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What's wrong with Jim Carroll?

Alrighty then… this has little to do with my subject (BPD), but I stumbled across a picture on wikipedia yesterday of Jim Carroll. I was writing a post on the ATSTP List about tough love. I will follow up here more on the tough love idea shortly, but I wanted to show how boundaries can be used in tough love, and about how those boundaries are for YOU, not for your loved one. In other words you have to enforce those boundaries for yourself. Boundaries are choices about what YOU will and will not do for/with/about your life and your loved ones. The best example of tough love that I could think of was a scene from “The Basketball Diaries” (the movie) which is based on the book by the same name by Carroll. I found the scene on YouTube here:

http://www.youtube.com/watch?v=WktborljI_o

The actual scene starts at 5:35 and be careful there are some pretty graphic things before the 5:35 mark. The scene involves Carroll’s (played by Leonardo DiCaprio) mother not giving him money for drugs. Carroll is a heroin addict at the time. It’s worth seeing just to see tough love in action. If you watch you will see that the tough love is tough on both of them and, more importantly, the mother chooses to use her boundary (“I will not give my son money for drugs”), rather than try and control HIS behavior, which many people think boundaries and tough love are all about.

Image of The Basketball Diaries
Image of Forced Entries: The Downtown Diaries: 1971-1973

Anyway, I started looking into Carroll on wikipedia and stumbled across this picture of Carroll taken last year (ok, he’s only 57 in the photo).

Jim Carroll at 57

Here is another photo taken of him in 2000 (when he was 50).

Jim Carroll in 2000

I mean, Jeez, what happened to him? Some have speculated heroin again, but it looks like meth or AIDS to me. Here’s a blog post about Carroll’s reading from last year. It’s just so sad.

Results from my latest poll

Last year, I launched a poll asking my readers how they are related to a person with BPD. The choices were:

  • Self
  • Spouse
  • Non-Spouse Partner
  • Child
  • Parent
  • Sibling or Other Relation
  • Friend
  • Ex-Partner or Ex-Spouse

I got 141 votes from 102 voters (you could choose more than one relationship if you had more than one). I have now closed that poll and wanted to present the results. I have two graphs that represent the results of that poll. One is a straight results graph:

bpd1graph.jpg

Which shows that the spouse category is the largest at about 22%. However, in the next graph I combined spouse, non-spouse partner and ex-partner (or spouse) and found the following:

bpd2graph.jpg

With 42.55% showing that the relationship is with a spouse/partner/ex. This could be explained by the fact that many children are not given the diagnosis until later in life (supposedly BPD is only diagnosiable at 18 years of age and more) and as the Time article notedthe “prime time” for BPD is in ones 20′s.

Rachel Getting Married and BPD

Anne Hathaway in Rachel Getting MarriedSo, when I read about the movie “Rachel Getting Married” I heard a lot of my wife as a young adult in the Anne Hathaway character. Here’s a review that agreed that the character is probably BPD:

The story is simple enough: two big, intelligent, loving, and interesting families gather at the big, comfy, casual Connecticut home of the bride’s dad for the wedding of a sweet daughter of one to the gorgeous and loving son of the other. Immediately, though, you know there’s trouble. Another daughter, Kym, (played by Anne Hathaway, looking the part – no glam here) is getting a weekend pass from rehab in order to attend. Aside from her substance abuse problems, Kym is a classic borderline personality (Google “borderline personality disorder” for more info on this diagnosis), addicted also to drama and crisis. She has guilt but almost no ability to resolve things in her own mind. Without trying, she creates squirmingly difficult situations. How others react to her made me squirm – it feels so familiar. Debra Winger is the mom, divorced from the good-guy dad. She is perfect – you know her. The bride-to-be is loving, patient, but you sense a simmering underneath. The script rings true. The camera work (director Demme made “Silence of the Lambs”) made my friend a little sick – there’s a lot of handheld, closeup, herky-jerky filming. Sit toward the back of the theatre and it won’t have that effect. The rehearsal dinner and the wedding go on a little too long – not unlike actual events. I loved this movie, I think the inner state of Kym is shown with burning accuracy. The music and dancing is a thrill to hear and watch. The people are real-people beautiful. It’s great that way. The competitive loading-the-dishwasher scene (not a spoiler here) reportedly really happened years ago between screenwriter Jenny Lumet’s dad Sidney Lumet and Bob Fosse, and Lumet used it in this terrific movie.

