Borderline Personality Disorder -- Real disease or lazy, catch-all diagnosis?

From reading this thread, I wonder how on earth folks with BPD ever get diagnosed at all. The sense of “I’m fine, YOU are all crazy.” seems to make that rather unlikely. It also makes it so that folks like OlivesMarch4th only get internal validation for what they are dealing with.

My own Mother is crazy. We had always joked about it and one day, I got a call from my brother who said “You know that our Mom is actually crazy, right?” and it opened a door for me mentally. We so casually call folks crazy, that honestly, it didn’t register that there is actually something wrong with my Mom.

Reading these stories makes me suspect something like BPD. She has improved in some ways with age, but in others has gotten worse. The level of self-delusion is astronomical at this point. Married 3 times, and every significant or insignificant other changed her completely. Compare and contrast: self-sufficient lifestyle traveling the world on a reconditioned Chinese Junk boat vs. 6 deck shoe card counter the star of Atlantic City casinos. Wheelchair bound back pain sufferer vs. marathon runner. Diabetic vs. Frozen Yogurt junkie. NPR listening/PBS watching liberal vs. Bush/McCain/Any Republican, Fox News Fanatic Republican. Volvo owning, american car hating vs. Dream Car Chevrolet Suburban.

Just keeping up with “who she is now.” is exhausting, toss in all the other looney parts and it is a handful. I’ve read up on several disorders trying to make sense of my Mom. I guess I shouldn’t expect to have any better luck than a psychiatrist.

Oh, and OlivesMarch4th, you’ve spent your entire life trying to deal with someone that sounds extremely painful to deal with. I would like to caution you from specializing in that without a tremendous amount of inner reflection. I would think my biggest fear for you is that you were conditioned at an extremely young age to be manipulated by precisely that type of person. I would think it would be quite dangerous mentally and emotionally for you. And I would make pretty damn certain that any co-dependent tendencies I had were extraordinarily well-eradicated before I would voluntarily enter any sort of relationship with someone with BPD.

Perhaps not dealing with the BPD’s themselves, but their relatives would be where your calling would lie, especially if you are one of the few that have managed to create a semi-functional relationship with one.

And to the folks who have expressed their experiences in this thread, I thank you very much and wish the absolute best for you. It was heartbreaking to read and I hope you find peace.

Sorta OT: I wonder what the diagnosis of Caylee Anthony’s mother will turn out to be.

I’ve read about anti-social personality disorder, and recognized my daughter in that as well. It’s scary stuff.

There’s no way she’d see a doctor, because in her mind, she’s great. In fact, she even has “Yes, I am awesome - thanks for noticing!” on her Facebook page. When she has had falling-outs with friends (she’s lost many), it’s always their fault.

And again, even if I could convince her to see someone, selfishly, I’m scared to try. She has made up so many lies about things done to her, that I’m afraid our family would be damaged. She once told a teacher her father tried to strangle her (he’s a jerk, but would never hurt her; he had grabbed her shoulder hard to keep her from running in a parking lot) and once yelled “she’s not my mother - help me!” when she was being scolded in a Burger King for misbehaving by my mother. When my second child was born, it was summer, so of course she was in and out of the house all day long. No big deal, but she did keep slamming the door one day, waking the baby up, so I told her to come in and out quietly. Next thing I know, I’m getting a call from a neighbor yelling at me and telling me what a terrible mother I was and that she’s calling CPS because my daughter told her I locked her out of the house and she was so hot and thirsty. Actually, I had several neighbors threaten CPS due to her lies, as well as my brother at one point. So I’m afraid she’d lie about being abused, either physically or sexually by my husband, and that scares me to death. My girls have already been through so much due to her. If it were just my husband and me, I’d risk it, but my girls don’t need anymore drama and stress.

Hey, whether you call it Borderline or not, I think when someone is seriously that messed up it’s obvious to everyone that something is going on. The sad news is my Mom is not the most screwed up person in our family. My uncle is paranoid schizoaffective and that pretty much underscores why Mom is so afraid to get help. She was extremely close to him before his first psychotic break and unfortunately was there to see him institutionalized in the 70s. He is in terrible shape, completely inundated with paranoid delusions and visual and auditory hallucinations, and inches closer to homelessness with each passing year. Our family is universally afraid of going crazy and avoids copping to even minor mental health problems as a result.

While I would love for her to get an official diagnosis, if only so I could start finding good resources on better understanding her, I know in my heart she’s sick and that’s all that really matters.

