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Old 12th December 2005, 9:07 PM   #1
NoFaith05
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Borderline Personality Dosorder

I think I am finally learning to forgive my ex-GF, because after doing some research on Borderline Personality Disorder, it ALL makes sense now! Everything that she did- her entire pattern of behavior- fits the description. Now I almost feel like I should try and help her, but as with most borderline patients, my help won't be appreciated. So I digress. Read this article, it's very interesting:

What is Borderline Personality Disorder?

Personality disorders affect about 10% of the general population. This group of mental disorders is defined by maladaptive personality characteristics that have a consistent and serious effect on work and interpersonal relationships. DSM-IV defines ten categories of personality disorder. Of these, Borderline Personality Disorder (BPD) is the most frequent in clinical practice. BPD is also one of the most difficult and troubling problems in all of psychiatry.

The term "borderline" is a misnomer. These patients were first described sixty years ago by psychoanalysts who noted they did poorly in treatment, and therefore theorized that this is a form of pathology lying on the border between psychosis and neurosis.

Although we no longer believe that patients with BPD have an underlying psychosis, the name "borderline" has stuck. A much more descriptive label would be "emotionally unstable: personality disorder." The central feature of BPD is instability, affecting patients in many sectors of their lives.

Thus, borderline patients show a wide range of impulsive behaviors, particularly those that are self destructive. They are highly unstable emotionally, and develop wide mood swings in response to stressful events. Finally, BPD may be complicated by brief psychotic episodes.

Most often, borderline patients present to psychiatrists with repetitive suicidal attempts. We often see these patients in the emergency room, coming in with an overdose or a slashed wrist following a disappointment or a quarrel.

Interpersonal relationships in BPD are particularly unstable. Typically, borderline patients have serious problems with boundaries. They become quickly involved with people, and quickly disappointed with them. They make great demands on other people, and easily become frightened of being abandoned by them. Their emotional life is a kind of rollercoaster.

What Causes BPD?

We are only beginning to understand the causes of BPD. As in most mental disorders, no single factor explains its development. Rather, multiple risk factors, which can be biological, psychological, or social, play a role in its etiology.

The biological factors in BPD probably consist of inborn temperamental abnormalities. Impulsivity and emotional instability are unusually intense in these patients, and these traits are known to be heritable. Similar characteristics can also be found in the close relatives of patients with BPD. Research suggests that the impulsivity that characterizes borderline personality might be associated with decreased serotonin activity in the brain.

The psychological factors in this illness vary a great deal. Some borderline patients describe highly traumatic experiences in their childhood, such as physical or sexual abuse. Others describe severe emotional neglect. Many borderline patients have parents with impulsive or depressive personality traits. However, some patients report a fairly normal childhood. Most likely, any of these scenarios is possible. Borderline pathology can arise from many different pathways.

The social factors in BPD reflect many of the problems of modern society. We live in a fragmented world, in which extended families and communities no longer provide the support they once did. In contemporary urban society, children have more difficulty meeting their needs for attachment and identity. Those who are vulnerable to BPD may have a particularly strong need for an environment providing consistent expectations and emotional security.

Most likely, BPD develops when all these risk factors are present. Children who are at risk by virtue of their temperament can still grow up perfectly normally if provided with a supportive environment. However, when the family and community cannot meet the special needs of children at risk, they may develop serious impulsivity and emotional instability.

The Course of BPD

Borderline personality disorder is an illness of young people, and usually begins in adolescence or youth. About 80% of patients are women. BPD is usually chronic, and severe problems often continue to be present for many years. About one out of ten patients eventually succeed in committing suicide. However, in the 90% who do not kill themselves, borderline pathology tends to "burn out" in middle age, and most patients function significantly better by the ages of thirty-five to forty. The mechanism for this improvement is unknown. However, other disorders associated with impulsivity, such as antisocial personality and substance abuse, also tend to burn out around the same age.

The level of long term improvement in borderline patients varies a great deal. A minority will develop a successful career, marry happily, and recover completely. A minority will continue to be highly symptomatic into middle age. In the majority of cases, both impulsivity and emotional instability decline over time, and the patient is eventually able to function at a reasonable level.

