Borderline Personality Disorder

The first thing that I said when the psychiatrist diagnosed me this condition was, "I don't have that!".  I went on my merry way in total denial for about 4 years and then about a week ago my therapist diagnosed me with Borderline Personality Disorder and I still loudly proclaimed  "I don't have that!".  Then I started checking out BPD online and began to see myself in the words.  A personal journey back to well being had begun.  I found out that my overwhelming self disgust, my almost constant desire to die since adolescence, my need to hide and be invisible, no self worth, a pattern of uncontrolled buying and spending habits, preoccupation with my health and my stomach always hurting all traced back to the BPD.  That discover calmed the wrenching my soul suffered daily, because I knew it was BPD...not me.  Does that make any sense to you?  Well, that knowledge put me back into control of my life and emotions and my world took an immediate 180.  WOW!  I mean the sun was brighter, I could hear the birds chirping outside my window, I was even humming. I was still broke, but I could see the light shining brightly ahead.  I had hope and that was something I hadn't had in a very long time.  It is nothing short of miraclous.  I pray that the information helps enlighten other souls out there living in a colorless universe.  That is my prayer.

First of all, I wanted to know what BPD was, so I went to the most trusted book in psychiatry, the Diagnostic and Statistical Manuel of Mental Disorders(DSMMD).  There are actually 3 more types of personality disorder which are a Cluster B condition, with BPD noted as dramatic-erratic.  There is emotional dysregulation, narcissictic, histronic and anti-social personality disorder. The disorder dates back to the 17th century, but it was Otto Kernberg who first formulated the theory as a failure to develop a sense of self in childhood.  Adolf Stern, in 1938, described the condition as being between pychosis and neurosis(I wondered where that borderline came in).  The large number of women being diagnosised with Borderline Personality Disorder have found it carries a stigma and discrimation because of it's name.  Current thinking does not agree with the disorder being classified as between pyschosis and neurosis and with the stigma attached to the name, have requested this disorder be renamed.  Dr. Leland M. Heller has recommended the name "Dyslimbia", meaning the dysfunction of the limbic system as he believes that BPD is exactly that.

One of the most prevalent causes, according to the DSMMH, is childhood trauma, including neglect, separation and abuse (whether it was sexual, verbal and/or physical).   The family appears to play a central role in the developement of BPD.  If the child was treated with negativity and indifference and lacking supportive or empathic responses from the care-giver, it is highly probable that they will grow up with BPD.  There are also a rather diverse list of other causes ranging from genetic predisposition (possibly inherited), neurobiological factors, neurological factors and of course, environmental factors.

Dr. Heller, states flatly in his book, "Recovering From BPD", "BPD is a medical problem, likely a form of epilepsy (brain cells firing inappropriately and out of control)...While other neropsychiatric disorders involve malfunction of the limbic system, the limbic system disfunction is profound in BPD."

Statistically, only 1-3% of adults in America today have Borderline Personality Disorder, but of that percentage, 75% are female.  The highest percentage is 3.1% of young women who are diagnosised with BPD, today.  This disorder accounts for 20% of the psychiatric hospitalizations. 

As far as therapy, psychotherapy isn't considered very effective, but does offer a certain amount of improvement.  The psychotherapy can range from serval months to more likely, several years.  Therapy is most often, one on one, but group therapy encourages interpersonal developement.  Psychotherapy, unfortunately has a very high drop out rate.  I can certainly understand that as I have dropped out of therapy every time I have started, but this time I know it is part of the condition and that might give me more incentive to stick it out.

The most effective of the psychotherapies is Schema as it focuses on deeper seated emotions, personality and fundamental ways of catergorizing & reacting to their world.  50% of patients on Schema Psychotherapy had a full recovery in 4 years and 2/3 showed a significate improvement.  I can handle 4 years having lived a lifetime with BPD.

Medications are not usually prescribed for individuals with this psyco-social condition, unless it is combined with symptoms such as anxiety and depression according to the DSMMH.  Anti-depressants called Selective Serotionin Reuptake Inhibitors or SSRI in higher than normal doses show improvement, but not in the typical 3-6 weeks, but instead in about 3 months.  Anti-psychotics are used when the patient displays symptoms like distorted thinking or false perceptions.  The problem with anti-psychotics is there are so many side effects, including considerable weight gain and the associated health problems that come along with it.  The DSMMH advised the most effective therapy is a combination of Schema psychotherapy and an SSRI, such as Olanzapine for one.

Dr. Heller was clear when he said that BPD should be treated with SSRI, specifically Prozac for severe depression.  An anti-psychotic for the Generalized Axiety Disorder(GAD), the most effective has been Risperdal  and Ritalin for ADD.  He further claims that according to his studies, BPD, is frequently accompanied by severe depression, GAD (and number of others disorder in this category) and ADD, as well.  He further claims that as this condition is purely medical, a full recovery to normalcy can be expected.  HOORAY!!  Sorry about that, got a little carried away there.

While I feel that the DSMMH has provided me with a sturdy foundation of information on BPD, it was Dr. Heller who gave me hope.  This is just one BPD victims opinion, but I suspect that the two schools of thought will meat neatly in the middle, when they discover that prolonged childhood abuse causes limpid disfunction. 

I am very pleased to have these new insights under my belt and may even help in my own recovery.  After all, no one, not a therapist nor a psychiatrist, no one knows you better than you know yourself.  I sincerely hope this information may guide even just one person onto the path of wellness.  Full recovery is waiting for you and me and it may be the first time in our lives we will have ever known what normalcy feels like.  Normalcy... just image!