I appreciate your concern and I think you bring up an excellent point regarding my chosen field. I have applied to four graduate schools of social work for this Fall. My statement of purpose is rather emphatically about how much I’d love to manage nonprofits, but in fact I’m already leaning toward clinical. Whatever I do it will certainly involve mental health, though if I do go the clinical route it is very likely my specialization would be in evidence-based treatment for PTSD. I am also very interested in treating trauma in immigrants. I have PTSD and I believe this insight and empathy, combined with rigorous clinical knowledge, could be very helpful to others. I think there is always a danger of getting too close emotionally, but I am a fiercely academic person and strongly committed to evidence-based treatments. My comment on treating Borderline was more of an idle speculation or curiosity. Maybe something will come of it, maybe not, though I will tell you that writing about all my conflicted feelings in this thread has definitely made it clear that I still have a lot of confusion and heartache to work out first.

Momofgirls, that is truly sad. It makes me so angry when people lie about abuse because it diminishes the truth that the rest of us struggle to speak. I got accused of lying about my stepdad’s real abuse, and that was in the face of a well-established record of being an honest, responsible kid. I can’t blame you for your fear or your anger. She sounds like a truly toxic person.

Holy shit. My crazy ex girlfriend wasn’t a psychopath at all. She had BPD.

Wish I’d known this 15 years ago.

What good would it have done you to know a different term?

Besides, “psycho” has a nice ring to it and is more understandable by the average person as meaning “batshit insane”.

Or as I thoroughly take pleasure in saying, “My ex-wife is certified by the Federal Government as being Completely Fucking Insane.” (she’s on SSDI for mental illness)

While it doesn’t explain how I allowed myself to continue to be present through some extremely crazy shit, nor does it allow me to forgive her any easier for it; it does, at the very least, explain that what I experienced was not rational, reasonable, or because of some flaw in me, deserved.

Oh, it wouldn’t have. I only realized she was crazy 14 years ago. It would have helped me to know about BPD 15 years ago when I was tryign to wreck my life by associating with her.

Disclaimer: I like all the other women I’ve ever dated and even stood for one at her wedding. Trust me, the Kate-Demon was genuinely way psycho. There was not a person in her life she did not drive away.

Just chiming in to say [[Olives]]

Can someone give (or link to) an explanation of the actual differences in behavior and thought of people with borderline personality disorder, narcissistic personality disorder, and antisocial personality disorder, e.g. how they would each respond to a given situation or something similar? They’re kind of jumbled together in my mind.

Valete,
Vox Imperatoris

[quote]
Momofgirls, being honest about what you feel can be the toughest part. And it’s so helpful to others who have similar feelings.

One word of caution to those who scoff at those who use suicide attempts as a way of manipulating and getting attention:

There is something terribly sad about a person who would resort to even a flimsey suicide attempt just to get attention. If someone is doing that,** then that person needs help.** I know that you hate to reenforce negative behavior, but if you don’t do something, that person may do serious damage to herself or himself. Suicide can be a very impulsive act. This is not the time to ignore someone’s threats.

You might consider taking that person to the emergency room and having her or him admitted to a psychiatric hospital for evaluation. (That usually takes about 3 days.) I’m not suggesting this unless the person is threatening to harm himself or someone else.

Thanks for letting your hair down on this topic.

[quote=“Zoe, post:89, topic:479327”]

I don’t know, Zoe. It may be sad, it may be terrible, it may mean the person needs help, but that doesn’t mean the other person is obliged to stand by them forever. People who make repeated suicide threats do so because they know that’s the one thing that the other person can’t ignore–it puts all the power in the threateners hand. I agree that when someone is actively threatening suicide, you can’t walk away. But the problem is, it doesn’t stop–you get through this crisis, and in a week or two there is another and another. I do think that at some point, you can walk out of their life without waiting for them to be “better”–because they likely aren’t going to get better, and if they do, it won’t be because of anything you do. And if a year later they manage to kill themselves, it’s not your fault.

ETA: I am sensitive to this because I have seen people use “if you leave me, I’ll kill myself” as a way to trap other people into miserable, abusive relationships for years.

This all sounds very much like my Aunt who used to threaten us with suicide if she didn’t get her way. I don’t think that she had a serious mental illness but she reached the edge of drama queen on a regular basis. Even though no one believed her after the 3rd or 4th time, my mother started calling 911 every time it happened. If she truly had suicidal impulses then she needed to be checked out, and if not she would quickly learn that a stay in the MHU isn’t fun. She stopped after one visit.