Anyone seen it? I haven’t yet.

Benzos, from ABC News

A story about stopping benzos from ABC News:

Tranquilizer Detox Withdrawal Can Last Years

FDA, Patients Say Quitting ‘Benzos’ Abruptly Can Lead to Horrific Side Effects

By LAUREN COX
ABC News Medical Unit

Dec. 1, 2008—

Americans take a lot of “benzos,” even if they don’t know exactly what “benzos” are.

In 2007, U.S. doctors wrote more than 82 million prescriptions for a type of tranquilizer called benzodiazepines, often called “benzos,” which includes Valium, Ativan, Xanax and Klonopin.

The positive effects of benzos are widely discussed in blogs, and in the media. But the much appreciated “mother’s little helper” drugs can have dangerous side effects that last for years. Some of the worst problems actually start once someone tries to stop taking them.

Negative symptoms began “probably the day after I stopped taking it [clonazepam] completely,” said Colin Moran, 41, co-founder of benzobuddies.org, an emotional support site with practical advice to help people safely stop taking benzodiazepines.

“I woke up and I thought I had a stroke,” he said. “My scalp, down the middle of my body — everywhere on the left was numb, and I could barely move on that side of the body.

“Even though I thought I had a stroke, I was in such a confused state that I didn’t even feel inclined to do anything about it,” said Moran.

Moran had taken clonazepam (a benzodiazepine often called Rivotril or Klonopin) for nearly two years before deciding to take a break. He even tried to “safely” taper off the dose over six weeks.

Finally, a friend forced him to call a neurologist, who informed him that he had not had a stroke but that he was experiencing withdrawal from the clonazepam.

The numbness was only the beginning. Moran later experienced nightmares, anxiety, night sweats and a bewildering mental fog.

Moran said he had never had such symptoms before he was prescribed clonazepam for a seizure problem, called brainstem myoclonus, which was characterized by spontaneous jerks in the body, trunk and limbs.

“Now I had to keep on this small dose, just so I could move,” he said.

Eventually Moran would join a minority of people who suffer from protracted withdrawal syndrome after stopping benzodiazepines.

“The two most dangerous drugs to detox off of are benzos and alcohol,” said Dr. Harris Stratyner, vice chairman of the National Council on Alcoholism and Drug Dependence.

“A lot of insurance companies want you in the hospital if you’re coming off of alcohol or benzos,” said Stratyner, who is also a clinical associate professor of psychiatry at the Mount Sinai School of Medicine in Manhattan, and vice president of the Caron Treatment Center in New York.

Withdrawal Can Strike At Random

Not only do benzos create a physical addiction, Stratyner said the drugs can alter how the brain processes neurotransmitters that calm a person down.

In fact, the U.S. Food and Drug Administration recommends short-term use of benzodiazepines for that very reason, warning that quitting benzodiazepines abruptly can result in more than 40 withdrawal side effects, including headache, anxiety, tension, depression, insomnia, confusion, dizziness, derealization and short-term memory loss.

However, for Moran, side effects of benzos extended to the time he was taking the drugs, as well.

Since clonazepam was the only drug available to treat his condition, Moran tried for years to take the drug, then to taper off for three months before he built up too much of a tolerance, and then to start again.

“I was a complete mess on benzos — confused, irrational and unemotional,” he said.

Two years after he started the new drugs, Moran decided to end his six-year romantic relationship.

“It just felt wrong. When I told her it was over, she told me that the medication had changed me,” said Moran. “I thought it was just a reaction to the breakup.”

But six weeks after his last dose, Moran said a he felt a flood of feelings he hadn’t felt in years.

“I think it was just normal emotions, but it had been years since I experienced them and so, I wasn’t used to coping with them,” he said.

Moran said he then realized his ex-girlfriend was right.

“I tried to repair the damage I had done to my personal life, but it was way too late,” he said.

To this day, Moran walks with a limp on his left side. He said he sees himself as an extreme case of common withdrawal symptoms.

Stratyner said 10 percent of people who quit abruptly may experience a “syndrome” of withdrawal symptoms that extend long after the drugs leave their bodies. This change can reverse, but for a small proportion of people, it can take months or years to recover.

“If you suddenly stop taking Klonopin (clonazepam) rapidly, you usually get cramping, you can have convulsions, you can have auditory hallucinations, nightmares,” said Stratytner. “It’s not unusual at all.”

