Do you have Borderline Personality Disorder?


By David Joel Miller

What are the signs and symptoms of Borderline Personality Disorder?

Problems with identifying Borderline Personality Disorder.

Borderline

Borderline
Photo courtesy of Pixabay.com

Borderline Personality Disorder formerly called Borderline conditions has received a lot of attention recently. It is one of those troubling conditions that looks differently to different people.

If you have Borderline Personality Disorder you know the suffering having this disorder can cause. If you have lived with someone who has Borderline Personality Disorder you know how frustrating this can be. This difference in perspective is one of the problems with the increased attention to the disorder.

Many of the symptoms of Borderline Personality Disorder overlap or are the same as symptoms of other disorders. So when should someone get a Borderline diagnosis and when should we call it something else? Sometimes those iffy cases get a notation put on their chart “Borderline traits” rather than the full diagnosis. Electronic medical records are making it harder to leave notes like that and this may result in more people getting the full diagnosis.

For the record, diagnosis is not a do it yourself project. Mental Health, as well as physical health diagnosing, should be done by a professional. But so many people out there are being called Borderline these days and talking about it is so common, it is worth looking at the whole “what is Borderline Personality Disorder?” question.

There are efforts to come up with some kind of definitive test for borderline and other mental health conditions. At this time we can read research reports of “markers” and risk factors for many mental illnesses but we can’t be sure what is causing them. For example over 95% of people with Borderline Personality Disorder also have a sleep disorder.

Lacking a good test, mental conditions are diagnosed by looking at symptoms and seeing if someone has enough symptoms and if they are severe enough to need treating.

With so many Borderline symptoms overlapping or look just like symptoms of other mental illnesses, what name something gets called may depend on which symptoms are seen at any given appointment and the perspective of the viewer. We want to avoid normal problems of life being called diseases but this causes another problem.

Many mental illnesses are caused by identifiable life events. PTSD and other stress disorders need an identifiable stressor to get diagnosed. Many, but not all, people with Borderline Personality Disorder can point to some life event that started their symptoms.

As more people know about Borderline Personality Disorder more people are coming to believe that they have the condition. Family, Friends, and relationship partners are likely to blame all the interpersonal or relationship problems on someone having Borderline Personality Disorder. I suspect that professionals are going along with this and giving the diagnosis out more often.

Is Borderline Personality Disorder an illness or a lack of mental wellness?

Symptoms of Borderline personality disorder can vary from person to person and they may vary in intensity. This has resulted in an increasing amount of discussion, and a past counselors soapbox blog post about whether there may be Levels or Types of Borderline Personality Disorder.  There has also been some professional discussion about whether some clients have been given the diagnosis because they angered the treating professional.

Some of you have noticed from my other writings that I believe strongly in Wellness and Recovery. (See post on Mental Illness or Mental Health.)

Many of the things we call “Mental illness” are on a continuum. Those problems get better or they get worse. Sometimes in life, we get sad. When that sadness keeps you from working or enjoying life we call it depression and it deserves to get treated. The same thing is true of Borderline Personality Disorder. Many people with this condition do get better.

As we look at the symptoms of Borderline Personality Disorder below I will comment on some of the questions you might have about each one of the symptoms. This discussion is based on the SAMHSA publication titled An Introduction to Co-Occurring Borderline Personality Disorder and Substance Use Disorders. This publication was written primarily for professionals but I include it here in case any of you want to see the original source. The SAMHSA publication draws on the DSM-5 (DSM is a registered trademark of the APA,which some of you may also want to consult. The paraphrasing and comments are mine, so let’s hope I get this right. If you have or think you may have this condition please see a professional in your area.

Below are some of the typical features of Borderline Personality Disorder.

Borderline Personality is not common except in psychiatric hospitals.

Estimates of how common Borderline Personality really vary. In the general population, it is estimated at around one to two percent. In inpatient psychiatric facilities the rate of Borderline Personality Diagnosis can reach 20%. That suggests to me that this is a very impairing condition.

Notice as we go through these symptoms that many of these are things that have been considered “female” characteristics. Turns out that three out of every four people who get the Borderline Personality Disorder Diagnosis are female. Also many of these symptoms are exactly what we would expect in someone with a Stress or Trauma Related Disorder as in Posttraumatic Stress Disorder or a Dissociative Disorder.

Borderline Personality Disorder is not simply a matter of being overly dramatic or wanting attention. Most, about 80%, attempt suicide and they die from suicide attempts at about 50 TIMES the rate of the general population. This does not need to happen as there are effective treatments for Borderline Personality Disorder available. Additionally about 80 percent of those with this diagnosis cut on themselves, which is often called Non-Suicidal Self Injury. Some people with this condition both cut and attempt suicide.