[quote=“Manda_JO, post:90, topic:479327”]

This is very sad, but I remember when my Aunt sat me down after my mother’s suicide attempt (I was about 15) and said, ‘‘Look, maybe it would be better for everyone if she did kill herself.’’ She didn’t mean it in a malicious way, and I almost typed the same thing here yesterday but couldn’t bring myself to do it… I’m still a little nauseated admitting that thought has crossed my mind. The suffering is very real, the cries for help very sincere, and my mother’s agony was palpable. In a way you come to wonder about it in the same way you wonder if euthanasia is the best option for someone slowly dying of a terminal illness. We didn’t want her to suffer anymore. We didn’t want to suffer anymore. I still think of her death as the moment when she will finally have peace.

I’m not at all implying support should not be available to people who are suicidal, but there comes a point when the loved ones have to let go of the responsibility for what happens and let people make their own choices. Suicide is a choice, and no person can push the blame for that on anyone else but themselves.

That said, Borderline is a real sickness and I truly believe these people deserve all of the compassion that you would give someone with anxiety or depression or any other mental illness. Boundaries must be established and in some cases people do have to sever ties, but someone out there somewhere needs to care for these people. Many Borderlines–including my mother–suffered severe and repeated trauma that contributed to the way they are today. They are suffering people who lash out at others out of pain, not malice.

It’s also worth noting between 4-10% of BPDs are successful in their suicide attempts. Anyone who would go that far in the name of attention-seeking is in true need of help.

ETA: Auto, thanks buddy. hugs you right back

Listening to all the horror these BPDs have inflicted on their families it seems to me there ought to be a bounty on them.

Seriously, I have to question why we (either the SDMB or society at large) would gladly round up a lynch mob to hunt down the man who abused young Olives in whatever way, but not the woman?

Seems to me that BPD people belong in solitary, not a hospital. And certainly not out in society.

I have no first-hand experience with people like this, so I have no personal axe to grind. But there is something very wrong with a society that would jail a burglar before they’d do the same to Olives’s Mom. Which crime is really worse?

Olives, you seem like a very fine person who’s come through a lot remarkably well. I hope you continue to thrive.

I’ll take a stab but I am not a mental health professional so I’d welcome anyone to correct me if I’m wrong.

I’m most confident about the difference between BDP and antisocial personality disorder. These would normally present very differently, though in the case of Momofgirls’ daughter it’s hard to say.

The antisocial personality’s fundamental problem is s/he is incapable of feeling empathy for other beings. There have been enough studies that indicate brain function is entirely different in these folks–they are as close to broken as you can get. They are capable of reasoning, and they know the difference between right and wrong, they just don’t care. While some anti-socials live relatively normal lives, in their extreme form you can get serial killers and rapists (Note: there is dissension among the medical community regarding whether or not anti-social and psychopathology are the same thing or separate disorders.)

A personal with anti-social personality disorder is entirely motivated by what they can gain from others, and they’ll systematically violate the trust and boundaries of others for their own personal gain without any remorse. These people are superficially very charming and often don’t give the ‘‘crazy’’ vibe at all, but once you get to know them it becomes fairly clear they are unfeeling assholes. They usually have a very high opinion of themselves, are very sociable and will charm their way into your circle of trust only to steal your jewelry when you aren’t looking. Then they’ll give you a heartfelt apology (they aren’t sorry, they just know if they apologize they’ll be able to take advantage of you again) and steal from you again when you let 'em back into your house. These are the sort of people you see on America’s Most Wanted for wooing older women and then cleaning out their bank accounts and abandoning them. At their best, they are God’s con artists. At their worst they are monstrous and inhumane people capable of horrifying acts of malice.
Now, Borderline:

What we’re talking about here is a crisis of identity. While it’s unclear what causes this, there are a high percentage of BPDs who have suffered repeated childhood trauma. As someone with Complex-PTSD I can relate the most strongly to this diagnosis because both involve feeling like the core of you, who you are, is nebulous and screwed up and hard to get a grip on. The book* Trauma and Recovery* which was mentioned earlier is actually a book about Complex-PTSD and it didn’t occur to me that it might apply to BPDs, but the emphasis in both cases is on restoring this shattered sense of self. As I mentioned before, even though I’ve never done cruel things or exhibited these kind of unreasonable behaviors, I relate a lot to my mother. (Complex-PTSD, I must note, lacks the manipulation and lies and drama and attention-seeking behavior and temper tantrums, lest you think I’m some kind of horrible person to be around. It’s a much more sympathetic disorder. ;))