But no one told that to Geraldine Burns, 53, the first time she decided to stop taking a benzo called Ativan (lorazepam).

“I never had a panic attack before I stopped taking Ativan,” said Burns, who remembers she was driving down a busy artery in Boston with her infant daughter and young son in the back seat when she suddenly felt like she couldn’t breathe.

“It was like you’re just coming out of your skin,” she said.

A psychiatrist prescribed Ativan for Burns at age 33, shortly after she gave birth to her daughter. She said she felt physically off at the time, like she weighed 1,000 pounds, but that her doctors thought it was a post-partum depression.

“I was handed Ativan in the hospital and told to go see a psychiatrist,” she said.

A year later, after receiving a prescription for Ativan, Burns said she still felt off.

“Then I read an article about how women could feel just how I felt, and it was an infection of the womb, and you don’t necessarily have to have a fever,” she said.

Burns said she called another doctor — an internist — about the article and he prescribed her antibiotics. Within five days of taking the antibiotics, Burns said she felt much better.

“So I stopped taking Ativan,” said Burns. “I didn’t know that you couldn’t just stop.”

The Danger of Going Cold Turkey

After the first panic attacks, Burns called her psychiatrist who, according to Burns, told her she shouldn’t have stopped the pills and that she needed to take Ativan “for the rest of my life.”

Burns continued to take Ativan and antidepressants for nine years; meanwhile, her anxiety and agoraphobia only increased. During that time, her body developed a tolerance for the drug, making coming off of it all the more risky.

Then, one day, at age 42, Burns went to a new gynecologist who informed her that benzodiazepines were extremely addictive. Burns decided to try and stop, then sue her psychiatrist.

“I was OK for about six months, and then I went into protracted withdrawal,” she said.

Burns experienced ringing in her ears, twitching on her face and hallucinations that bugs were crawling all over her scalp.

Ten years later, many of her symptoms have calmed down. But Burns decided she would spend her time helping others through benzosupport.org and Benzobookreview.com.

Cindy, who asked ABCNews.com not to use her last name, found help through Burns and her Web site last year. Like many people with benzo withdrawal symptoms, Cindy said the only sign that she wasn’t crazy were others on the Internet with similar symptoms.

“Three years ago, I was a very, very healthy 49-year-old,” said Cindy, of Rhode Island. “I never had a psychiatric history; I never was on any psychiatric drugs. Never on any drugs, really.”

Cindy’s gynecologist first prescribed her Valium after she hit a bout of insomnia with menopause. It worked, but eight months later, she began to feel depressed and have rashes. Cindy said her doctor told her she could quit taking the drug if she liked, so she did.

Three weeks later, Cindy said she couldn’t stand or walk without holding on to a wall, and she had inexplicable feelings of physical fear. Eventually, her two college-aged children found her unresponsive on the floor. They wrapped her up in a blanket and took her back to the gynecologist.

“I said, ‘I need to go to the hospital,’” said Cindy. “She told me to go home.”

Cindy said she has recovered slightly but is still so disoriented that she has trouble reading and writing. Eventually, she had to quit her job as a social worker.

“It took four months. I literally lost my mind,” she said.

Withdrawal Can Lead to ‘Derealization’

In addition to the fear, Cindy said she went through a “depersonalization,” where people and objects appeared unreal and untrustworthy to her, as if she was in a dream world.

“Nothing was right,” she said.

Now, Cindy said, she mistrusts doctors, and will absolutely refuse to take another drug again. Instead, she relies on emotional support from Burns while her body slowly recovers.

Burns and Moran admit their online support groups have stirred mild controversy with people’s doctors for the medical advice about tapering doses of drugs. However, they said all agree their sites can provide initial emotional support to people struggling with withdrawal.

“Don’t let the horror stories get to you,” said Burns. “We’ve got lots of people who get better.”

Alison Kellagher is one such person. She took benzodiazepines for 17 years, originally just to treat a couple of panic attacks she had in a new job.

“I went to a psychiatrist and he just immediately prescribed a Xanax, and it was to take every day,” said Kellagher. “It helped for a number of years, but as the dose got higher, the side effect of depression became stronger.”

Kellagher eventually decided to stop, and even went to a detox program to help her slowly taper off the drugs. Yet, the years had taken their toll and she experienced withdrawal.

