.

Protection: Difficult things will likely happen in a BP relationship and it is important that you try to protect everyone (you, the BPD, the children) - financially, emotionally, etc. Be prepared for digressions when they occur - they will. This could range from controlling the bank accounts, to educating the children, to having a suicide threat plan. You can mitigate some of the damage.

Preserve Your Emotional Health: The intensity of emotional reactions, and the rage take a toll on even the strongest. Since you cannot escape the natural human impulses to "recoil when raged" upon or "be overly protective" when idealized, it really important to have other outlets / escapes to keep yourself grounded. It's important not to become isolated. It's important to have a significant emotional support system for yourself (e.g., close friends) that goes beyond the relationship.

Understand Why: There are a many reasons to be in BP relationship or to try. It's a deeply personal decision. Sometimes the reasons are unhealthy- such as BPD/NPD relationships, BPD/Co-dependent relationship, etc. It's important to understand your own emotional health and what motivates you to "stay in" and build a life that "evolves around" and has to "continually compensate for" the acts of a destructive person. Many professionals enter therapy when they are treating BPD to stay grounded. It is a good idea for you too.

High Functioning, low functioning - Part two: High function in Borderline Personality Disorder
Getting back on track.

“High-functioning borderlines act perfectly normal most of the time. Successful, outgoing, and well-liked, they may show their other side only to people they know very well. Although these BP's may feel the same way inside as their less-functional counterparts, they have covered it up very well-so well, in fact, that they may be strangers unto themselves. Non-BP's involved with this type of BP need to have their perceptions and feelings confirmed. Friends and family members who don't know the BP as well may not believe stories of rage and verbal abuse. Many non-BP's told us that even their therapists refused to believe them when they described the BP's out-of-control behavior.



This description of High Functioning BPD is spot on for me. Even down to the comment about the therapist refusing to believe me when I told her about the out of control behavior of my youth. The violence and uncontrollable wrath. (Which I discuss here).

One of the biggest differences between high functioning and low functioning BPDs is the ability to recognize how much of a problem this disorder is and not allow it to overrun their lives completely. To recognize how adversely it will affect their professional and social lives if they let anyone see it. To make a conscious decision to present a different image. I see clearly how easily it can consume my life and destroy my relationships. I can foresee the results of letting go of  my control. Foresee how other people will react to how I feel and impulsively want to react; alienation and abandonment from the people I need to have around me. In understanding how this impulsive behavior can affect me, I can avoid some of these behaviors.

I’ve always refused to be controlled. By anyone, or even by my Self; me darker urges. Always fighting against letting this overrun my life. I won’t tell you this is easy. It’s a constant struggle, one that I am not able to overcome some days. Often it feels like a losing battle. But this war isn’t over and I’m doing all that I can to gain an advantage over this enemy within. I analyze myself, my behavior, how I interact with others, how I present myself. I push myself to get out of bed and live my life out loud.

When I meet new people it sometimes feels like I’m living a split personality. The witty, sociable, successful woman that knows everyone and laughs a lot. It’s not until I reluctantly let someone closer to me, that my façade begins to break down. Little by little letting them see who I really am. I guess part of me still is that sociable hostess that smiles and masquerades. It’s not a complete picture though. I hide the darker aspects of myself as long as I can. To the casual observer, I do this very well. To those rare few that are willing to break through my mask, they see how much I’m crumbling inside. Maybe not the full extent, because part of me still refuses to show such weakness to anyone, but when I am in closer contact with people that seem to care about me, it is impossible to continue to hide who I can be.

Low functioning BPDs tend to externalize their problems; unable to maintain a regard for those around them, consumed by their own emotional catastrophes, they lash out at each instance of instability; lost in the moment. While high functioning BPDs may feel the exact same emotional crisis, they tend to internalize more. Instead of lashing out in the moment, they control the impulse and wait until they are alone and take it out on themselves. Only affecting those absolutely closest to them. To the person suffering, and to those around and caring for the person suffering, one is not better than the other. Not emotionally, not mentally. For me, while I may not be able to stop the emotional melt down, I can usually recognize that, despite how it feels, my world is not actually ending. Having at least one solid relationship, one stable support makes an incredible difference as well. Knowing that there is someone I can turn to, that is willing to help me, see that there will be a tomorrow can make all the difference. Tomorrow I will pick myself up, and do what I need to do. The same as the day before, and the day before that. There is a small comfort in knowing the sun does continue to rise, and tomorrow is one more chance to keep going. Sometimes we just need a reminder.

High functioning BPs often consume their daily lives with a self imposed structure; scheduling away every hour, every minute. Proactively attempting to avoid emotional disaster. This provides an external stability that makes the internal instability a little easier to bear. While things are so frantic inside, there is a calm in knowing there is order in the world. I have done this ever since I was little. Every hour scheduled away with activities, sports, studying. At University when I was so often alone, at some of the loneliest points I’ve ever been in, I kept a ridiculous course load, maximizing the number of credits I could take, developing rigorous study schedules that consumed my day allowing little time to be left to my own thoughts. This didn’t always work. It didn’t actually fix the fact that the sadness and depression was still there, waiting to surface when I could no longer keep up my guard. But in pushing myself, providing myself with a goal, I had something to reach for. Something to motivate me to keep going.

Maybe that’s another attribute of the high functioning BP; the ability to look to the future. Having something to look forward to, to reach for and achieve… It’s hard not to feel a little proud, a little relieved in knowing that such things can still be accomplished, despite it all.

10 Things You Discover About Yourself When You’re Diagnosed With Borderline Personality Disorder
AUG. 29, 2013
By CARRIE-LYNNE DAVIS
You must meet 5 out of 9 criteria to be diagnosed with Borderline Personality Disorder (this is from DSM-IV):
1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.”
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in.
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
1. People will not understand you.
Or your diagnosis. If you tell a friend you have Borderline Personality Disorder, I guarantee that, if they’re not a psych major or a fellow member of the Krazy Klub, they’ll mention “Girl, Interrupted,” Jodi Arias, or that football guy. I’ve even heard, “Oh… like Glenn Close from Fatal Attraction?” And they step away from you ever-so-slowly. Hell no. Just because we have BPD does not mean we are inherently evil, future murderers, or out to get you, my pretties, and your sexy boyfriends, too! The media, medical community, and even the very researchers that have written about BPD have contributed to the negative stigma attached to the Borderline diagnosis. Most of this is fueled by misinformation. What most people don’t realize about people with BPD is that above all else, we just want to be loved, understood, and respected. We want to be happy and healthy, just like the rest of you freaks.
2. What feels right at first is usually wrong, wrong, wrong.
Your natural reactions to stressful events tend to exacerbate the stress of that event. Borderlines often feel the most extreme version of a feeling. A fight with the bf/gf can almost instantly send you into a head-exploding rage or a major, debilitating depression – either he/she is the Anti-Christ / Torturer of You 4Ever / User & Abuser Extraordinaire, or you just destroyed the best and only relationship your sorry ass will ever have and omghowfuckingstupidareyou and you’re never going to find someone that loved you the way that he/she loved you and so you have no reason to live and maybe you should just text them and ask them to forgive you– pleasepleasepleaseOMGyou’lldoANYTHING! It’s okay to feel extreme. It’s not okay to recklessly act on those extreme feelings. Certain therapies (CBT, DBT) are great for identifying and extinguishing chaotic, seemingly uncontrollable emotions when they arise before they cause you to use That-Professor-Who-Criticized-You’s email address to sign them up for a tentacle porn website’s email updates or tell a good friend who forgot your birthday that it’s fine, really, you knew they didn’t give a shit about you anyway.
3. Sometimes you’re the villain.
After finding out you have BPD, it’s necessary to review your life, particularly those times when you felt wronged. Some of those “So-and-So fucked me over royally” moments from your past suddenly seem to have new meaning. The first time it happened to me, it felt like when a game-changing piece of evidence surfaced on a Law & Order episode and the whole nature of the crime had consequently changed. Except I was both the unknowing audience and the criminal the audience had never suspected.
Did my best friend actually betray me by calling the cops after I told her I was suicidally depressed in order to get her attention, or was she genuinely concerned for my life and did what she thought was best? Did my boyfriend really break up with me because he never cared about me, never loved me, and always hated me, or was it because I drove him away with my incessant accusations fueled by the fear of those accusations being true?
These new realizations about some of the most painful moments in your life can be bitter pills to swallow, but those pills are the medicine that will help you get better.
4. You have a love/hate relationship with your diagnosis.
Your life has most likely been, well, hellish. Finally knowing what your role is in the insufferable pain you feel (and sometimes cause) can be a massive relief. One of the most helpful practices for improving your life after you’ve been accurately diagnosed is consistent therapy with a professional you trust and to be 100% honest with them about your life. That can be super fucking hard to do at first. Therapy flipped my whole shit upside down. I used to truly, madly, deeply believe that I was the victim in almost every situation, completely justified in taking from someone who I thought didn’t deserve what I wanted, and I felt it was normal to constantly require praise because that was how I’d learned to value myself as a human being.
After years of therapy, when I find myself daydreaming about that cute-ass bartender I’ve had a couple dates with and suddenly feel the overwhelming urge to text him a craaaazy amount of times just to reassure myself that he’s still into me and I’m still worthy of being liked, I am able to stop myself. As a teenager, that was nearly impossible. Now I can catch myself before I let the batshit-bullshit torpedo out of my brain and subsequently scare people away that I’m trying to befriend or love. Once you recognize that a thought or behavior is a manifestation of your disorder and not how you actually want to act/feel/think, it’s easier to be in get your shit together.
5. You’ve got some extra baggage.
Statistically, you’re more likely to also be an alcoholic, cutter, habitual shoplifter, gambler, pill-popper, frequent overdrafter, Adderall sniffer, reckless driver, dope-copper, or compulsive woo-hoo’er. You’re more likely to eat way too much, way too little, or be an active member of the double-finger diet club like I was for a near-decade.
Many of us are hard-wired for impulsivity; we experience intense, unbearable emotions and have—err—differently-abled “stop and go” receptors in our brains that are fucking terrible at their job, which is to remind us about things like how binge-drinking at a party where you don’t know anyone will make you feel less anxious in the short term, until you get so shit-canned that you become “That Hot Mess at that Party Last Night” and you don’t remember what you did or who you backed dat ass up on or when that humiliating Facebook photo was taken or why the hell you now have two mismatched black boots that are clearly different brands, sizes, and styles.
The most detrimental aspect of this impulsivity is that we consistently fail to remember what happens when the chase ends and we’re left feeling even lower and emptier than ever. The desire for pleasure becomes even more enthralling in this state. And so, the chase becomes cyclical and has no end. This is the biggest complication in getting better. Most Borderlines who committed suicide had a long standing addiction they were unable to shake. Programs like AA and NA can be quite therapeutic for Borderlines because they’re so inclusive, saccharinely positive about living one day at a time, the meetings are run by a familiar set of routines, and the program itself offers a set of principles by which you can live until you get healthier and feel enough strength and conviction to develop your own.
6. It’s not your fault!
Most folks are under the impression that “personality disorder” is just headshrinker jargon for “shitty person.” People tend to equate personality with identity. Rah, rah, rah, if the problem’s with your personality, then it must be a choice! Right? No, not really. Or at all. There are many different players in the development of BPD. Research suggests that it can be attributed to both biological factors and your shitty-ass childhood. Nature and nurture double-teamed us. And it hurts. Biologically, genetics, neurobiological factors, and irregularities in certain areas of the brain can all contribute to the development of BPD in a child. A good 65% of us with BPD have a mother or father who also has it.
Hint: It’s probably the one who both calls you and fights with you the most.
A lot of us were abused as kids. A lot of us had at least one parent who continuously shamed us for expressing emotions. A lot of us never had a stable parental figure that we could rely on to be there and not disappear. These are all things that can drive identity disturbance, fear of abandonment, emotional extremes, “splitting”, etc.
I’m not saying any of this shit is an excuse to act out, however. Just because it’s not our fault that we have this disorder does not mean we are not responsible for our actions, especially when they hurt others or ourselves. Living with BPD means having to evaluate your intentions, feelings, and actions on a regular basis until the healthy ways become the natural ways.
7. You’re interesting and exciting to others.
If there exists any kind of “upside” to the behaviors I described above, it could be that to those we meet for the first time, we often exude a mysterious passion and insatiable lust for life that both men and women find pretty alluring. Most high-functioning Borderlines I’ve met have been intelligent, artistic, and overwhelmingly charming, despite their issues. We can be some of the most entertaining people at parties. We’ve got some of the best stories because we’ve experienced some crazy shit and the attention of a crowd fuels our performance of such stories. People tend to be drawn to us, entertained by us, romanced by us. Our [American] culture has glamorized being whimsically impulsive, thrill-seeking, and acutely intuitive, e.g. the “Manic Pixie Dream Girl” craze. Most artistic muses I’ve met and read about exhibit a number of Borderline traits. There’s just something arresting about our oceanic moods, lust for pleasure, and that dreamy way in which we drift with obstinacy from genre to genre, scene to scene, person to person, desperately searching for who we really are.
Tell me that isn’t romantic as hell.
8. You’re crazy in bed.
Alright, alright. This is purely a theory I have based on all the Borderlines I’ve known personally, my own experiences, and research. Maybe the old wives’ tale is true: insecure girls are just good in the sack. Why, you ask? We have an insatiable desire to please those who want to please us, we’re eerily intuitive (particularly if we grew up in scary and/or unpredictable households wherein we had to figure out how to act all the time to avoid explosive conflict), and some of us have some serious Daddy/Mommy/Authority issues, which can certainly make for, well, interesting sex. The finely-tuned Borderline intuition is an example of what I like to call a “mental illness gift” that can be used for good or evil. It’s what can make us good at manipulation, invalidation, or thought policing. But it can also be used to pick up on how your loved ones are feeling even if they’re trying to hide it, be insanely good at gift-giving, know intrinsically how to act around different people, and decipher exactly what it is that makes your lover tick sexually.
Why are Borderlines so Sexual?







Why are Borderlines so Sexual?


The Why’s of Sex, Promiscuity, and Borderline Personality Disorder


Why are you so sexual my dear Borderline? That’s a good question isn’t it? One that does not come with a quick answer. This is a first. I’ve found almost no information on why sex seems to be such a prominent feature of Borderline Personality Disorder. What I have found has been only a paragraph or a sentence here or there. So let’s look at what I’ve found, what I feel, and what some of my own theories are.

One of the more obvious theories as to why people with BPD have such reckless sex lives is the fact that they constantly feel emotional emptiness. “Even when they find a stable emotional relationship their fear of abandonment causes them to become paranoid about the stability of their relationship and the validity of the love coming from their partner. A possibility for the reasoning behind sex and borderline personality disorder is that the sufferer of BPD actually tries to self-sabotage their relationship in order to end the relationship before they are actually abandoned by their partner. Another theory as to reckless sex and borderline personality disorder is that the BPD sufferer actually gets an emotional high from bonding with the sexual partner even if only for a short time. They are literally trying to fill in emptiness inside themselves and they try and try to fill that void with sex. After having a sexual affair the person with borderline personality disorder may not have the same amount of guilt as someone with non-BPD. The reason is projection; oftentimes people with borderline personality disorder project their negative behaviors onto others including their partners. This means that someone with borderline personality disorder who is having a reckless sexual affair may have a tendency to build a fake affair that their spouse or loved one is having in their head. They literally make themselves believe that their partner is also cheating and that they are therefore justified in having their reckless sexual affair.”

A previous article I mentioned notes that there may be a number of reasons for the more negative attitudes about sex. “First, many women with BPD are survivors of child abuse, which may contribute to overall negative reactions to adult sexual experiences. Also, women with BPD are more likely to experience a great deal of conflict in their relationships, so they may feel less positive about sex because relationships in general feel less fulfilling.”

Having these negative attitudes doesn’t however, justify why we may still have an attitude directed towards reckless sex. I would take this from a different angle and say that perhaps due to previous abuse there is a subconscious need for approval where it was not given, withheld, or used against us. Overt sexual behavior may be a way of taking back control, exerting control in the present where control was once absent.

Also, knowing that we have the ability to interest and consume someone with our sexuality or ability to seduce them is a form of validation of our own self-worth.

Those are my thoughts currently. I’m sure I’d have more but I’m utterly brain fried from today andyesterday at work. I’ll be sure to post more on this if the thoughts should arise.




So there’s that. To fill an emotional emptiness with a physical, well ::grins:: I don’t have an argument for this. I also believe that when it comes to sex, people with BPD are more likely to be sexually open and adventurous. We can be virtually uninhibited. Or exactly the opposite. I’ve noticed a trend towards the extremes. Either we’re all or nothing. So you may have borderlines like myself that are ALL for sex or those that have severe issues from resultant traumatic experiences and avoid it whenever possible.

Another theory comes from Thomas R. Lynch, a psychologist at Duke University. He and his colleagues found a clue in the reading of facial expressions. “The researchers asked 20 adults with BPD and 20 mentally healthy people to watch a computer-generated face change from neutral to emotional. They told subjects to stop the changing image the moment they had identified the emotion. On average, the people with BPD correctly recognized both the unpleasant expressions and the happy faces at a much earlier stage than the other participants did. The results suggest that BPD patients are hyperaware of even subtly emotive faces—problematic in people who are intensely reactive to other people’s moods. So, for example, a hint of boredom or annoyance on a person’s face that most people would not notice might produce anger or fears of abandonment in a person with BPD. Conversely, someone with BPD might see a happy expression as a sign of love and react with inappropriate passion, leading to the whirlwind, stormy romances that rock the lives of people with BPD.”

I’ve talked about hypersensitivity before. It’s very easy to read too much into what we see in someone else and I do think this theory has some validity, but I don’t think it’s substantial all on its own. This may be a contributing factor but not the main reason.


I’ve said before that I use sex as a means to be close, but not too close. It’s comforting. It allows that very real, very human connection that makes me feel less hollow and alone, while maintaining my safeguards.  I’ve been so hurt and traumatized due to past abuse and experiences that while some part of me does need this closeness, at the same time I do not trust it. There’s something more personal about letting someone into my mind, than into my body. If I can distract them with my body, they’ll have proven themselves not trustworthy enough to get into my mind, but at the same time, I have someone near. I’ll have validated my own paranoia and satisfied my need to not be alone. How’s that for messed up. When I’m alone I feel empty. Sex is one of those ultimate expressions of being not alone. Having your life literally interwined in the arms and legs of another, it’s an encompassing experience, without being completely consumed. There’s the ability to maintain a distance while holding someone close. Or maybe there’s some overdeveloped primitive instinct that if we find a partner, let them into our lives in such a way, we will develop a bond. And from there maybe a lasting one. The more partners, the greater the likelihood of this happening.



9. Your best friend/partner is one strong motherfucker.
You have both preciously loved and vehemently hated them. You’ve probably accused them of not caring about you and maybe even caused a fight based on your feelings, not fact. One particularly damaging feature of BPD is what’s called “splitting,” which is when you alternate between idealizing and devaluing a person. Way more often than not, you don’t even know you’re doing it and it can occur over anything from a full-on blowout to a perceived slight, regardless of the other person’s true intentions. For me, I tend to experience splitting with the people I care about most and have the greatest fear of losing. The intense Borderline fear of being abandoned by someone you love can drive you to both obsess over their involvement in your life and also push them away in response to perceived or anticipated rejection. My favorite BPD book is appropriately called, “I Hate You, Don’t Leave Me,” and the title, though a little cheesebally, accurately describes how splitting feels. You both love the person for the fuzzy feelings that the close relationship fosters and hate them for the equally unfuzzy and scary feelings that losing that close relationship provokes.
10. You are also one strong motherfucker.
Having BPD pretty much guarantees you a rough time in maintaining healthy, stable relationships, regulating your emotions, reacting to stress, subduing your impulsive whims, and remembering who you are and what you value at all times. It’s a hard disorder to live with. But it gets easier with the more awareness you have about yourself and the more willing you are to act in healthy ways, despite how it goes against everything that comes naturally to you. It gets better, Borderlines! And then it gets worse. But then it gets better again! And so on, until you’ve got a firm grasp on identifying the BPD parts of your personality and knowing how to use what you know to be the best person you can be. Because honestly, that’s how we’re going to successfully love someone healthily and be loved back, to give respect and be respected, to understand and be understood. As a person with Borderline Personality Disorder, I spent most of my life feeling like the weary captain of a damaged ship, trying to stay afloat in a treacherous storm.
I spent years wallowing in despair about my situation instead of working to save myself from myself. If you have BPD, you’ve probably unknowingly spent your life trying to get others to save you, but this simply isn’t possible. Please remember: yes, the storm within you is raging, chaotic, and seemingly endless, but all you must do is hold on and navigate your way out of the storm. A happy, healthy life does exist beyond.



Lack of Object Constancy
 “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.”