With a borderline you can see the drama coming a mile away. There are bouts of depression, anxiety, and rage triggered by seemingly innocuous things. It might be helpful, and some have argued this is the case, to think of BPD as a kind of rapid-cycling form of Bipolar Disorder. BPDs cannot regulate their emotions effectively. They have very poor coping skills for dealing with their feelings. They can’t just be sad–they must be devastated . They can’t just be angry–they must be outraged. Everything is black-or-white, good-or-evil; you are a horrible person or you are the best person. They are paranoid, perceive the slightest misunderstanding as a deliberate act of malice against them and often vacillate between embracing and rejecting others. The key is that there is marked instability in interpersonal relationships. They are capable of feeling empathy, but tend to have a strong narcissism that interferes with their ability to be effective friends, parents or lovers. They drive people away not because they are such uncaring assholes but because they are so needy and so demanding and so difficult to please.

On its face, honestly, BPD looks much different to me than antisocial personality disorder. While antisocials are prone to fits of rage and mild dysphoria, they are not emotionally all across the board like this. Antisocials are smooth operators who don’t care about their relationships to others, whereas you can smell the loneliness and desperation on a BPD from a mile away. All three of these disorders are characterized by narcissism, the difference is

I don’t know a ton about NPD, but personally I think of it like a mild form of antisocial personality disorder. I think narcissists can feel empathy on some level, but not to the extent that they are able to have successful, healthy relationships. NPDs need constant validation of their awesomeness. They tend to be charming and arrogant and only keep those around who will constantly stroke their ego. They can be obsessed with what others think about them, obsessed with becoming more successful, earning more money, getting more recognition. A lot of movie stars are narcissists, though I know enough people struggling in show business to tell you that they were narcissists way before they ever got famous.

I have a friend who I am almost certain has this disorder. He’s the kind of guy who will respond to news that your grandmother is in the hospital with a story about this performance he did yesterday that everybody thought was amazing. He is his #1 fan. While he is capable of feeling others’ pain, it’s on a very superficial level, enough that I like being around him, but not enough that I would ever want to get close to him.

So I guess I would characterize it like this:

antisocial personality disorder: lack of empathy
Real World Example: Charles Manson

borderline personality disorder: lack of identity and stability
Real World Example: Marilyn Monroe (speculated)

narcissistic personality disorder: overinflated sense of self
Real World Example: Ayn Rand

Written out this way, instead of the usual laundry list of symptoms, this REALLY describes my daughter. I’ve just thought that maybe she didn’t have as bad a case of BPD as some of the other kids I’ve read about on my email list, because she’s never threatened suicide, or been violent towards us (although I did recently find out she hit one of my other daughters with a wooden spoon and broke it). Although for all I know, she’s threatened suicide to boyfriends or friends. I don’t know a lot of her friends because they don’t stay around for very long.

I’m pretty sure she has stolen from me in the past, although I can’t prove it. But many of my things went missing when she lived here, and there were several times I’d go to get money out of my wallet and think “I could’ve sworn I had more than that!” And we got many apologies from her that didn’t mean anything because she’d go right back to the same behaviors. She thinks that an apology wipes out any offenses, and thinks we’re assholes when we tell her it doesn’t work that way.

It was hard to discipline her because she didn’t care if anything was taken away. It wasn’t until she was a teenager and got a cell phone and her license that she finally showed any emotion about those things being taken away.

I really think she’s a combination of APD and BPD, if that’s possible. She’s definitely not narcissistic, at least not the part of becoming more successful and earning more money. She works as little as possible and has been fired a few times.

My husband and I finally came to the conclusion, like Manda Jo said, that we’re not obliged to deal with this forever. We can’t. We have two other kids who need us much more right now. My mother is an enabler, and is very happy in that role towards my daughter, so I know no harm will come to my daughter and that she has a place to go if it comes to that (which I think it will). I know it’s not a healthy situation, but it’s for the best at the moment.

I really wish there were a “better” example of APD than Charles Manson!

Yeah

I’ve been noting while reading these stories that the word woman follows the descriptor “bat shit insane” much more than the word man…

This may be in part because men exhibiting the same symptoms may be diagnosed differently.