“Then, I was in a profoundly alerted consciousness, immediately after stopping,” said Kellagher. “It was the feeling of being in terror, but it was just a physiological state of terror.”

Kellagher said she thinks she’s lucky because it only lasted several months.

“The first three months was 24-7. Then, it started to let up a little bit by three to six months. By a year, I was pretty comfortable,” she said. “I wasn’t 100 percent, but I was functioning and feeling almost normal.”

The experience motivated Kellagher, who worked in the bicycle clothing industry, to get a master’s degree for counseling. Now, she coaches people through protracted benzodiazepine withdrawal over the phone.

“People usually need some help keeping hope alive,” said Kellagher, who runs the site stoppingbenzos.com. “It’s hard not to get bogged down in depression, because it’s a long process.”

1 in 5 Young Adults Has Personality Disorder, Study Finds

A report from the AP on study:

1 in 5 Young Adults Has Personality Disorder, Study Finds

Tuesday , December 02, 2008

AP

CHICAGO  —
Almost one in five young American adults has a personality disorder that interferes with everyday life, and even more abuse alcohol or drugs, researchers reported Monday in the most extensive study of its kind.

The disorders include problems such as obsessive or compulsive tendencies and anti-social behavior that can sometimes lead to violence. The study also found that fewer than 25 percent of college-aged Americans with mental problems get treatment.

One expert said personality disorders may be overdiagnosed. But others said the results were not surprising since previous, less rigorous evidence has suggested mental problems are common on college campuses and elsewhere.

Experts praised the study’s scope — face-to-face interviews about numerous disorders with more than 5,000 young people ages 19 to 25 — and said it spotlights a problem college administrators need to address.

Study co-author Dr. Mark Olfson of Columbia University and New York State Psychiatric Institute called the widespread lack of treatment particularly worrisome. He said it should alert not only “students and parents, but also deans and people who run college mental health services about the need to extend access to treatment.”

Counting substance abuse, the study found that nearly half of young people surveyed have some sort of psychiatric condition, including students and non-students.

Personality disorders were the second most common problem behind drug or alcohol abuse as a single category. The disorders include obsessive, anti-social and paranoid behaviors that are not mere quirks but actually interfere with ordinary functioning.

The study authors noted that recent tragedies such as fatal shootings at Northern Illinois University and Virginia Tech have raised awareness about the prevalence of mental illness on college campuses.

They also suggest that this age group might be particularly vulnerable.

“For many, young adulthood is characterized by the pursuit of greater educational opportunities and employment prospects, development of personal relationships, and for some, parenthood,” the authors said. These circumstances, they said, can result in stress that triggers the start or recurrence of psychiatric problems.

The study was released Monday in Archives of General Psychiatry. It was based on interviews with 5,092 young adults in 2001 and 2002.

Olfson said it took time to analzye the data, including weighting the results to extrapolate national numbers. But the authors said the results would probably hold true today.

The study was funded with grants from the National Institutes of Health, the American Foundation for Suicide Prevention and the New York Psychiatric Institute.

Dr. Sharon Hirsch, a University of Chicago psychiatrist not involved in the study, praised it for raising awareness about the problem and the high numbers of affected people who don’t get help.

Imagine if more than 75 percent of diabetic college students didn’t get treatment, Hirsch said. “Just think about what would be happening on our college campuses.”

The results highlight the need for mental health services to be housed with other medical services on college campuses, to erase the stigma and make it more likely that people will seek help, she said.

In the study, trained interviewers, but not psychiatrists, questioned participants about symptoms. They used an assessment tool similar to criteria doctors use to diagnose mental illness.

Dr. Jerald Kay, a psychiatry professor at Wright State University and chairman of the American Psychiatric Association’s college mental health committee, said the assessment tool is considered valid and more rigorous than self-reports of mental illness. He was not involved in the study.

Personality disorders showed up in similar numbers among both students and non-students, including the most common one, obsessive compulsive personality disorder. About 8 percent of young adults in both groups had this illness, which can include an extreme preoccupation with details, rules, orderliness and perfectionism.

Kay said the prevalence of personality disorders was higher than he would expect and questioned whether the condition might be overdiagnosed.

All good students have a touch of “obsessional” personality that helps them work hard to achieve. But that’s different from an obsessional disorder that makes people inflexible and controlling and interferes with their lives, he explained.

