Borderline Personality Disorder?

Question

I've been told that I may have BPD. I was wondering if anyone knew a good website or atleast a few traits of this disorder...

Answer 1

Borderline personality disorder (BPD) is defined within psychiatry and related psychological fields as a mental disorder characterized primarily by emotional dysregulation, extreme "black and white" thinking, or "splitting" (believing that something is one of only two possible things, and ignoring any possible "in-betweens"), and chaotic relationships. It is described by mental health professionals as a serious mental illness characterized by pervasive instability in mood, interpersonal relationships, self-image, identity, and behavior, and a disturbance in the individual's sense of self.

The disturbances suffered by those with borderline personality disorder have a wide-ranging and pervasive negative impact on many or all of the psychosocial facets of life, including employability and relationships in work, home, and social settings.

Diagnosis

DSM criteria

The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the widely-used American Psychiatric Association guide for clinicians seeking to diagnose mental disorders, defines Borderline Personality Disorder ("B.P.D." or BPD) 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.". BPD is classed on "Axis II", as an underlying pervasive or personality condition, rather than "Axis I" for more circumscribed mental disorders. A DSM diagnosis of BPD requires any five out of nine listed criteria to be present for a significant period of time. There are thus 256 different combinations of symptoms that could result in a diagnosis, of which 136 have been found in practice in one study The criteria are:

1. Frantic efforts to avoid real or imagined abandonment. [Not including 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, promiscuous sex, eating disorders, substance abuse, reckless driving, binge eating). [Again, not including 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.

--- from the DSM-IV-TR, 301.83.

Comparable diagnoses

The World Health Organization's ICD-10 has a comparable diagnosis called Emotionally Unstable Personality Disorder - Borderline type. This requires, in addition to the general criteria for personality disorder: disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual); liability to become involved in intense and unstable relationships, often leading to emotional crisis; excessive efforts to avoid abandonment; recurrent threats or acts of self-harm; and chronic feelings of emptiness.

The Chinese Society of Psychiatry's CCMD has a comparable diagnosis of Impulsive Personality Disorder. A patient diagnosed as having IPD must display "affective outbursts" and "marked impulsive behavior", plus at least three out of eight other symptoms. The construct has been described as a hybrid of the impulsive and borderline subtypes of the ICD's Emotionally Unstable Personality Disorder, and also incorporates six of the nine DSM BPD criteria.

Aspects of BPD

It has been said that there is probably no other mental disorder about which so many articles and books have been written (particularly, in the past, from a psychoanalytic perspective) yet about which so little is known from empirical research

Studies suggest that individuals with BPD tend to experience frequent, strong and long-lasting states of aversive tension, often triggered by perceived rejection, being alone or perceived failure. Individuals with BPD may show lability (changeability) between anger and anxiety or between depression and anxiety and temperamental sensitivity to emotive stimuli The negative emotional states particularly associated with BPD have been grouped into four categories of: extreme feelings in general; feelings of destructiveness or self-destructiveness; feelings of fragmentation or "identitylessness"; and feelings of victimization.

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. Attachment studies suggest individuals with BPD, while being high in intimacy- or novelty-seeking, can be hyper-alert to signs of rejection or not being valued and tend towards insecure, ambivalent, preoccupied or fearful attitudes towards relationships They tend to view the world generally as dangerous and malevolent, and themselves as powerless, vulnerable, unacceptable and unsure in self-identity

Individuals with BPD are often described, including by some mental health professionals (and in the DSM-IV), as deliberately manipulative or difficult, but analyses and findings generally trace behaviors to inner pain and turmoil, powerlessness and defensive reactions, or limited coping and communication skills There has been limited research on family members' understanding of borderline personality disorder and the extent of burden or negative emotion experienced or expressed by family members. Parents of individuals with BPD have been reported to show co-existing extremes of over-involvement and under-involvement. BPD has been linked to somewhat increased levels of chronic stress and conflict in romantic relationships, decreased satisfaction of romantic partners, abuse, and unwanted pregnancy; these links may largely be general to personality disorder and subsyndromal problems but such issues are commonly raised in support groups and published literature for partners of individuals with BPD.