Object Constancy - They may have problems with object constancy. When a person leaves (even temporarily), they may have a problem recreating or remembering feelings of love that were present between themselves and the other. Often, BPD  patients want to keep something belonging to the loved one around during separations.


My therapist tells me I have a lack of object constancy.


Out of sight, out of mind: For me, I don’t believe people hold me in their memories. If I’m not around, or I am not in some form of contact/communication with them, I don’t exist in their world. I have an extraordinarily hard time holding onto the thought that people remember me, hold me dear or care for me when I am not in their physical presence. Out of sight, no longer connected. I'm sure to most people this is not how they perceive relationships (be it friendship, dating, familial). I think it should be a consistent progression of emotions and experiences that build together to form a deep bond. I also have a hard time holding onto the strong emotions I feel for those I care about, and when I do manage to I also manage to convince myself that I am the only one that feels this way and no one else could possibly share my depth of emotion though I desperately hope they do. This creates a feeling of panic and loss for something that may actually be there and I need to find a way to reaffirm these feelings in myself and others every time I am back in contact with them. It’s a maddening cycle of doubt, loss, connection and disconnection.

Holding Time:  I have a hard time holding together one event after the other. I remember events just fine, but holding onto the sentiment of events in series that something is bound. It doesn't always feel to me that everything is connected. One thing may happen after another, but it does not seem like things hold together in essence after the former has passed. Like if I'm gone too long, that I was there before will cease to be  relevant. There is no continuum of events. Everything is like a single instance in time and I have to completely reestablish how I am connected to the event, the environment, the people every time.  It’s very difficult for me to remember that everything is NOT a series of individual events. They ARE a continuum. The attachment of one event bleeds into the sentiment of the next giving life to yet another. That continuum is what binds memories, sentiment, and relationships. Yes? At least that is what I imagine it should be. I imagine so, I don’t feel it.

I often have terrible anxiety when people leave. There’s a desperate need to understand how others feel about me, hold me to them, our connection, because I can’t hold onto this concept myself. On the other hand, when people do leave, abandon me, never to return, after a while it’s as if they were never in my life. I have memories of experiences with people, but no emotional connection to the memories. It’s like I’m remembering a story someone else told me. Sometimes this happens immediately, other times it takes weeks of panic at the loss before I break from the emotional attachment I’ve been able to build. Lately though, I notice this happening more and more quickly, with less time spent obsessing over every instance that lead to the break.

My dissociation helps me here because after the initial fear and anxiety, my emotions deaden. I become numb to the experiences I have just been through. I feel detached from my own body and it becomes logical that others wouldn’t be attached to me when I am not even attached to myself.

How attached are things, moments in time, events, really? How does it feel to be so strongly bound by sentiment that you feel indefinitely connected by a series of things? I simply don’t know.

What is borderline personality disorder?
BPD is one of many personality disorders listed in the manuals used by doctors when they are giving someone a psychiatric diagnosis.
Below are the symptoms of borderline personality disorder according to government guidelines (National Institute for Health and Care Excellence [NICE] 2009). A doctor may diagnose you with borderline personality disorder if you have five or more of these symptoms and if the symptoms have a significant impact on your everyday life.
• you have emotions that are up and down (for example, feeling confident one day and feeling despair another), with feelings of emptiness and often anger
• you find it difficult to make and maintain relationships
• you have an unstable sense of identity, such as thinking differently about yourself depending on who you are with
• you take risks or do things without thinking about the consequences
• you harm yourself or think about harming yourself (for example, cutting yourself or overdosing)
• you fear being abandoned or rejected or being alone
• you sometimes believe in things that are not real or true (called delusions) or see or hear things that are not really there (called hallucinations).
If you have been diagnosed with borderline personality disorder you may be more likely to experience other mental health related problems, such as depression, anxiety, eating disorders or substance misuse (misusing drugs or alcohol).
The question of 'personality disorders' is controversial. What some experts term as 'personality' others regard as 'the self'; so any suggestion that a person's self is disordered, damaged or flawed can be distressing. What matters is that you get the help you feel you need. If after reading this booklet you feel you may have BPD, you may want to talk to someone who is medically qualified – be very wary of making a self-diagnosis.
How common is BPD?
BPD is thought to affect less than one per cent of the general population. It's been estimated that three-quarters of those given this diagnosis are women. It's a condition that is usually diagnosed in adults only.
What if I disagree with the diagnosis?
Some people feel they are only given this diagnosis because they do not fit easily into any other category. If you feel your GP or psychiatrist has misunderstood you, you are entitled to ask for a second opinion, although this doesn't necessarily mean that your request will be granted. If you are having problems getting the help you need, you may find an advocate (someone who can speak up for you and support you) useful. (For more information about advocates, contact the Mind Infoline or see The Mind guide to advocacy.)
What are the common feelings and experiences of people with BPD?
If you have BPD you may have had a series of unstable and intense relationships, or felt the need to cling too long to damaging relationships. This may be because you feel insecure, alone or lack self-worth.
You may have a poor self image, feel that you don't fit or belong, and find that your moods and feelings change rapidly. Therefore you may find social relationships difficult.
I have BPD and for me it feels like [I'm] a child being forced to live in an adult world. I feel too fragile and vulnerable for the world I live in.
Many people with BPD experience a deep sense of emptiness.
Feeling bereft and lifeless – with a void I can't fill no matter how much food I put down or activity, exercise, self harm and constant thinking I've gone through. I try to keep busy to combat the emptiness but it only masks it. The best antidote is to try to experience life and relationships more fully, then store the better memories.
You may feel tempted to harm yourself if your emotions become intensely painful and hard to cope with or express.
When it was really bad, I would be in so much emotional pain that suicide seemed like the only way I could find any release. My attempts at overdosing kept failing: I was secretly screaming for someone to just listen to me and show me a way out. But in the end, if they wouldn't or couldn't be bothered to help me I would rather have been dead than carry on as I was – I just didn't care about anything, apart from getting rid of the pain.
Research shows that people with BPD are more likely to have suicidal thoughts and make suicide attempts compared to people with other psychiatric diagnoses. If this applies to you, or someone close to you, you can find information about where to get help in Getting help in an emergency.
What causes BPD?
The causes of BPD are unclear. Most researchers think that BPD develops through a combination of factors, including temperament, childhood and adolescent experiences. Difficult life events such as the early loss of a parent, childhood neglect, sexual or physical abuse are common in people diagnosed with BPD, though this is not always the case.
Stressful experiences, such as the break-up of a relationship or the loss of a job, can lead to already present symptoms of BPD getting worse.
Identity Disturbance
Definition:
Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view
Who Are You Today?
Identity disturbances involve an illogical or incoherent, inconsistent pattern of thoughts and feelings which go beyond logical pessimism, low self-image or a negative outlook. People with an Identity Disturbance may frequently speak, think or act in ways which are contradictory, even to themselves. They may think their fabulous one day, and think nothing of themselves the next. Their actions or thoughts may flip from self-serving into self-effacing, or from healthy choices into self-destructive patterns for no apparent reason. They may excel in one activity and appear incompetent in another, or oscillate seasonally from energetic and enthusiastic to lethargic and withdrawn.
This arises partly because positive and negative thought patterns are not always based on facts. The human mind has an ability to simplify the complexity of the world with quick, emotional judgments about what we consider good and bad, desirable and undesirable. However, if a person’s emotional thoughts are not backed up by rational fact-based thoughts, this emotional “shorthand” can result in erroneous black and white thinking - known as splitting - which when applied to the self can lead to an inaccurate self-perception.
People who suffer from Personality Disorders are sometimes prone to think more emotionally than logically. This can lead to extreme emotional highs and lows in response to the natural ebb and flow of life’s circumstances, which can lead to make unsubstantiated, grandiose claims of superiority one day and self-condemning statements of worthlessness the next.
In a 2000 study of patients with identity disturbances, Tess Wilkinson-Ryan, and Drew Westen identified four types of identity disturbance:
1. Role absorption (in which patients tend to define themselves in terms of a single role or cause),
2. Painful incoherence (a subjective sense of lack of coherence),
3. Inconsistency (in thought, feeling, and behavior),
4. Lack of commitment (e.g., to jobs or values).
The researchers concluded that identity disturbance distinguishes patients with borderline personality disorder from other psychiatric patients and that it occurs in patients with BPD whether or not they have a history of being abused.
Source: Identity Disturbance in Borderline Personality Disorder: An Empirical Investigation by Tess Wilkinson-Ryan, A.B., and Drew Westen, Ph.D.
What it Looks Like
• A woman frequently flips between describing herself as a “great catch” and as a failure in relationships.
• A mother oscillates between seeing herself as indispensable to her children and rejected by them.
• A man is a high-functioning, charismatic over-achiever at work and a depressed recluse at home.
What it feels like
People who live with someone who has an identity disturbance often find themselves wondering which “face” they will be presented with when they next walk through the door. They may try to find logical patterns in their behavior, or try to work out ways to control their mood.
Because of the inconsistencies in what the person with the Personality Disorder is doing and saying, Nons may accuse them of “faking it” or “putting it on”. They may begin to suspect that the person with the Personality Disorder is presenting a false negative view in order to excuse themselves for breaking promises, escape from consequences of their behaviors or to avoid responsibility.
When you are living with a person who has an Identity Disturbance, the only workable choice is usually to accept they have a psychological condition which is unrelated to external events and circumstances. It’s tempting to try to improve the situation by repeating arguments or reactions that have worked for you in the past - or in other relationships – however, this will generally result in confusion or frustration.
What NOT to do
• Don’t put yourself in the role of the “fixer” of a loved one’s mood or feelings. You weren’t responsible for getting them into a negative thought pattern and it’s not your job to get them out of it.
• Don’t feel obliged out of “love” or “commitment” to join in with a downward spiral of negative thought. They are free to have negative thoughts and you are free to have positive ones.
• Don’t thought-police or unleash a barrage of criticisms about their attitude or their mood. Allow a person with a Personality Disorder to own their own thoughts and feelings. That’s their stuff.
• Don’t nag, argue for hours, or get into circular conversations.
• Don’t try to manipulate them “out of it” by trying to change the mood or the environment. Their sudden mood change was probably not caused by an external event and probably won’t be fixed by it.
• Don’t blame yourself for what the other person is feeling or how they are behaving. Don’t look for ways to change yourself to try to fix another person. You are only responsible for your own words and actions.
• Don’t stay in the room if the situation becomes physically, verbally or emotionally unhealthy.
• Don’t go it alone or keep what you are experiencing a secret.
What TO do
• Remind yourself that this is a mental illness and that you are not to blame.
• Detach yourself from being responsible for how another person is feeling, behaving or thinking.
• Turn your attention on your own behavior and your own thought patterns. Discard the unhealthy and learn what is healthy for yourself and pursue it - regardless of what reaction you get from the person with the Personality Disorder.
• Talk about it! Talk to trusted friends and family about what you are dealing with.
• If you are ever confronted with violence or abuse, get yourself and any children immediately out of the room and call for help. Report all acts of violence, threats of violence or self-harm to the police.
• Maintain your healthy lifestyle and thought patterns. You will need them. If necessary, explain to your loved-one gently, but firmly that you are doing what you need to do for yourself and then close the conversation.

________________________________________
For More Information & Support...
If you suspect you may have a family member or loved-one who suffers from a personality disorder, we encourage you to learn all you can and surround yourself with support as you learn how to cope.
• Support Forum - Read real stories. Ask questions.
• Top 100 Traits of people with Personality Disorders.
• Toolbox - Ideas for coping and common mistakes.
• Personality Disorder Glossary - Learn the lingo.
• Links to Personality Disorder-related sites.
• Books about personality disorders.
Butcher, Baker, Candlestick Maker Career Issues with BPD Identity Disturbance person. Who is he, teacher or businessman?
Someone made an interesting observation about me the other day, and I have to admit, it's true.  Over the years, I've had a very difficult time sticking with any one job or professional career path.  I have gotten easily bored and, in the past (before learning DBT), would take this as a cue that I needed to change things up again. I would often find myself ending up in a state of emotional crisis and using this as an excuse to break free from my current job. I can now see that I often fed into my own fears and didn't feel confident in my own right to simply make a choice to move on. Instead, I sabotaged my circumstances and destroyed relationships, all to feel safe and start over again. Again and again.
According to the DSM (Diagnostical Statistical Manual of Psychiatric Criteria for diagnosing Borderline Personality Disorder, one of the main symptoms is:"Identity disturbance: Markedly or persistently unstable self-image or sense of self,"
"BPs may not have a clearly defined sense of who they are; as a result, it can be difficult to know where their job or career interests really lie. The BP may be looking for an identity in their job: a job gives an identity to the person, instead of the person's identity leading to a job. For instance, Susan cannot figure out what she wants to do, she has started several “careers” including teaching, script writing, retail, and medical technology, but nothing seems to be able to keep her interest. Susan keeps finding herself adding training classes and entry-level jobs to her resume. However, due to her identity issues, it is 10 years later and she is no closer to knowing what she wants to do for a living, nor has she finished any degree or certificate program.Over the years, to only name some of the jobs/careers I have done, I have been a: preschool teacher, telephone operator, makeup artist, advertising assistant, office manager, social worker, and a cashier. I am only in my mid 30's, mind you.Ah, the chameleon-like nature of one with BPD. And, what I am about to say about my past behavior, please know that at the time, I meant it with no malice. I didn't do these things in order to be deceptive, sneaky, or manipulative (though I can see how non-BPDs could interpret my/other people with BPD's behavior as such in this particular scenario), but I would study up for my interviews and have all of the right answers.  Most people do this anyway, but when I got to the interview, I studied the person interviewing me and others who worked there and tried to BE like them.  I didn't know how to just be me and never thought that trying to allow myself to do so would ever land me a job. I didn't think I was good enough and, in fact, didn't even know who I was.
While I never lied about my educational background or credentials and wasn't doing anything illegal, in retrospect, my experience was a lot like Leonardo DiCaprio's character in the film "Catch Me if You Can," in that he was able to assimilate into a variety of professional roles and mimic others around him in order to feel competent.Now, I look toward long term goals of stability, but I still do not have a real clear path laid out. I currently work part-time in an administrative professional role and am taking two post baccalaureate classes, but I am easily distracted. An example of this is that I love the show "Dancing With The Stars." I am so moved and amazed by the transformation and progress that these complete and total non-dancers make by the end of the show. Some end up looking as if they've been dancing their entire lives professionally.Each season, around the times when the show is starting and ending, I start to tell my boyfriend that I want to invest in professional ballroom dance lessons and want to become a dancer. Mind you, I have two left feet, no sense of kinesthetics, and no sense of rhythm. My boyfriend reminds me of how, when I see other people doing something that seems exciting, such as starting a cupcake business or moving to L.A. to do makeup on celebrities, I suddenly think that I, too, must do that same thing in order to be happy.He's right. For years, I would see someone living out their dreams with passion, and I would follow THEIR dreams, thinking it would make me happy.  Now I know that it isn't the object of THEIR desires that I was really seeking but to have that desire of my very own. It's taken many years to sort that out, but I've discovered that my passions are writing and helping others, hence this blog

Borderline Personality Disorder
June 10, 2013
Borderline Personality Disorder
“And only in the Remembrance of Allah will the hearts find tranquility” Holy Quran (13: 29)
Introduction
Borderline Personality Disorder (BPD) is a psychiatric personality disorder. It is so termed because these patients always seem to be hanging on the border between normal people or psychos, such are there behavioral and mood swings. From being perfectly all right in one second to being totally bizarre in the next second. They keep their audiences well awake most of the day!
Etiology
Borderlines are born with an innate biological tendency to react more intensely to lower levels of stress than others and to take longer to recover. They peak “higher” emotionally on less provocation and take longer coming down. In addition, they were raised in environments in which their beliefs about themselves and their environment were continually devalued and invalidated. These patients most likely experienced a lot of physical as well as psychological trauma/violence during much of their childhood & they were mostly helpless against the continued verbal & physical abuse.
Criteria for Diagnosis
• Intense unstable relationships in which the borderline always ends up getting hurt. One has to hesitate in diagnosing a patient as BPD without its presence.
• Repetitive self-destructive behavior, often designed to prompt rescue.
• Chronic fear of abandonment and panic when forced to be alone.
• Distorted thoughts/perceptions, particularly in terms of relationships and interactions with others.
• Hypersensitivity, meaning an unusual sensitivity to nonverbal communication.
• Impulsive behaviors that often embarrass the borderline later.
• Poor social adaptation: in a way, borderlines tend not to know or understand the rules regarding performance in job and academic settings.
Further Borderline characteristics
1. Affect
Chronic/major depression, helplessness, hopelessness, worthlessness, guilt, anger, anxiety , loneliness , boredom, emptiness
2. Cognition
odd thinking, unusual perceptions, non-delusional paranoia (thinking that others are harming/planning to harm him)
3. Impulse action patterns
Substance abuse/dependence, sexual deviance, manipulative suicide gestures, other impulsive behaviors e.g. drinking, gambling,
4. Interpersonal relationships
Intolerance of aloneness. Fear of abandonment, engulfment, annihilation fears, stormy relationships, manipulativeness, dependency , devaluation, masochism/sadism, demandingness, entitlement
Borderline Traits
Traits involving emotions:
Quite frequently people with BPD have a very hard time controlling their emotions. They may feel ruled by them. One researcher said, “People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.”
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
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.
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. Someone with BPD said, “I have a hard time figuring out my personality. I tend to be whomever I’m with.”
6. Chronic feelings of emptiness or boredom. Someone with BPD said, “I remember describing the feeling of having a deep hole in my stomach. An emptiness that I didn’t know how to fill. My therapist told me that was from almost a “lack of a life”.
Traits involving relationships
7. Unstable, chaotic intense relationships characterized by splitting.
8. Frantic efforts to avoid real or imagined abandonment
• Splitting: the self and others are viewed as “all good” or “all bad.” Someone with BPD said, “One day I would think my doctor was the best and I loved her, but if she challenged me in any way I hated her. There was no middle ground as in like. In my world, people were either the best or the worst. I couldn’t understand the concept of middle ground.”
• 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. This happens often.
• Great difficulty trusting people and themselves. Early trust may have been shattered by people who were close to you.
• Sensitivity to criticism or rejection.
• Feeling of “needing” someone else to survive
• Heavy need for affection and reassurance
9. Transient, stress-related paranoid ideation or severe dissociative symptoms
This means feeling “out of it,” or not being able to remember what you said or did. This mostly happens in times of severe stress.
Mass Awareness & Vigilance of BPD
1. Public Awareness: The public should be taught these basic criteria for diagnosing a patient of BPD so that the person him or herself tries to seek treatment (which is very rare) or his family members seek treatment for him/her.
2. Vigilance: Be on lookout for Borderline: If you know anyone in your immediate or near family, your neighbors, your friends, your colleagues or any other acquaintances who you suspect most likely fulfill these criteria, then seek immediate treatment/contact health administrator/NGO
Treatment of BPD
Since this personality disorder brings the most suffering for the patient himself as well as his close ones, treatment is immediately required. It maybe the only way of saving a stormy marriage or a broken family. One thing that the family members or close ones can remain assured about: the person with BPD in reality loves them and cannot live without them; he doesn’t behave like this with people who he doesn’t love; so one should never let go of these people that easily: SEEK TREATMENT!
Psychological Treatment:
This includes different types of behavioral therapy including cognitive therapy. Cognitive therapy tries to change how a person thinks and involves talk therapy that focuses on helping the person understand how their thoughts and behaviors affect each other.
Other types of psychotherapy include interpersonal and psychoanalytical therapy.
Pharmacological Therapy:
The use of psychiatric treatment medications, like antidepressants (for example, fluoxetine , sertraline , citalopram, escitalopram , venlafaxine , duloxetine, or trazodone , mood stabilizers (for example, divalproex sodium , carbamazepine , or lamotrigine , or antipsychotics (for example, olanzapine , and risperidone may be useful in addressing some of the symptoms of BPD but do not manage the illness in its entirety. However there is increased tendency to commit suicides with medications. Partial hospitalization is an intervention that involves the individual with mental illness being in a hospital-like treatment center during the day but returning home each evening.
Best Treatment:
Obviously the best treatment is cognitive & spiritual therapy from reading the Holy Quran/Bible, remembering God in zikr (remembrances) and in prayers especially Tahajjud (late night prayers) and seeking his forgiveness.
Famous People with BPD:
As someone once said “Nations sometimes tend to suffer personality disorders as a whole, en masse”. Well, it certainly goes true for Pakistan for it seems the nation as a whole may be suffering from Borderline Personality Disorder! Our leaders surely made some impulsive decisions like President Musharraf! It is however much under-diagnosed in this country due to scarcity of psychiatrists as well as lack of public awareness and the sense of shame attached with visiting a psychiatrist.
(Late): Lade Diana, Angelina Jolie, Britney Spears are famous personalities with BPD.
Books Recommended on BPD
1. I Hate you, don’t leave me by Randi Kreger
2. Sometimes I act crazy by Jerold Kreisman
3. Get me Out by Rachael Reiland
4. Treatment of BPD by Joel Paris
By the way, how many of you are thinking you have BPD after reading this article?