Obsessive compulsive personality disorder differs from the better known OCD, or obsessive-compulsive disorder, which features repetitive actions such as hand-washing to avoid germs.

OCD is thought to affect about 2 percent of the general population. The study didn’t examine OCD separately but grouped it with all anxiety disorders, seen in about 12 percent of college-aged people in the survey.

The overall rate of other disorders was also pretty similar among college students and non-students.

Substance abuse, including drug addiction, alcoholism and other drinking that interferes with school or work, affected nearly one-third of those in both groups.

Slightly more college students than non-students were problem drinkers — 20 percent versus 17 percent. And slightly more non-students had drug problems — nearly 7 percent versus 5 percent.

In both groups, about 8 percent had phobias and 7 percent had depression.

Bipolar disorder was slightly more common in non-students, affecting almost 5 percent versus about 3 percent of students.

Sad, sad suicide of teen watched online

I read this article yesterday on my mobile… how horribly sad:

Fla. teen commits suicide with live Web audience

MIAMI (AP) — A college student committed suicide by taking a drug overdose in front of a live webcam as some computer users egged him on, others tried to talk him out of it, and another messaged OMG in horror when it became clear it was no joke. Some watchers contacted the Web site to notify police, but by the time officers entered Abraham Biggs’ home — a scene also captured on the Internet — it was too late.

Biggs, a 19-year-old Broward College student who suffered from what his family said was bipolar disorder, or manic depression, lay dead on his bed in his father’s Pembroke Pines house Wednesday afternoon, the camera still running 12 hours after Biggs announced his intentions online around 3 a.m.

It was unclear how many people watched it unfold.

Biggs was not the first person to commit suicide with a webcam rolling. But the drawn-out drama — and the reaction of those watching — was seen as an extreme example of young people’s penchant for sharing intimate details about themselves over the Internet.

Biggs’ family was infuriated that no one acted sooner to save him, neither the viewers nor the Web site that hosted the live video, Justin.tv. The Web site shows a video image, with a space alongside where computer users can instantly post comments.

Only when police arrived did the Web feed stop, “so that’s 12 hours of watching,” said the victim’s sister, Rosalind Bigg. “They got hits, they got viewers, nothing happened for hours.”

She added: “It didn’t have to be.”

An autopsy concluded Biggs died from a combination of opiates and benzodiazepine, which his family said was prescribed for his bipolar disorder.

Biggs announced his plans to kill himself over a Web site for bodybuilders, authorities said. But some users told investigators they did not take him seriously because he had threatened suicide on the site before.

Some members of his virtual audience encouraged him to do it, others tried to talk him out of it, and some discussed whether he was taking a dose big enough to kill himself, said Wendy Crane, an investigator with the Broward County medical examiner’s office.

A computer user who claimed to have watched said that after swallowing some pills, Biggs went to sleep and appeared to be breathing for a few hours while others cracked jokes.

Someone notified the moderator of the bodybuilding site, who traced Biggs’ location and called police, Crane said.

As police entered the room, the audience’s reaction was filled with Internet shorthand: “OMFG,” one wrote, meaning “Oh, my God.” Others, either not knowing what they were seeing, or not caring, wrote “lol,” which means “laughing out loud,” and “hahahah.”

An online video purportedly from Biggs’ webcam shows a gun-wielding officer entering a bedroom, where a man is lying on a bed, his face turned away from the camera. The officer begins to examine him, as the camera lens is covered. Authorities could not immediately verify the authenticity of the video, though it matched their description of what occurred.

Montana Miller, an assistant professor of popular culture at Bowling Green State University in Ohio, said Biggs’ very public suicide was not shocking, given the way teenagers chronicle every facet of their lives on sites like Facebook and MySpace.

“If it’s not recorded or documented then it doesn’t even seem worthwhile,” she said. “For today’s generation it might seem, `What’s the point of doing it if everyone isn’t going to see it?’”

She likened Biggs’ death to other public ways of committing suicide, like jumping off a bridge.

Crane said she knows of a case in which a Florida man shot himself in the head in front of an online audience, though she didn’t know how much viewers saw. In Britain last year, a man hanged himself while chatting online.

In a statement, Justin.tv CEO Michael Seibel said: “We regret that this has occurred and want to respect the privacy of the broadcaster and his family during this time.”

The Web site would not say how many people were watching the broadcast. The site as a whole had 672,000 unique visitors in October, according to Nielsen.