BPD can be very burdensome for the patient's family. It is particularly difficult to deal with suicidal threats and attempts. Parents often wonder if they are at fault for the patient's condition and patients sometimes blame their parents, and some therapists will agree with them. However, the scientific evidence does not justify the conclusion that the family carries the primary responsibility for the development of borderline personality disorder.

The Treatment of BPD

There is no specific or universal method of treatment for BPD. At times, drugs can take the edge off impulsive symptoms. For example, some patients do better with low dose neuroleptics. However, no psychopharmacological agent has any specific effect on the underlying borderline pathology. In spite of the association between impulsivity and low serotonin activity, specific serotonin reuptake inhibitors (such as fluoxetine) rarely produce a dramatic improvement.

The mainstay of treatment for BPD has always been, and continues to be psychotherapy. However, because of their impulsivity, about two thirds of borderline patients drop out of treatment within a few months. Those patients who stay in therapy will usually improve slowly over time.

The chaos that characterizes border line patients makes them difficult cases for therapists. A patient with BPD may be continuously suicidal for months or years. Moreover, many of the same problems that patients have with other people arise in their relationships with helping professionals.

A number of different therapeutic methods have been tried with borderline patients. The largest clinical literature has come from psychoanalytically oriented therapists. Traditionally, psychotherapists focus on building a strong working alliance with the borderline patient. When the therapeutic relationship provides a safe haven, it is easier to work on developing better relationships with other people.

Most of the work in psychotherapy consists of helping patients to be less impulsive, and to exercise better judgment in their management of their personal lives.

In view of the frequency of reported childhood trauma in borderline patients, some therapists have suggested that BPD should be thought of as a form of post traumatic stress disorder. These clinicians tend to focus on uncovering negative events so as to help patients process them. However, there is no evidence that these methods are successful. In fact, there is some reason to suspect they can make patients worse, by focusing too much on the past, and not enough on the present. In addition, borderline patients can be particularly prone to develop false memories in psychotherapy.

Recent research suggests that cognitive-behavioral therapy, which has developed methods targeting impulsivity and emotional instability, may be particularly appropriate for borderline patients. Studies of a behavioral treatment specifically developed for patients with BPD, "dialectical behavior therapy," indicate that this approach can bring suicidality under control within one year. However, we do not know whether this method provides an effective long term treatment for the disorder.

BPD creates enormous suffering in those afflicted with it. Most patients describe a continuous state of emotional chaos, swinging from extremes of depression, anger, and anxiety. Borderline patients often need to feel suicidal in order to know that they can escape from their dysphoric feelings. The road to recovery in BPD is often long and difficult. However, borderline patients are often attractive and productive people. When treatment is successful, the patient, the therapist, and the family can all feel that it was well worth the trouble to see things through.

We need to conduct more research on the causes of BPD in order to develop more rational methods of treatment. In the future, we will probably have methods of pharmacotherapy and psychotherapy specifically designed for this challenging patient population. In the meantime, the best hope for most patients consists of linking up with a good therapist.
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Old 12th December 2005, 9:09 PM   #2
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Unless she was diagnosed you are not the man to diagnose her mental issues.

There is a good book called "Stop Walking on Eggshells" for the person who lives with someone who has BPD.
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Old 13th December 2005, 8:11 AM   #3
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Its not a difficult diagnosis to make...but the best thing you can do is stay away , far far away from her. If you mess around with trying to help, you run the risk of being sucked back into the matrix. As a wise poster on another forum was fond of saying, "Be glad you met a Borderline in the wild and survived." So take a look in a full length mirror and notice that you survived the encounter fully intact, hopefully, and then be thankful. Learn about the disorder, but stay away from the ex who is afflicted.

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Old 13th December 2005, 8:27 AM   #4
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Quote:
Originally Posted by bendit
Its not a difficult diagnosis to make...

It requires a diploma/training to make the diagnosis.. If he tells people that she has BPD and she doesn't he could be doing her a lot of harm.

BPD traits are found in people that don't have the disorder and are fine.
Some of the traits are also found in Bipolar people as well

It is best left to a professional

As Bendit said.. Stay away from her
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Old 13th December 2005, 8:43 AM   #5
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Originally Posted by Art_Critic
Unless she was diagnosed you are not the man to diagnose her mental issues.
That is so true!