PART OF THE “BREAKING THE CODE OF SILENCE” SERIES



In my early teens I began to experience overwhelming, unshakeable mood swings that, like a lens applied to my perspective, coloured my life. I would feel them starting, a slow-motion crushing sensation, like being caught in an industrial compactor, and I would be filled with dread.
I needed to be around people when they occurred, the places my thoughts took me to frightened me, but I was criticised at home for being moody, so I spent a lot of time alone waiting for them to pass.
What is Borderline Personality Disorder?
I suffer from Borderline Personality Disorder (BPD). I was first treated for depression at 15 but doctors can’t make a diagnosis of BPD on an adolescent, due to their personality still being in its formative stage. It’s a condition in which people exhibit long-term patterns of instability and turbulence in the areas of self-image, relationships and emotions.
There are 10 classified personality disorders and of those, BPD is the most common, most complex, most studied, and certainly one of the most devastating, with up to 10% of those diagnosed committing suicide. It exists in approximately 2-4% of the general population; up to 20% of all psychiatric inpatients and 15% of all outpatients.
How is it diagnosed?
A person is required to be exhibiting five or more of the symptoms below for a diagnosis of BPD to be made:
• Frantic efforts to avoid real or imagined abandonment
• A pattern of unstable and intense relationships characterized by alternating between extremes of idealization and devaluation
• Identity disturbance, such as a significant and persistent unstable self-image or sense of self
• Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
• Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
• Emotional instability due to significant reactivity of mood (e.g., intense episodic depression, irritability, or anxiety)
• Chronic feelings of emptiness
• Inappropriate, intense anger or difficulty controlling anger
• Transient, stress-related paranoid thoughts or severe dissociative symptoms
What causes it?
BPD is thought to result from a mixture of biological, genetic, social and psychological factors. In other words doctors aren’t sure and are keeping their options open, but studies have shown a high correlation between traumatic events during childhood and occurrence of BPD. I always knew my experiences growing up and my relationship with my parents were responsible for a large part of my mental health issues and as I grew older, I tried to maintain a distance from them to help myself. But it was incredibly difficult to accept that they weren’t the supportive family I needed and every so often I would allow myself the hope that perhaps they could be. That never proved to be the case.
Thankfully, with BPD, the symptoms become less intense as a person ages and sufferers experience few of the extreme symptoms by the time they reach their 40’s or 50’s.
What does BPD mean to me?


A diagnosis of BPD at 25 didn’t give me any great insight at the time, beyond the confirmation that I wasn’t completely to blame for my uncontrollable mood-swings and self-destructive tendencies. I was in a very dark place, frequently suicidal, self-harming and full of self-hate. It wasn’t until much later, after therapy, that I began to gain a greater understanding of myself, and even then, it could be frustratingly fleeting; a glimpse of something that resonated within me but was too intangible to pin down.
While symptoms differ from person to person, my BPD affected me in a number of ways:
• I experienced frightening mood swings for no apparent reason, and needed company to distract me from them. It was like having a video constantly playing in your head and being unable to switch it off. I couldn’t sleep or concentrate. Sometimes I used music to escape it, as I got older I used alcohol and drugs. I used to wish I could be knocked unconscious and wake up when it had passed.
• I had difficulty dealing with emotional reactions to things. Even today I’m not conscious of what I feel straight away, it takes a while for it to condense into something I can verbalise. I might experience extreme anger and frustration but be unable to express it – this led to me taking it out on myself by either demolishing my confidence with self-doubt or punishing myself physically through impulsive, destructive behaviour – cutting, substance abuse, starvation, binging and purging. I would feel the anger building and be scared of what it would force me to do. At times like that, calling The Samaritans helped me through. They didn’t judge, just listened sympathetically and that gave me the strength I needed to hang on.
• I experienced Splitting, “All-Or-Nothing Thinking” where everything was either one extreme or another: good or evil, innocent or corrupt, I would put people on a pedestal only to tear them down and demonise them when I felt slighted. I would easily become paranoid and read all sorts of things into a person’s behaviour. I would over-analyse my own words and actions, terrified I had inadvertently offended someone and caused them to dislike me.
• I had periods of Depersonalisation – a feeling of watching yourself while having no control over the situation. I could feel myself becoming distant, travelling to a kind of empty place with no feelings. I used to dream a lot about trying to say something but being unable to make myself heard, or trying to run from something but being unable to make my legs work. I felt like I didn’t exist, I was on the wrong planet; I couldn’t relate to the people around me – I looked like them on the outside but inside was an empty space.
• One of the core areas of BPD is concerned with identity and self-image. I remember my husband telling me once that he knew me better than I knew myself. That’s an uncomfortable thing to hear. To a certain extent I had to agree with him – his logic and ability to recognise the patterns in my behaviour and thought processes enabled him a clearer view than I could ever hope for. But at the same time, I knew he was completely unaware of the intensity and nature of the thoughts that invaded my consciousness. The dark ones are too horrific to share and the light ones (I thought) just made me sound ridiculous.  It feels impossible to put them into words – like trying to catch a cloud in a matchbox.
I still don’t have a clear sense of who I am. If asked to describe myself, I have to consult other people. On one level, I know I have opinions, likes and dislikes. I HATE mushrooms and I know the difference between right and wrong, but there seems to be something in me that is very impressionable. Every time I watch a film I come away identifying with some aspect of a character and wondering if that’s who I am. For a while, my thoughts and behaviour might change, until the influence wears off and I’m back to being a blank canvas again. I feel as though I have some definable “pieces” but they’re not enough, or don’t fit to make a whole person.
Learning to live with it
I was treated with medication to get my head into a better place and I had Cognitive Behavioural Therapy to help me deal with my triggers. I discovered the thought and behavioural patterns I had become enmeshed in and worked hard to undo years of ingrained habit. It was slow and difficult work. I would get so frustrated when I could identify my problems but my habitual response would automatically kick in. Knowing the problem was one thing, but fixing it was another. It was particularly difficult to deal with people who triggered my symptoms but I eventually faced them and voiced my feelings. Doing this, in spite of my fear, gave me strength in the face of their denial and helped to give me another tangible “piece” of Me to fit with the others.
Hard work and persistence won out in the end. I wanted to change things, and with support from my husband and mental health team I did. I finally received confirmation from The Priory that I was in good mental health and no longer required treatment. That was some years ago now. I still have difficult times, but I know that if I dig deep, I have the tools to get through them. Thankfully now those times are few and far between.

Famous People with Borderline Personality Disorder
Borderline personality disorder (BPD) is a type of mental health disorder that causes significant amount of emotional instability. It can cause a variety of other stressful behavioral and mental issues, such as severely distorted self-image and may feel worthless and flawed fundamentally and is characterized by anger, frequent mood swings and impulsiveness. However, there are many great and famous people who suffer from borderline personality disorder and who had made great contributions to the world.
Doug Ferrari
Doug Ferrari, also known as “Dougzilla,” is one of the famous comedians whose life changed after he was diagnosed with borderline personality disorder. He suffered from severe anger outbursts, beating his wife and ultimately destroying his home. He was even sent to jail due to doing this. However, now, he is dedicated to personal therapy, maintenance, medications and performs at charity events, trying his best to spread awareness about BPD. Since the year 2004, he has been clean and sober and he will never forget the community support that he was provided especially by Pritchard, who encouraged him to attend recovery group meetings and also helped him with his turnaround.
Angelina Jolie

Angelina Jolie is a famous American actress, screenwriter, film director and author. She has been given an Academy Award, three Golden Globe Awards and two Screen Actors Guild Awards. In the years 2009, 2011 and 2013, she was named Hollywood’s highest-paid actress by the Forbes magazine. Angelina Jolie went voluntarily into a Neuropsychiatric Institute in the late 1990’s as she claimed suicidal and homicidal ideations. However, it was reported that she had no intention or plan to carry them out. She was given a diagnosis of presumptive borderline personality disorder, which stands of an Axis II Personality Disorder in the Diagnostic and Statistical Manual of Mental Illness (DSM-IV).
Lindsay Lohan

Lindsay Morgan Lohan is an American actress, recording artist and model. She started her career when she was only three years old as a child fashion model. She earned several MTV Movie Awards and Teen Choice Awards for Freaky Friday and Mean Girls. Lindsay Lohan participated in AA in the year 2006 and suffered from a car accident in the year 2007, when authorities obtained cocaine from her vehicle. During the year 2007 only, she was arrested and sent to rehab for a DUI. She starred in The Other Side in the year 2009; however was fired from it in the year 2010. She has been sentenced to jail this month as she has violated the terms of her probation. She is suspected universally of getting BPD.
Britney Spears

Britney Jean Spears is an American singer-songwriter, recording artist, dancer, entertainer, actress, occasional author and a former television music competition judge. Britney Spears is accused of extremely impulsive behavior when she married her childhood friend Jason Allen Alexander in January 2004 at The Little White Wedding Chapel in Las Vegas. The marriage was annulled after a mere 55 hours and it was stated that Spears “lacked understanding of her actions”. Her second marriage also lasted for a short duration. She shaved her head bald, was admitted to rehab centers and has felt as if she is a bad kid suffering from ADD. Also her behaviors showed indications of BPD.
Amy Winehouse

Amy Jade Winehouse was and English songwriter-singer. She battled with substance abuse which was the subject of media attention when it occurred. In the year 2005, she had a period when she drank heavily, abuse drugs, and suffered from violent mood swings and weight loss. Moreover, she admitted in various interviews of having problems with depression, self-harm and eating disorders. In the year 2008 she started binge drinking after she kicked a drug habit. By the summer of 2011, she started a pattern of abstaining from alcohol for a few weeks and then relapsing into drinking habit. In the morning hours of 23rd July 2011, she died of one such relapse which led to alcohol intoxication.
Courtney Love

Courtney Michelle Love is an American singer-songwriter, musician, artist, actress and author. For a great deal of her life she has struggled with problems of substance abuse. In her early adult years, she had experimented with numerous opiates. At the age of 19, she tried cocaine. In the year 2003, she was arrested for breaking windows of the apartment of her boyfriend while she was under the influence of a controlled substance. She was then treated for an accidental overdose of oxycodone. She was admitted to rehab after she lost custody of her daughter. She then entered house arrest after she violated the terms of her parole. This behavior of Love is analogous to outbursts of BPD.
Princess Diana

Princess Diana had struggled to get rid of an eating disorder. She also faced difficulty in maintaining relationships. According to some experts her BPD was the result of divorce of her parents and the neglect during her childhood years. Her relationship with Prince Charles was broken due to her behavior of self-mutilation, one of the most indicative traits of borderline personality disorder, binge eating and promiscuity. One of the Princess’s relatives quoted that Diana was of a perfectly good character but was short tempered, a trait which overtook her. Borderline personality identifies her temperament. Diana used to cut her arms and legs when her emotional pain became intolerable.
Marilyn Monroe

An American model, actress and singer, Marilyn Monroe went on to become a major sex symbol during the years of 1950s and early 1960s. She starred in a number of successful commercial motion pictures during that time. Marilyn Monroe demonstrated traits of BPD including promiscuity, drug abuse and suicidal ideation. She also suffered from low self-esteem and out of fear of abandonment she demonstrated extreme attachment in relationships. She died from an overdose of barbiturates, which became the subject of conjecture. Her death was classified as a “probable suicide” officially; however, the possibilities of a homicide or an accidental overdose of drugs have not been ruled out completely.




Who Am I? Borderline Personality Disorder and Identity Problems
Understanding Identity Issues in BPD

• BPD
 IStockphoto 2008 © Tatiana Gladskikh
Do you ever find yourself asking: Who am I? What do I believe in? What is my place in this world? If you do, you are not alone. Many people with borderline personality disorder (BPD) struggle with identity issues -- one of the core symptoms of the disorder.
Plenty of people without BPD struggle with identity issues, too. But people with BPD often have a very profound lack of sense of self. If you struggle with the feeling that you have no idea who you are or what you believe in, this may be a symptom you can relate to.
"Who Am I?" – What Is Identity?
What exactly is “identity”? Identity can be hard to describe, but let’s look at how some experts would define it.
First, most experts view identity as your overarching sense and view of yourself. A stable sense of identity means being able to see yourself as the same person in the past, present, and future. In addition, a stable sense of self requires the ability to view yourself in one way despite the fact that sometimes you may behave in contradictory ways.
Identity is quite broad, and includes many aspects of the self. Your sense of self or identity is probably made up of your beliefs, attitudes, abilities, history, ways of behaving, personality, temperament, knowledge, opinions, and roles. Identity can be thought of as your self-definition; it’s the glue that holds together all of these diverse aspects of your self.
Why Is Identity Important?
Having a sense of identity probably serves many different functions. First, if you have a strong identity, it allows you to develop self-esteem. Without knowing who you are, how can you develop a sense that you are worthwhile and deserving of respect?
In addition, a strong identity can help you to adapt to changes. While the world around you is constantly changing, if you have a strong sense of self, you essentially have an anchor to hold you while you adapt. Without that anchor, changes can feel chaotic and even terrifying.
The Question "Who Am I?" and BPD
One of the symptoms of BPD listed in the Diagnostic and Statistical Manual of Mental Disordersis “identity disturbance,” or a markedly and persistently unstable self-image or sense of self. For example, consider this quote from a borderline patient that was included in a review of the topic published in the Journal of Personality Disorders):
“. . . it is very difficult for me to let other people get close to me. I am simply too afraid that they will discover that I am nothing at all, that I am nobody, a shadow, a ghost. I am afraid that they will find out that I don’t have any opinion about anything, no attitudes, no ideology, that I don’t know anything about anything, and suddenly they will figure out how boring I really am.”
People with BPD often report that they have no idea who they are or what they believe in. Sometimes people with BPD report that they simply feel “non-existent.” Others even report that they are almost like a chameleon in terms of identity; they change who they are depending on their circumstances and what they think others want from them.
For example, you might find yourself being the “life of the party” at social events, but having a somber and serious demeanor at work functions. Of course, everyone changes their behavior to some degree in different contexts, but in BPD this shift is much more profound; many people with BPD report that in addition to behavior, their thoughts and feelings change to match the current situation.
Identity problems in BPD are sometimes called “identity diffusion.” This refers to difficulties determining who you are in relation to other people. Some people with BPD may describe this as having difficulties understanding where you “end” and the other person “begins.” As a result, many people with BPD struggle to set up and maintain healthypersonal boundaries.
Why Do People With BPD Have Identity Problems?
Unfortunately, there has been very little research on the identity problems associated with BPD, but there are many theories as to why people with BPD often struggle with identity.
For example, Marsha Linehan, Ph.D., who founded dialectical behavior therapy, believes you develop identity by observing your own emotions, thoughts, and feelings, in addition to others’ reactions to you. If you have BPD and the associated emotional instability, impulsive behavior, and dichotomous thinking, you may have difficulty forming a coherent sense of self because your internal experiences and outward actions are not consistent.
In addition, many people with BPD come from chaotic or abusive backgrounds, which may contribute to unstable sense of self. If you determine who you are based on others’ reactions to you, and those reactions have been unpredictable and/or scary, you have no framework for developing a strong sense of identity.
How to Find Yourself
So how do you go about answering the question “who am I?” Of course, there is no magic solution for identity problems -- these issues are complicated. However, most treatments for BPD include components that can help you to begin to discover who you are and what you stand for. The first step in finding yourself is finding a good therapist who can help you work on identity problems.
In addition, there are ways that you can work on identity issues on your own. For example, this exercise is one way that people begin to discover their own identity:
• Values Exercise: Finding Meaning

Finding Meaning
An Exercise to Help You Find More Meaning in Your Life
Do you need help finding meaning in your life? Many people with borderline personality disorder (BPD) struggle with feelings of emptiness, identity problems, and depressed mood. Together, the symptoms of BPD can leave you searching for meaning in your life.
This is one exercise that is designed to help you identify what is meaningful to you. Of course, finding meaning is not an easy process, and no one exercise will get you there; finding meaning takes work and is best accomplished with the help of a good therapist. In fact, this may be an exercise that you want to work on with your therapist.
Finding Meaning – What Is Meaningful to Me?
The first step toward finding meaning in your life is to determine what aspects of your life are meaningful to you. This exercise, which is adapted from an exercise from Acceptance and Commitment Therapy (a type of cognitive behavioral therapy that is related to Dialectical Behavior Therapy for BPD, can help you assess what is meaningful to you.
To begin this exercise, take out a notebook or a sheet of paper. Down the left side of the page, write the following list:
• Intimate Relationships
• Parenting
• Family
• Friendships/Socializing
• Education/Personal Growth
• Career
• Recreation
• Spirituality/Religion
• Physical Health
• Helping Others
Now that you have the list, next to each item write a number between 1 and 5 that corresponds with how important you personally find each area to be in your life, with 5 = extremely important and 1= not at all important.
If you are not sure, just write a question mark. Remember that there are no right answers, and no one will ever have to see this list. Just write down what you feel is important to you (not what anyone else says should be important to you).
Finding Meaning – Define What Would Bring You Meaning
Now that you have rated each domain on the list in terms of importance to you, pick the two domains that you rated as most important. If you rated every domain as exactly as important as any other, go back and think about whether there is actually one or two domains that stand out as more important than the others (even if only by a little bit).
For the one or two domains that you picked out as most important, write one or two sentences about how you would like to behave in each domain. This is important- this is not about how you would like to feel or think (e.g., I would like to be confident and self-assured). Instead, focus on behavior, or how you would like to act in that domain. Here is an example from the “intimate relationships” domain:
”I would like to be a kind and caring partner. I would like to say supportive things to my partner when they are feeling down, and I would like to do things for them that will help make their life a little easier. I would also like to act as if I am worthwhile in relationships by asking for the things I need.”
Finding Meaning – Putting It Together
Now look at what you have written how you would like to behave in the one or two domains that you chose as most important to you. Hopefully you have written one or two sentences that describe behaviors or actions that you would like to take in those domains. These are the types of actions that can help you find meaning in your life—these are the ways that you would like to be in the areas of your life that are most important to you.
Don’t be surprised if reading the statements you have written makes you sad—perhaps you are not acting the way you would like in these areas of your life, or perhaps you feel no where near where you would like to be in these areas (e.g., maybe you are not in an intimate relationship despite the fact that it is very important to you).
If you are struggling with this exercise and are having a hard time finishing it, put it down and come back to it another time. This can be a very difficult exercise, and sometimes it requires some time to “digest,” so let it sit for a while and try again when you are ready. You can also try talking it over with a friend, or a therapist, to get more input.
If you have completed this exercise you have taken a very important step toward living a more meaningful life—you have determined what areas of your life are most important to you, and you have specified a few actions you could take that would move you toward having more meaning in your life.