Miami lawyer William Hill said there is probably nothing that could be done legally to those who watched and did not act. As for whether the Web site could be held liable, Hill said there doesn’t seem to be much of a case for negligence.

“There could conceivably be some liability if they knew this was happening and they had some ability to intervene and didn’t take action,” said Hill, who does business litigation and has represented a number of Internet-based clients. But “I think it would be a stretch.”

Condolences poured into Biggs’ MySpace page, where the mostly unsmiling teen is seen posing in a series of pictures with various young women. On the bodybuilding Web site, Biggs used the screen name CandyJunkie. His Justin.tv alias was “feels_like_ecstacy.”

Rosalind Bigg described her brother as an outgoing person who struck up conversations with Starbucks baristas and enjoyed taking his young nieces to Chuck E. Cheese. He was health-conscious and exercised but was not a bodybuilder, she said.

“This is very, very sudden and unexpected for us,” the sister said. “It boggles the mind. We don’t understand.”

___

Associated Press Writers Jessica Gresko and Lisa Orkin Emmanuel and the AP News Research Center in New York contributed to this report.

(This version CORRECTS sister’s last name in next-to-last graf.)

BPD mentioned in defense of alleged muderer

I stumbled across this article today about the trial of a man who allegedly killed his ex-girlfriend…. I thought some of the wording was interesting. I have marked up this article to show what I found interesting about it.

Ventura murder trial opens

A Ventura woman tried break free from her killer’s grip but was stabbed more than 130 times in a deadly attack, a prosecutor told a jury today in the murder trial of 24-year-old Uriel Cruz.

Prosecutor Rebecca Day told jurors that the 2007 death of Barbarita Yvonne Luna, 25, was premeditated murder and that her alleged killer, Cruz, had been lying in wait.

“She was using her hands to push him away, but she couldn’t get out of his grasp,” Day said in her opening statement to the Ventura County Superior Court jury.

The prosecutor said Cruz and Luna were romantically involved until she broke off their relationship, and she refused his numerous requests to get back together.

Cruz is accused of stabbing Luna to death in a car in the parking lot of the Target store on Main Street in Ventura on May 11, 2007. Authorities say he drove away and was arrested later the same day by Los Angeles County sheriff’s deputies in Calabasas after his relatives urged him to turn himself in.

Today, the jury saw photographs taken by Los Angeles County deputies. One showed Cruz standing next to his car with blood on his clothes and face. Other photos showed the victim’s lifeless and bloody body, slumped in the passenger side of the car.

Cruz’s lawyer, Josie Banuelos of the county Public Defender’s Office, said he never intended to kill Luna.

In her opening statement to the jury, Banuelos said Cruz has a borderline personality disorder and a history of cutting himself to relieve his mental pain. Banuelos said he bought the knife to mutilate himself and had no intention of killing Luna.

“That knife was for him because he was going to go see Ms. Luna. He was afraid he might be hearing something he didn’t want to hear, and he could cut himself to relieve the pain,” Banuelos said.

She said every interview Cruz had with detectives indicates that he told them: “I didn’t intend to kill her. Why would I kill the woman I love?”

Day pointed out to jurors that Cruz isn’t using the insanity defense in his trial.

The Emotionally Transmitted Disease

Here is an article on CNN that caught my eye. I found it funny because, over a year ago, a friend of mine and I discussed this very topic and he urged me to write a book about it. I started, but ended up with WHINE, because I felt more comfortable talking about BPD.

Beware catching this from your spouse

  • Story Highlights
  • Studies: Emotional contagion in marriage can harm spouse with bad moods
  • Wives more likely to get hardening of arteries from hostile fights with husband
  • If your husband is in nasty mood, go for a walk and recognize it’s his mood
  • In happy marriage, one spouse’s optimism can rub off on partner

By Kathyrn Matthews

(OPRAH.com) — For better or for worse, when you get married, you sign on for a life of sharing –bedsheets, bathroom space, cold germs. Moods, too, as it turns out. And it’s becoming increasingly clear that “emotional contagion,” the unconscious tendency to mimic the emotions of others, affects spousal health.

Heart bypass patients with neurotic and anxious spouses, for instance, were much more likely to be depressed 18 months after surgery — independent of their own personality — according to one study led by John M. Ruiz, Ph.D., assistant professor of clinical psychology at Washington State University.

The findings are troubling because depression is known to put recovering cardiac patients at higher risk of further heart attacks and death.