One of my friends is in the psychiatric ward because of his depression and he met some people there who suffer from borderline disorder. Believe me, according to his description this is not something that should be diagnosed by a layman (and especially not by exes).

I sincerely dislike it when people after a breakup/rejection start to analyze for all different kinds of disorders or psychological problems. One of my friends once sent me an email with the subject 'psychogram' where he analyzed why I rejected him, why I still wanted to date an ex of mine, why I did this and that. Unfortunately I did the same analyzing thing with someone else and no wonder he was pissed off , but hopefully I learned and won't do it again, not in front of him at least.
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Old 13th December 2005, 9:11 AM   #6
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i think it is quite common to do this. it is a reaction to feeling rejected. rather to think there is something wrong with them than with you. sometimes it can be taken to extremes though.
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Old 13th December 2005, 12:57 PM   #7
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I sincerely dislike it when people after a breakup/rejection start to analyze for all different kinds of disorders or psychological problems.
Nothing wrong with suspecting a disorder - as the OP says, it helps you to understand behaviour. I agree someone shouldn't tell others about their informal 'diagnosis' but it might be worthwhile suggesting it to the ex (if you're still communicating) and suggesting the ex get a formal diagnosis.

A lot of folks are wandering around undiagnosed - you do at least some of them a favour by suggesting they find out.
Quote:
BPD traits are found in people that don't have the disorder and are fine.
Most disorder traits are found in people who don't have disorders. Disorders are regular traits writ large; that which makes the traits a disorder is their severity and the extent to which the affect someone's life.
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Old 13th December 2005, 9:43 PM   #8
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My ex GF was showing some strange behavior and I thought I was going nuts. A friend turned me on to the book "Stop Walking on Eggshells" after giving some examples and it made things a litle clearer for me. I dont know if she had BPD but she had ALL the characteristics of BPD. Its a great book and helps to understand why people might have any personality traits they might have. Abandonment seems to be the root of a lot of evil with some relationships I think.
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Old 14th December 2005, 3:10 AM   #9
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Originally Posted by Outcast
Nothing wrong with suspecting a disorder - as the OP says, it helps you to understand behaviour. I agree someone shouldn't tell others about their informal 'diagnosis' but it might be worthwhile suggesting it to the ex (if you're still communicating) and suggesting the ex get a formal diagnosis.
He didn't diagnose any disorder, he just started listing perceived mistakes that I made, that I was stupid for liking someone else and not him, that I had played with him and strung him along, that he had always doubted that men and women could be friends anyway and I should have sensed his feelings for him (even though he had told me various times he wasn't interested in me and he got upset when I told him exactly the same thing about friendship between men and women), etc... If he had known more about disorders he probably would have diagnosed me with narcissicism or some other disorder.

I just find it dangerous when people come up with a diagnosis for such a complex disorder as borderline. Sometimes it's 'just' a breakup and nothing more...
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Old 14th December 2005, 3:15 AM   #10
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Wasn't talking about you and your guy, loony. He was talking through his hat. I was talking about the OP and others whose partners seem to actually have many symptoms.

It's one thing for someone to say you have symptoms just because they're trying to get your goat and quite another to see and recognize genuine symptoms.
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Old 14th December 2005, 3:32 AM   #11
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I just get worried when a layman comes with this Heureka attitude and says: " it ALL makes sense now! Everything that she did- her entire pattern of behavior- fits the description."

To me it would look more like wishful thinking and the attempt to rationalize someone else's behavior and put labels on him in order to understand him better. I guess disorders are quite complex, especiall borderline disorder, and saying that a person's entire pattern of behavior fits the description seems irrealistic to me. He's portraying her as "the" borderline patient and that seems a little bit too enthusiastic. Makes me wonder if he has analyzed the reasons for the breakup and his part in it with the same passion. I find people difficult enough to understand and even though people do have disorders, the majority probably doesn't and I would find it more important to approach the breakup and the relationship rationally and objectively.
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Old 14th December 2005, 3:37 AM   #12
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To me it would look more like wishful thinking and the attempt to rationalize someone else's behavior and put labels on him in order to understand him better.
Sometimes, but don't let your experience colour your observation of others'.
Often one is too close in a relationship to realize that one is dealing with someone with a disorder. Of course laymen shouldn't diagnose, but the reason there are self-diagnosis lists for all these conditons is precisely so that people can spot people who may need help. I agree this can be misused but everything can and there is good to be had, too, in that some people endured a lot of abuse without knowing why only to realize later that they were dealing with someone with not just regular issues but an actual disorder.