I am not ashamed to say I have borderline personality disorder.
By _Heather_, May 2, 2013
 My name is Heather. I’m a Leo, I am afraid of heights, I am a natural redhead, I take milk but no sugar in my tea. I have borderline personality disorder too.
I’ve been a mental health campaigner for a couple of years now. There is one subject I haven’t talked about. My borderline personality disorder has been a secret. I am happy to talk about suffering from Bipolar disorder too, but so far, I have been silent about my other diagnosis.
There are many reasons for this. Firstly, borderline personality isn’t very visible, it is missing from many campaigns, there aren’t any celebrities speaking out about it. Many people see the words ‘personality disorder’ and think of criminals. This is sadly untrue, but stigma remains. Secondly, within the mental health world, the disorder is seen as incurable, the sufferer dismissed as not worth engaging with.  Again, this is untrue, recovery is possible. Thirdly, talking about my diagnosis means I would have to talk about taboo issues like suicide attempts, self harm and impulsive behaviour.
I spoke about my diagnosis as part of my Time to Change media training
I completed some media training with Time to Change a couple of  weeks ago, where I took my chance to practice a TV interview with the trainer. I chose to speak about borderline personality disorder. It was really daunting, I had never spoken about it in a room of strangers before, I don’t even talk about very much with people closest to me! As the microphone was held under my nose, I tried to think of everyone I had encountered who shared my diagnosis and felt alone. I remembered that dialectical behavioural therapy, a therapy with measurable successful outcomes that could reach people with borderline personality disorder, was not available in most of the UK. I recalled the stories of those people who were offered no treatment and rejected by their community mental health teams. I have heard of people who self harmed being stitched up without anaesthesia and suicide attempts being ignored. I recalled how empty I felt when I was diagnosed. I felt ashamed of who I was, if my personality was disordered, I must be a terrible person?
I have borderline personality disorder. I have a trauma background, not everyone who has this diagnosis does, but it can be a common factor. The disorder stems from what is thought to be biochemical vulnerability and experiences of trauma and invalidation. In everyday life, it is a set of behaviours that sufferers used to cope, which start to become destructive. When I feel empty or l don’t know who I am, the pain of that used to drive me to alcohol abuse, self harm, risky sexual behaviour and trying to block out my emotions. I was lucky that my county did offer NHS dialectical behavioural therapy. I learned how to express my emotions and soothe myself so I could stop self harming and start to move on in my life.
Borderline personality disorder isn't a death sentence, it's a stepping stone
I have lived alone in my own flat for two years, which I fund. I am a daughter, sister, granddaughter and niece to a family I am close to. I have a set of loyal and loving friends who I can count on. I have a fantastic boyfriend; our relationship is stable, happy and healthy. I am working on my career, I write every day. I have finished therapy and given up self harm and alcohol abuse. I have had three years without crisis intervention or admission to hospital. Being diagnosed with borderline personality disorder wasn’t a death sentence; it was a stepping stone to having the life I wanted all along.
I am going to keep talking about borderline personality disorder because I believe that it needs to be reclaimed as an illness that marks that someone has suffered, they have tried to cope as best they could and they need help. I know that having intense emotions can also mean having a great sense of empathy, courage, love and kindness, as well as instability. I believe that there is hope; that people can recover if they are given the tools to do so. A study from Mclean Hospital in the US in 2010 showed that ten years after a hospitalisation, 86% of treated patients had a stable and sustained recovery, another study in 2005 showed that sufferers who got treatment saw a large improvement in their ability to work and socialise over the course of six years, 56% were able to succeed in those areas. I know from my own research that care for borderline personality disorder is poor in the UK and that I am in a position to begin to speak out about that.
So: I am Heather and I am not ashamed to say, I have borderline personality disorder.