Another study showed that hardening of the coronary arteries was more likely in wives when they — or their husbands — expressed hostility during fights.

As for how one catches a partner’s foul humor, the brain’s aptly named “mirror neurons” are to blame, says John T. Cacioppo, Ph.D., director of the Center for Cognitive and Social Neuroscience at the University of Chicago and co-author of “Emotional Contagion.”

These neurons fire in response to other people’s actions and intentions, especially when you care about the individual. So if you see that your husband is anxious or depressed, you literally feel his pain. There are, however, a few ways to prevent spousal mood infection. Oprah.com: What’s really going on in his head!

Disengage

When he makes a nasty remark and you give it right back, you’re off to the races. You can avoid getting stuck in this loop by planning how you will respond to his negativity. One option is to walk away: Take a stroll around the block, go for a bike ride. Once you’re on your own, you can see how much your partner’s mood is really affecting you. If it’s substantial, you might schedule more alone time in your relationship.

Or ask him to exercise with you or visit a therapist (see “Play as a Team”) to try to improve his mood. If you’re the problem, leaving the premises when you feel a funk coming on is also a good way to keep him — and the marriage — healthy.

Let him see the light

His doldrums could be a symptom of seasonal affective disorder — yours too. If either of you is worse in the winter, cheerier when it’s sunny, try installing bright full-spectrum lighting.

Play as a Team

Demanding that he go to a shrink is often not an effective way to motivate him to get help, Cacioppo says. Suggesting that you see a couples therapist together may prove more successful.

Keep your spirits up

People who are content in their relationships are much less vulnerable to a spouse’s neuroticism, according to Ruiz’s research. On the flip side, in a happy marriage, one partner’s optimism may rub off on the other — an actual health benefit. Did someone say optimism? The good news is, you can catch that too.

By Kathyrn Matthews from “O, The Oprah Magazine” © 2008

Malaysian Report on BPD in that country

Here the text of a report on BPD in Malaysia

Personality disorder common, says expert

2008/10/12
IPOH: Stormy relationships, intense mood swings and suicide attempts are among the experiences faced by Malaysians with borderline personality disorders (BPD). For those living or working with them, the experience is like “walking on broken glass”.

“They consume you emotionally. They want to get under your skin and into your mind,” said psychotherapist associate professor Dr Brian Ho Kong Wai at his plenary talk at the Seventh Perak Mental Health Convention yesterday.

The usual reaction was to reject a person with BPD, which only reinforced their feelings of betrayal and abandonment.

BPD was a common psychiatric disorder, he said, estimating that one or two out of every 100 Malaysians had it, and that it was more common in women.

According to Ho, Susanna Kaysen, who wrote her memoir entitled Girl, Interrupted, had BPD, while other celebrities, including Marilyn Monroe and Princess Diana, were said to have many traits indicating that they had BPD.

Besides having difficulties in maintaining close relationships, those with BPD had feelings of emptiness and engaged in risk-taking behaviour which put them in circumstances which were inherently dangerous, he said.

They might also be confused about their identity, have brief transient psychotic or disassociative episodes, experience significant disruption to their relationships and work, and be sensitive to criticism and feared rejection, he added.

Are people with BPD manipulative?

“We are all manipulative. We don’t become what we are without being manipulative.

“If you are a businessman, you will network with others. Is that being manipulative?

“Someone who is truly manipulative will not be discovered as such. We are talking about those who are faulty in the skills and ways of dealing with people.”

Ho said that problem could have been caused by childhood BPD, a common disorder from neglect or abuse, or a traumatic event which led to a person failing to mature from seeing “black and white” such as good-looking heroes and ugly villains as described in fairy tales, to accepting “grey” areas.

“Everything is clearly right or clearly wrong to them. There is no middle ground. What they perceive as good is idolised and omnipotent.

“When they find that it is gone, it is hated and rejected. There is a lot of negativity.”

He said the main treatment of BPD was not medication but building trust and negotiating with patients, helping them accept changes, identify their emotional reactions and learn new skills like being mindful and adapting.

“You have to do a little re-parenting in helping them to grow and go. Remember that some of them had traumatic childhood experiences and lacked nurturing.”

While many improve as they grow older, those who recover more quickly are those who are likeable, honest, able to see the truth about themselves, willing to try to improve themselves and seek therapy, and have a supportive group of friends and family.

