Coming Out Of The Mental Illness Closet
Mostly I'm really OUT already & have been for years, but I rarely if ever talk about the main diagnosis I've had since I first went into therapy at age 12. BPD & Panic Disorder are the two diagnoses all of the therapists, psychiatrists & psychologists have agreed on since then. They're the ones I, after doing the reading, have also agreed with. I've been slapped with other diagnoses that I've just laughed off, such as Manic Depression (not even close), that never stuck beyond that one mental health worker. I don't talk about Borderline Personality Disorder because I've always found it much easier to deal with the stigma of depression & anxiety over that of a "personality disorder." There's just so much I can deal with in a public sphere, you know? I guess I feel like it's pretty appropriate to finally fully come out with this. No excuses, it just is.
From the National Institute of Mental Health website:
"Borderline personality disorder (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the 'borderline' of psychosis, people with BPD suffer from a disorder of emotion regulation. While less well known than schizophrenia or bipolar disorder (manic-depressive illness), BPD is more common, affecting 2 percent of adults, mostly young women. There is a high rate of self-injury without suicide intent, as well as a significant rate of suicide attempts and completed suicide in severe cases. Patients often need extensive mental health services, and account for 20 percent of psychiatric hospitalizations. Yet, with help, many improve over time and are eventually able to lead productive lives.
Symptoms
While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression, and anxiety that may last only hours, or at most a day. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse. Distortions in cognition and sense of self can lead to frequent changes in long-term goals, career plans, jobs, friendships, gender identity, and values. Sometimes people with BPD view themselves as fundamentally bad, or unworthy. They may feel unfairly misunderstood or mistreated, bored, empty, and have little idea who they are. Such symptoms are most acute when people with BPD feel isolated and lacking in social support, and may result in frantic efforts to avoid being alone.
People with BPD often have highly unstable patterns of social relationships. While they can develop intense but stormy attachments, their attitudes towards family, friends, and loved ones may suddenly shift from idealization (great admiration and love) to devaluation (intense anger and dislike). Thus, they may form an immediate attachment and idealize the other person, but when a slight separation or conflict occurs, they switch unexpectedly to the other extreme and angrily accuse the other person of not caring for them at all. Even with family members, individuals with BPD are highly sensitive to rejection, reacting with anger and distress to such mild separations as a vacation, a business trip, or a sudden change in plans. These fears of abandonment seem to be related to difficulties feeling emotionally connected to important persons when they are physically absent, leaving the individual with BPD feeling lost and perhaps worthless. Suicide threats and attempts may occur along with anger at perceived abandonment and disappointments.
People with BPD exhibit other impulsive behaviors, such as excessive spending, binge eating and risky sex. BPD often occurs together with other psychiatric problems, particularly bipolar disorder, depression, anxiety disorders, substance abuse, and other personality disorders.
Treatment
Treatments for BPD have improved in recent years. Group and individual psychotherapy are at least partially effective for many patients. Within the past 15 years, a new psychosocial treatment termed dialectical behavior therapy (DBT) was developed specifically to treat BPD, and this technique has looked promising in treatment studies. Pharmacological treatments are often prescribed based on specific target symptoms shown by the individual patient. Antidepressant drugs and mood stabilizers may be helpful for depressed and/or labile mood. Antipsychotic drugs may also be used when there are distortions in thinking.
Recent Research Findings
Although the cause of BPD is unknown, both environmental and genetic
factors are thought to play a role in predisposing patients to BPD
symptoms and traits. Studies show that many, but not all individuals
with BPD report a history of abuse, neglect, or separation as young
children. Forty to 71 percent of BPD patients report having been sexually abused, usually by a non-caregiver.
Researchers believe that BPD results from a combination of individual
vulnerability to environmental stress, neglect or abuse as young
children, and a series of events that trigger the onset of the disorder
as young adults. Adults with BPD are also considerably more likely to
be the victim of violence, including rape and other crimes. This may
result from both harmful environments as well as impulsivity and poor
judgement in choosing partners and lifestyles."
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