From Wikipedia, the free encyclopedia
Borderline personality disorder
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Not to be confused with multiple personality disorder.
Borderline personality disorder
Classification and external resources
ICD-10
F60.3ICD-9
301.83MedlinePlus
000935eMedicine
article/913575MeSH
D001883Borderline personality disorder (BPD) (called emotionally unstable personality disorder, emotional intensity disorder, borderline type in the ICD-10) is a cluster-B personality disorder whose essential features are a pattern of marked impulsivity and instability of affects, interpersonal relationships, and self image. The pattern is present by early adulthood and occurs across a variety of situations and contexts.[1]
Other symptoms may include intense fears of abandonment and intense anger and irritability, the reason for which others have difficulty understanding.[1][2] People with BPD often engage in idealization and devaluation of others, alternating between high positive regard and great disappointment.[3] Self-harm and suicidal behavior are common.[4]
This disorder is recognized by the Diagnostic and Statistical Manual of Mental Disorders. Because a personality disorder is a pervasive, enduring and inflexible pattern of maladaptive inner experience and pathological behavior, there is a general reluctance to diagnose personality disorders before adolescence or early adulthood.[5] Some emphasize, however, that without early treatment, symptoms may worsen.[6]
There is an ongoing debate about the terminology of this disorder, especially the word "borderline".[7][8] The ICD-10 manual refers to this disorder as Emotionally unstable personality disorder and has similar diagnostic criteria. There is related concern that the diagnosis of BPD stigmatizes people with BPD and supports discriminatory practices, because it suggests that the personality of the individual is flawed.[9] In the DSM-5, the name of the disorder remains the same.[5]
Contents
 [hide]
• 1 Signs and symptoms
o 1.1 Emotions
o 1.2 Behavior
o 1.3 Self-harm and suicidal behavior
o 1.4 Interpersonal relationships
o 1.5 Sense of self
o 1.6 Cognitions
• 2 Diagnosis
o 2.1 Diagnostic and Statistical Manual
o 2.2 International Classification of Disease
o 2.3 Millon's subtypes
o 2.4 Family members
o 2.5 Adolescence
o 2.6 Differential diagnosis and comorbidity
? 2.6.1 Comorbid Axis I disorders
? 2.6.1.1 Mood disorders
? 2.6.1.2 Premenstrual dysphoric disorder
? 2.6.2 Comorbid Axis II disorders
• 3 Causes
o 3.1 Genetics
o 3.2 Brain abnormalities
? 3.2.1 Hippocampus
? 3.2.2 Amygdala
? 3.2.3 Prefrontal cortex
? 3.2.4 Hypothalamic-pituitary-adrenal axis
o 3.3 Neurobiological factors
? 3.3.1 Estrogen
o 3.4 Adverse childhood experiences
o 3.5 Other developmental factors
o 3.6 Mediating and moderating factors
? 3.6.1 Executive function
? 3.6.2 Family environment
? 3.6.3 Self-complexity
? 3.6.4 Thought suppression
• 4 Management
o 4.1 Psychotherapy
o 4.2 Medications
o 4.3 Mindfulness
o 4.4 Services
• 5 Prognosis
• 6 Epidemiology
• 7 History
• 8 Controversies
o 8.1 Credibility and validity of testimony
? 8.1.1 Dissociation
? 8.1.2 Lying as a feature of BPD
o 8.2 Gender
o 8.3 Manipulative behavior
o 8.4 Stigma
? 8.4.1 Physical violence
? 8.4.2 Mental healthcare providers
o 8.5 Terminology
• 9 Society and culture
o 9.1 Film and television
o 9.2 Literature
o 9.3 Awareness
• 10 Notes
• 11 References
• 12 Further reading
• 13 External links
Signs and symptoms[edit]
The most distinguishing symptoms of BPD are marked sensitivity to rejection and thinking about and feeling afraid of possible abandonment.[10] Overall, the features of BPD include unusually intense sensitivity in relationships with others, difficulty regulating emotions, and impulsivity. Other symptoms can include feeling unsure of one's personal identity and values, having paranoid thoughts when feeling stressed, and severedissociation.[10]
Emotions[edit]
People with BPD feel emotions more easily, more deeply, and for longer than others do.[11][12] Emotions may repeatedly resurge and persist a long time.[12] Consequently, it can take longer than normal for people with BPD to return to a stable emotional baseline following an intense emotional experience.[13]
In Marsha Linehan's view, the sensitivity, intensity, and duration with which people with BPD feel emotions have both positive and negative effects.[13] People with BPD are often exceptionally idealistic, joyful, and loving.[14] However, they can feel overwhelmed by negative emotions, experiencing intense grief instead of sadness, shame and humiliation instead of mild embarrassment, rage instead of annoyance, and panic instead of nervousness.[14] People with BPD are especially sensitive to feelings of rejection, isolation, and perceived failure.[15] Before learning other coping mechanisms, their efforts to manage or escape from their intense negative emotions can lead to self-injury or suicidal behavior.[16] They are often aware of the intensity of their negative emotional reactions and, since they cannot regulate them, they shut them down entirely.[13] This can be harmful to people with BPD, as negative emotions alert people to the presence of a problematic situation and move them to address it.[13]
While people with BPD feel joy intensely, they are especially prone to dysphoria, or feelings of mental and emotional distress. Zanarini et al. recognize four categories of dysphoria that are typical of this condition: extreme emotions; destructiveness or self-destructiveness; feeling fragmented or lacking identity; and feelings of victimization.[17] Within these categories, a BPD diagnosis is strongly associated with a combination of three specific states: 1) feeling betrayed, 2) "feeling like hurting myself", and 3) feeling out of control.[17] Since there is great variety in the types of dysphoria experienced by people with BPD, the amplitude of the distress is a helpful indicator of borderline personality disorder.[17]
In addition to intense emotions, people with BPD experience emotional lability, or changeability. Although the term suggests rapid changes between depression and elation, the mood swings in people with this condition actually occur more frequently between anger and anxiety, and between depression and anxiety.[18]
Behavior[edit]
Impulsive behaviors are common, including: substance or alcohol abuse, eating disorders, unprotected sex or indiscriminate sex with multiple partners, reckless spending and reckless driving.[19] Impulsive behaviors can also include quitting jobs or relationships, running away, and self-injury.[20]
People with BPD act impulsively because it gives them immediate relief from their emotional pain.[20] However, in the long term, people with BPD suffer increased pain from the shame and guilt that follow such actions.[20]A cycle often begins in which people with BPD feel emotional pain, engage in impulsive behaviors to relieve that pain, feel shame and guilt over their actions, feel emotional pain from the shame and guilt, and then experience stronger urges to engage in impulsive behaviors to relieve the new pain.[20] As time goes on, impulsive behaviors can become an automatic response to emotional pain.[20]
Self-harm and suicidal behavior[edit]
Self-harming or suicidal behavior is one of the core diagnostic criteria in the DSM IV-TR. Management of and recovery from this behavior can be complex and challenging.[21] The suicide rate among patients with BPD is 8 to 10 percent.[10][22]
Self-injury is common, and can take place with or without suicidal intent.[23][24] The reported reasons for non-suicidal self-injury (NSSI) differ from the reasons for suicide attempts.[16] Reasons for NSSI include expressing anger, self-punishment, generating normal feelings (often in response to dissociation), and distracting oneself from emotional pain or difficult circumstances.[16] In contrast, suicide attempts typically reflect a belief that others will be better off following the suicide.[16] Both suicidal and non-suicidal self-injury are a response to feeling negative emotions.[16]
Sexual abuse can be a particular trigger for suicidal behavior in adolescents with BPD tendencies.[25][quantify]
Interpersonal relationships[edit]
People with BPD can be very sensitive to the way others treat them, feeling intense joy and gratitude at perceived expressions of kindness, and intense sadness or anger at perceived criticism or hurtfulness.[26] Their feelings about others often shift from positive to negative after a disappointment, a perceived threat of losing someone, or a perceived loss of esteem in the eyes of someone they value. This phenomenon, sometimes called splitting or black-and-white thinking, includes a shift from idealizing others (feeling admiration and love) to devaluing them (feeling anger or dislike).[27] Combined with mood disturbances, idealization and devaluation can undermine relationships with family, friends, and co-workers.[28] Self-image can also change rapidly from positive to negative.
While strongly desiring intimacy, people with BPD tend toward insecure, avoidant or ambivalent, or fearfully preoccupied attachment patterns in relationships,[29] and they often view the world as dangerous and malevolent.[26] BPD is linked to increased levels of chronic stress and conflict in romantic relationships, decreased satisfaction of romantic partners, abuse and unwanted pregnancy. However, these factors appear to be linked to personality disorders in general.[30]
Manipulation to obtain nurturance is considered to be a common feature of BPD by many who treat the disorder, as well as by the DSM-IV.[31][32] However, some mental health professionals caution that an overemphasis on, and an overly broad definition of, manipulation can lead to misunderstanding and prejudicial treatment of people with BPD within the health care system.[33] (See Manipulative behavior and Stigma under Controversies.)
Sense of self[edit]
People with BPD tend to have trouble seeing a clear picture of their identity. In particular, they tend to have a hard time knowing what they value and enjoy.[34] They are often unsure about their long-term goals for relationships and jobs. This difficulty with knowing who they are and what they value can cause people with BPD to experience feeling "empty" and "lost".[34]
Cognitions[edit]
The often intense emotions experienced by people with BPD can make it difficult for them to control the focus of their attention—to concentrate.[34] In addition, people with BPD may tend to dissociate, which can be thought of as an intense form of "zoning out".[35] Dissociation often occurs in response to experiencing a painful event (or experiencing something that triggers the memory of a painful event). It involves the mind automatically redirecting attention away from that event, presumably to protect against experiencing intense emotion and unwanted behavioral impulses that such emotion might otherwise trigger.[35] Although the mind's habit of blocking out intense painful emotions may provide temporary relief, it can also have the unwanted side effect of blocking or blunting the experience of ordinary emotions, reducing the access of people with BPD to the information contained in those emotions which helps guide effective decision-making in daily life.[35] Sometimes it is possible for another person to tell when someone with BPD is dissociating, because their facial or vocal expressions may become flat or expressionless, or they may appear to be distracted; at other times, dissociation may be barely noticeable.[35]
Diagnosis[edit]
Personality
disordersCluster A (odd)• Paranoid
• Schizoid
• SchizotypalCluster B (dramatic)• Antisocial
• Borderline
• Histrionic
• NarcissisticCluster C (anxious)• Avoidant
• Dependent
• Obsessive–compulsiveNot specified• Depressive
• Passive-aggressive
• Sadistic
• Self-defeating
• Psychopathy• v
• t
• eDiagnosis of borderline personality disorder is based on a clinical assessment by a qualified mental health professional. The best method is to present the criteria of the disorder to patients and to ask them if they feel that these characteristics accurately describe them.[10] Actively involving patients with BPD in determining their diagnosis can help them become more willing to accept it.[10] Although some clinicians prefer not to tell patients with BPD what their diagnosis is, either from concern about the stigma attached to this condition or because BPD used to be considered untreatable, it is usually helpful for patients with BPD to know their diagnosis.[10] This helps them know that others have had similar experiences and can point them toward effective treatments.[10]
In general, the psychological evaluation includes asking the client about the beginning and severity of symptoms, as well as other questions about how symptoms impact the client's quality of life. Issues of particular note are suicidal ideations, experiences with self-harm, and thoughts about harming others.[36] Diagnosis is based both on the client's report of his or her symptoms and on the clinician's own observations.[36] Additional tests for BPD can include a physical exam and laboratory tests to rule out other possible triggers for symptoms, such as thyroid conditions or substance abuse.[36]
Diagnostic and Statistical Manual[edit]
The Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) has removed the multiaxial system. Consequently, all disorders, including personality disorders, are listed in Section II of the manual. A person must meet 5 of 9 criteria to receive a diagnosis of borderline personality disorder.[37] The DSM-5 defines the main features of BPD as a pervasive pattern of instability in interpersonal relationships, self image, and affects, as well as markedly impulsive behavior.[37]
In addition, the DSM-5 proposes alternative diagnostic criteria for Borderline personality disorder in section III, "Alternative DSM-5 Model for Personality Disorders." These alternative criteria are based on trait research and include specifying at least four of seven maladaptive traits.[38]
According to Marsha Linehan, many mental health professionals find it challenging to diagnose BPD using the DSM criteria, since these criteria describe such a wide variety of behaviors.[39] To address this issue, Linehan has grouped the symptoms of BPD under five main areas of dysregulation: emotions, behavior, interpersonal relationships, sense of self, and cognition.[39]
International Classification of Disease[edit]
The World Health Organization's ICD-10 defines a disorder that is conceptually similar to borderline personality disorder, called (F60.3) Emotionally unstable personality disorder. Its two subtypes are described below.[40]
F60.30 Impulsive type
At least three of the following must be present, one of which must be (2):
1. marked tendency to act unexpectedly and without consideration of the consequences;
2. marked tendency to engage in quarrelsome behavior and to have conflicts with others, especially when impulsive acts are thwarted or criticized;
3. liability to outbursts of anger or violence, with inability to control the resulting behavioral explosions;
4. difficulty in maintaining any course of action that offers no immediate reward;
5. unstable and capricious (impulsive, whimsical) mood.
F60.31 Borderline type
At least three of the symptoms mentioned in F60.30 Impulsive type must be present [see above], with at least two of the following in addition:
1. disturbances in and uncertainty about self-image, aims, and internal preferences;
2. liability to become involved in intense and unstable relationships, often leading to emotional crisis;
3. excessive efforts to avoid abandonment;
4. recurrent threats or acts of self-harm;
5. chronic feelings of emptiness.
6. demonstrates impulsive behavior, e.g., speeding, substance abuse[41]
The ICD-10 also describes some general criteria that define what is considered a Personality disorder.
Millon's subtypes[edit]
Theodore Millon has proposed four subtypes of BPD. He suggests that an individual diagnosed with BPD may exhibit none, one, or more of the following:[42]
Subtype Features
Discouraged (including avoidant features)
Pliant, submissive, loyal, humble; feels vulnerable and in constant jeopardy; feels hopeless, depressed, helpless, and powerless.
Petulant (including negativistic features)
Negativistic, impatient, restless, as well as stubborn defiant, sullen, pessimistic, and resentful; easily slighted and quickly disillusioned.
Impulsive (including histrionic or antisocial features)
Capricious, superficial, flighty, distractible, frenetic, and seductive; fearing loss, becomes agitated, and gloomy and irritable; potentially suicidal.
Self-destructive (including depressive or masochisticfeatures)
Inward-turning, intropunitively angry; conforming, deferential, and ingratiating behaviors have deteriorated; increasingly high-strung and moody; possible suicide.
Family members[edit]
People with BPD are prone to feeling angry at members of their family and alienated from them. On their part, family members often feel angry and helpless at how their BPD family members relate to them.[43]
A study in 2003 found that family members' experiences of burden, emotional distress, and hostility toward people with BPD were actually worse when they had greater knowledge about BPD.[44] These findings may indicate a need to investigate the quality and accuracy of the information received by family members.[44]
Parents of adults with BPD are often both over-involved and under-involved in family interactions.[45] In romantic relationships, BPD is linked to increased levels of chronic stress and conflict, decreased satisfaction of romantic partners, abuse, and unwanted pregnancy. However, these links may apply to personality disorders in general.[30]
Adolescence[edit]
Onset of symptoms typically occurs during adolescence or young adulthood, although symptoms suggestive of this disorder can sometimes be observed in children.[46] Symptoms among adolescents that predict the development of BPD in adulthood may include problems with body-image, extreme sensitivity to rejection, behavioral problems, non-suicidal self-injury, attempts to find exclusive relationships, and severe shame.[10] Many adolescents experience these symptoms without going on to develop BPD, but those who experience them are 9 times as likely as their peers to develop BPD. They are also more likely to develop other forms of long-term social disabilities.[10]
Clinicians are discouraged from diagnosing anyone with BPD before the age of 18, due to the normal ups and downs of adolescence and a still-developing personality. However, BPD can sometimes be diagnosed before age 18, in which case the features must have been present and consistent for at least 1 year.[2]
A BPD diagnosis in adolescence might predict that the disorder will continue into adulthood.[2][47] Among adolescents who warrant a BPD diagnosis, there appears to be one group in which the disorder remains stable over time, and another group in which the individuals move in and out of the diagnosis.[48] Earlier diagnoses may be helpful in creating a more effective treatment plan for the adolescent.[2][47] Family therapy is considered a helpful component of treatment for adolescents with BPD.[49]
Differential diagnosis and comorbidity[edit]
Lifetime comorbid (co-occurring) conditions are common in BPD. Compared to those diagnosed with other personality disorders, people with BPD showed a higher rate of also meeting criteria for[50]
• mood disorders, including major depression and bipolar disorder
• anxiety disorders, including panic disorder, social anxiety disorder, and post-traumatic stress disorder (PTSD)
• other personality disorders
• substance abuse
• eating disorders, including anorexia nervosa and bulimia
• attention deficit hyperactivity disorder[51][non-primary source needed]
• somatoform disorders
• dissociative disorders
Comorbid Axis I disorders[edit]
Gender differences in Axis I lifetime comorbid diagnosis, 2008[52] and 1998[50]Axis I diagnosis Overall ( % ) Male ( % ) Female ( % )
Mood disorders 75.0 68.7 80.2
Major depressive disorder
32.1 27.2 36.1
Dysthymia
_9.7 _7.1 11.9
Bipolar I disorder
31.8 30.6 32.7
Bipolar II disorder
_7.7 _6.7 _8.5
Anxiety disorders 74.2 66.1 81.1
Panic disorder with agoraphobia
11.5 _7.7 14.6
Panic disorder without agoraphobia 18.8 16.2 20.9
Social phobia
29.3 25.2 32.7
Specific phobia
37.5 26.6 46.6
PTSD
39.2 29.5 47.2
Generalized anxiety disorder
35.1 27.3 41.6
Obsessive-compulsive disorder**
15.6 --- ---
Substance use disorders 72.9 80.9 66.2
Any alcohol use disorder
57.3 71.2 45.6
Any drug use disorder
36.2 44.0 29.8
Eating disorders** 53.0 20.5 62.2
Anorexia nervosa**
20.8 _7 * 25 *
Bulimia nervosa**
25.6 10 * 30 *
Eating disorder not otherwise specified**
26.1 10.8 30.4
Somatoform disorders** 10.3 10 * 10 *
Somatization disorder**
_4.2 --- ---
Hypochondriasis**
_4.7 --- ---
Somatoform pain disorder**
_4.2 --- ---
Psychotic disorders**
1.3 _1 * _1 *
* Approximate values
** Values from 1998 study [50]
--- Value not provided by study
A 2008 study found that at some point in their lives, 75 percent of people with BPD meet criteria for mood disorders, especially major depression and Bipolar I, and nearly 75 percent meet criteria for an anxiety disorder.[52] Nearly 73 percent meet criteria for substance abuse or dependency, and about 40 percent for PTSD.[52] It is noteworthy that less than half of the participants with BPD in this study presented with PTSD, a prevalence similar to that reported in an earlier study.[50] The finding that less than half of patients with BPD experience PTSD during their lives challenges the theory that BPD and PTSD are the same disorder.[50]
There are marked gender differences in the types of co-morbid conditions a person with BPD is likely to have--[50] a higher percentage of males with BPD meet criteria for substance-use disorders, while a higher percentage of females with BPD meet criteria for PTSD and eating disorders.[50][52][53] In one study, 38% of participants with BPD met the criteria for a diagnosis of ADHD.[51]In another study, 6 of 41 participants (15%) met the criteria for an autism spectrum disorder (a subgroup that had significantly more frequent suicide attempts).[54]
Regardless that it is an infradiagnosed disorder, a few studies have shown that the "lower expressions" of it might lead to wrong diagnoses. The many and shifting Axis I disorders in people with BPD can sometimes cause clinicians to miss the presence of the underlying personality disorder. However, since a complex pattern of Axis I diagnoses has been found to strongly predict the presence of BPD, clinicians can use the feature of a complex pattern of comorbidity as a clue that BPD might be present.[50]
Mood disorders[edit]
Many people with borderline personality disorder also have mood disorders, such as major depressive disorder or a bipolar disorder.[28] Some characteristics of BPD are similar to those of mood disorders, which can complicate the diagnosis.[55][56][57] It is especially common for people to be misdiagnosed with bipolar disorder when they have borderline personality disorder, or vice versa.[58] For someone with bipolar disorder, behavior suggestive of BPD might appear while the client is experiencing an episode of major depression or mania, only to disappear once the client's mood has stabilized.[59] For this reason, it is ideal to wait until the client's mood has stabilized before attempting to make a diagnosis.[59]
At face value, the affective lability of BPD and the rapid mood cycling of bipolar disorders can seem very similar.[60] It can be difficult even for experienced clinicians, if they are unfamiliar with BPD, to differentiate between the mood swings of these two conditions.[61]However, there are some clear differences.[58]
First, the mood swings of BPD and bipolar disorder tend to have different durations. In some people with bipolar disorder, episodes of depression or mania last for at least two weeks at a time, which is much longer than moods last in people with BPD.[58] Even among those who experience bipolar disorder with more rapid mood shifts, their moods usually last for days, while the moods of people with BPD can change in minutes or hours.[61] So while euphoria and impulsivity in someone with BPD might resemble a manic episode, the experience would be too brief to qualify as a manic episode.[59][61]
Second, the moods of bipolar disorder do not respond to changes in the environment, while the moods of BPD do respond to changes in the environment.[59] That is, a positive event would not lift the depressed mood caused by bipolar disorder, but a positive event would potentially lift the depressed mood of someone with BPD. Similarly, a negative event would not dampen the euphoria caused by bipolar disorder, but a negative event would dampen the euphoria of someone with borderline personality disorder.[59]
Third, when people with BPD experience euphoria, it is usually without the racing thoughts and decreased need for sleep that are typical of hypomania.[59] And severe, high levels of sleep disturbance are rarely a symptom of BPD, whereas they are a common symptom of bipolar disorders (along with appetite disturbance).[59]
Because the two conditions have a number of similar symptoms, BPD was once considered to be a mild form of bipolar disorder,[62][63] or to exist on the bipolar spectrum. However, this would require that the underlying mechanism causing these symptoms be the same for both conditions. Differences in phenomenology, family history, longitudinal course, and responses to treatment indicate that this is not the case.[64] Researchers have found "only a modest association" between bipolar disorder and borderline personality disorder, with "a strong spectrum relationship with [BPD and] bipolar disorder extremely unlikely."[65] Benazzi et al. suggest that the DSM-IV BPD diagnosis combines two unrelated characteristics: an affective instability dimension related to Bipolar-II, and an impulsivity dimension not related to Bipolar-II.[66]
Premenstrual dysphoric disorder[edit]
Premenstrual dysphoric disorder (PMDD) occurs in 3–8 percent of women. Symptoms begin 5–11 days before a woman's period and cease a few days after it begins.[67] Symptoms may include: marked mood swings, irritability, depressed mood, feeling hopeless or suicidal, a subjective sense of being overwhelmed or out of control, anxiety, binge eating, difficulty concentrating, and substantial impairment of interpersonal relationships.[68][69] Women with PMDD typically begin to experience symptoms in their early twenties, although many do not seek treatment until their early thirties.[68] Although some of the symptoms of PMDD and BPD are similar, they are different disorders. They are distinguishable by the timing and duration of symptoms, which are markedly different: the symptoms of PMDD occur only during the luteal phase of a woman's menstrual cycle,[68] whereas BPD symptoms occur persistently at all stages of the menstrual cycle. In addition, the symptoms of PMDD do not include impulsivity.[68]
Comorbid Axis II disorders[edit]
Percentage of people with BPD and a lifetime comorbid Axis II diagnosis, 2008[52]Axis II diagnosis Overall ( % ) Male ( % ) Female ( % )
Any Cluster A 50.4 49.5 51.1
Paranoid 21.3 16.5 25.4
Schizoid 12.4 11.1 13.5
Schizotypal 36.7 38.9 34.9
Any Other Cluster B 49.2 57.8 42.1
Antisocial 13.7 19.4 _9.0
Histrionic 10.3 10.3 10.3
Narcissistic 38.9 47.0 32.2
Any Cluster C 29.9 27.0 32.3
Avoidant 13.4 10.8 15.6
Dependent _3.1 _2.6 _3.5
Obsessive-compulsive 22.7 21.7 23.6
More than two-thirds of people diagnosed with BPD also meet the criteria for another Axis II personality disorder at some point in their lives. (In a 2008 study, the rate was 73.9 percent.)[52] Cluster A disorders, which include paranoid, schizoid, and schizotypal, are the most common, with a prevalence of 50.4 percent in people with BPD.[52] The second most common are another Cluster B disorder, which include antisocial, histrionic, andnarcissistic. These have an overall prevalence of 49.2 percent in people with BPD, with narcissistic being the most common, at 38.9 percent; antisocial the second most common, at 13.7 percent; and histrionic the least common, at 10.3 percent.[52] The least common are Cluster C disorders, which include avoidant, dependent, and obsessive-compulsive, and have a prevalence of 29.9 percent in people with BPD.[52] The percentages for specific comorbid Axis II disorders can be found in the table below.
Causes[edit]
As is the case with other mental disorders, the causes of BPD are complex and not fully agreed upon.[8] Evidence suggests that BPD and post-traumatic stress disorder (PTSD) may be related in some way.[70] Most researchers agree that a history of childhood trauma can be a contributing factor,[71] but less attention has historically been paid to investigating the causal roles played by congenital brain abnormalities, genetics, neurobiological factors, and environmental factors other than trauma.[8][72]
Genetics[edit]
The heritability of BPD is estimated to be 65%.[73] That is, 65 percent of the variability in symptoms among different individuals with BPD can be explained by genetic differences. (Note that this is different from saying that 65 percent of BPD is "caused" by genes.) Twin studies may overestimate the effect of genes on variability in personality disorders due to the complicating factor of a shared family environment.[74]
Twin, sibling and other family studies indicate partial heritability for impulsive aggression, but studies of serotonin-related genes have suggested only modest contributions to behavior.[75]
Brain abnormalities[edit]
Hippocampus[edit]
The hippocampus tends to be smaller in people with BPD, as it is in people with post-traumatic stress disorder (PTSD). However, in BPD, unlike PTSD, the amygdala also tends to be smaller.[76]
Amygdala[edit]
The amygdala is smaller and more active in people with BPD.[76] Decreased amygdala volume has also been found in people with obsessive-compulsive disorder.[77] One study has found unusually strong activity in the left amygdalas of people with BPD when they experience and view displays of negative emotions.[78] Since the amygdala is a major structure involved in generating negative emotions, this unusually strong activity may explain the unusual strength and longevity of fear, sadness, anger, and shame experienced by people with BPD, as well as their heightened sensitivity to displays of these emotions in others.[76]
Prefrontal cortex[edit]
The prefrontal cortex tends to be less active in people with BPD, especially when recalling memories of abandonment.[79] This relative inactivity occurs in the right anterior cingulate (areas 24 and 32).[79] Given its role in regulating emotional arousal, the relative inactivity of the prefrontal cortex might explain the difficulties people with BPD experience in regulating their emotions and responses to stress.[80]
Hypothalamic-pituitary-adrenal axis[edit]
The hypothalamic-pituitary-adrenal axis (HPA axis) regulates cortisol production, which is released in response to stress. Cortisol production tends to be elevated in people with BPD, indicating a hyperactive HPA axis in these individuals.[81] This causes them to experience a greater biological stress response, which might explain their greater vulnerability to irritability.[82] Since traumatic events can increase cortisol production and HPA axis activity, one possibility is that the prevalence of higher than average activity in the HPA axis of people with BPD may simply be a reflection of the higher than average prevalence of traumatic childhood and maturational events among people with BPD.[82] Another possibility is that, by heightening their sensitivity to stressful events, increased cortisol production may predispose those with BPD to experience stressful childhood and maturational events as traumatic.
Increased cortisol production is also associated with an increased risk of suicidal behavior.[83]
Neurobiological factors[edit]
Estrogen[edit]
Individual differences in women's estrogen cycles may be related to the expression of BPD symptoms in female patients.[84] A 2003 study found that women's BPD symptoms were predicted by changes in estrogen levels throughout their menstrual cycles, an effect that remained significant when the results were controlled for a general increase in negative affect.[85]
Symptoms experienced due to disturbed levels of estrogen are often misdiagnosed as BPD, like extreme mood swings and depression. As endometriosis is an estrogen responsive disease, severe PMS and PMDD symptoms are observed, that are both physical and psychological in nature. Hormone-responsive mood disorders also known as reproductive depression are seen to cease only after menopause or hysterectomy. Psychotic episodes treated with estrogen in women with BPD show considerable improvement but must not be prescribed to those with endometriosis as it worsens their endocrine condition. Mood stabilizing drugs used for bipolar disorder do not help patients with disturbed estrogen levels. A correct diagnosis between endocrine disorder and psychiatric disorder must be made.[citation needed]
Adverse childhood experiences[edit]
There is a strong correlation between child abuse, especially child sexual abuse, and development of BPD.[71][86][87][88][89] Many individuals with BPD report a history of abuse and neglect as young children.[90] Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically or sexually abused by caregivers of either gender. They also report a high incidence of incest and loss of caregivers in early childhood.[91]
Individuals with BPD were also likely to report having caregivers of all sexes deny the validity of their thoughts and feelings. Caregivers were also reported to have failed to provide needed protection and to have neglected their child's physical care. Parents of all sexes were typically reported to have withdrawn from the child emotionally, and to have treated the child inconsistently.[91] Additionally, women with BPD who reported a previous history of neglect by a female caregiver and abuse by a male caregiver were significantly more likely to report experiencing sexual abuse by a non-caregiver.[91]
It has been suggested that children who experience chronic early maltreatment and attachment difficulties may go on to develop borderline personality disorder.[92]
However, none of these studies provide evidence that childhood trauma necessarily causes or contributes to causing BPD. Rather, both the trauma and the BPD could be caused by a third factor. For example, it could be that many caregivers who tend to expose children to traumatic experiences do so partly because of their own heritable personality disorders, the genetic predisposition for which they may pass on to their children, who develop BPD as a result of that predisposition and other factors, and not as a result of prior mistreatment.[93]
Other developmental factors[edit]
The intensity and reactivity of a person's negative affectivity, or tendency to feel negative emotions, predicts BPD symptoms more strongly than does childhood sexual abuse.[94] This finding, differences in brain structure (seeBrain abnormalities), and the fact that some patients with BPD do not report a traumatic history,[95] suggest that BPD is distinct from the post-traumatic stress disorder that frequently accompanies it. Thus researchers examine developmental causes in addition to childhood trauma.
Newer research published in January 2013, from Dr Anthony Ruocco at the University of Toronto, has highlighted two patterns of brain activity that may underlie the dysregulation of emotion indicated in this disorder; there has been described increased activity in the brain circuits responsible for the experience of heightened negative emotions, coupled with reduced activation of the brain circuits that normally regulate or suppress these generated negative emotions. These two neural networks are seen to be dysfunctionally operative in the frontolimbic regions but the specific regions vary widely in individuals, which calls for the analysis of more neuroimaging studies. Also, differing from earlier studies, sufferers of BPD showed less activation in the amygdala in situations of increased negative emotionality than the control group. Dr. John Krystal, Editor of Biological Psychiatry added that: "This new report adds to the impression that people with borderline personality disorder are 'set-up' by their brains to have stormy emotional lives, although not necessarily unhappy or unproductive lives," [96]
Writing in the psychoanalytic tradition, Otto Kernberg argues that a child's failure to achieve the developmental task of psychic clarification of self and other and failure to overcome splitting might increase the risk of developing a borderline personality.[97]
A child's inability to tolerate delayed gratification at age 4 does not predict later development of BPD.[98]
Mediating and moderating factors[edit]
Executive function[edit]
While high rejection sensitivity is associated with stronger symptoms of borderline personality disorder, executive function appears to mediate the relationship between rejection sensitivity and BPD symptoms.[98] That is, a group of cognitive processes that include planning, working memory, attention, and problem-solving might be the mechanism through which rejection sensitivity impacts BPD symptoms. A 2008 study found that the relationship between a person's rejection sensitivity and BPD symptoms was stronger when executive function was lower, and that the relationship was weaker when executive function was higher.[98] This suggests that high executive function might help protect people with high rejection sensitivity against symptoms of BPD.[98]
A 2012 study found that problems in working memory might contribute to greater impulsivity in people with BPD.[99]
Family environment[edit]
Family environment mediates the effect of child sexual abuse on the development of BPD. An unstable family environment predicts the development of the disorder, while a stable family environment predicts a lower risk. One possible explanation is that a stable environment buffers against its development.[100]
Self-complexity[edit]
Self-complexity, or considering one's self to have many different characteristics, appears to moderate the relationship between Actual-Ideal self-discrepancy and the development of BPD symptoms. That is, for individuals who believe that their actual characteristics do not match the characteristics that they hope to acquire, high self-complexity reduces the impact of their conflicted self-image on BPD symptoms. However, self-complexity does not moderate the relationship between Actual-Ought self-discrepancy and the development of BPD symptoms. That is, for individuals who believe that their actual characteristics do not match the characteristics that they should already have, high self-complexity does not reduce the impact of their conflicted self-image on BPD symptoms. The protective role of self-complexity in Actual-Ideal self-discrepancy, but not in Actual-Ought self-discrepancy, suggests that the impact of conflicted or unstable self-image in BPD depends on whether the individual views self in terms of characteristics that she hopes to acquire, or in terms of characteristics that she should already have.[101]
Thought suppression[edit]
A 2005 study found that thought suppression, or conscious attempts to avoid thinking certain thoughts, mediates the relationship between emotional vulnerability and BPD symptoms.[94] A later study found that the relationship between emotional vulnerability and BPD symptoms is not necessarily mediated by thought suppression. However, this study did find that thought suppression mediates the relationship between an invalidating environment and BPD symptoms.[102]
Management[edit]
Main article: Management of borderline personality disorder
Psychotherapy is the primary treatment for borderline personality disorder.[103] Treatments should be based on the needs of the individual, rather than upon the general diagnosis of BPD. Medications are useful for treating comorbid disorders, such as depression and anxiety.[104] Short-term hospitalization has not been found to be more effective than community care for improving outcomes or long-term prevention of suicidal behavior in those with BPD.[105]
Psychotherapy[edit]
Long-term psychotherapy is currently the treatment of choice for BPD.[106] There are five such treatments available: mentalization-based treatment (MBT), transference-focused psychotherapy, dialectical behavior therapy (DBT), general psychiatric management, and schema-focused therapy.[107] While DBT is the therapy that has been studied the most, empirical research has shown that all of these treatments are effective for treating BPD, except for schema-focused therapy.[107] Long-term therapy of any kind, including schema-focused therapy, is better than no treatment, especially in reducing urges to self-injure.[106]
Mentalization-based therapy and transference-focused psychotherapy are based on psychodynamic principles, while dialectical behavior therapy is based on cognitive-behavioral principles and mindfulness.[106] General psychiatric management combines the core principles from each of these treatments, and it is considered easier to learn and less intensive.[107] Randomized controlled trials have shown that DBT and MBT are the most effective, and the two share many similarities.[108][109] Researchers are interested in developing shorter versions of these therapies to increase accessibility, to relieve the financial burden on patients, and to relieve the resource burden on treatment providers.[106][109]
From a psychodynamic perspective, a special problem of psychotherapy with people with BPD is intense projection. It requires the psychotherapist to be flexible in considering negative attributions by the patient rather than quickly interpreting the projection.[110]
Medications[edit]
A 2010 review by the Cochrane collaboration found that no medications show promise for "the core BPD symptoms of chronic feelings of emptiness, identity disturbance and abandonment." However, the authors found that some medications may impact isolated symptoms associated with BPD or the symptoms of comorbid conditions.[111]
Of the typical antipsychotics studied in relation to BPD, haloperidol may reduce anger, and flupenthixol may reduce the likelihood of suicidal behavior. Among the atypical antipsychotics, aripiprazole may reduce interpersonal problems, impulsivity, anger, psychotic paranoid symptoms, depression, anxiety, and general psychiatric pathology. Olanzapine may decrease affective instability, anger, psychotic paranoid symptoms, and anxiety, but a placebo had a greater ameliorative impact on suicidal ideation than olanzapine did. The effect of Ziprasidone was not significant.[111]
Of the mood stabilizers studied, valproate semisodium may ameliorate depression, interpersonal problems, and anger. Lamotrigine may reduce impulsivity and anger; topiramate may ameliorate interpersonal problems, impulsivity, anxiety, anger and general psychiatric pathology. The effect of carbamazepine was not significant. Of the antidepressants, amitriptyline may reduce depression, but mianserin, fluoxetine, fluvoxamine andphenelzine sulfate showed no effect. Omega-3 fatty acid may ameliorate suicidality and improve depression. As of 2010, trials with these medications had not been replicated, and the effect of long-term use had not been assessed.[111]
Because of weak evidence and the potential for serious side effects from some of these medications, the UK National Institute for Health and Clinical Excellence (NICE) 2009 clinical guideline for the treatment and management of BPD recommends: "Drug treatment should not be used specifically for borderline personality disorder or for the individual symptoms or behavior associated with the disorder." However, "drug treatment may be considered in the overall treatment of comorbid conditions." They suggest a "review of the treatment of people with borderline personality disorder who do not have a diagnosed comorbid mental or physical illness and who are currently being prescribed drugs, with the aim of reducing and stopping unnecessary drug treatment."[112]
Mindfulness[edit]
In the past two decades, many psychiatrists, psychologists, and other mental health professionals have incorporated mindfulness meditation training into their psychotherapy practice.[113] Mindfulness meditation has been used to help treat or ameliorate the symptoms of disorders such as major depressive disorder, chronic pain, generalized anxiety disorder, and borderline personality disorder, and research has found therapy based on mindfulness to be effective, particularly for reducing anxiety, depression, and stress.[114]
Mindfulness meditation has been defined as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”[115]
Services[edit]
Individuals with BPD sometimes use mental health services extensively. They accounted for about 20 percent of psychiatric hospitalizations in one survey.[116] The majority of patients with BPD continue to use outpatient treatment in a sustained manner for several years, but the number using the more restrictive and costly forms of treatment, such as inpatient admission, declines with time.[117] Experience of services varies.[118] Assessing suicide risk can be a challenge for clinicians, and patients themselves tend to underestimate the lethality of self-injurious behaviors. People with BPD typically have a chronically elevated risk of suicide much above that of the general population and a history of multiple attempts when in crisis.[119] Approximately half the individuals who commit suicide meet criteria for a personality disorder. Borderline personality disorder remains the most commonly associated personality disorder with suicide.[120]
Prognosis[edit]
With treatment, the majority of people with BPD can find relief from distressing symptoms and achieve remission, defined as a consistent relief from symptoms for at least two years.[121][122] A longitudinal study tracking the symptoms of people with BPD found that 34.5% achieved remission within two years from the beginning of the study. Within four years, 49.4% had achieved remission, and within six years, 68.6% had achieved remission. By the end of the study, 73.5% of participants were found to be in remission.[121] Moreover, of those who achieved recovery from symptoms, only 5.9% experienced recurrences. A later study found that ten years from baseline (during a hospitalization), 86% of patients had sustained and stable recovery from symptoms.[123]
Thus contrary to popular belief, recovery from BPD is not only possible but common, even for those with the most severe symptoms.[121] However, it is important to note that these high rates of relief from distressing symptoms have only been observed among those who receive treatment of some kind.[121]
Patient personality can play an important role during the therapeutic process, leading to better clinical outcomes. Recent research has shown that BPD patients with higher levels of trait agreeableness undergoing Dialectical Behavior Therapy (DBT) exhibited better clinical outcomes than other patients either low in Agreeableness or not being treated with DBT. This association was mediated through the strength of a working alliance between patient and therapist; that is, more Agreeable patients developed stronger working alliances with their therapists which in turn led to better clinical outcomes.[124]
In addition to recovering from distressing symptoms, people with BPD also achieve high levels of psychosocial functioning. A longitudinal study tracking the social and work abilities of participants with BPD found that six years after diagnosis, 56% of participants had good function in work and social environments, compared to 26% of participants when they were first diagnosed. Vocational achievement was generally more limited, even compared to those with other personality disorders. However, those whose symptoms had remitted were significantly more likely to have good relationships with a romantic partner and at least one parent, good performance at work and school, a sustained work and school history, and good psychosocial functioning overall.[125]
Epidemiology[edit]
The prevalence of BPD was initially estimated to be 1 to 2 percent of the general population[122][126] and to occur three times more often in women than in men.[127][128] However, the lifetime prevalence of BPD in a 2008 study was found to be 5.9% of the general population, occurring in 5.6% of men and 6.2% of women.[52] The difference in rates between men and women in this study was not found to be statistically significant.[52]
Borderline personality disorder is estimated to contribute to 20 percent of psychiatric hospitalizations, and to occur among 10 percent of outpatients.[4]
29.5 percent of new inmates in Iowa fit a diagnosis of borderline personality disorder in 2007,[129] and the overall prevalence of BPD in the U.S. prison population is thought to be 17 percent.[4] These high numbers may be related to the high frequency of substance abuse and substance use disorders among people with BPD, which is estimated at 38 percent.[4]
History[edit]
The coexistence of intense, divergent moods within an individual was recognized by Homer, Hippocrates and Aretaeus, the last describing the vacillating presence of impulsive anger, melancholia and mania within a single person. The concept was revived by Swiss physician Théophile Bonet in 1684 who, using the term folie maniaco-mélancolique,[130] described the phenomenon of unstable moods that followed an unpredictable course. Other writers noted the same pattern, including the American psychiatrist C. Hughes in 1884 and J.C. Rosse in 1890, who called the disorder "borderline insanity".[131] In 1921, Kraepelin identified an "excitable personality" that closely parallels the borderline features outlined in the current concept of BPD.[132]
The first significant psychoanalytic work to use the term "borderline" was written by Adolf Stern in 1938.[133] It described a group of patients suffering from what he thought to be a mild form of schizophrenia, on the borderline between neurosis and psychosis.
The 1960s and 1970s saw a shift from thinking of the condition as borderline schizophrenia to thinking of it as a borderline affective disorder (mood disorder), on the fringes of bipolar disorder, cyclothymia and dysthymia. In the DSM-II, stressing the intensity and variability of moods, it was called cyclothymic personality (affective personality).[2] While the term "borderline" was evolving to refer to a distinct category of disorder, psychoanalysts such as Otto Kernberg were using it to refer to a broad spectrum of issues, describing an intermediate level of personality organization[132] between neurosis and psychosis.[134]
After standardized criteria were developed[135] to distinguish it from mood disorders and other Axis I disorders, BPD became a personality disorder diagnosis in 1980 with the publication of the DSM-III.[122] The diagnosis was distinguished from sub-syndromal schizophrenia, which was termed "Schizotypal personality disorder".[134] The DSM-IV Axis II Work Group of the American Psychiatric Association finally decided on the name "borderline personality disorder," which is still in use by the DSM-IV today.[136] However, the term "borderline" has been described as uniquely inadequate for describing the symptoms characteristic of this disorder.[137]
Controversies[edit]
Credibility and validity of testimony[edit]
The credibility of individuals with personality disorders has been questioned at least since the 1960s.[138] Two concerns are the incidence of dissociative episodes among people with BPD, and the belief that lying is a key component of this condition.
Dissociation[edit]
Researchers disagree about whether dissociation, or a sense of detachment from emotions and physical experiences, impacts the ability of people with BPD to recall the specifics of past events. A 1999 study reported that the specificity of autobiographical memory was decreased in BPD patients.[139] The researchers found that decreased ability to recall specifics was correlated with patients' levels of dissociation.[139] However, a larger study in 2010 found that people with BPD and without depression had more specific autobiographical memory than did people without BPD and with depression. The presence of depression (though not its severity) was the main factor related to a decreased ability to recall the specifics of past events. This decreased ability was found to be unrelated to dissociation and other symptoms of BPD,[140] thus supporting the reliability of the testimony of people with BPD.
Lying as a feature of BPD[edit]
Some theorists argue that patients with BPD often lie.[141] However, others write that they have rarely seen lying among patients with BPD in clinical practice.[141] Regardless, lying is not one of the diagnostic criteria for BPD.
The belief that lying is a distinguishing characteristic of BPD can impact the quality of care that people with this diagnosis receive in the legal and healthcare systems. For instance, Jean Goodwin relates an anecdote of a patient with multiple personality disorder, now called dissociative identity disorder, who suffered from pelvic pain due to traumatic events in her childhood.[142] Due to their disbelief in her accounts of these events, physicians diagnosed her with borderline personality disorder, reflecting a belief that lying is a key feature of BPD. Based upon her BPD diagnosis, the physicians then disregarded the patient's assertion that she was allergic to adhesive tape. The patient was in fact allergic to adhesive tape, which later caused complications in the surgery to relieve her pelvic pain.[142]
Gender[edit]
Feminists question why women are three times more likely to be diagnosed with BPD than men, while other stigmatizing diagnoses, such as antisocial personality disorder, are diagnosed three times as often in men.[143][144][145]
One explanation is that some of the diagnostic criteria of BPD uphold stereotypes about women. For example, the criteria of "a pattern of unstable personal relationships, unstable self-image, and instability of mood," can all be linked to the stereotype that women are "neither decisive nor constant".[146] Women may be more likely to receive a personality disorder diagnosis if they reject the traditional female role by being assertive, successful, or sexually active.[147] If a woman presents with psychiatric symptoms but does not conform to a traditional, passive sick role, she may be labelled as a "difficult" patient and given a BPD diagnosis.[147]
Since BPD is a stigmatizing diagnosis even within the mental health community (see Stigma), some survivors of childhood sexual abuse who are diagnosed with BPD are thus re-traumatized by the negative responses they receive from healthcare providers.[148] One camp argues that it would be better to diagnose these women with post-traumatic stress disorder, as this would acknowledge the impact of abuse on their behavior. Critics of thePTSD diagnosis argue that it medicalizes abuse rather than addressing the root causes in society.[149] Regardless, a diagnosis of PTSD does not encompass all aspects of the disorder (see Brain abnormalities andTerminology).
Manipulative behavior[edit]
Manipulative behavior to obtain nurturance is considered by the DSM-IV-TR and many mental health professionals to be a defining characteristic of borderline personality disorder.[150] However, Marsha Linehan notes that doing so relies upon the assumption that people with BPD who communicate intense pain, or who engage in self-harm and suicidal behavior, do so with the intention of influencing the behavior of others.[151] The impact of such behavior on others – often an intense emotional reaction in concerned friends, family members, and therapists – is thus assumed to have been the person's intention.[151]
However, since people with BPD lack the ability to successfully manage painful emotions and interpersonal challenges, their frequent expressions of intense pain, self-harming, or suicidal behavior may instead represent a method of mood regulation or an escape mechanism from situations that feel unbearable.[152] Linehan notes that if, for example, one were to withhold pain medication from burn victims and cancer patients, leaving them unable to regulate their severe pain, they would also exhibit "attention-seeking" and self-destructive behavior in order to cope.[153]
Stigma[edit]
The features of BPD include emotional instability, intense unstable interpersonal relationships, a need for intimacy, and a fear of rejection. As a result, people with BPD often evoke intense emotions in those around them. Pejorative terms to describe people with BPD, such as "difficult," "treatment resistant," "manipulative," "demanding" and "attention seeking," are often used, and may become a self-fulfilling prophecy as the negative treatment of these individuals triggers further self-destructive behavior.[154]
Physical violence[edit]
The stigma surrounding borderline personality disorder includes the belief that people with BPD are prone to violence toward others.[155] While movies and visual media often sensationalize people with BPD by portraying them as violent, the majority of researchers agree that people with BPD are unlikely to physically harm others.[155] Although people with BPD often struggle with experiences of intense anger, a defining characteristic of BPD is that they direct it inward toward themselves.[156] One of the key differences between BPD and antisocial personality disorder (ASPD) is that people with BPD tend to internalize anger by hurting themselves, while people with ASPD tend to externalize it by hurting others.[156] In addition, adults with BPD have often experienced abuse in childhood, so many people with BPD adopt a "no-tolerance" policy toward expressions of anger of any kind.[156] Their extreme aversion to violence can cause many people with BPD to overcompensate and experience difficulties being assertive and expressing their needs.[156] This is one way in which people with BPD choose to harm themselves over potentially causing harm to others.[156] Another way in which people with BPD avoid expressing their anger through violence is by causing physical damage to themselves, such as engaging in non-suicidal self injury.[16][155]
Mental healthcare providers[edit]
People with BPD are considered to be among the most challenging groups of patients to work with in therapy, requiring a high level of skill and training in the psychiatrists, therapists and nurses involved in their treatment.[157] A majority of psychiatric staff report finding individuals with BPD moderately to extremely difficult to work with, and more difficult than other client groups.[158] Efforts are ongoing to improve public and staff attitudes toward people with BPD.[159][160]
In psychoanalytic theory, the stigmatization among mental healthcare providers may be thought to reflect countertransference (when a therapist projects their own feelings on to a client). Thus a diagnosis of BPD "often says more about the clinician's negative reaction to the patient than it does about the patient" and "explains away the breakdown in empathy between the therapist and the patient and becomes an institutional epithet in the guise of pseudoscientific jargon".[134] This inadvertent countertransference can give rise to inappropriate clinical responses, including excessive use of medication, inappropriate mothering, and punitive use of limit setting and interpretation.[161]
Some clients feel the diagnosis is helpful, allowing them to understand that they are not alone and to connect with others with BPD who have developed helpful coping mechanisms. However, others experience the term "Borderline Personality Disorder" as a pejorative label rather than an informative diagnosis. They report concerns that their self-destructive behavior is incorrectly perceived as manipulative, and that the stigma surrounding this disorder limits their access to healthcare.[162] Indeed, mental health professionals frequently refuse to provide services to those who have received a BPD diagnosis.[163]
Terminology[edit]
Because of the above concerns, and because of a move away from the original theoretical basis for the term (see history), there is ongoing debate about renaming Borderline Personality Disorder. While some clinicians agree with the current name, others argue that it should be changed,[9] since many who are labelled with "Borderline Personality Disorder" find the name unhelpful, stigmatizing, or inaccurate.[9][164] Valerie Porr, president of Treatment and Research Advancement Association for Personality Disorders states that "the name BPD is confusing, imparts no relevant or descriptive information, and reinforces existing stigma."[165]
Alternative suggestions for names include emotional regulation disorder or emotional dysregulation disorder. Impulse disorder and interpersonal regulatory disorder are other valid alternatives, according to John Gunderson of McLean Hospital in the United States.[166] Another term suggested by psychiatrist Carolyn Quadrio is post traumatic personality disorganization (PTPD), reflecting the condition's status as (often) both a form of chronic post traumatic stress disorder (PTSD) as well as a personality disorder.[89] However, although many with BPD do have traumatic histories, some do not report any kind of traumatic event, which suggests that BPD is not necessarily a trauma spectrum disorder.[95]
The Treatment and Research Advancements National Association for Personality Disorders (TARA-APD) campaigned unsuccessfully to change the name and designation of BPD in DSM-5, published in May 2013, in which the name Borderline personality disorder remains unchanged and it is not considered a Trauma- and stressor-related disorder.[1]
Society and culture[edit]
Film and television[edit]
There are several films portraying characters either explicitly diagnosed or with traits suggestive of BPD. Some of these films may be misleading if they are thought to depict this disorder. The films Play Misty for Me[167]and Girl, Interrupted, based on the memoir by Susanna Kaysen, with Winona Ryder playing Kaysen both suggest the emotional instability of the disorder; however, the first case shows a person more aggressive to others than to herself, which is not characteristic of the disorder.[168] The 1992 film Single White Female, like the first example, also suggests characteristics, some of which are actually atypical of the disorder: the character Hedy suffers from a markedly disturbed sense of identity and abandonment leads to drastic measures.[169] The main character in the film American Psycho (2000), Patrick Bateman, was psychologically evaluated and diagnosed with borderline personality disorder with schizotypal features.[170] In the HBO series The Sopranos Dr. Melfi, Tony Soprano's therapist, suggests that his mother may suffer from BPD and quotes from the DSM definition of the disorder. The characterization definitely exhibits all the traits. In the NBC sitcom "Will & Grace" Grace Adler asks best friend and roommate Will Truman to forge her doctor's signature to evade jury duty because of borderline personality disorder and a high risk for a psychotic break.[171] Another film directed by Lasse Hallström, What's Eating Gilbert Grape, shows a clear example of the disorder in the seductive neighbor Betty (Mary Steenburgen).
Psychiatrists Eric Bui and Rachel Rodgers argue that the character of Anakin Skywalker/Darth Vader in the Star Wars films meets six of the nine diagnostic criteria; Bui also found Anakin a useful example to explain BPD to medical students. In particular, Bui points to the character's abandonment issues, uncertainty over his identity, and dissociative episodes.[172] Other films attempting to depict characters with the disorder include Fatal Attraction, The Crush, Mad Love, Malicious, Interiors, Notes On a Scandal, The Cable Guy, Mr. Nobody and Cracks.[173]
Unfortunately, dramatic portrayals of people with BPD in movies and other forms of visual media contribute to the stigma surrounding borderline personality disorder, especially the myth that people with BPD are violent toward others.[155] The majority of researchers agree that in reality, people with BPD are very unlikely to harm others.[155]
Literature[edit]
The Buddha and the Borderline: My Recovery from Borderline Personality Disorder through Dialectical Behavior Therapy, Buddhism, and Online Dating is a memoir by Kiera Van Gelder.
Girl, Interrupted is a memoir by American author Susanna Kaysen, relating her experiences as a young woman in a psychiatric hospital in the 1960s after being diagnosed with borderline personality disorder.
Get Me Out of Here: My Recovery from Borderline Personality Disorder is a memoir by author Rachel Reiland, relating her treatment and recovery from borderline personality disorder.[174]
Songs of Three Islands, by Millicent Monks, is a memoir speculating about the impact of BPD upon the Carnegie family. Readers have criticized it for presenting a biased and stigmatizing view of BPD.[175]
In Lois McMaster Bujold's science fiction novel Komarr, Tien Vorsoisson has BPD, per the author; his disorder drives a large part of the story.[176]
Kreisman, Jerold J MD, I Hate You—Don't Leave Me: Understanding the Borderline Personality
Awareness[edit]
In early 2008, the United States House of Representatives declared the month of May as Borderline Personality Disorder Awareness Month.[177][178]

