Thursday, 10 December 2009

10 things I think you should know...

Tamara Doodler gave me an award and did a very cool post where instead of listing 6 things about herself, she listed 6 little known facts about HIV/AIDS.

I wanted to do a similar thing about something that in some ways only entered my life this year, but in some ways has been a part of my life almost since I can remember. I guess that many people have never even heard of it, but here are:

10 things you may or may not know about Borderline Personality Disorder (known as BPD):

(Please know that I write only from my personal experience and from books that I have read. None of this is certifiably accurate and I am open to correction. For the best information, read the books I recommend at the end of this or see a professional).

1) Borderline Personality Disorder is best understood as an emotional disorder. People who develop BPD have no emotional "skin", they feel everything far more intensely than normal people. As a result they are in a lot of emotional pain for most of their lives.

2) Most of the symptoms of BPD manifest as a result of the ways they attempt to deal with this intense pain. The symptoms of BPD are destructive and maladaptive ways of dealing with pain. There are 9 criteria for being diagnosed with BPD, but you only need to fulfill 6 to be diagnosed with BPD. Many people will experience some of the 9 in their lives, but people with BPD exhibit at least 6 pervasively, ie much of the time throughout their lives, starting in early adulthood.

3) The biggest problem for a person with BPD is that they perceive or read rejection, abandonment or invalidation into every situation. People with BPD have felt so much emotional pain their whole lives that they start to anticipate it at all times in order to protect themselves. The problem is that they perceive rejection when it is not there. They can percieve rejection in a tone of voice, or in a comment about the weather. This can appear to someone who does not have BPD as jealousy, as paranoia, or as just incomprehensible. This perceived rejection causes the person with BPD agony, even if the rejection was not there at all. As you can imagine, this leads to problems in relationships.

It is a tragic situation because people with BPD are desperate for someone to love them, and yet they push those who love them away because they are so afraid of rejection.

4) A defining characteristic of BPD is rage. One of the ways in which people who suffer from BPD deal with their pain is by projecting that pain onto someone else in the form of an intense and terrifying rage. The rage can be verbal or physical, often both. Because of these rages and their results, this disorder carries a heavy stigma.

Some people have likened a BPD rage to demonic possession. This analogy has crossed my mind in the past. However this is not helpful at all. There are many stories of people with BPD being subjected to exorcisms. That is disgraceful. People with BPD are in pain. They are suffering from mental illness and need sympathy and understanding, and most importantly psychological help. They do not need to be treated like demons.

5) People often confuse BPD with psychopathy. This is incorrect. A defining characteristic of psychopathy is lack of guilt. People with BPD suffer from guilt. Guilt and shame are definitions of how they see themselves. They see themselves as only worthy of rejection.

6) Other destructive methods of dealing with their emotional pain include self harming in the form of cutting or other methods, eating disorders, staying in abusive relationships, substance abuse, impulsive spending or driving. As you can see it is quite a bitch of a disease. Not everyone who suffers from any of the above has BPD as well. But it is really hard to see the BPD if it is there underneath all the other stuff that has to be treated first.

7) BPD is also often comorbid with other mental illnesses such as bipolar, major depression, anxiety, avoidant personality disorder, OCD, OCPD, to name a few. So people often have to be treated not only for the nightmarish BPD but other nightmarish diseases as well.

8) As far as I know and have been told, self harming in the form of cutting is not usually about a desire to die for people with BPD. The desire to die is strong in people with BPD, make no mistake. About 10% of people with BPD commit suicide. Most will try. But apparently self harming is all about making the emotional pain less by turning it into physical pain. Actualising the pain makes it slightly easier to deal with. I have also heard that it helps to calm people with BPD down when they are in the midst of a raging episode.

9) There are treatments that help BPD. Nothing can "cure" BPD. You cannot teach someone to no longer feel emotional pain. Some people are made with more sensitive nervous systems than others. What you can teach is how to recognise real rejection vs imagined rejection, and constructive methods of dealing with pain rather than destructive ones. There are also drugs that can level the intensity of emotions somewhat.