Symptom – Intense fear of abandonment and efforts to avoid it.

Many, not all, people with Borderline Personality Disorder were abused or neglected as children. Some had this experience in adult life. This suggests that these fears are both rationally based on experience and learned. If you learned to be fearful you can learn to not be fearful. But lessons learned very early in life may be much more difficult to unlearn. For many this fear of abandonment makes sense.

Borderline symptom – troubled, vacillating relationships with others.

In a single session with a therapist someone high in borderline traits may tell the therapist that they love them and they are the only on that ever understood them and then later they will say that they hate the therapist and “you just don’t understand at all.”

The same thing happens in their personal relationships. They fall in love quickly and they fall out just as rapidly. They have over inflated views of their potential partners and then they feel tricked, deceived and angry. Relationships with someone who has Borderline Personality Disorder can include fabulous sex followed by violent fights.

Don’t know who you are and who you are keeps changing.

People with borderline conditions have more difficult than others in telling you what they like, who they are and they look to others to define themselves.

Impulsive acts are common in Borderline Personality Disorders.

Risky sexual behaviors are the most commonly noted behaviors. Over-spending and reckless driving are also included in this definition. Frequent conflicts with others are common.

Suicidal Behaviors or Self-Mutilation.

People with borderline personality disorder are often overwhelmed by emotion and then hurt themselves rather than express their anger towards the person that angered or hurt them. This kind of sudden flip in their feelings towards others and then their impulsive behavior can look a lot like Bipolar and turns out that many people get both diagnosis or they are moved back and forth. It is of course very possible for someone to have more than one disorder.

Borderline make people feeling empty.

Since people with Borderline do not know who they are and they fear being abandoned, this makes sense. If you look for your self-worth from others and then feel empty or nothing at all when you are not getting positive interactions from those others you can feel empty. Some of these characteristics may sound like an immature or selfish person. If you did not get enough food as a child you may be physically stunted. If you are abused or neglected as a child or abused drugs and alcohol, then you may not have learned the lessons you need to learn back then. The result is continuing to use coping strategies that may have kept you alive or got some of your needs met as a child but they are not working now. This is true of some people with Borderline Personality Disorder but not all.

Remember that these explanations are ideas about how things could happen but not precise formulas for how it did happen to any one particular person.

Episodes of strong, excessive anger.

There is no specific diagnosis for “anger issues” despite how common referrals to therapy for “Anger Management” are. Anger is a symptom reported in many other mental or emotional issues. What further clouds this picture is the high rate of Bipolar Disorder and Substance Use Disorders among those with Borderline Personality Disorder. Depression can also lead to irritability and then anger. What is looked for in Borderline Personality Disorders is sudden explosive anger often with fights and violence, that come on unexpectedly with someone who shortly before was a close friend or loved one.

Borderline may include Stress related Dissociation or Paranoia.

This can be a problematic symptom in practice. Part of the way we identify paranoia is that the fear is excessive. Men are taught to approach things they fear. Kill it if possible. This results in men getting acting out, violence related diagnoses. Women are taught to avoid danger and if you have been victimized in the past you recognize danger coming. So if you have been abused once the fear that your new boyfriend will abuse you sounds reasonable not paranoid. See how this can be an issue?

It is also possible that “dissociation” gets pathologized. Some dissociating or “spacing out” is normal in children or those who are overwhelmed. People who suffer trauma may well dissociate. So it seems to me that cases of excessive dissociation may get swept into the Borderline Personality Disorder category rather than being recognized for what they are. As before someone could have both Borderline Personality Disorder and Dissociative Disorder.

Those are my thoughts on recognizing Borderline Personality Disorder and how it and other conditions may be getting mixed together. If you or someone you care about may have this condition consider professional help. If they do not have this problem please stop calling everyone you dislike Borderline. You may also want to check out other counselorssoapbox posts on Personality Disorders.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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2 thoughts on “Do you have Borderline Personality Disorder?