• Thread Tools
1. 28-04-13, 05:52 PM#1
LailaTheMuslim

Stop eating my Chicken!!!                    
Join Date
Dec 2009
Location
London init Brav
Gender:
  Female
Posts
6,085
Rep Power
38
Experiences with Borderline Personality Disorder?
My life has been turned upside down these last few years and i've recently found out I may have a condition called Borderline Personality Disorder:
here are the symptoms:


• overwhelming feelings of distress, anxiety, worthlessness or anger
• difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses
• difficulty maintaining stable and close relationships
• sometimes, periods of loss of contact with reality
• in some cases, threats of harm to others



Ok, so my life has become on big emotional mess, and although on the outside I see to have it together, I feel like I am in a constant state of upheaval inside.

What should I do to seek help?
The thing is, I am really not ready to take anti-depressants, I have no experience, and I don't like the side effects that come with it.

Can anyone advise me where to go from here?
WhenTheWorldPushesYouToYourKnees-
You'reInThePerfectPositionToPray (Islam.07)

The Prophet (peace and blessings of Allaah be upon him) said: “O people, beware of this shirk, for it is more subtle than the footsteps of an ant. The one whom Allaah willed should speak said to him, “How can we beware of it when it is more subtle than the footsteps of an ant, O Messenger of Allaah?” He said, “Say, Allaahumma innaa na’oodhu bika min an nushrika bika shay’an na’lamuhu wa nastaghfiruka limaa laa na’lam (O Allaah, we seek refuge with You from knowingly associating anything with You, and we seek Your forgiveness for that which we do unknowingly).” (Narrated by Ahmad, 4/403)


“My intercession will be for those among my ummah who have committed major sins.” [Classed as Sahih by al-Albaani in Sahih Abi Dawood, 3965]
 Reply With Quote
28-04-13, 06:21 PM#2
ceeri_sista

Odan
Join Date
Jan 2012
Location
??? ??????? ???????
Gender:
  Female
Posts
1,972
Rep Power
65
Re: Experiences with Borderline Personality Disorder?
Sometimes small things add up, and they can cause imbalance in your life and affect your mood and so on.

Maybe you should try small changes, because yes anti-depressants have really bad side effects. The worst part is that you said you already have a tendency to dependency, if you start taking anti-depressants this can be compounded terribly.

Honestly if you start becoming anti-social you are making the situation worse. If you have family members, and close friends you can confide in talk to them about the things that worry you.

Also get a blood test done sometimes severe deficiencies can affect you. And it is worse when you become an insomniac and stay up all night, and sleep all day. Ask if vit D. supplements can help you, and try to get some sun (outdoor activities).

Eat foods that will help you feel better. Fresh fruits, vegetables, and stay away from processed foods as much as possible.

I know this might not be the answer you are looking for. But sometimes making small changes gradually can help you.

As much as possible try to pray your prayers on time, and read your adhkaar. Whenever you feel upset or distressed say du`a al hazan.

May Allah   give you shifaa', and protect you and us from severe distress and depression.
 Reply With Quote
28-04-13, 06:30 PM#3
?????

-------------------------
Join Date
Dec 2012
Location
UK
Gender:
  Female
Posts
3,083
Rep Power
113
Re: Experiences with Borderline Personality Disorder?
Are you able to look at the causes of these things and try to eradicate them?

Do you have someone you can talk to without being judged and them consequently running a mile? And then there are the other types who are just like omg I know what you are going through, you would never guess what happened to me today and half an hour later you end up counselling them. Hence having friends does not always equal having someone to talk to.

People used to tell me doctors prescribe anti depressants at the drop of a hat but I really found it to be the opposite. They are pretty useless for physical problems never mind pyschological ones.

Being in a state of purity actually helps, maybe because these thoughts and feelings come from Shaytaan or something but it really does work. You can try it by maintaining Wudhu during a time you would not usually, and see if you feel any different.

Adhkar in the morning and evening will also help, there are some beautiful Du'aas in Fortress of the Muslim for general distress and negative feelings.

I'm sorry if I have misunderstood what you mean and I hope someone can advise you better than I have.
Last edited by ?????; 28-04-13 at 06:33 PM.
 Reply With Quote
28-04-13, 06:32 PM#4
MuslimBrother'

??? ??????? ?????? ????
Join Date
Nov 2012
Location
Assembling The Army
Gender:
  Male
Posts
1,233
Rep Power
26
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
My life has been turned upside down these last few years and i've recently found out I may have a condition called Borderline Personality Disorder:
here are the symptoms:


• overwhelming feelings of distress, anxiety, worthlessness or anger
• difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses
• difficulty maintaining stable and close relationships
• sometimes, periods of loss of contact with reality
• in some cases, threats of harm to others



Ok, so my life has become on big emotional mess, and although on the outside I see to have it together, I feel like I am in a constant state of upheaval inside.

What should I do to seek help?
The thing is, I am really not ready to take anti-depressants, I have no experience, and I don't like the side effects that come with it.

Can anyone advise me where to go from here?
Sister, do not take anti-depressants. You will become dependent on them and constantly feel in a bad state.

It almost sounds as if I went through similar things. I had extreme bouts of depression and considered suicide as my only option, to the point where I was going to carry it out. I don't really know what happened after other than the fact that Islam really changed my life. It wasn't merely reading Islamic material or having patience (in a time when I couldn't possibly have any) but I felt at ease and comfort. Engage is spiritual activities and gain closeness to Allah (s.w.t) through dhikr and material that will move your heart towards Allah (s.w.t).