Suicidal or self-harming behaviour is one of the core diagnostic criteria in DSM IV-TR, and management of and recovery from this can be complex and challenging. The suicide rate is approximately eight to ten percent. The most recognized form of self-injury is automutilation (cutting the self), usually of the arms, but often other areas such as the legs, chest, belly, and face. Self-injury attempts are highly common among patients and may or may not be carried out with suicidal intent BPD is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression, with interpersonal stressors appearing to be particularly common triggers.Ongoing family interactions and associated vulnerabilities can lead to self-destructive behavior. Stressful life events related to sexual abuse have been found to be a particular trigger for suicide attempts by adolescents with a BPD diagnosis

Mnemonic

A commonly used mnemonic to remember some features of borderline personality disorder is PRAISE:

* P - Paranoid ideas
* R - Relationship instability
* A - Angry outbursts, affective instability, abandonment fears
* I - Impulsive behaviour, identity disturbance
* S - Suicidal behaviour
* E - Emptiness

http://www.nimh.nih.gov/publicat/bpd.cfm

http://www.stanford.edu/~corelli/borderline.html

http://www.palace.net/~llama/psych/bpd.html

http://www.bpdcentral.com/

http://www.psycom.net/depression.central.borderline.html

http://www.mentalhealth.com/dis/p20-pe05.html

http://www.mayoclinic.com/health/borderline-personality-disorder/DS00442

http://www.mhsanctuary.com/borderline/

http://psychcentral.com/disorders/sx10.htm

Answer 2

I was almost diagnosed with this before they figured out that it was actually psychotic depression ;-). BPD is characterized by instability in relationships and seeing things in black and white - no middle ground. People with BPD take things hard and tend to overthink issues. There is accompanying depression, usually with some variety of self-abuse including eating disorders. That's about all I know.

Answer 3

Check out the National Insitute of Mental Health's website. You'll find a good description of the disorder and current research into it.

A close friend of mine has BPD. It can be challenging to deal with but with persistence and support it can be managed successfully.

Good luck

Answer 4

Do a yahoo or google search on borderline personality disorder. Also, sometimes manic depression is confused with bpd.

Answer 5

Get the book, I Hate You, Don't Leave Me.

Get a great therapist and prepare for a hard time. You can get over BPD, but it's very hard.

Borderlines see everything in black or white. I had a girl in my class who had this. She hated me one day (she actually smashed in my car one time with a big rock or hammer) and liked me the next day. After she smashed my car (and I knew it was her, but couldn't prove it), I became consistently indifferent to her. I didn't react much to her, because people with this illness have widely-swinging mood fluctuations, and drive everyone around them nuts. They are so needy, so over the top about everything. They have to be noticed, they have to stir up trouble. If you don't obey them, they go nuts with retaliation. They are determined to be in control, to be the one with power and everyone has to jump to their tune or else they will pout, yell, do whatever to get that control back. They are very hard to be around. They make everyone around them crazy with frustration. It isn't much fun to think you are the one that stirs up trouble and makes evryone unhappy, is it? That's what a true borderline does, because of their anxiety.

You became borderline early in your life. You first of all probably have a genetic vulnerability and then either you went into daycare or else your parents didn't give you enough love and attention when you needed it early on. It looks like manic-depression sometimes.

My mother was borderline. I never want to be around a borderline again. But there really is hope. Get the book and get going on the therapy. You owe it to yourself and to the world.

My advice is also to get around horses. They can be calming.

Answer 6

check out
http://www.nimh.nih.gov/publicat/bpd.cfm
http://en.wikipedia.org/wiki/Borderline_personality_disorder
http://www.borderlinepersonalitytoday.com/main/dsmiv.htm