  1. Oh lord, funny I was diagnosed after I pissed off the hospital emergency shrink that she let me down the last time just letting me go. She said borderline then made me sign a consent form to release her from my file(!) So I never took it seriously until a year or so later when I was being arrested for domestic and my girlfriend mentioned it to which the cops replied oh boy better find another boyfriend. I was severely invalidated, emotionally neglected and psychologically screwed with by both parents, and physically abused and psychologically tormented by by father with my mother’s consent – because when I was the victim, she was relieved. I can trace it back to the first time my father was torturing me, I can to my mother with bruises, screaming and crying that my father was kicking me crying and yelling, all the way to the area to force me to play hockey. The abuse didn’t do it. It was when my mother told me “Your father loves you, he wouldn’t do that. It must have been your imagination.” When I insisted it was NOT my imagination and showed the bruises and blood, my mother swatted me with her hand and told me to go upstairs. I dissociated, and called a hunger strike. I wanted to die already at five or six years old. Neither parents ever apologized, they just sent my older brother up to make me laugh and forget about. The pattern continued for 40 more years until my brohter had a heart attack as he was devalued and discarded by them when his wife was discovered not able to bear children after they had three still-births. My mother discarded his need for comfort the way she had mine forever, and at such a low point for his first time, at 44, healthy and strong he dropped from a heart attack. My mother never accepted it was her, but it was. Her mourning was short and insincere. As a borderline, single, 40, I was REALLY abandoned, and so I actually got a break in that I was forced to confront the fear of abandonment once and for all. We were so close since birth I had never realized how much he was in essence half of me. With my bro gone, and me having estranged myself from my abusive parents, there is no fear of abandonment left because there is no one left! I believe I was close to being schizophrenic during the first year after going no-contact with my parents, but lucky I had done so much LSD as a teenager I was able to keep a grip on reality. I have no doubt that without the LSD I’d be schizophrenic. I also have little doubt that without a ton of coke, crack, mdma, and speed my heart would have gone too – but 30 years of those nothing can overload this sucker. Oh yeah, as if I have to say it…. I never cut… I always used massive doses of psychedelics and stimulants, parties and women, hedonistic gluttony. There was a short period where I would punch myself in the face in the mirror but after my brother died that sort of seemed pointless. Suffice it to say, I have checked myself into the emergency psychiatric intake at least 20-30 times in my life before being diagnosed, and about 5 times afterwards. All from suicidal intentions or half-attempts due to going crazy from either a job loss or a breakup, or the worst culprit in my life… jealousy after pushing a girlfriend away and then getting paranoid and not knowing what to do because I can’t seem to handle being together or apart. Borderline really sucks. It gets us arrested, addicted, abusive, and makes us aggressive and assholish. The one good trait I was a little disappointed to discover was attributed to my condition is that we learned very young that we can use sex to keep our relationships, and so it appears the majority of us are amazing open-minded insatiable nymphomaniac lovers. That’s been my one bread and butter, I had forgotten for decades that in my early teens I spent serious effort watching straight and lesbian porno studying them to figure out what women like the best. I guess it paid off since it works subconsciously. If I didn’t have that confidence I wouldn’t be so confident up front, and I’m sure every girlfriend in 45 years would have left me after a few weeks, but I did keep a few for years.The ones with personality disorders I assure you, but still, its an accomplishment. I drive my girlfriends CRAZY the way women drive their boyfriend crazy in college. I’m a cool macho straight dude who quickly becomes that chick with the googly eyes who writes poetry and glorifies you to the point of near suffocation. Face it, we stayed with her mostly for the sex she gave us too. Well, it works both ways dudes. All you have to be is commit to being a male slut at puberty and treat it at least fifty times more seriously than whatever subject you are most interested in at school. We also tend to talk a lot and open up much quicker, we have no boundaries since we had no respect given to our boundaries within our early families. And this posting surely is an example of that, and I hope a decent outline from a very honest borderline middle-age suffering since childhood actually-was-totally-abandoned male. I’ve noticed all of us are very outgoing and charismatic, and yet regardless of what our vocation is we are underachievers due to our lives having been continually interrupted by emotional dis-regulation and the fallout that comes from it… breakups, substance abuse, quitting jobs before we are fired so as to preempt potential abandonment by doing it first, and our tendency to spend massive amounts of money in sprees when we are feeling good. In essence spending ourselves towards another crisis. We rather get rid of the money quickly than risk saving it and hanging on.. because we know one life event it can be swallowed up in expense. We’d rather just blow it and preempt even our cash leaving us, I kid you not. We are not the type to hang onto consumables of any kind. I’m not sure there is another personality disorder that can produce the kind of confession rambling I’ve just provided here – but we should all thank god for that, shouldn’t we! One last thing! We are not narcissists, we know we have problems, but we do become haughty and impatient subconscious manipulators when we are facing any personal insult that might trigger potential abandonment fears, however false the perception, however tiny and fleeting the trigger. God dammit we just want to be loved! I read and agree at our core we are still looking for someone to love us the way we wanted our parents to have – with mutual exclusivity and excessive compassion. Apparently as I’ve discovered there is nobody who can give that mutually and that excessively without completely forgetting who they are and royally neglecting their own needs while also supremely screwing up their own lives before they realize we’ve broken up in fear and disappeared into the ether. Oh my god, what have I done!!! 🙂 BYE. If you have any questions post them in reply and .I’m sure you can guess I will certainly provide a long-winded answer, more than you’l want to know, so ask at your own risk.

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