These are classifications and terms thrown by "medical professionals" for people to succumb to and fall into a state of subjugation by taking medicines that make them dependent on them. Do not fall for this as you will not be any happier than you were before it. True happiness and positivity comes about from attaining a level of contentment with yourself and with what Allah (s.w.t) has given you, which is Islam. Personally, I considered myself very fortunate for Allah (s.w.t) having to guide me from what I was in my past, as it was actually a very evil past I had. It reduced me to tears to realize that for all those years I assumed that He didn't love me or that He didn't even exist, He had always loved and cared for all I done for Him.

It may be that one day, you will feel this and after that, You will be at peace. After that it is a constant struggle of shaytaan trying to call you to other falsehoods which inshallah, Allah (s.w.t) will give you the strength to fight it.
Last edited by MuslimBrother'; 28-04-13 at 06:37 PM.
Leader of the Anti-Barelvi Initiative: Join Today!
 Reply With Quote
28-04-13, 06:40 PM#5
Plumeria

Senior Member                    
Join Date
Dec 2012
Location
US
Gender:
  Female
Posts
980
Rep Power
24
Re: Experiences with Borderline Personality Disorder?
The thing with these 'psychological disorders' such as borderline or bipolar or anti social is you read about them and one automatically assumes that they fall under that category. Now please, I'm not saying this applies to you. I'm just saying is that these disorders are just set up in such a way that you think you are suffering from all of them. I just want to say, don't delve too much into textbook definitions of these disorders, you'll end up losing your mind. Lol

I studied psychology in college and wallah I thought that I was suffering from every disease the book mentioned. Lol psych tends to do that to you. Just do dhikr and remember Allah always
 Reply With Quote
28-04-13, 06:43 PM#6
Know_Thyself

Senior Member                    
Join Date
Sep 2012
Gender:
  Male
Posts
948
Rep Power
11
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
My life has been turned upside down these last few years and i've recently found out I may have a condition called Borderline Personality Disorder:
here are the symptoms:


• overwhelming feelings of distress, anxiety, worthlessness or anger
• difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses
• difficulty maintaining stable and close relationships
• sometimes, periods of loss of contact with reality
• in some cases, threats of harm to others



Ok, so my life has become on big emotional mess, and although on the outside I see to have it together, I feel like I am in a constant state of upheaval inside.

What should I do to seek help?
The thing is, I am really not ready to take anti-depressants, I have no experience, and I don't like the side effects that come with it.

Can anyone advise me where to go from here?


Who said that you may have BPD?

Also, did you experience these symptoms prior to your life turning upside down (sorry to hear that) a few years ago? Could this possible case of BPD have been brought due to the stress of the last few years, or where the results of the last few years due to the possible BPD?

It also says on the NHS Website:
How does BPD develop?
The causes of BPD are unclear. However, as with most conditions, BPD appears to be the result of a combination of genetic and environmental factors.
Traumatic events that occur during childhood are associated with developing BPD. An estimated eight out of 10 people with BPD experience parental neglect or physical, sexual or emotional abuse during their childhood.

If the above is true in your case then having counselling may be a route to go down, in combination perhaps with the medicine such as anti-depressants. If you definitely don't want to take the medicine but do go into counselling/therapy than at least you are dealing with one of the factors, namely the environmental factor.

All in all, we can do as much as possible to help alleviate our illness/condition, but the cure comes from Allah (SWT).

Have patience and pray, and insha'Allah things will work out, "Seek Allah's help with patient perseverance and prayer. It is indeed hard except for those who are humble." (2:45)
"Verily man is in loss, except such as have faith, and do righteous deeds, and join together in the mutual enjoining of truth, and of patience and constancy." (103:2-3)
"With every difficulty there is relief. Verily, with every difficulty there is relief. (94:5-6)

Also, check out my display picture! Every time I see it, a certain calm washes over me . Also hearing Surah Ad Duha helps as well over ayaahs that speak about patience and the reward for those who are pious.

May Allah make it easy for you. Ameen
 Reply With Quote
28-04-13, 06:43 PM#7
Plumeria

Senior Member                    
Join Date
Dec 2012
Location
US
Gender:
  Female
Posts
980
Rep Power
24
Re: Experiences with Borderline Personality Disorder?
And definitely nix on the anti depressants. One of the biggest side effects of this types of medications is that they increase suicidal risk. Lol that always made me scratch my head, like a medicine is supposed to elevate your mood and take you out of a depressed state, yet they increase your chance of suicide. Bad idea.


 Reply With Quote
28-04-13, 06:54 PM#8
Know_Thyself

Senior Member                    
Join Date
Sep 2012
Gender:
  Male
Posts
948
Rep Power
11
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by Plumeria
And definitely nix on the anti depressants. One of the biggest side effects of this types of medications is that they increase suicidal risk. Lol that always made me scratch my head, like a medicine is supposed to elevate your mood and take you out of a depressed state, yet they increase your chance of suicide. Bad idea.


Sometimes I think this is on purpose! I suppose there is a lot of money in the pharmaceutical industry, hence the need to have more people suffering (or think they're suffering) in order to sell the 'medicine'... I hope not... Although, I did read a book by John Pilger where he interviewed a guy who was head of a help program for those dying in Africa of various diseases, and it turns out they were actually injecting people with the disease. The guy went on to say that he regretted it etc etc. The thing is Pilger may have taken his words out of context because vaccines etc generally tend to have a small amount of the virus to help the body build immunity to it etc...
 Reply With Quote
28-04-13, 06:58 PM#9
Mecca

Senior Member                    
Join Date
Dec 2012
Gender:
  Male
Posts
747
Rep Power
27
Re: Experiences with Borderline Personality Disorder?
If I would look at the symptoms of mental illnesses online, I would probably self diagnose myself with a dozen different mental illnesses. My point is, dont self diagnose yourself. Go to a doctor and they might attach a nice label on you, and then give you a cocktail of pills, that may or may not help you at all other then put you to sleep.
 Reply With Quote
28-04-13, 07:10 PM#10
?????

-------------------------
Join Date
Dec 2012
Location
UK
Gender:
  Female
Posts
3,083
Rep Power
113
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by Mecca
If I would look at the symptoms of mental illnesses online, I would probably self diagnose myself with a dozen different mental illnesses. My point is, dont self diagnose yourself. Go to a doctor and they might attach a nice label on you, and then give you a cocktail of pills, that may or may not help you at all other then put you to sleep.


They don't even do that anymore. They just send you home.
 Reply With Quote
28-04-13, 07:13 PM#11
neelu

Senior Member                    
Join Date
Oct 2002
Location
With my youtube budgies
Gender:
  Female
Posts
7,396
Rep Power
175
Re: Experiences with Borderline Personality Disorder?
Laila you've already said your household may be afflicted by sihr so it's quite likely that your symptoms are a manifestation of the same problem as well. I can give you the obvious advice which is to maintain a state of ghusl/wudhu, maintain regular prayers, do dhikr and read quran regularly etc but I'll also suggest other practical measures depending on your lifestyle. If your lifestyle is too busy that it's become overwhelming then find a way to cut down the load, whether it means reducing your work hours, resting and relaxing more after work/school etc or on the other hand if your lifestyle is not busy enough (eg unemployed and not got much to do with your time), then you need to find things that help fill your time such as going for a walk in the park or somewhere a little more scenic and close to nature- if you love animals then find out if your family would let you keep a pet as if you find the right one, it can have a very calming effect (but bear in mind pets require a lot of responsibility and care).

Check out the sticky thread on mental health awareness. I'm sure someone else on this forum has borderline personality disorder so I hope that person will be able to PM or approach you inshaAllah if that person is still here.

With regret I must admit my brother's ex wife has borderline personality disorder and she has been like a nightmare come true for the whole family. It never mattered how polite we were towards her even when she was spewing nonsense, it never mattered if we gave her all the space and privacy she asked for, it never mattered how much we were considerate to her feelings she threw it all back in our faces and treated us like something stuck to the bottom of her shoe and continues to treat us in that manner. I feel sorry for her children who have to live with her day to day- they love her but are so afraid of her tantrums it puts them on edge and damages them emotionally but as the courts always favour the mother there is nothing we can do about it.
The Lyme Disease pandemic: http://www.youtube.com/watch?v=z5u73ME4sVU
 Reply With Quote
28-04-13, 07:17 PM#12
Reminders

Senior Member                  
Join Date
Apr 2012
Gender:
  Female
Posts
188
Rep Power
12
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
My life has been turned upside down these last few years and i've recently found out I may have a condition called Borderline Personality Disorder:
here are the symptoms:


• overwhelming feelings of distress, anxiety, worthlessness or anger
• difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses
• difficulty maintaining stable and close relationships
• sometimes, periods of loss of contact with reality
• in some cases, threats of harm to others



Ok, so my life has become on big emotional mess, and although on the outside I see to have it together, I feel like I am in a constant state of upheaval inside.

What should I do to seek help?
The thing is, I am really not ready to take anti-depressants, I have no experience, and I don't like the side effects that come with it.

Can anyone advise me where to go from here?
Assalamu 'alaykum sister

I'm really sorry to hear that you're experiencing such mental/emotional struggles.

Although you can identify with these symptoms, you can never be sure that you do actually have BPD until it's clinically confirmed - it could just be a long phase of emotional distress or it could be another mental illness altogether. Your best bet is to see your doctor so you can find out exactly what the problem is. (S)he will ask you a range of in depth questions about your feelings, how long you've been experiencing them, your past experiences (such as any traumatic events in your life), your relationships with others etc - all of these things will then be weighed against each other to see if there is any underlying mental illness. I know the idea of going to seek real medical help can be daunting, even embarrassing, but the longer you put it off, the worse your symptoms could get and the more likely you are to do something dangerous/harmful.

Treatment is usually psychotherapy with medication. There might even be times of hospitalisation because of the risk of self-harm and the intense feelings. There's also a wealth of self-help material for BPD sufferers online if you haven't come across them already. If you do turn out to have BPD and you still have a fear of medication, I would advise that you talk to your doc about it and familiarise yourself with the prescribed pills and do your own research. A lot of the fear people have of meds is usually down to not being familiar with what they do and how they work.

The most important advice I can give you as a Muslim is to try to focus on your relationship with Allah, engage in as much dhikr as you possibly can. People used to say this to me and I ignored their advice, partly because I found it very difficult due to my lack of iman, and partly because I felt like it wouldn't help me (every time I tried, I never felt like I was doing it properly and found it difficult to concentrate). If you don't already engage in dhikr or you can relate to my past experience with it, I would advise that you pick up a copy of 'fortress of the Muslim' and start with the morning and evening dhikr, and the ad'iya before sleep - read each once. For me, the results were instantaneous alhamdulillah. I felt like a fool for not doing it earlier. It can be something that's difficult to keep up with, but in the end it's worth it.

I hope you find some benefit in this post, and I hope that things get better for you.
Last edited by Reminders; 28-04-13 at 07:19 PM.
"Truly, I am Allah; there is no God but I; therefore serve Me"
[20:14]
 Reply With Quote
28-04-13, 07:18 PM#13
C Bear

Sleeping...                    
Join Date
Apr 2005
Location
C Bear World
Gender:
  Female
Posts
4,504
Rep Power
87
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
My life has been turned upside down these last few years and i've recently found out I may have a condition called Borderline Personality Disorder:

Ok, so my life has become on big emotional mess, and although on the outside I see to have it together, I feel like I am in a constant state of upheaval inside.

What should I do to seek help?
The thing is, I am really not ready to take anti-depressants, I have no experience, and I don't like the side effects that come with it.

Can anyone advise me where to go from here?
If things are that bad, then I think you should see your GP and ask for a referral. It may be BPD, it may be something else. But getting it checked means you at least have closure and know where to go.

You don't need to take anti-depressants. There are alternative therapies, eg counselling, CBT, aromatherapy, reflexology, TCM etc, which may be slower, but I'd prefer them over anti-depressants. If you do go down the alternative route, it goes without saying, check that the practitioner is from a professional regulated body.

May Allah make it easy for you and heal your mind sis, ameen
  Islamic Prints
Why be so loyal to glasses when glasses are not loyal to you?

Enormity = wicked act. Enormousness = great size. The difference: you can haz. Learn it, love it.
For great justice!
 Reply With Quote
28-04-13, 07:19 PM#14
Know_Thyself

Senior Member                    
Join Date
Sep 2012
Gender:
  Male
Posts
948
Rep Power
11
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by neelu
Laila you've already said your household may be afflicted by sihr so it's quite likely that your symptoms are a manifestation of the same problem as well. I can give you the obvious advice which is to maintain a state of ghusl/wudhu, maintain regular prayers, do dhikr and read quran regularly etc but I'll also suggest other practical measures depending on your lifestyle. If your lifestyle is too busy that it's become overwhelming then find a way to cut down the load, whether it means reducing your work hours, resting and relaxing more after work/school etc or on the other hand if your lifestyle is not busy enough (eg unemployed and not got much to do with your time), then you need to find things that help fill your time such as going for a walk in the park or somewhere a little more scenic and close to nature- if you love animals then find out if your family would let you keep a pet as if you find the right one, it can have a very calming effect (but bear in mind pets require a lot of responsibility and care).

Check out the sticky thread on mental health awareness. I'm sure someone else on this forum has borderline personality disorder so I hope that person will be able to PM or approach you inshaAllah if that person is still here.

With regret I must admit my brother's ex wife has borderline personality disorder and she has been like a nightmare come true for the whole family. It never mattered how polite we were towards her even when she was spewing nonsense, it never mattered if we gave her all the space and privacy she asked for, it never mattered how much we were considerate to her feelings she threw it all back in our faces and treated us like something stuck to the bottom of her shoe and continues to treat us in that manner. I feel sorry for her children who have to live with her day to day- they love her but are so afraid of her tantrums it puts them on edge and damages them emotionally but as the courts always favour the mother there is nothing we can do about it.
Sorry to hear that. May Allah make it easy for all those involved. Ameen

Is there no way to contest her having custody of the children due to her not being mentally stable? Or has this already been tried?
 Reply With Quote
28-04-13, 07:23 PM#15
LailaTheMuslim

Stop eating my Chicken!!!                    
Join Date
Dec 2009
Location
London init Brav
Gender:
  Female
Posts
6,085
Rep Power
38
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by neelu
Laila you've already said your household may be afflicted by sihr so it's quite likely that your symptoms are a manifestation of the same problem as well. I can give you the obvious advice which is to maintain a state of ghusl/wudhu, maintain regular prayers, do dhikr and read quran regularly etc but I'll also suggest other practical measures depending on your lifestyle. If your lifestyle is too busy that it's become overwhelming then find a way to cut down the load, whether it means reducing your work hours, resting and relaxing more after work/school etc or on the other hand if your lifestyle is not busy enough (eg unemployed and not got much to do with your time), then you need to find things that help fill your time such as going for a walk in the park or somewhere a little more scenic and close to nature- if you love animals then find out if your family would let you keep a pet as if you find the right one, it can have a very calming effect (but bear in mind pets require a lot of responsibility and care).

Check out the sticky thread on mental health awareness. I'm sure someone else on this forum has borderline personality disorder so I hope that person will be able to PM or approach you inshaAllah if that person is still here.

With regret I must admit my brother's ex wife has borderline personality disorder and she has been like a nightmare come true for the whole family. It never mattered how polite we were towards her even when she was spewing nonsense, it never mattered if we gave her all the space and privacy she asked for, it never mattered how much we were considerate to her feelings she threw it all back in our faces and treated us like something stuck to the bottom of her shoe and continues to treat us in that manner. I feel sorry for her children who have to live with her day to day- they love her but are so afraid of her tantrums it puts them on edge and damages them emotionally but as the courts always favour the mother there is nothing we can do about it.
thanks, alhamdulilah. Yes, I 've said the black magic might be present, my family are trying to see a sheikh inshallah.
As for your sister in law, I'd say I have a completely confused mental state and I feel horrid all the time, but I keep it inside as I am a naturally quiet individual. This is completely unhealthy, as every one in a while, I completely blow up and get into fights with my family. They think I am unreasonably aggressive, when I get angry.

This is probably the worst disorder that you can have.
WhenTheWorldPushesYouToYourKnees-
You'reInThePerfectPositionToPray (Islam.07)

The Prophet (peace and blessings of Allaah be upon him) said: “O people, beware of this shirk, for it is more subtle than the footsteps of an ant. The one whom Allaah willed should speak said to him, “How can we beware of it when it is more subtle than the footsteps of an ant, O Messenger of Allaah?” He said, “Say, Allaahumma innaa na’oodhu bika min an nushrika bika shay’an na’lamuhu wa nastaghfiruka limaa laa na’lam (O Allaah, we seek refuge with You from knowingly associating anything with You, and we seek Your forgiveness for that which we do unknowingly).” (Narrated by Ahmad, 4/403)


“My intercession will be for those among my ummah who have committed major sins.” [Classed as Sahih by al-Albaani in Sahih Abi Dawood, 3965]
 Reply With Quote
28-04-13, 07:25 PM#16
Know_Thyself

Senior Member                    
Join Date
Sep 2012
Gender:
  Male
Posts
948
Rep Power
11
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
thanks, alhamdulilah. Yes, I 've said the black magic might be present, my family are trying to see a sheikh inshallah.
As for your sister in law, I'd say I have a completely confused mental state and I feel horrid all the time, but I keep it inside as I am a naturally quiet individual. This is completely unhealthy, as every one in a while, I completely blow up and get into fights with my family. They think I am unreasonably aggressive, when I get angry.

This is probably the worst disorder that you can have.


Who said that you may have BPD?

Also, did you experience these symptoms prior to your life turning upside down (sorry to hear that) a few years ago? Could this possible case of BPD have been brought due to the stress of the last few years, or where the results of the last few years due to the possible BPD?

It also says on the NHS Website:
How does BPD develop?
The causes of BPD are unclear. However, as with most conditions, BPD appears to be the result of a combination of genetic and environmental factors.
Traumatic events that occur during childhood are associated with developing BPD. An estimated eight out of 10 people with BPD experience parental neglect or physical, sexual or emotional abuse during their childhood.

If the above is true in your case then having counselling may be a route to go down, in combination perhaps with the medicine such as anti-depressants. If you definitely don't want to take the medicine but do go into counselling/therapy than at least you are dealing with one of the factors, namely the environmental factor.

All in all, we can do as much as possible to help alleviate our illness/condition, but the cure comes from Allah (SWT).

Have patience and pray, and insha'Allah things will work out, "Seek Allah's help with patient perseverance and prayer. It is indeed hard except for those who are humble." (2:45)
"Verily man is in loss, except such as have faith, and do righteous deeds, and join together in the mutual enjoining of truth, and of patience and constancy." (103:2-3)
"With every difficulty there is relief. Verily, with every difficulty there is relief. (94:5-6)

Also, check out my display picture! Every time I see it, a certain calm washes over me . Also hearing Surah Ad Duha helps as well over ayaahs that speak about patience and the reward for those who are pious.

May Allah make it easy for you. Ameen
 Reply With Quote
28-04-13, 07:26 PM#17
LailaTheMuslim

Stop eating my Chicken!!!                    
Join Date
Dec 2009
Location
London init Brav
Gender:
  Female
Posts
6,085
Rep Power
38
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by Know_Thyself
Sorry to hear that. May Allah make it easy for all those involved. Ameen

Is there no way to contest her having custody of the children due to her not being mentally stable? Or has this already been tried?
well I think its sounds horrible for a mother to loose custody of her children, this woman sounds confused and Allah is the manager of people's lives and He can make people because mentally unfit, or mentally well.

I think in those type of situation joint custody is good, bcoz the children can see their father and be looked after, but the mother wont loose custody of her kids.
WhenTheWorldPushesYouToYourKnees-
You'reInThePerfectPositionToPray (Islam.07)

The Prophet (peace and blessings of Allaah be upon him) said: “O people, beware of this shirk, for it is more subtle than the footsteps of an ant. The one whom Allaah willed should speak said to him, “How can we beware of it when it is more subtle than the footsteps of an ant, O Messenger of Allaah?” He said, “Say, Allaahumma innaa na’oodhu bika min an nushrika bika shay’an na’lamuhu wa nastaghfiruka limaa laa na’lam (O Allaah, we seek refuge with You from knowingly associating anything with You, and we seek Your forgiveness for that which we do unknowingly).” (Narrated by Ahmad, 4/403)


“My intercession will be for those among my ummah who have committed major sins.” [Classed as Sahih by al-Albaani in Sahih Abi Dawood, 3965]
 Reply With Quote
28-04-13, 07:28 PM#18
LailaTheMuslim

Stop eating my Chicken!!!                    
Join Date
Dec 2009
Location
London init Brav
Gender:
  Female
Posts
6,085
Rep Power
38
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by Know_Thyself


Who said that you may have BPD?

Also, did you experience these symptoms prior to your life turning upside down (sorry to hear that) a few years ago? Could this possible case of BPD have been brought due to the stress of the last few years, or where the results of the last few years due to the possible BPD?

