Introduction to BPD

Back in May, I discovered that it was Borderline Personality Awareness month. I decided to post information about this illness every day throughout May on a social media site.  3 years ago, I was diagnosed with BPD myself but was told that I have probably had it since adolescence. It affects my life greatly and I wanted to raise awareness and let people know exactly what it is. I am going to put the information on this blog in hope that I can reach a larger audience and raise more awareness and understanding...

Day 1

What is Borderline Personality Disorder?

Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behaviour, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed BPD as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.

Because some people with severe BPD have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name "borderline personality disorder" is misleading, a more accurate term does not exist yet.

Most people who have BPD suffer from:

- Problems with regulating emotions and thoughts

- Impulsive and reckless behavior

- Unstable relationships with other people.

People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.

Day 2:

Criteria:

This is the criteria for being diagnosed with BPD. You need to have 5 or more of these characteristics. I have all 9. Tomorrow I will go into more detail about each characteristic.

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and 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-mutilating 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., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

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.

Day 3:

Behaviour:

Yesterday I posted the criteria for having Borderline Personality Disorder. In order to be diagnosed with this illness, you need to have 5 or more of the 9 criteria.

People with BPD have longer, deeper and more extreme reactions to situations. They are susceptible to impulsive behaviour in an attempt to relieve themselves of the unbearable emotional pain they experience. They also take a lot longer to come back to base point than a person without BPD.

This emotion is backed by a very real fear of abandonment. For instance, I spend most of my time worrying about being left by the people I love the most. I have no friends and this is because I have made sure that I get rid of them before they can abandon me. I feel so lonely sometimes but would rather that than be abandoned.

We also have a pattern of unstable and very intense interpersonal relationships. I have had so much pain in relationships. People with BPD do something called "splitting" which means we view others as either all good or all bad. There is nothing in between. I can love someone one minute and despise them the next. It is so confusing not just for me but for others. For this reason I have decided that I cannot have another relationship, not ever.

We have intense mood swings. I often display inappropriate bouts of anger, I feel great sadness, panic or despair. My moods can change 57,000 times a day. It is confusing and frightening. Most of the time I can't tell how I am feeling, I can't label my emotions because I am feeling too many things at once.

Tomorrow I will continue. I am finding this really hard and almost wish I hadn't started but this is something I need to do. No- one knows about BPD and I have lived with it my whole life. I don't suppose anyone is even reading this but I will try my best to raise awareness.........

Day 4:

Causes:

I will start by saying.... May the fourth be with you.

BPD is likely to be caused by a combination of factors:

*Genes from your parent/caregiver may make you more vulnerable to develop it.

*Research suggests that some people with BPD have a number of regions in the brain with abnormal structure and function.

*Events that happened in your past, such as your relationship with your family and your upbringing appear to play an important role in BPD. Unresolved fear, anger and distress from childhood can lead to a variety of distorted adult thinking patterns. You may have BPD because of one of these factors or a combination.

BPD is often misdiagnosed. It is often confused with Bipolar Disorder. However, with Bipolar, mood changes last weeks or even months but with BPD, mood changes are much shorter and are often within a day! oh joy!

Co-morbidity means that BPD often occurs with other illnesses. This also makes it hard to diagnose because symptoms can overlap with BPD symptoms. Other illnesses include major depression, which I have, anxiety disorders, substance abuse and eating disorders among others. I personally have depression - hence not being diagnosed earlier with BPD, OCD, panic attacks and anxiety disorder. I used to have the cleaning type of OCD but that has developed into obsessive compulsive thoughts and ruminations. These are repetitive and disturbing and often quite horrific. I also have PTSD ( Post traumatic stress disorder) and something as simple as a noise can give me a flashback to a past traumatic event.

BPD is a serious mental illness and it is well documented that mental illness and physical illness can be related. A lot of sufferers have back pain, migraines and fibromyalgia amongst other things.

