April 17, 2012
-
Borderline Personality Disorder
Borderline Personality Disorder (BPD) is a serious and often life-threatening disorder that is characterized by severe emotional pain and difficulties managing emotions. The problems associated with BPD include impulsivity (including suicidality and self-harm), severe negative emotion such as anger and/or shame, chaotic relationships, an extreme fear of abandonment, and accompanying difficulties maintaining a stable and accepting sense of self
Completed suicide occurs in 8%-10% of individuals with this disorder, and self-mutilative acts (e.g., cutting or burning) and suicide threats and attempts are very common. Recurrent job losses, interrupted education, and broken marriages are common.
Very stressful or chaotic childhoods are commonly reported (e.g., physical and sexual abuse, neglect, hostile conflict, and early parental loss or separation). Mood disorders, Substance-Related Disorders, Eating Disorders (usually Bulimia), Posttraumatic Stress Disorder, Attention-Deficit/Hyperactivity Disorder, and other Personality Disorders frequently co-occur with this disorder.
Individuals with BPD can be very sensitive to the way others treat them, reacting strongly to perceived criticism or hurtfulness. Their feelings about others often shift from positive to negative, generally after a disappointment or perceived threat of losing someone. Self-image can also change rapidly from extremely positive to extremely negative. Impulsive behaviors are common, including alcohol or drug abuse, unsafe sex, gambling and recklessness in general.
Individuals with BPD are at high risk of developing other psychological disorders such as anxiety and depression. Other symptoms of BPD, such as dissociation, are frequently linked to severely traumatic childhood experiences, which some put forth as one of the many root causes of the borderline personality.
The Diagnostic and Statistical Manual of Mental Disorders fourth edition, DSM IV-TR, a widely used manual for diagnosing mental disorders, defines borderline personality disorder (in Axis II Cluster B) as:
A pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
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., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
5. Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself.
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 anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation, delusions or severe dissociative symptomsIt is a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
When comparing individuals diagnosed with BPD to those diagnosed with other personality disorders, the former showed a higher rate of also meeting criteria for:
anxiety disorders
mood disorders (including clinical depression and bipolar disorder)
eating disorders (including anorexia nervosa and bulimia)
dissociative disordersNumerous studies have shown a strong correlation between child abuse, especially child sexual abuse, and development of BPD. Many individuals with BPD report to have had a history of abuse and neglect as young children. They were also much more likely to report having caregivers (of both genders) deny the validity of their thoughts and feelings.
Comments (11)
We’re still trying to determine whether my mother is borderline or a combination of other disorders. Growing up with a chaotic parent who hallucinates and is paranoid is not a fun time.
My wife and wife and I had lots of abuse in our youth. WE had a very hard time adjusting in school and life. Somehow, we have been able to make it. I had serious professional counseling in my 40′s. That helped.
Thanks for all of the information.
frank
that video made me laugh. it does a good job depicting the symptoms though.
My husband brought this disorder to my attention. I may have it.
It’s nice to see this recognized. I, myself, have borderline personality disorder.
Yeah, I’ve been fairly certain that I’ve had it for years. I got diagnosed with “Borderline Traits” when i was 18 (due to their being apprehensive to diagnose someone with a PD at my age at the time). I am not nearly as outwardly destructive or extroverted as they are often portrayed. Although I get very resentful at people, I am pretty good at hiding it because I am smart enough to fear the repercussions and have a serious streak of intense social anxiety. Overall it makes me Avoidantish, there’s some MH professionals who now identify an “Avoidant-Borderline mix PD” which is exactly me.
Basically, me:
I have intense, INTENSE moods, passions and feelings on both sides of the spectrum. They usually will not last longer than a few hours or days, sometimes weeks. I have intense anxiety and anger that is nearly uncontrollable at times. It builds up fast and I feel like I’ll lose control, panic attack. Usually at these times I get a bit of that “paranoid ideation” and I also disassociate a lot, which is another common trait. I am convinced no one actually cares about me or anything that matters (worse depending on mood) and when someone does something wrong I catastrophize it and cannot conceive of it as something trivial. It’s very “personal” to me. I’ve dealt with bulimia off and on (usually on) for 9 years. I tried to kill myself twice in senior year of high school; once was to get the guy’s attn who took my virginity. He was a real dick. I went back and forth telling him to kill himself and then worshipping him, etc. Constant tension in the relationships I’ve had since; I overread things, man, to the point of self-torture. I am always convinced that I’ll find out everyone’s betraying me. Unfortunately I am usually right (but humans are human). I have a hard time feeling rejected. A single incident can completely change my view of another person, good or bad. In a good way, I take apologies well because I never expect anyone to bother. A bad word or sign of disinterest will make me hate someone, but I rarely will show it. I just feel it, and it tears me up. I’m rly tired right now so I hope this all made sense. BPD is pretty much me, but I am tame about it. I will likely never have good friends or man because I am so fucked up.
Thank you for raising awareness and sharing this information.
Very interesting information. Maybe Bryce Finger has BPD. ..hmm….that would explain a lot of things.
thanks for posting this again. i’m copying/pasting it into private blog for future reference.
i was diagnosed with this when i was younger… i am still dealing
with it daily. im often angry, suicidal and anxiety ridden. it is not a
fun life. i work very hard to keep myself in check because i am married
with 2 kids. (i think if i wasnt i would probably have killed myself
years ago… probably from drugs or alcohol… both of which i managed
to quit.) i still have desires to cut myself more often than not… but
its another thing i cant do… i cant let my kids walk into the bathroom
and see me bleeding.
another trait of BPD is only seeing things
in black and white. there is no grey zone. you are either with me or
against me. i always have to remind myself that people are just…
people. flawed, just like me. and if i expect people to give me the
space, love and care that i need then i need to do the same for them.
and yes, sometimes its an act. i have to pretend to be
normal…human…because if i am not angry then im empty.
blah blah blah the baby is awake.
Being borderline is no picnic… I wish I didn’t have it.