It also says on the NHS Website:
How does BPD develop?
The causes of BPD are unclear. However, as with most conditions, BPD appears to be the result of a combination of genetic and environmental factors.
Traumatic events that occur during childhood are associated with developing BPD. An estimated eight out of 10 people with BPD experience parental neglect or physical, sexual or emotional abuse during their childhood.

If the above is true in your case then having counselling may be a route to go down, in combination perhaps with the medicine such as anti-depressants. If you definitely don't want to take the medicine but do go into counselling/therapy than at least you are dealing with one of the factors, namely the environmental factor.

All in all, we can do as much as possible to help alleviate our illness/condition, but the cure comes from Allah (SWT).

Have patience and pray, and insha'Allah things will work out, "Seek Allah's help with patient perseverance and prayer. It is indeed hard except for those who are humble." (2:45)
"Verily man is in loss, except such as have faith, and do righteous deeds, and join together in the mutual enjoining of truth, and of patience and constancy." (103:2-3)
"With every difficulty there is relief. Verily, with every difficulty there is relief. (94:5-6)

Also, check out my display picture! Every time I see it, a certain calm washes over me . Also hearing Surah Ad Duha helps as well over ayaahs that speak about patience and the reward for those who are pious.

May Allah make it easy for you. Ameen
hi sis. I've been to doctors with depression, all offered me anti-depressants, and maybe counselling. I really don't feel comfortable with anti-depressants. The last few weeks I was doing personal research on mental illness and found most of symptoms in line with BPD, I have chronic dissociation which is unique to BPD.
WhenTheWorldPushesYouToYourKnees-
You'reInThePerfectPositionToPray (Islam.07)

The Prophet (peace and blessings of Allaah be upon him) said: “O people, beware of this shirk, for it is more subtle than the footsteps of an ant. The one whom Allaah willed should speak said to him, “How can we beware of it when it is more subtle than the footsteps of an ant, O Messenger of Allaah?” He said, “Say, Allaahumma innaa na’oodhu bika min an nushrika bika shay’an na’lamuhu wa nastaghfiruka limaa laa na’lam (O Allaah, we seek refuge with You from knowingly associating anything with You, and we seek Your forgiveness for that which we do unknowingly).” (Narrated by Ahmad, 4/403)


“My intercession will be for those among my ummah who have committed major sins.” [Classed as Sahih by al-Albaani in Sahih Abi Dawood, 3965]
 Reply With Quote
28-04-13, 07:32 PM#19
neelu

Senior Member                    
Join Date
Oct 2002
Location
With my youtube budgies
Gender:
  Female
Posts
7,396
Rep Power
175
Re: Experiences with Borderline Personality Disorder?
I don't think he's interested in trying to get custody of the kids as they are close to their mother in spite of her issues, but rather he wants joint custody and he does have a form of that (where he sees them on weekends) but he just wants her to give up her drama queen crap of throwing a spanner in the works, from time to time saying one or more of the kids can't come cos' of such and such and making false allegations against him to the school and much more besides.

He can't say she's mentally unstable cos' it doesn't work like that in the courts. The courts would only pay attention if he could prove that the kids (or her) are in imminent danger cos' of mental illness such as her beating the kids or something- they can't do anything about a personality disorder that results in some emotional abuse cos' she's a drama queen. The other problem is, to confirm she has a personality disorder, she'd have to admit that she needs to see a shrink cos' something is wrong with her, but she will never admit anything is up with her and never agree to see a shrink so she'll always go without a diagnosis and if we say she has BPD we'll be told it's just hearsay cos' her diagnosis hasn't been confirmed by a shrink- as you can see it's a catch 22 as the onus is on her admitting to the problem and seeking help before anyone will admit to it.

We made the mistake of feeling sorry for her cos' she used to tell my bro sob stories about her past and my bro would keep telling us "be gentle with her" even when she can be like a rottweiler. We should have put her in her place early on but I've learned my lesson and don't put up with abuse from anyone anymore.
The Lyme Disease pandemic: http://www.youtube.com/watch?v=z5u73ME4sVU
 Reply With Quote
28-04-13, 07:48 PM#20
Know_Thyself

Senior Member                    
Join Date
Sep 2012
Gender:
  Male
Posts
948
Rep Power
11
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
hi sis. I've been to doctors with depression, all offered me anti-depressants, and maybe counselling. I really don't feel comfortable with anti-depressants. The last few weeks I was doing personal research on mental illness and found most of symptoms in line with BPD, I have chronic dissociation which is unique to BPD.
I'm a dude...   lol

Also, I gave you greetings of peace, I want it paid back in kind! Lol!

Depression is one thing, BPD is something else. Before you start believing that you have BPD through self diagnosis, I would suggest going to a doctor first.

I would advise that you see a counselor for the depression and more importantly have Taqwa of Allah (not saying you don't have it at the moment!).
 Reply With Quote
28-04-13, 08:01 PM#21
Reminders

Senior Member                  
Join Date
Apr 2012
Gender:
  Female
Posts
188
Rep Power
12
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
hi sis. I've been to doctors with depression, all offered me anti-depressants, and maybe counselling. I really don't feel comfortable with anti-depressants. The last few weeks I was doing personal research on mental illness and found most of symptoms in line with BPD, I have chronic dissociation which is unique to BPD.
Then you should definitely go to your doctor with all of your concerns about possibly having BPD. Treatment for BPD is completely different to that of depression so you will definitely find it more helpful. And like I said earlier, try to do your own in-depth research on the meds you're given (if you haven't already), usually people fear the medication because they don't know much about what it does to help, how it works, what the side effects are, so they can't really weigh it up for themselves. If you are diagnosed with BPD, you don't have to take the medication and can go solely on the psychotherapy. But for some people, meds really are necessary. I hope everything works out for you in the end sis.
"Truly, I am Allah; there is no God but I; therefore serve Me"
[20:14]
 Reply With Quote
28-04-13, 08:10 PM#22
SILURES

Kaffir                    
Join Date
Jun 2008
Location
WALES
Gender:
  Male
Posts
14,302
Rep Power
371
Re: Experiences with Borderline Personality Disorder?
i dont blame you not want the tablets for this. a cousin of mine around two years ago suffered from something simular (not sure what exactly but the symptoms seem close) and the docs gave them to her straight away. they helped the symptoms of the disease but didnt cure her. funny it was getting diagnosed with breast cancer that sorted her head out.

http://www.indigo-herbs.co.uk/acatal...epressant.html

dont know if this will be any help.

"One will not enter Paradise, if one has an atom’s weight of arrogance in his/her heart." a man thenasked, "One may love his clothes to look good and his shoes to look good?!" The Prophet replied, "Allah is beautiful and loves beauty, arrogance is: rejecting the truth and looking down on people."
 Reply With Quote
28-04-13, 08:12 PM#23
Know_Thyself

Senior Member                    
Join Date
Sep 2012
Gender:
  Male
Posts
948
Rep Power
11
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
well I think its sounds horrible for a mother to loose custody of her children, this woman sounds confused and Allah is the manager of people's lives and He can make people because mentally unfit, or mentally well.

I think in those type of situation joint custody is good, bcoz the children can see their father and be looked after, but the mother wont loose custody of her kids.
When I say the children should be in the custody of the father, I don't mean that the mother should not be given access to her children at all.

My point is that, if the children are becoming emotionally damaged due to being under the guardianship of the mother, then for the sake of the children, they should be moved to a less toxic environment, as the damage inflicted upon them could have far reaching consequences, and then returned until the mother has been cured of her mental illness and she meets the necessary criteria.

In some cases, the husband is better placed and in others the mother. If they both fit the criteria, then this is where a variety of opinions arise.

Agreed, it is horrible for a mother to lose custody of her children, but I find it even more horrible when the children are within a toxic environment...

And Allah knows best.
 Reply With Quote
28-04-13, 08:16 PM#24
Magic.

Odan
Join Date
Dec 2011
Gender:
  Male
Posts
5,882
Rep Power
107
Re: Experiences with Borderline Personality Disorder?
nvm
Last edited by Magic.; 28-04-13 at 08:20 PM.
 Reply With Quote
28-04-13, 08:18 PM#25
Know_Thyself

Senior Member                    
Join Date
Sep 2012
Gender:
  Male
Posts
948
Rep Power
11
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by neelu
I don't think he's interested in trying to get custody of the kids as they are close to their mother in spite of her issues, but rather he wants joint custody and he does have a form of that (where he sees them on weekends) but he just wants her to give up her drama queen crap of throwing a spanner in the works, from time to time saying one or more of the kids can't come cos' of such and such and making false allegations against him to the school and much more besides.

He can't say she's mentally unstable cos' it doesn't work like that in the courts. The courts would only pay attention if he could prove that the kids (or her) are in imminent danger cos' of mental illness such as her beating the kids or something- they can't do anything about a personality disorder that results in some emotional abuse cos' she's a drama queen. The other problem is, to confirm she has a personality disorder, she'd have to admit that she needs to see a shrink cos' something is wrong with her, but she will never admit anything is up with her and never agree to see a shrink so she'll always go without a diagnosis and if we say she has BPD we'll be told it's just hearsay cos' her diagnosis hasn't been confirmed by a shrink- as you can see it's a catch 22 as the onus is on her admitting to the problem and seeking help before anyone will admit to it.

We made the mistake of feeling sorry for her cos' she used to tell my bro sob stories about her past and my bro would keep telling us "be gentle with her" even when she can be like a rottweiler. We should have put her in her place early on but I've learned my lesson and don't put up with abuse from anyone anymore.
I understand now.

I feel it should be flagged up though. Are there no cases where custody has been given to one of the parents due to the parent having a mental illness such as BPD?

Re the false allegations etc, as long as she is not poisoning the children against their father etc or blocking access then let her says what she wants! Insha'Allah the truth will be made clear.

May Allah make this easy for you all. Ameen
 Reply With Quote
28-04-13, 08:32 PM#26
Safaa


Account Disabled
                   
Join Date
Jan 2013
Location
You Wish...
Gender:
  Female
Posts
1,572
Rep Power
0
Re: Experiences with Borderline Personality Disorder?
d.p
Last edited by Safaa; 28-04-13 at 09:01 PM.
 Reply With Quote
28-04-13, 08:43 PM#27
Safaa


Account Disabled
                   
Join Date
Jan 2013
Location
You Wish...
Gender:
  Female
Posts
1,572
Rep Power
0
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by SILURES
i dont blame you not want the tablets for this. a cousin of mine around two years ago suffered from something simular (not sure what exactly but the symptoms seem close) and the docs gave them to her straight away. they helped the symptoms of the disease but didnt cure her. funny it was getting diagnosed with breast cancer that sorted her head out.

http://www.indigo-herbs.co.uk/acatal...epressant.html

dont know if this will be any help.
Uk has all these chinese herbal shops they always have some strange concoctions for almost anything you want,

God do they smell bad or what.

Its like someone bottled a fart lol
 Reply With Quote
28-04-13, 08:48 PM#28
LailaTheMuslim

Stop eating my Chicken!!!                    
Join Date
Dec 2009
Location
London init Brav
Gender:
  Female
Posts
6,085
Rep Power
38
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by Know_Thyself
I'm a dude...   lol

Also, I gave you greetings of peace, I want it paid back in kind! Lol!

Depression is one thing, BPD is something else. Before you start believing that you have BPD through self diagnosis, I would suggest going to a doctor first.

I would advise that you see a counselor for the depression and more importantly have Taqwa of Allah (not saying you don't have it at the moment!).
salaamu alaikum brother!
WhenTheWorldPushesYouToYourKnees-
You'reInThePerfectPositionToPray (Islam.07)

The Prophet (peace and blessings of Allaah be upon him) said: “O people, beware of this shirk, for it is more subtle than the footsteps of an ant. The one whom Allaah willed should speak said to him, “How can we beware of it when it is more subtle than the footsteps of an ant, O Messenger of Allaah?” He said, “Say, Allaahumma innaa na’oodhu bika min an nushrika bika shay’an na’lamuhu wa nastaghfiruka limaa laa na’lam (O Allaah, we seek refuge with You from knowingly associating anything with You, and we seek Your forgiveness for that which we do unknowingly).” (Narrated by Ahmad, 4/403)


“My intercession will be for those among my ummah who have committed major sins.” [Classed as Sahih by al-Albaani in Sahih Abi Dawood, 3965]
 Reply With Quote
28-04-13, 08:49 PM#29
blanchoir

Odan
Join Date
Oct 2009
Gender:
  Male
Posts
5,642
Rep Power
393
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
My life has been turned upside down these last few years and i've recently found out I may have a condition called Borderline Personality Disorder:
here are the symptoms:


• overwhelming feelings of distress, anxiety, worthlessness or anger
• difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses
• difficulty maintaining stable and close relationships
• sometimes, periods of loss of contact with reality
• in some cases, threats of harm to others



Ok, so my life has become on big emotional mess, and although on the outside I see to have it together, I feel like I am in a constant state of upheaval inside.

What should I do to seek help?
The thing is, I am really not ready to take anti-depressants, I have no experience, and I don't like the side effects that come with it.

Can anyone advise me where to go from here?
no, you don't have borderline personality disorder.

Purify your soul.

look into Knowing yourself to Know God by Imam Al-Ghazalli
The world has moved on, yet I have not taken a single step forward.
 Reply With Quote
29-04-13, 01:34 AM#30
amatullaah

Odan                    
Join Date
Sep 2006
Gender:
  Female
Posts
2,240
Rep Power
44
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by blanchoir
no, you don't have borderline personality disorder.

Purify your soul.

look into Knowing yourself to Know God by Imam Al-Ghazalli
Akhi please don't be so dismissive of a possible serious medical problem.

Ukhti unless anyone here (or someone they know) has the disorder themselves or work in the medical field, they won't have any knowledge about this possible disorder you may have that would be beneficial to you.

Please see the PM I sent you.

Edit: Laila you need to see a doctor for a referral to a psychiatrist who could examine your symptoms and make a proper diagnosis. Disassociation isn't unique to BPD. ReadReminders' post.
Last edited by amatullaah; 29-04-13 at 01:44 AM.
O you who believe! Enter perfectly in Islam (by obeying all the rules and regulations of the Islamic religion) and follow not the footsteps of Shaitan (Satan). Verily! He is to you a plain enemy (Al-Baqarah 2:208)
 Reply With Quote
29-04-13, 01:45 AM#31
Reminders

Senior Member                  
Join Date
Apr 2012
Gender:
  Female
Posts
188
Rep Power
12
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by Amatullaah
Akhi please don't be so dismissive of a possible serious medical problem.

Ukhti unless anyone here (or someone they know) has the disorder themselves or work in the medical field, they won't have any knowledge about this possible disorder you may have that would be beneficial to you.

Please see the PM I sent you.
Assalamu 'alaykum. Any chance you could share the PM if it's beneficial advice? Might help some others who are quietly going through a similar problem to Laila's. Jazakallah khair
"Truly, I am Allah; there is no God but I; therefore serve Me"
[20:14]
 Reply With Quote
29-04-13, 01:48 AM#32
amatullaah

Odan                    
Join Date
Sep 2006
Gender:
  Female
Posts
2,240
Rep Power
44
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by Reminders
Assalamu 'alaykum. Any chance you could share the PM if it's beneficial advice? Might help some others who are quietly going through a similar problem to Laila's. Jazakallah khair
See my PM.
O you who believe! Enter perfectly in Islam (by obeying all the rules and regulations of the Islamic religion) and follow not the footsteps of Shaitan (Satan). Verily! He is to you a plain enemy (Al-Baqarah 2:208)
 Reply With Quote
29-04-13, 10:57 AM#33
Know_Thyself

Senior Member                    
Join Date
Sep 2012
Gender:
  Male
Posts
948
Rep Power
11
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
salaamu alaikum brother!

 Reply With Quote
29-04-13, 11:39 AM#34
The_Unseen_Hand

Senior Member                  
Join Date
Nov 2008
Gender:
  Male
Posts
623
Rep Power
19
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
Can anyone advise me where to go from here?
Don't listen to most the advice on this thread. Most people don't understand BPD at all. Ask your GP for a psych referral for a mental health assessment. A lot of mental health issues have similar symptoms and that includes personality disorders. A proper diagnosis is the first step toward treatment. And don't despair if you do get a diagnosis, there's a lot of effective treatments for BPD. A combination of antipsychotics and dialectical behaviour therapy over a 12 month period has a very good success rate, for example.
 Reply With Quote
29-04-13, 05:52 PM#35
Ariadne

lost in Earth                    
Join Date
Dec 2011
Location
gone.
Gender:
  Female
Posts
3,465
Rep Power
119
Re: Experiences with Borderline Personality Disorder?
Dear sister, we are not professional physicians here. You should really go to a therapist.

For a while, you can try The Emotion Code (there's its free ebook about it online). All you need is magnet (even refrigerator magnet works) to release the trapped emotion associated with the imbalance. It is very easy, safe, and you can do it DIY. But physician all the way!

My Blog ~~ http://DecodingEden.com
 Reply With Quote
29-04-13, 05:55 PM#36
amatullaah

Odan                    
Join Date
Sep 2006
Gender:
  Female
Posts
2,240
Rep Power
44
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by The_Unseen_Hand
Don't listen to most the advice on this thread. Most people don't understand BPD at all. Ask your GP for a psych referral for a mental health assessment. A lot of mental health issues have similar symptoms and that includes personality disorders. A proper diagnosis is the first step toward treatment. And don't despair if you do get a diagnosis, there's a lot of effective treatments for BPD. A combination of antipsychotics and dialectical behaviour therapy over a 12 month period has a very good success rate, for example.
Jazak'Allahu khayran for speaking with knowledge. Ukhti you should definitely ask your GP for a referral for a psych assessment. There are often overlaps between the various personality disorders, and you can have co-morbidity as well. Only a professional can diagnose you and help you.

However, as far as I'm aware, the most recent research suggests that after 2 years of dialectical behaviour therapy, clinicians have seen an large increase in the rates of remission. Anti-psychotics are not necessarily used to treat symptoms, however. It depends on the individual; they could also be prescribed anti-anxiety or anti-depressants to deal with the symptoms of the disorder. However to treat the core problem (i.e. to cure the disorder), dialectical behaviour therapy has proven to be the most effective. But there is also an increase in use of mentalization theraphy and transference therapy as well, since they seem to have a positive impact. And it all really depends on the individual. Which is why all treatment plans are customized to individuals needs.

This site is a very good resource of dealing with BPD.

And this site is good if you're in the UK because it is UK-specific.
O you who believe! Enter perfectly in Islam (by obeying all the rules and regulations of the Islamic religion) and follow not the footsteps of Shaitan (Satan). Verily! He is to you a plain enemy (Al-Baqarah 2:208)
 Reply With Quote
01-05-13, 11:10 PM#37
LailaTheMuslim

Stop eating my Chicken!!!                    
Join Date
Dec 2009
Location
London init Brav
Gender:
  Female
Posts
6,085
Rep Power
38
Re: Experiences with Borderline Personality Disorder?
bump!
still feeling very emotional, can't even trust myself around other people, I feel violent and hostile all the time for no reason. I keep it all in but I wonder if I will explode, any moment.
WhenTheWorldPushesYouToYourKnees-
You'reInThePerfectPositionToPray (Islam.07)

The Prophet (peace and blessings of Allaah be upon him) said: “O people, beware of this shirk, for it is more subtle than the footsteps of an ant. The one whom Allaah willed should speak said to him, “How can we beware of it when it is more subtle than the footsteps of an ant, O Messenger of Allaah?” He said, “Say, Allaahumma innaa na’oodhu bika min an nushrika bika shay’an na’lamuhu wa nastaghfiruka limaa laa na’lam (O Allaah, we seek refuge with You from knowingly associating anything with You, and we seek Your forgiveness for that which we do unknowingly).” (Narrated by Ahmad, 4/403)


“My intercession will be for those among my ummah who have committed major sins.” [Classed as Sahih by al-Albaani in Sahih Abi Dawood, 3965]
 Reply With Quote
01-05-13, 11:32 PM#38
afrasayab

Member                  
Join Date
Oct 2004
Location
Canada
Gender:
  Male
Posts
818
Rep Power
24
Re: Experiences with Borderline Personality Disorder?
  Originally Posted by LailaTheMuslim
bump!
still feeling very emotional, can't even trust myself around other people, I feel violent and hostile all the time for no reason. I keep it all in but I wonder if I will explode, any moment.
May Allah have mercy on you and cure you of your condition. I don't trust anti-depressants and that should be the last resort. There are many other natural things that you can take and do. First i would recommend that you perform ruqia on yourself on regular basis. Secondly see a good naturopath. You can also look into stuff like St. John's Wort for depression. Vitamin b12, b6, and b5. Also get your thyroid checked, basically your hormonal levels.

There are many things you can and should do before popping those pills.
Please pray for my health. Jazak Allah