sTiLl TrYiNg To WrAp My HeAd RoUnD tHiS

BORDERLINE PERSONALITY DISORDER

The main feature of borderline personality disorder (BPD) is a pervasive pattern of instability in interpersonal relationships, self-image and emotions. 

People with borderline personality disorder are also usually very impulsive.

*i can be...but mostly i just lie on the couch all day every day now

This disorder occurs in most by early adulthood. 

The unstable pattern of interacting with others has persisted for years and is usually closely related to the person’s self-image and early social interactions. 

*ok, so i hate me...but doesn't everybody hate themselves, really...and anyone who says they don't...well, aren't they lying to us...or possibly even themselves?

The pattern is present in a variety of settings (e.g., not just at work or home) and often is accompanied by a similar lability (fluctuating back and forth, sometimes in a quick manner) in a person’s emotions and feelings. 

*wow, so this IS a 'thing'...i'm not just COMPLETELY mental?!!

Relationships and the person’s emotion may often be characterized as being shallow.

A person with this disorder will also often exhibit impulsive behaviours and have a majority of the following symptoms:

• frantic efforts to avoid real or imagined abandonment. 
• *i'm going to go out on a limb and suggest my agoraphobia is rooted in this too -can't go out =can't meet anyone =can't have anyone 'forget' to meet me =can't be abandoned
• a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation 
• * CHECK
• identity disturbance: markedly and persistently unstable self-image or sense of self 
• * see my post from ages ago called "i am a chameleon"...WOAH!
• impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
• chronic feelings of emptiness 
• * but of course! i do nothing = i am nothing
• recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour 
• * i am nothing = why am i still here...wasting everything i use
• 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) 
• *Well i've now been irritable for 5 months...i cannot remember ANY good days...but then, my mind is warped...so who knows?!
• inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) 
• * i only rage with myself i made a spelling error in a page on my diary and cut and cut and cut...til i was too sore to hurt me anymore...that might have been a smidge intense and a bit of a massive reaction considering what it really was was insignificant in the scheme of things...
• transient, stress-related paranoid ideation or severe dissociative symptoms
• * i don't really know what this means so i don't know if i tick this box or not

As with all personality disorders, the person must be at least 18 years old before they can be diagnosed with it. Borderline personality disorder is more prevalent in females (75 percent of diagnoses made are in females). It is thought that borderline personality disorder affects approximately 2 percent of the general population. Like most personality disorders, borderline personality disorder typically will decrease in intensity with age, with many people experiencing few of the most extreme symptoms by the time they are in the 40s or 50s. ***oh, so there's hope..if i make it that far of course...

DETAILS ABOUT BORDERLINE PERSONALITY DISORDER SYMPTOMS

Frantic efforts to avoid real or imagined abandonment.

The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in self-image, emotion, thinking and behaviour. Someone with borderline personality disorder will be very sensitive to things happening around them in their environment. They experience intense abandonment fears and inappropriate anger, even when faced with a realistic separation or when there are unavoidable changes in plans. For instance, becoming very angry with someone for being a few minutes late or having to cancel a lunch date. People with borderline personality disorder may believe that this abandonment implies that they are “bad.” These abandonment fears are related to an intolerance of being alone and a need to have other people with them. Their frantic efforts to avoid abandonment may include impulsive actions such as self-mutilating or suicidal behaviours.

Unstable and intense relationships.

People with borderline personality disorder may idealise potential caregivers or lovers at the first or second meeting, demand to spend a lot of time together, and share the most intimate details early in a relationship. However, they may switch quickly from idealising other people to devaluing them, feeling that the other person does not care enough, does not give enough, is not “there” enough. These individuals can empathise with and nurture other people, but only with the expectation that the other person will “be there” in return to meet their own needs on demand. These individuals are prone to sudden and dramatic shifts in their view of others, who may alternately be seen as beneficent supports or as cruelly punitive. Such shifts often reflect disillusionment with a caregiver whose nurturing qualities had been idealised or whose rejection or abandonment is expected.

Identity disturbance.

There are sudden and dramatic shifts in self-image, characterised by shifting goals, values and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with borderline personality disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing and support. These individuals may show worse performance in unstructured work or school situations.

Impulsivity in potentially self-damaging areas.

They may gamble, spend money irresponsibly, binge eat, starve themselves, purposefully purge, abuse substances, engage in unsafe sex, or drive recklessly. 

Displays of recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour

Completed suicide occurs in 8%-10% (*THAT STATISTIC scares me...i TRULY believe i am in that 10%*) of such individuals, and self-mutilative acts (e.g., cutting or burning) and suicide threats and attempts (*hate the use of the word THREAT here...makes me feel like a liar or attention-seeker!!!!*) are very common. Recurrent suicidality is often the reason that these individuals present for help. (*and yet no help comes anymore...because you all know i'm in that 10 percentile too don't you?!!!*)  These self-destructive acts are usually precipitated by threats of separation or rejection or by expectations that they assume increased responsibility. Self-mutilation may occur during dissociative experiences and often brings relief by reaffirming the ability to feel or by expiating the individual’s sense of being evil.

Individuals with Borderline Personality Disorder may display affective instability that is 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)

The basic dysphoric mood of those with Borderline Personality Disorder is often disrupted by periods of anger, panic, or despair and is rarely relieved by periods of well-being or satisfaction. These episodes may reflect the individual’s extreme reactivity troubled by chronic feelings of emptiness.

Easily bored, they may constantly seek something to do. (*but attention span is shot to frick!*) Individuals with Borderline Personality Disorder frequently express inappropriate, intense anger or have difficulty controlling their anger. 

They may display extreme sarcasm, enduring bitterness, or verbal outbursts. The anger is often elicited when a caregiver or lover is seen as neglectful, withholding, uncaring, or abandoning. Such expressions of anger are often followed by shame and guilt and contribute to the feeling they have of being evil. (*enter self-harm*) 

During periods of extreme stress, transient paranoid ideation or dissociative symptoms (e.g., depersonalisation) may occur (Criterion 9 -the one i can't wrap my head round all the jargon within), but these are generally of insufficient severity or duration to warrant an additional diagnosis. These episodes occur most frequently in response to a real or imagined abandonment. Symptoms tend to be transient, lasting minutes or hours. The real or perceived return of the caregiver’s nurturance may result in a remission of symptoms.

HOW IS BORDERLINE PERSONALITY DISORDER DIAGNOSED

Personality disorders such as borderline personality disorder are typically diagnosed by a trained mental health professional, such as a psychologist or psychiatrist. Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment. There are no laboratory, blood or genetic tests that are used to diagnose borderline personality disorder.

Many people with borderline personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events.
A diagnosis for borderline personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis.

CAUSES OF BORDERLINE PERSONALITY DISORDER

Researchers today don’t know what causes borderline personality disorder. There are many theories, however, about the possible causes of borderline personality disorder. Most professionals subscribe to a biopsychosocial model of causation — that is, the causes of are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress). This suggests that no single factor is responsible — rather, it is the complex and likely intertwined nature of all three factors that are important. If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be “passed down” to their children.

TREATMENT OF BORDERLINE PERSONALITY DISORDER

Treatment of borderline personality disorder typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder. Medications may also be prescribed to help with specific troubling and debilitating symptoms.