10) the problem lies in diagnosis. Getting someone with BPD to get help is one problem. Getting the correct help, when there is so much misinformation about BPD that many shrinks cannot even recognise it or believe it exists, is another problem.


I am sure many people have absolutely no idea what I am talking about or why I would bother to write this. I don't blame you. Why would you know about BPD or think about it unless you have it or know someone who has it?

In my experience, current public knowledge about mental illness is on a par with attitudes in medieval times. People don't speak about it, and do not understand it at all. The exorcisms are a good measure of how we demonise mental illness.

There are no celebrities officially diagnosed with BPD. I can tell you many that stand out to me as likely candidates. Amy Winehouse for one. People have speculated about Van Gogh all the way through to Marilyn Monroe and Lady Di.

But because of the huge stigma attached to BPD, because of the fear and misunderstanding, no one bears the name of the disorder, no one comes forward.

No one makes the millions of sufferers feel relieved to know that they are not alone in this hell. Perhaps these celebrities and others could have been helped, been given the treatment they needed if it wasn't for the misinformation, the silence, the secretiveness. Perhaps some lives could have been saved.

I just want it to be out in the open, for people to learn about and understand mental illness a bit better. There is no need to live in the dark ages any more. We need to learn how not to be afraid of it, because our fear is holding back the potential for people who suffer from mental illness to access the help and information they need.


If you want to know more about BPD, I have read the following books and found them helpful. Please read them rather than taking what I say as fact, because I speculate and guess and they speak from fact.

1) Get Me Out of Here: My Recovery from Borderline Personality Disorder by Rachel Reiland.
2) The Borderline Personality Disorder Survival Guide: Everything You Need to Know About Living with BPD by Alex Chapman, Kim Gratz
3) Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder. by Paul T. Mason (Author), Randi Kreger (Author)


Gillian said...

An interesting post and congrats on your blog award.

Damaria Senne said...

thanks for the info. I didn't even know how much i don't know about it.

Anonymous said...

Thanks for the informative post, interesting :) lol when I read about feeling things so intensely and the rage part I thought hmmmm maybe I suffer from BPD but the rest didn't apply :) I feel sorry for people who do suffer from it as life will always be a difficult journey for them. And obviously someone in your life is affected *hugs* for you.

boldly benny said...

This was interesting and very accessible - thanks for writing it.

LadyFi said...

Thank you for sharing - this can't have been easy for you.

All these kinds of disorders would be better out in light of day where they could get some sun and understanding...

Tamara said...

Thank you, Po, for the post. I am with you - getting things out into the open is a big step forward in demolishing the stigma still associated with mental illness and helping people.

Helen said...

You make a good point. We're all clued up on physical ilness/disorders but we don't think or talk about mental and emotional problems any more than we have to.

Nicely done, and thanks for the info, I didn't know too much about it and now I know a little bit.

Anonymous said...

Um... this sounds almost like me but I'm only 4 out of the nine. Sjoe.

I think I'm a hyperchonndriasc really.

But it was interesting to find out.
Thank you for the info.

You know you're a scientist (or know scientists) why does fruit fizz conssistently like Eno when you put it in a fizzy drink? I saw it yesterday for the first time... and its been bothering me since.

nicola jarvis said...