In fact maybe your ex had one!
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Old 14th December 2005, 7:08 AM   #13
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Quote:
Originally Posted by loony
I just get worried when a layman comes with this Heureka attitude and says: " it ALL makes sense now! Everything that she did- her entire pattern of behavior- fits the description."

To me it would look more like wishful thinking and the attempt to rationalize someone else's behavior and put labels on him in order to understand him better. I guess disorders are quite complex, especiall borderline disorder, and saying that a person's entire pattern of behavior fits the description seems irrealistic to me. He's portraying her as "the" borderline patient and that seems a little bit too enthusiastic. Makes me wonder if he has analyzed the reasons for the breakup and his part in it with the same passion. I find people difficult enough to understand and even though people do have disorders, the majority probably doesn't and I would find it more important to approach the breakup and the relationship rationally and objectively.
Why are you so worried what "HE" chooses to do in the analysis of HIS own relationship? Its his right to try and figure out whatever it is he needs to in the context of what he has been through. BPD is a fairly easy diagnosis to make, primarily because the symptoms have been published all over the WWW, and there are plenty of people who have encountered a BPD person in the wild and survived to talk about it, who also can and do shed light in forums across the Internet. This notion that you need a diploma on the wall to identify them couldn't be further from the truth. I don't believe in "high priests". I believe in knowing something for yourself.

Trying to figure out why that truck seemed to come out of nowhere to just miss hitting you is a perfectly valid survival strategy. If it happens that the truck has a certain label on its side identifying it as a particularly dangerous truck, then its worth knowing how to identify those trucks so as to avoid them in the future.

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Old 14th December 2005, 8:19 AM   #14
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Originally Posted by loony
Sometimes it's 'just' a breakup and nothing more...
Word......
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Old 14th December 2005, 8:56 AM   #15
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I have to disagree with Art Critic and some of the others. I have had many relationships, and yes I often analyze what went wrong after a break-up (in order to avoid making the same mistakes in the future). I am a bright person, and I do have several degrees hanging on my wall- they are just not in psychology. But I have learned a lot about this disorder, because my ex's behavior was baffling. She had me so confused and stressed that I was having suicidal thoughts (I used to be a VERY well-adjusted person).

I happen to know a lot about disorders, because I HAVE ONE. I have been diagnosed with OCD, which leads to depression and anxiety. I see a therapist once a month, and take medication for it. But when I was younger (about the same age as my ex) I had no idea what was wrong with me. I thought I was going crazy. I suffered from panic attacks, headaches, and severe emotional distress. My ex is suffering from these exact same problems! I have noticed it, and her BEST FRIENDS have also noticed it! We have all seen her pattern of behavior, and are concerned. I wouldn't go out and make some wild acusation about my ex- declaring that she is borderline- just to satisfy my own needs. That's just plain wrong. I actually care about this person, and I seriously think she needs help. I don't want her to continue hurting herself, or others.

She has ALL of the classic symptoms: She attaches to people very quickly, and then detaches from them just as quickly. Her relationships are very intense, but often rocky. She has severe mood swings. She is a very effective liar- I have caught her in the middle of some real whoppers. She has an unhealthy obscession with sexual activity. She has cut herself as a form of punishment (with a knife- many times). She does not feel worthy of me, or any other friend for that matter. Her self-esteem is in the toilet. She can't ever be alone. She doesn't function well within a social environment. She doesn't have a personality of her own, and has no sense of her own self identity.

I am a rational person. I dated this girl- none of you on this forum dated her, or even know her. So, you don't have any frame of reference. I posted this thread because I think that this is a REAL problem, and I don't know if I should help her or not. I am not labeling her with BPD, but I am wondering if she should get a professional diagnosis- because it would HELP her.
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