Coping with BPD Traits

[Brigit]

Borderline Personality Disorder (BPD) is mental health disorder that generates significant emotional instability.

 

Signs and symptoms of borderline personality disorder may include:

 

• Impulsive and risky behavior, such as risky driving, unsafe sex, gambling sprees or illegal drug use
  
• Awareness of destructive behavior, including self-injury, but sometimes feeling unable to change it
  
• Wide mood swings
  
• Short but intense episodes of anxiety or depression
  
• Inappropriate anger and antagonistic behavior, sometimes escalating into physical fights
  
• Difficulty controlling emotions or impulses
  
• Suicidal behavior
  
• Feeling misunderstood, neglected, alone, empty or hopeless
  
• Fear of being alone
  
• Feelings of self-hate and self-loathing
  

 

http://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/basics/definition/con-20023204

 

My psychiatrist diagnosed me with depression and anxiety. I asked him if I had BPD which I was positive he'd say yes. He didn't. He said I do have BPD traits but I don't qualify for the diagnosis.

 

Fine.

 

However, these traits are strong at times especially during PMS week which thankfully has just past. Sometimes I feel very fragmented and unstable and other times I feel OK. Today, I'm feeling a little sad but the BPD traits seem under control. Right now. They get really bad when my husbands family interfere in our relationship. I have intense abandonment fears. When I'm feeling really unstable I cannot work on anything other than calming down but now that I am stable I want to work on my issues.

 

Does anyone else suffer from BPD or have BPD traits? If so how are you doing today?

[Haydn]

You should have a look at `Downtowns` posts. lots of useful stuff.

 

I think everyone has a slight leaning towards something.

[Emilia]

Everyone in the whole wide world has them. It's the extent that matters. A lot of women can relate to PMS anxiety

[Brigit]

You should have a look at `Downtowns` posts. lots of useful stuff.

 

I think everyone has a slight leaning towards something.

 

I've read his stuff. He's an expert

[Brigit]

Everyone in the whole wide world has them. It's the extent that matters. A lot of women can relate to PMS anxiety

 

Yes. That's true. I think at one point in my life I would have qualified for the full blown diagnosis but not now. I don't just suffer from depression and anxiety I can tell my thinking is a bit different than the norm.

[Emilia]

Yes. That's true. I think at one point in my life I would have qualified for the full blown diagnosis but not now. I don't just suffer from depression and anxiety I can tell my thinking is a bit different than the norm.

 

Bwahaha join the club.

[carhill]

OP, I'm not a clinician and IMO if you can form and maintain healthy interpersonal relationships and have been able to throughout your life, regardless of transient issues you may have faced in the mental health area, it's overwhelmingly likely you do not meet the diagnosis criteria for BPD.

 

Generally, it starts young and continues, absent treatment being effective, throughout life.

 

I usually outline my 'sky is blue' example......one day, my best friend, his wife and I went out to lunch at this old log cabin looking place and it was raining and I could see outside the door and the storm had broken and the sun was shining through in a beautiful way and I commented on that, the beauty of it, and she just started ranting at me, where a few moments before had been completely normal and apparently sane, sufficiently loud and abrasive that her H had to intervene and other people in the restaurant started looking over.

 

I've known her over 20 years and the behaviors have been consistent throughout time, the classic vacillation between idolization and demonization, from sexual mania to abject hatred. If her H wasn't my best friend, I wouldn't have any contact with her at all. Exceedingly difficult to maintain a healthy relationship. Like he says, which one will we get today?

 

I'm not getting that from yourself but, then again, this is an electronic message board and none of us know each other personally here. Hence, I tend to align with your doctor. He knows you better and has clinical experience.

[Brigit]

OP, I'm not a clinician and IMO if you can form and maintain healthy interpersonal relationships and have been able to throughout your life, regardless of transient issues you may have faced in the mental health area, it's overwhelmingly likely you do not meet the diagnosis criteria for BPD.

 

Generally, it starts young and continues, absent treatment being effective, throughout life.