congrats on your award, plus coming from South Africa (as i lived there as a child)-thank you for highlighting Borderline Personality Disorder. I have lived with this condition all my life and not even my extended family understand or want to know about this or how it affects me, they all are of the opinion that i am juvenile, retarded, stupid, whatever, than understand the emotional strain, distress and pain that i live with. made more so as my extended family and parents have cut ties with me. i still have my children in my life, who understand my PD as they have been bought up with it, this is an example of the current and following generations being able to understand and support others in the similar condition. my children grew up with illness and my parents were not considerate of this either as they believed discipline and tough parenting were more effective disciplines of coping. this all adds to my own personal distress and experience of BPD and basing my case more on parental neglect and overharsh discipline and critisism. i have no answers, all i know is i still hear messages and the tone, from being a child, and im now in my 50s and i havent been able to let that go. i also was a high achiever up till now, where i am floundering. i tried very hard to over compensate in every area of my life in order to forge ahead career wise as well as with relationships and i pushed myself to excess which burnt me out and caused other long term physical problems for me. i married an abuser, again classic as a child of domestic violence and i would love to be able to write about BPD in a way that others understood so that others were both aware and knowledgeable. i carry enough messages that conflict, that tell me i am not good enough or that i "should" do this, that or the other, yet i am no longer able to do any of this, which adds to the guilt that South African Sea Monkey mentioned of not fitting in, which again arouses the rage and pain. i never before expressed these states, but held on to them, i now am destructive and unable to unpickle or behave in a consistently rational way. i hope my post helps others too

po said...

Gillian and Damaria: thanks for reading! It must have been pretty boring to read if you don't even know someone who has it. But you may know someone who doesn't even know they have it, who knows, maybe one day you can help them.

Anon: life will definitely always be a difficult journey for them and those who love them.

boldlybenny: thanks!

LAdyfi: I hope that exposure will help people, at least stop the exorcisms!

Tamara: There is a long long way to go before we emerge from the dark ages. But we have come along from lobotomies at least, I guess.

Helen:yeah psychological problems are usually misunderstood as bad behaviour, bad parenting, bad attitude, just generally being a crap person. I have made these judgements before so I am guilty too. But psychological problems ARE physical problems, which people really don't get, just because their nervous systems are involved and we think we can control them. And we can, to some degree, but the brain scientists still need to work out what is going on there.

Paula: well actually I am not a proper certified scientist, I don't have no Phd, but Eno fizzes cos the citric acid reacts with the alkaline baking soda. As to fruit???!!! Never seen this. But fruit has citric acid (well citrus fruits do) and fizzy drinks are also very acidic! So it makes no sense to me cos you need something alkaline to make it fizz. Is it diet fizzy drink? Cos the sweeteners in those can be alkaline. I dunno.

Someone with BRAINS?

po said...

Nicola: oh no I am so sorry to hear that you suffer from this. You have my sympathy really. The attitudes you speak of, the attitudes of bad discipline, bad parenting, bad person, I know all of those. I grew up with all of those and I had the same attitudes too. Those attitudes were applied to a family member of mine for 17 years, and when they didn't work we just kept trying. Again and again. IT was like hitting a brick wall. I was way too selfish to see that the person was suffering, that there was something terribly wrong. All I could see was my own suffering because he did make my life quite hellish. Only now do I realise what pain he must have been in, ALL the time, enough pain to make him kill himself. I have never been in that much pain, and probably never will be. It is too late for him. Way way too late. But the attitudes of teachers and shrinks at the time were: blame the parent, there must be something wrong with the parent. Not something wrong with the poor child, as in he could be sick. And the attitudes I encounter today (I have another loved one with BPD) have not changed much. The shrink I know of thinks that only abused people can have bpd, which is often true but not always true. All people with BPD suffer as much pain as an abused normal person, so all people with BPD can be thought of as being abused even if they are not by normal standards.

And the shrink also thinks that only completely non-funcional criminals have bpd, which is not true at all, many people with bpd are highly functional. Many shrinks do not even believe it exists!

You have my utmost sympathy really. I cannot personally identify with your pain or your shame/guilt, but I have seen it and seen how badly it affects people and how you feel so dark and alone. I am so sorry your family could not come to understand you better. Hardly anyone understands. We need to change that so badly!

Have you ever had treatment for BPD? I am interested to know if it is effective or if it doesn't really lessen the pain and loneliness at all?

I think the ultimate way for a BPD sufferer to kick the disease in the nuts, is to live. To live and to survive the hell is to show your true strength to everyone. And to share your story and help others to have the courage to live to.

Thanks so much for reading and writing, Nicola.

Ches said...

Sounds hectic Po...sad and I hope people with this are treated fairly.

I glad to say, I'm all for life!