by Urban Woodswalker About 36 years ago, I had a classmate in pre-med whose mood could swing from friendliness to extreme outbursts of anger over tr
by Urban Woodswalker
About 36 years ago, I had a classmate in pre-med whose mood could swing from friendliness to extreme outbursts of anger over trifle issues within a matter of hours. We labeled him queer and always dealt with him with caution. In our fifth year in the medical school, during our Psychiatry posting, while treating the topic of Bipolar diseases, we believed his problem must be Manic-Depressive Psychosis. With the benefit of what I know now, I believe he probably had Borderline Personality Disorder.
Diagnostic and Statistical Manual of Mental disorders DSM-IV lists Borderline Personality Disorder as a psychiatric diagnosis and defines it as a prolonged disturbance of personality function. Adolph Stern used the term in 1938 to describe it because it lies on the borderline between neurosis and psychosis.
It is a serious disorder of the mind that causes affected persons to nurse a paralyzing fear of being abandoned by a loved one. The affected person manifests a siege mentality that makes him/her exhibit a bewildering range of emotions from idealizations like great admiration and love to devaluation such as intense anger and dislike within a short span of time. Such a person exhibits outbursts of rage that lead to verbal and physical abuse against others. They read meaning into little matters and personalize issues becoming so extremely sensitive that they cannot sustain family relationships or workplace relationships. Borderline Personality Disorder is basically a disorder of emotion control. A woman suffering from this condition could make life unbearable for the husband for coming late from work for any reason because she believes he must be having an affair.
The instability of mood in Borderline Personality Disorder results in unstable behaviour, poor self-image and a distorted identity, all of which lead to social isolation. The level of frustration can be so high that it leads to self-injury of all sorts, attempted suicides and successful suicides in some cases. The extreme feeling of insecurity makes them want love and pushes them in to sexual promiscuity and substance abuse. Divorce rate is high for the few who get married and did not seek professional help because of their chronic inability to manage their emotions.
In the United States, about 2% of adults mostly females 75% suffer from it and it is responsible for 20% of hospital psychiatric admissions. The causes of Borderline Personality Disorder like many other ailments have been attributed to environmental and genetic factors. However predisposing factors are a history of separation from significant persons early in life, history of physical and emotional abuse, 40 to 71% report a history of sexual abuse by a non-care giver. Recent research findings have linked Borderline Personality Disorder to impaired regulation of the neural circuits that modulate emotions. Amygdala, a part of the brain is part of this neural circuit. Onset of the illness may be at adolescence or young adulthood. Triggers for precipitating this disorder include traumatic events like violence of all sorts, rape, alcoholism and substance abuse.
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Commonly question about What is Borderline Personality Disorder?
In dealing with borderline personality disorder what is the best way to really know how you are feeling?I have a tough time trying to discern how I feel sometimes. Other times I know I have a problem and I will sit there in front of someone that could help me and say that I am fine. I just get sick and tired of the back and forth crap. Anybody out there who has a handle on borderline disorder?
Currently, the most effective way to deal with BPD is with Dialectical Behavior Therapy. I have BPD, but we don t have the DBT classes in my area, so I bought a self-guided book that is loosely based on the original DBT. It s called Don t Let Your Emotions Run Your Life by Scott Spradlin, and I ve found it very helpful. It slowly works you through accepting your emotions and learning not to ignore them. It explains why you may have learned to shut off your emotions and guides you towards recognizing them. The author says the recognizing the emotion and realizing you have the right to feel that way is the first step towards regulating your emotions and not getting upset. I ve found that to be true. I m about 3/4 of the way through the workbook and can see a real difference. My husband and my therapist both noticed a difference as well.
I d recommend the book-- it s usually on sale on Amazon for less than $15.
If you don t want to buy a whole book right now, here s a few tips:
Sit quietly and observe your surroundings, noting how it feels, sounds, smells, looks, etc. The next step is to learn to describe your surroundings without adding any emotional extras. Next, apply these idas to your emotions. When you feel emotional, just focus on how you are feeling and accept it without feeling guilty about it. If you learned to hide your feelings, you have to relearn that they are totally valid.
The workbook has weekly worksheets where you record you feelings, thoughts, things that triggered those thoughts, your reactions and how beneficial (or not beneficial,) they were, etc. It s very user friendly!
What is the difference between bipolar disorder and borderline personality disorder?I see some symptoms in common between the 2, but is bipolar disorder more extreme? and how can borderline personality disorder be cured?
Bipolar is a chemical imbalance in the brain and Borderline is a set of learned behaviors and thoughts that were developed to cope with a traumatic childhood. Borderline does not have a chemical component so meds do not help with Borderline. The mood swings in Bipolar last for weeks or months and do not have triggers. The mood swings in Borderline are triggered by events and only last hours or at most a couple of days and they can change in a flash. People with Bipolar can be overly emotional and dramatic but usually only when in a manic episode. Borderlines are like that all the time. People with Borderline tend to self harm and have eating disorders while you do not see this as much in Bipolar. Those with Borderline tend to be very dramatic and have certain behaviors and ways of seeing things that are unique to Borderline, they have an intense fear of abandonment, they tend to see thing in black and white only (things are either very good or completely evil, nothing in between), they love you one minute then hate you the next without much in between. They tend to self harm and threaten suicide as a way to manipulate people, ie: threatening suicide during a fight then swallowing a handful of tylenol in front of the person who made them mad... knowing the person will stop them and that the tylenol will not hurt them. Someone with Bipolar who is suicidal will more likely isolate themselves and attempt suicide quietly and with conviction. Really the only similarity is the mood swings but even those are very different in the two disorders. What make is difficult is that people with Bipolar often ALSO have Borderline. As Bipolar runs in families someone may have also had a parent with Bipolar and developed Borderline as a way to cope with their tumultuous childhood.....
It is impossible so say which is more extreme as people have anywhere from ild to completely debilitating cases so an extreme case of Bipolar is worse than a mild case of Borderlien and visa versa. Bipolar can be treated with medication but Borderline can not. Meds can be used to treat some of the symptoms but not the disorder itself. The only cure for Borderline is therapy and until recently even that was not very helpful. People with Borderline tend to see their disorder as being part of who they are. For instance, my sister in law (ex sister in law) has it and she just says she is a "hot tempered latin chick" and she thinks it is sexy.. she refuses to admit that it might be her fault that she cannot maintain a relationship and cannot keep a job for more than 6 months because she is so nasty to other people.... She likes how she is. They usually end up seeing the therapist as the enemy who is trying to take away their personality and they stop going to therapy... or they see it as hopeless and cling to that, "I CAN T get better, it s not my fault I have a disorder, pity me". Those with Borderline get a bad rap (so do those with Bipola but more so with Borderline), they can be EXTREMELY difficult to be around but they are in tremdous pain..... that does nto change the fact that they are difficult but they are not just bitchy and manipulative as some people think.
I once heard Borderline described as being "an emotional burn victim", they have no protective skin over their emotions.... they are always on the surface and always raw and they have little control over them.
What is the SIMPLEST way to define Borderline Personality Disorder?I have a cousin who just got diagnosed with Borderline Personality Disorder
I know WHAT the disorder is, I know the symptoms, and I can tell when she s having an "episode"
I am aware of the clinical definition of BPD, but does anyone have a SIMPLE way to define the disorder? Something in maybe 3 sentences or less? Thanks
(oh and "simple" doesn t mean "the person s nuts")
She has trouble regulating her emotions, which switch easily and often. This causes her to have unhealthy relationships and she uses poor coping skills to tolerate distress. Unstability is a recurrent theme in her life.