 

I usually outline my 'sky is blue' example......one day, my best friend, his wife and I went out to lunch at this old log cabin looking place and it was raining and I could see outside the door and the storm had broken and the sun was shining through in a beautiful way and I commented on that, the beauty of it, and she just started ranting at me, where a few moments before had been completely normal and apparently sane, sufficiently loud and abrasive that her H had to intervene and other people in the restaurant started looking over.

 

I've known her over 20 years and the behaviors have been consistent throughout time, the classic vacillation between idolization and demonization, from sexual mania to abject hatred. If her H wasn't my best friend, I wouldn't have any contact with her at all. Exceedingly difficult to maintain a healthy relationship. Like he says, which one will we get today?

 

I'm not getting that from yourself but, then again, this is an electronic message board and none of us know each other personally here. Hence, I tend to align with your doctor. He knows you better and has clinical experience.

 

Although it isn't an official diagnosis I've always thought of myself as "The Quiet Borderline" I won't take my anger out on others but the thoughts in my head can be pretty scary.

 

That being said I am able to form long term healthy relationships in spite of my thoughts and behavior. Even at my worst I always had close friends and have a pretty good relationship with my mom. But I do have traits seen in the quiet borderline type. Right now I feel so stable but a few days ago not so much.

[Downtown]

I've always thought of myself as "The Quiet Borderline".... That being said I am able to form long term healthy relationships.

Brigit, thanks for the kind words. I agree with Haydn, Emilia, and Carhill that everyone occasionally exhibits all of the BPD traits because they are simply basic human ego defenses that we all have. At low to moderate levels, they are helpful and increase our chances of survival. BPD therefore is not something one "has" or "doesn't have." Rather, it is a set of behavioral traits we all have to some degree.

 

Moreover, we will find ourselves at various points on that BPD spectrum at various times in our lives -- sometimes being at the high end. During early childhood, for example, we all behave like full-blown BPDers. And many of us start behaving that way again during our teenage years when the hormones are raging -- which is why therapists generally are reluctant to diagnose BPD until a person has reached 18. And, of course, our BPD traits can temporarily flare up again during other hormone changes (e.g., pregnancy, postpartum, PMS, or perimenopause) or as a result of head trauma or drug abuse.

 

Unfortunately, that spectral nature of BPD is not at all evident in the APA's diagnostic manual (DSM-5) because it retains the dichotomous diagnostic approach that's been in use for BPD since 1980. At that time, the APA adopted this yes-or-no approach because it was under pressure from many groups to create a bright line between "having" and "not having" BPD and other PDs.

 

These groups included the insurance companies (who don't want to pay unless the traits are severe), the courts (who don't want to force people into mental institutions), and the psychologists themselves (who didn't trust their ability to produce a consistent diagnosis nationwide absent a bright line). Those psychologists have grown to recognize that, if they are ever to be taken seriously by the rest of the scientific community, they have to abandon the absurd notion that a person "has BPD" when meeting 100% of the diagnostic criteria -- but doesn't when meeting only 90%. That's as silly as claiming that everyone under 6'4" is "short" and everyone under 270 pounds is "skinny."

 

This is why the psychiatric community is now in the process of replacing its embarrassing dichotomous methodology with a graduated diagnostic model (i.e., no impairment, some, moderate, severe, and extreme). Indeed, that methodology is already included in a separate part ("Section III") of DSM-5 as an "Alternative Model for Personality Disorders." It is there to encourage therapists to start using it and doing empirical tests to see if various therapists can produce similar diagnostic results using that model.

 

Once that transition is complete (likely in the next DSM update), it should be apparent to the lay public that the BPD spectrum applies to EVERYONE in the country. Hence, it will be evident that the primary reason for learning BPD traits (i.e., warning signs) is to better understand one's OWN behavior, not to simply identify the 6% of individuals who have severe traits throughout their lives.