ABC News Reports: Ignored Psych Patient Dies on Hospital Floor

Ignored Psych patient dies in NY hospital….

Ignored Psych Patient Dies on Hospital Floor

Video Shows Death in NYC Hospital Already Faces a Lawsuit for ‘Squalid’ Psych Care

By DAVID SCHOETZ

July 1, 2008—

Even pared down to a few minutes, the hour-long surveillance video is disturbing.

At 5:32 a.m. June 19, a woman in a hospital gown in the waiting area of the psychiatric emergency room of a New York City hospital topples first to her knees before collapsing on her face.

A full hour passes. Other people stream in and out of the waiting room, including hospital security guards. The woman writes something on the ground before going completely still. Finally, someone takes notice and alerts the staff. But by then, at 6:36 a.m., the woman is already dead.

The woman, 49-year-old Esmin Green, died on the floor of the waiting room at the Kings County Hospital Center Psychiatric Emergency Department. Her exact cause of death has not been released.

The native of Jamaica, who had been waiting for a bed when she collapsed, had been involuntarily admitted the previous day for “agitation and psychosis,” according to the City Health and Hospital Corp., which acknowledged June 20 that Green had been left unattended on the ground for an hour.

Alan Aviles, the president of the Health and Hospital Corp., had already announced that six hospital employees, including staff members who oversee patient care and security, face disciplinary action for their lack of response. Two of the employees were fired, while four unionized staff members must go through termination proceedings.

The hospital, in the Brooklyn borough of New York City, may have a much bigger problem on its hands. In May, Kings County Hospital was targeted in a federal lawsuit by three organizations that described hospital conditions as “inhumane.” Attorneys for the plaintiff released the footage of Green’s death Monday night to illustrate in brutal detail some of the allegations made in the suit.

The Mental Hygiene Legal Service, New York Civil Liberties Union and Kirland & Ellis LLP filed the lawsuit after an investigation at the hospital “showed that Kings County psychiatric facilities are overcrowded and often dangerously unsanitary and that patients — including children and the physically disabled — are routinely ignored and abused,” according to the groups’ May 3 release announcing the suit.

The groups claim that alleged mistreatment of patients at the hospital is a violation of the federal Americans With Disabilities Act as well as several New York State provisions that guarantee the delivery of mental health services in a safe and sanitary manner.

Aviles is named as one of the lead defendants in the 36-page suit, which specifically cites five patients, all with some type of disability, who allege “abusive and neglectful” treatment at Kings County.

One patient, L.D., claimed that she was laughed at when she asked to call her family and was placed in a bed with soiled sheets. Another patient, identified as J.P., said that she had to sleep sitting up in a wheelchair after she got up in the night to use the bathroom and returned to find another patient in her bed.

The New York Daily News reported that in addition to the neglect in Green’s case, staff members entered false information into her medical chart during the hour in which she lay on the ground to cover up the lack of treatment.

At 6 a.m. on the morning of her death, according to the Daily News, Green’s medical chart reportedly listed the patient as “awake, up and about, went to the bathroom.” Green had been in the same spot on the ground for more than a half-hour. At 6:08 a.m., she stopped moving, according to the footage. But her chart described her at 6:20 a.m. as “sitting quietly in the waiting room.” In reality, she may have already been dead.

Ana Marengo, a spokeswoman for the Health and Hospital Corp., would not address the exact entries in Green’s medical chart, but did say, “There appears to be some discrepancies” that have been forwarded, along with the entire case, to various New York City investigative departments.

“It is clear that some of our employees failed to act based on our compassionate standards of care,” administrators wrote in a statement last night that followed the video’s release.

Hospital administrators outlined a series of improvements already made to the Kings County psychiatric program, including the addition of staff and expanding space to cope with overcrowding. They pledged a series of improvements, including the appointment of an “interim administrator” who will report directly to Aviles, and a guarantee that patients in the psychiatric emergency unit will be checked on every 15 minutes.

In June, USA Today reported that nearly 80 percent of hospitals said that mentally ill patients sometimes wait up to four hours or more for emergency care, citing a study by the American College of Emergency Physicians that surveyed 328 emergency medical directors.

Physicians blamed the delayed care on shrinking budgets that have prompted many hospitals to either consolidate mental health services or shut them down completely. Since 2000, the number of psychiatric beds has dropped 12 percent, according to the medical organization’s statistics.