Self-Harm/BPD/BP..... Recovery ?

Question

Diagnosed with BPD and BP II -- suffer from comorbid self injury (cutting) as well as eating disorders. Been treated in therapy for over 8 months. I've spent time in a psych ward, and had the full work up, getting in touch with board members. The question, is this: recovery. I know that there is no such thing for BPD, so for that, more like up-keeping normality. As those with it are, I am very impatient and impulsive. I've contemplated suicide on and off (before hospitalization, and now after). I'm doing all the outpatient work, but I'm falling down and find it slightly scary. The self injury has been getting worse in damage, (frequency the same).. and really, don't feel like living (though no plans have been made; just a continual feeling).

What are some options of recovery I haven't checked into? How can I get this under control? I feel ridiculous about going to the ER, because there is really nothing life threatening. I just don't know what step to take; i'm clawing each day

Am currently on medications -- Lithium and Lamictal.

As well, yes, we are working with DBT :)

Answer 1

There is a great book you can read on Borderline Personality Disorder called "I Hate You, Don't Leave Me" however I cannot recall the author's name. It may help give you more insight into some of the dynamics but also help you feel less alone in your struggle. Also Marsha Linehan's Skills Training Manual for Borderline Personality is excellent, but expensive-you may be able to get it from a college library or from your therapist and ask her to copy the sections for you on Mindfulness. It is written as group exercises, but the core info is there.
Other general options to consider in addition to therapy would be support groups (contact your local chapter of NAMI) and also possibly a Day Treatment program, even if only for a short period until you feel more stable. That is their main purpose and it represents a step between hospitalization and traditional out-patient treatment. I'd also encourage you to tell your therapist how you are struggling right now and to request more frequent sessions and re-evaluate after a few weeks.
In regard to the self-injury, here is some info from previous posts I've made that I hope may be of some help to you-it's nothing especially new or brilliant, but in case you haven't heard it before, here goes:
There are multiple reasons why people self-mutilate and each case needs to be explored individually. The most common reason is that it occurs in order to induce a dissociative state and assists people who have been traumatized with achieving a state of emotional numbness and you hear it described as soothing for them. The physiological basis for it stems from the release of endorphins-the brain's natural painkillers-which function much like opiates and dull the experience of emotional pain. Other reasons include the opposite rationale-people who feel numb emotionally and who have shut down will self-mutilate in order to feel something and remember they are alive. Others do it for self-punishment and feel relief from guilt or shame and see the letting of blood as a way to purge themselves of guilt. It may be a way of re-enacting and attempting to master early traumatic experiences This often happens during a dissociative state where people are recalling experiences which were traumatizing and they feel a need to punish/purge themselves for what they often mistakenly believe they have done wrong. There are also folks who do it as a way to cope with unrelenting chronic physical pain from other sources as it creates an alternative pain that distracts them from the chronic pain (think of the principle behind how a TENS unit works). In more rare instances it can be a response to psychotic states where folks are responding to command hallucinations or believe they are purging themselves from some evil inside them. There are other less common reasons, depending on the form of self-mutilation (eye enucleation, castration, etc.) that tend to be symbolic in nature. But most commonly it is done in response to increased feelings of tension with which the individual cannot cope and it becomes a way for them to dissociate their emotional pain and achieve an emotional numbing. The goal of treatment is to fully understand the reasons that sustain the behavior and in the latter case (the most common) to help people develop affect tolerance and the ability to cope with and soothe their emotional pain in healthier ways.

I'm a therapist and I agree with all the folks here who speak from personal experience that you need to speak with a professional that can help you explore healthier alternatives. The longer you wait, the harder it gets, so please seek some assistance. Cutting really only works for a while and eventually it'll lose it's charm and you may find yourself cutting deeper and more often in order to achieve the same effect.

Just a couple of ideas to help get you started-try to stop in small steps. Set yourself a goal to not cut for a certain time period and when you've mastered that, set yourself a goal to refrain for longer periods, depending on how frequently you are cutting. Take it one day, one hour at a time if necessary. You can do this with each episode when you feel the impulse to cut in order to increase your self-control each time you feel the desire. What you'll also find is that as you go for longer and longer periods of time without giving in to the urge to cut, you'll become more aware of all your feelings and what is driving them and therapy can really help you to understand it better and give you options to consider. Ultimately you need to make a choice to stop the behavior or it won't stop. But for starters, try making a choice to refrain for a little longer than usual and challenge yourself to extend the time for longer and longer intervals. Setting a goal to stop can be daunting, but breaking it down into steps usually works and it allows you gradual access to your emotions so you can learn alternate methods of coping a little at a time.