[Brigit]

This is why the psychiatric community is now in the process of replacing its embarrassing dichotomous methodology with a graduated diagnostic model (i.e., no impairment, some, moderate, severe, and extreme). Indeed, that methodology is already included in a separate part ("Section III") of DSM-5 as an "Alternative Model for Personality Disorders." It is there to encourage therapists to start using it and doing empirical tests to see if various therapists can produce similar diagnostic results using that model.

 

Once that transition is complete (likely in the next DSM update), it should be apparent to the lay public that the BPD spectrum applies to EVERYONE in the country. Hence, it will be evident that the primary reason for learning BPD traits (i.e., warning signs) is to better understand one's OWN behavior, not to simply identify the 6% of individuals who have severe traits throughout their lives.

 

I've studied BPD extensively. Here's the criteria and my baseline behaviors:

 

(1) frantic efforts to avoid real or imagined abandonment.

 

Moderate Impairment. It gets severe if my husband's family interferes with our life. If there is no stressor (like today) I'm not even thinking about it.

 

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

 

No Impairment within the last year.

 

(3) identity disturbance: markedly and persistently unstable self-image or sense of self

 

No Impairment within the last year.

 

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).

Contacting the OM is the only impulsive behavior I have.

 

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

 

Moderate Impairment. When primary relationship seems threatened suicidal thoughts that include planning take place.

 

(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)

 

Moderate impairment.

 

(7) chronic feelings of emptiness

Some Impairment.

 

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Some Impairment.

 

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

No Impairment.

[Downtown]

Severe dissociative symptoms. No Impairment.

Are you pretty sure about this one, Brigit? If you have several other BPD traits at moderate level, you may be doing a moderate amount of splitting and not realize it. It would be apparent to others -- and perhaps sometimes even to you -- in the form of a moderate degree of black-white thinking. In any event, even if it is moderate it apparently is not strong enough to undermine your marriage or your close LTRs with friends.

 

Recurrent suicidal behavior.... Moderate Impairment. When primary relationship seems threatened suicidal thoughts that include planning take place.

Well, Brigit, now I see what you mean by "pretty scary" thoughts in your head. The suicide "planning," of course, is what is so scary. These thoughts may arise entirely from your depression and have nothing to do with BPD traits. Yet, if you are concerned that BPD may be contributing to it, I suggest you obtain a second opinion from a psychologist (ideally, one with experience in treating BPDers if there is one in your city).

 

If that psychologist agrees that you have BPD traits that are strong enough to warrant treatment, you may want to hire him to teach you emotional-regulation skills such as is done in DBT and CBT. While your psychiatrist is good for meds, a psychologist with that specialized training usually is better for therapy.

 

If you do have several BPD traits at a moderate level -- and not just simple depression (which can be treated with meds) -- the conventional "talk therapy" likely won't be very effective. For treating BPD traits, what seems to be most effective is specific instruction on how to learn the emotional skills that you had no opportunity to learn in early childhood.

 

These may include, e.g., how to be mindful of the present instead of escaping into thoughts of the future or past; how to tolerate strong mixed feelings so as to avoid black-white thinking; how to self sooth using self-distraction and other techniques; how to better regulate your emotions to avoid intense feelings; and how to intellectually challenge your intense feelings instead of accepting them as self-evident "facts."

 

Significantly, your suicidal ideation may be due entirely to your depression -- not BPD traits at all -- as your psychiatrist said. Yet, if another professional determines that your moderate BPD traits do play a contributing role, you likely are an excellent candidate for the BPD treatment programs that are available in major cities. I say this because, if you have moderate BPD traits as you suspect, you have an amazing level of self awareness. It is the lack of self awareness and lack of ego strength that causes the success rate for BPD treatment to be so low. Being very aware and having only moderate traits, then, means you likely are already over the two largest hurdles.

