For many, getting the diagnosis of Borderline Personality Disorder (BPD) comes as a relief. Finally, something to explain the mood swings, constant fear of abandonment, and relationship challenges. For others, it becomes an obstacle to treatment. Understandably, working with someone with BPD can be quite challenging, and often therapists allow only a few in their caseload. But new treatment approaches and an improved understanding of the disorder are giving sufferers and family members hope.
According to National Education Alliance: Borderline Personality Disorder, 14 million adults are struggling with BPD. Traits or symptoms include:
Intense fear of abandonment
A pattern of unstable and intense relationships
Recurrent suicidal behavior or non-suicidal self-injury
Invalidating our feelings is like throwing petrol onto an already fierce raging fire.
Bon: I think the same could be said of emotionally dysregulated moments with loved ones…
Borderline Personality Disorder: Open Letter to Emergency Department and Hospital Based Staff
By SONIA NEALE
~ 4 min read
People with a diagnosis of BPD are often accused of manipulation and splitting in psychiatric settings. A quick Google search reveals that manipulation is the action of manipulating someone in a clever or unscrupulous way, the skilful handling, controlling or using of something or someone, to manage or influence skilfully, especially in an unfair manner, to manipulate people’s feelings. I have never felt skilful, clever, influential or in control in an emergency department or hospital setting yet I have been accused of manipulation and splitting.
What I do feel is shame, shame, shame and more shame, along with confusion and fear. I feel physically sick and unsafe. My body is burning internally. Shame causes the amygdala in our brain to produce a cocktail of poisonous chemicals. We are burning from the inside out. Invalidating our feelings is like throwing petrol onto an already fierce raging fire.
Imagine a grizzly bear bounding into emergency and bailing you up against a wall and someone in charge expects, no demands, that you sing “The Star-Spangled Banner.” How many of you would be able to do that with adrenaline and cortisol screaming around your brain and body?
In BPD, the most typical suicidal behavior is an overdose of pills, occurring in an interpersonal context. These overdoses usually carry a message—sometimes for a lover and sometimes for a therapist. Patients with BPD also tend to cut their wrists repetitively, and/or carry out other actions to hurt themselves.
Managing Suicidality in Patients With Borderline Personality Disorder
July 01, 2006
By Joel Paris, MD
Suicidality is a defining feature of borderline personality disorder (BPD). It is also the feature that creates the most anxiety among those who treat patients with this disorder. It is rare to find patients with BPD who have never shown any suicidal behavior. As described in criterion 5 in DSM-IV-TR,1 these patients are characterized by “recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.” Suicidal ideas and threats are ubiquitous, and most patients make multiple suicide attempts.2 Suicidality in patients with BPD is chronic and can continue for extended periods (months to years).3,4 This feature helps distinguish patients with BPD from those with classic mood disorders, who are suicidal only when acutely depressed. While BPD often begins with repetitive suicide attempts starting in adolescence and continuing into young adulthood, these behaviors tend to remit over time.5,6 Suicidal thoughts vary in intensity over time, waxing when life is stressful and waning when it is not.7
Suicidality in patients with BPD is associated with traits of affective instability. 8-10 Instead of continuous depression or mania, lasting for weeks to months, the rapid mood swings of BPD occur in response to life events.11 The unique quality of these symptoms is shown by the failure of mood in BPD to respond consistently to antidepressants.12-14 Suicidal actions are also associated with impulsive personality traits.3 Soloff and associates2 reported a mean of 3 lifetime attempts in patients with BPD, and the frequency of attempts was related to levels of impulsivity.2,15 Continue reading Managing Suicidality in Patients With Borderline Personality Disorder →
My 22-year old daughter, diagnosed with bipolar disorder and borderline personality disorder, has refused treatment for four years. She self-medicates with marijuana, methamphetamine, and alcohol. Occasionally, she gets caught using or possessing drugs and is thrown in a county jail.
Punishing people for mental illness is a return to the Dark Ages
By Rachel Pruchno
POSTED: 01/17/2015 05:00:00 PM MST
This week, jury selection will begin in Aurora in the case of James Holmes. Central to the case is whether people with serious mental illness should be treated or punished.
Robert and Arlene Holmes acknowledge that some people view their son James as a monster. Certainly the rampage on July 20, 2012, that killed 12 people and injured 70 during the premier showing of “The Dark Knight Rises” in an Aurora movie theater was a monstrous act. But James is not a monster. He is a man who was suffering from untreated serious mental illness.
Holmes has pleaded not guilty by reason of insanity. He doesn’t deny he was the shooter, but he and his attorneys claim he had been experiencing a psychotic episode. Now a sentencing trial will decide whether to execute him or imprison him for life.
The course discusses the clinical treatment of these illnesses and teaches the knowledge and skills that family members need to cope more effectively as caregivers.
National Alliance on Mental Illness offers Family to Family education program
By Hunterdon County Democrat
on January 16, 2015 at 2:24 PM, updated January 16, 2015 at 2:28 PM
NAMI, the National Alliance on Mental Illness, Family to Family Education Program is a 12-week course for anyone with an adult (over 18 years) family member or close friend with a mental illness (brain disorder). The course is taught by trained NAMI family members. All course materials are furnished at no cost.
The curriculum focuses on Schizophrenia, Major Depression, Mania, Schizoaffective Disorder, Mood Disorders, Borderline Personality Disorder, Anxiety Disorders, Bipolar Disorder, Obsessive-Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD).
An estimated 80 percent of borderline patients attempt suicide, with an average of three attempts per person According to most statistics, about 10 percent succeed, making BPD one of the most lethal existing psychiatric illnesses.
How Patient Suicide Affects Psychiatrists
Mental-health practitioners whose clients kill themselves can face stigma from their colleagues, lawsuits, and a toll on their own psyches—making them less likely to take on suicidal patients who need their help.
SULOME ANDERSONJAN 20 2015, 7:10 AM ET
It’s hard to listen to a psychiatrist who sounds so broken. I expect a mental-health provider to seem healthy, detached. But even over the phone, the weariness in Dr. Brown’s voice is palpable.
“This is what we do when people die,” he says. “Even if they die an expected death, it seems to be human nature to go back over [it]. What should I have said that I didn’t, or shouldn’t have said that I did? Could I have done more or did I do too much? This seems to be a part of the grieving process. I think it’s especially intense in a situation where you have direct responsibility for helping the person get better.”