Also, remove and get rid of all the things with which you regulary cut. Many people have certain items they use all the time and it becomes like a ritual. Removing these things will help you gain delay time by not having them readily accessible. It won't prevent you from getting other objects, but it will decrease the likelihood that you'll act on impulse alone.

Another option that has worked for some folks is to take a doll or stuffed animal that you love and cut it instead and then stitch it up or bandage it. It allows you to vent your feelings, but also helps you recognize and empathise with the pain you are inflicting by doing this and that in turn helps develop understanding towards yourself and gives you an opportunity to engage in actions designed to help heal the hurt. Loving something else, even a stuffed animal, is often a path towards learning to love and care for yourself.

Rubber bands, drawing a red line with a marker or ice are substitutes and some folks do find this helpful, but ultimately you need to break away from the cycle of causing yourself pain in order to numb up your emotions.

One other thought to consider. What you experience when you cut is really more like relief from pain than it is like truly feeling happy. The absence of pain is not the same as feeling happy, so don't settle for less than really being happy. Good luck!!!!

I wish could be more helpful, but the generic stuff is about all we can do on here. Good luck and hang in there and remember how you feel today and this moment is not how you will always feel-that's a promise!

Answer 2

There is most certainly recovery for BPD. You said you've been in therapy for over 8 months. I don't know if that means you were only diagnosed 8 months ago, or only have been in therapy for 8 months but have been diagnosed longer. Either way, recovery (from anything) takes time. I know it's hard to be patient, especially with something like this, because you want to feel better, and you want to feel better NOW. There is no miracle cure, no miracle pill, no magic words. However, there is a therapy called DBT (Dialectical Behavior Therapy) that was specifically designed to treat people with BPD. I've known it to be a life-saver for many people. If you do a Yahoo! search on it, you'll come up with tons of hits, as it's pretty popular now, especially since it's been successful for so many people.

I hope I can offer you some hope with this: I used to be diagnosed with BPD; I fit many of the symptoms. Now, however, I'm only diagnosed with "BPD traits," those being the occasional self-harm (less than once a year), and the chronic feelings of emptiness, although that has been lessening since last summer.

I wish the best for you, and hope you can start feeling better as you travel down your path of recovery. It can be done! Don't give up! :)

Answer 3

I have suffered from the disorders you mention, and I can tell you from my own experience that you can recover. I have a hunch that your childhood was very difficult, and you were probably sexually abused. Your personality disorder is a result of that, and with hard work in therapy you can overcome the way you think and feel and live a normal life. It won't be easy, but I promise you it can be done.

In addition, I think your self-harm is more of an obsessive/compulsive behavior, and it can be alleviated with medication and behavior modification therapy. There are many medications for obsessive/compulsive behaviors, and therapy will teach you other things you can do to alleviate your stress. Some ideas I have for you now are whenever you feel like cutting or clawing, go outside and run until that anxiety and panic passes. You can do any kind of physical activity that gets you out of the house and gets you moving.

Additionally, remove all the objects in your house that you like to use to cut yourself with, and if your fingernails are a problem, cut them and file them very short so you can't use them either.

You aren't alone. Lots of people suffer or have suffered from these disorders. It took me a long time to recover from my problems, and it took a lot of hard work, but now I live a happy, normal life. You are obviously intelligent and strong and determined, and you will be okay. Please don't let what happened to you when you were little affect you in a bad way for the rest of your life. I know you're in a lot of pain and probably very lonely too, but things will get better. Please stay in therapy, and please tell your doctor about your increased desire to cut yourself. You will overcome this one day.

Answer 4

COngratulations on taking theose monumental steps.. You have climbed out of the pit and now you are scared....It;s ok...it happens. Do you have a support network..frinds family, counselors or otheres you can rely on? That's the key. I know its cliche but it works. Having that group or person you can call on or go to to to confide and rely on is vital in climbing that hill...use it if you have it, find it if you don't, but seek it none the less. Iknow its again cliche but pick upo the phone, go see that person to talk with them and say i need help....I need support...I don't want to be alone and i don't want to keep doing this.

Utilize those tools and stay in touch with your clinician to make sure that the meds are working if your taking them....which you should be....BPG is tricky to manage and it take time and manipulation to find the right dose and or med.....

In the mean time trust someone enough to let them in to help in the rough times and you'll be ok...

I applaud you and i wish you the best of luck

Answer 5

Byron Katie would be helpful to you on a spiritual/psych. level:
http://www.thework.com/thework.asp#3

For health on a physical level:
Add a daily serving of seafood (any kind) for 4 months to work a real miracle.
(Staying on such a diet after seeing 4 months' result, ought to be a very obvious decision.)