Sorry this has been a long one..........tomorrow people.

Day 5:

Personality Disorders:

There are 10 different personality disorders. 

These are: Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependant and Obsessive- compulsive.

You can have one type of personality disorder or if you're lucky like me, you can cross over into other types. When I was diagnosed, I was told I had personality disorder with borderline, avoidant and depressive features.

So I am a typical borderline with all the criteria of a borderline but I am avoidant.

Someone with Narcissistic personality disorder would have an inflated sense of self importance and someone with Antisocial personality disorder may be callous and cynical. These people may have that diagnosis alone or it may be mixed with one or more of the other disorders. To be a personality disorder, symptoms must have been present for an extended period of time ,are inflexible and pervasive and are not a result of drugs/ alcohol or another psychiatric condition. The symptoms can be traced back to adolescence or early adulthood and cause distress or negative consequences in different aspects of a persons life.

The Avoidant finds loss and rejection so painful that they will choose to be lonely rather than risk trying to connect with others. They feel it is better to keep silent than to tell others how they feel. I personally avoid everything. I don't like to go out, I don't want to socialise or have friends. I have a long pattern of withdrawal and self-hatred and sensitivity to criticism. I have social anxiety so remove myself from social situations to avoid being rejected or feeling ashamed. No-one would ever choose to live this lifestyle as it destroys virtually everything around them. I am aware that my behaviour is destructive but I feel unable to change it. I see danger in everything and I avoid things because of fear. I am scared of the world and the people in it. If I do have to meet anyone for any reason, they are scanned for any slight sign of rejection -a look, a sigh, anything at all. I will take it and see it as a sign that they hate me. Even the words they use in a conversation will be taken away and I will ruminate on them, over and over until I am convinced that I am hated. I feel unworthy and it is absolutely exhausting. These irrational thoughts then turn into self-hatred which makes me withdraw more. I have never even been able to post anything on facebook because I think I will be judged, or hated or it wouldn't be good enough or it will offend etc etc...I am a victim of my own mind.

Anyway I have no idea why I am going on about myself so much, it's meant to be about the illness. I'll behave myself tomorrow....

Day 6:

Triggers

People with Borderline Personality Disorder feel emotions more easily, more deeply and for longer than others do. They are also hyper-vigilant. Emotions repeatedly surge and persist for a long time. It takes longer than normal for BPD sufferers to return to a stable emotional baseline following an intense emotional experience. If most people's emotional baseline is 20 on a scale of 0 -100, then people with BPD are continuously at 80. What is sadness in most people would be overwhelming despair in a person with BPD. Anger becomes rage, fear becomes terror etc etc. BPD sufferers describe overwhelming, almost constant emotional pain. Strong emotions are very easily "triggered". Triggers are something that sets off a past traumatic event in our minds or causes us to have distressing thoughts. A sound or a word can bring us back to a place where we didn't feel safe and we may respond in the now with a similar reaction. 

These events can be external, something that happens outside of yourself, or internal, as in something that happens in your mind, like a memory or a thought. You may even have a trigger that sets off another trigger!

BPD individuals often behave in a way that is destructive to themselves and to those around them. This is called "acting-out". Those with, for instance, with Antisocial, Narcissistic and Histrionic personality disorders engage in this behaviour. 

However, I personally engage in something called "acting-in". 

I am more self-destructive than outwardly destructive. This is also known as being a "quiet borderline". All the emotions such as anger, aggression etc are internalised rather than verbalised or used to impact on others. This means that often people are unaware of the extent that I and other quiet borderlines experience pain and despair.

People that act-in often have a sense of isolation and a lack of connection to the outside world. They may spend lots of time rationalizing their emotions or harming themselves out of despair. There are inconsistent feelings, one minute self-hating and the next more confident. This inconsistency is common to all BPD sufferers but those with quiet borderline are more likely to hide this emotional reality from their loved ones in a way that becomes painfully isolating.