[Brigit]

Significantly, your suicidal ideation may be due entirely to your depression -- not BPD traits at all -- as your psychiatrist said. Yet, if another professional determines that your moderate BPD traits do play a contributing role, you likely are an excellent candidate for the BPD treatment programs that are available in major cities. I say this because, if you have moderate BPD traits as you suspect, you have an amazing level of self awareness. It is the lack of self awareness and lack of ego strength that causes the success rate for BPD treatment to be so low. Being very aware and having only moderate traits, then, means you likely are already over the two largest hurdles.

 

I've contacted the DBT program in my area and they don't take my insurance. The cost isn't affordable. I do have the DBT workbook written by Marsha and I've been trying to do the exercises myself. I do meditate and listen to at least an hour of Eckart Tolle daily as his talks are all about living in the present moment. Also, I listen to a lot of Tara Brach who does a fair amount of DBT training in her talks (noticing thoughts, can I be with this etc..) The reason why I have insight is probably due to my Masters in Social Work. If I can get my sh*t together I have the credentials to be a therapist and I've worked in the field in the past but due to my emotional instability it was difficult for me to hold a full time job.

[Downtown]

The reason why I have insight is probably due to my Masters in Social Work.

Perhaps so. But I believe you have that backwards and thus are greatly underestimating an innate ability you've had since childhood -- and one that is very rare in combination with BPD traits sufficiently strong to temporarily derail you from the social work job. It is far more likely that your M.S.W. resulted from your high level of self awareness than vice versa. If so, you likely will be an excellent therapist/social worker when you get your emotions under better control.

[Brigit]

Perhaps so. But I believe you have that backwards and thus are greatly underestimating an innate ability you've had since childhood -- and one that is very rare in combination with BPD traits sufficiently strong to temporarily derail you from the social work job. It is far more likely that your M.S.W. resulted from your high level of self awareness than vice versa. If so, you likely will be an excellent therapist/social worker when you get your emotions under better control.

 

I was good at my job. The paperwork was over-whelming and I was constantly worried about safety issues with my patients. Most were paranoid schizophrenics. I'm not sure that job was the right fit but I was able to help some of the higher functioning patients.

 

Right now, I feel stable but I know the next wave of insanity will come once triggered. Could be in five minutes or five days. But it will come.

[Downtown]

Right now, I feel stable but I know the next wave of insanity will come once triggered. Could be in five minutes or five days. But it will come.

Brigit, I realize you're using "insanity" figuratively, not literally. But, in the interest of other readers, we should note that BPD traits are not a sign of insanity, craziness, or psychosis -- all of which mean that one has lost touch with physical reality (e.g., believing the TV news anchor is speaking to you personally). Although BPD is a "thought distortion," what is distorted is not the perception of physical reality but, rather, that of other peoples' intentions and motivations.

 

Significantly, even healthy folks also get these same distortions (albeit, to a lesser degree) whenever they experience intense feelings such as anger or infatuation. The human condition is that our intellectual judgement of other peoples' intentions flies out the window whenever we experience very intense feelings.

[Brigit]

Brigit, I realize you're using "insanity" figuratively, not literally. But, in the interest of other readers, we should note that BPD traits are not a sign of insanity, craziness, or psychosis -- all of which mean that one has lost touch with physical reality (e.g., believing the TV news anchor is speaking to you personally). Although BPD is a "thought distortion," what is distorted is not the perception of physical reality but, rather, that of other peoples' intentions and motivations.

 

Significantly, even healthy folks also get these same distortions (albeit, to a lesser degree) whenever they experience intense feelings such as anger or infatuation. The human condition is that our intellectual judgement of other peoples' intentions flies out the window whenever we experience very intense feelings.

 

Absolutely. I use insane in a comical manner. Right this moment life is fine so my thinking is very logical and calm. If a big stressor came that would upset my sense of safety my emotions could get out-of-control. Worry thoughts would infiltrate my brain and I'd come up with a massive amount of scenarios of how my world would crumble. Depending upon how traumatized I was about the event would indicate how long it would take for me to recover. I've never had to be hospitalized but I have gotten very bad.

 

Big triggers:

Loss of safety

Rejection

Loss of loved ones

Edited June 21, 2015 by Brigit