Based on diagnostic statistics, borderline personality disorder is more prevalent in women than men. But antisocial personality disorder is more prevalent among men than women. Whether it’s due to biased diagnosis or an existing difference in prevalence is uncertain, but regardless there is clearly enough crazy to go around.

LSL I appreciate your kind and thoughtful observations, but my Mom is mentally ill in part because she has been deeply traumatized. She deserves psychiatric care more than jail time. For the record, I would feel the same way about her needs if she were a male. But then again I’m kind of a softy.

Please let me clarify. Billfish678 grasped the wrong end of my point and ran with it.

My issue is NOT with the maleness or femaleness of the abuser.

My point is that the kind of damage a BPD does to a child is as harmful as the kind of damage a pedophile or child-beater does to a child. Both are extremely harmful.

Yet in our present system, the latter is a throw-away-the key crime where all hope of rehabilitation is assumed not to exist. And the former is left to run in society & perhaps obtain counseling at insurance company expense. Even though it seems to me that for our current state of psychiatric medicine, BPD is as incurable as pedophilia, and certainly less curable than simple violent behavior.

That is the discrepancy I was trying to invoke. I’m sorry if somebody else got it wrapped up in gender politics.

Many (Most?) broken people in our world, including the ones who rob convenience stores, are the product of more trauma than they could absorb without breaking. Some broke easily, others absorbed a shitload of pain before they broke. But broken they are and in many/most cases we lack the tools to really repair them back to healthy.

It seems to me that we as a society make a lot of ignorant, artificial (should I say superstitious) distinctions about which sorts of brokenness deserve sympathy & which deserve punishment.

And that thought is what motivated my overall comment.

Sorry LSL if I made you look bad by association.

Like you said, a lot of these “broken” people, of either gender, do serious damage to others around them.

I just get tired of the “if its a guy he’s an asshole, throw him in the clinker, but if its a woman, she’s got issues and needs help” “imbalance” I personally percieve when it comes to these things.

Ah, I understand. You make a very interesting point, though I do want to point out that emotional abuse isn’t necessarily specific to Borderlines. Even though there is plenty of documentation that it does tremendous, lasting damage to a child, emotional abuse isn’t really a legally prosecutable crime. My Mom did smack and shove me around a bit but for the most part the actual physical abuse was minimal. It was more about creating this environment of fear. She openly acknowledges that she was trying to scare me because it was the only way she could make me behave.

One day when I was in the 12-13 age range she threatened to shoot me with my stepdad’s shotgun, I must clarify, she didn’t actually have the gun in her hands–it was in the next room. She’d been doing the usual wreaking havoc in my bedroom but I was starting to stand up for myself and her usual ‘‘throwing shit around’’ tactics weren’t working. So she screamed something along the lines of,

‘‘Do I need to go into the bedroom and get your Dad’s shotgun and come back in here and shoot you, then will you shut up?’’
Silence.
‘‘Is that what you want?’’
‘‘No.’’

I still don’t know if she had it in her to do something like that. She’d done a ton of violent things she didn’t mean to, so I figured she might really do it. I was already crying so I just shut my mouth and tried to stifle the sound and didn’t move an inch. I’m not gonna lie; I was as scared as if I’d been staring down the barrel. Everything just sort of froze in time. I didn’t move or say a word and eventually she ran out of steam and she left me alone.

It took me a long time to really get how psychologically damaging instances like that were for me. I think I’ve said to my husband a million times, ‘‘Do you think she really could have shot me? I don’t know if she really would have shot me.’’ His answer has been invariably the same: ‘‘It doesn’t matter. Her intentions don’t matter. They are irrelevant to whether or not this was a severely traumatizing experience.’’

And in therapy, I told a counselor, ‘‘Well I want to clarify that I never actually saw her destroy the couch with a butcher knife.’’ I got the same answer. Doesn’t matter.

I use these two examples for a reason. In both cases there was no actual physical harm that came to me, only the threat of physical harm. Probably the fear was heightened by the fact that I’d seen her lose control many times and go further than she intended to go on more than one occasion. She might have never said she explicitly regretted these things, but I learned to pick up on her regret anyway. She surprised herself more than once with how far she went; I’ve seen it in her eyes.

Regardless, in essence, in the eyes of the law, there is no crime. My stepfather (yeah, the one that abused me) was so unnerved by the shotgun incident that he dragged me to work one day and called social services* He didn’t tell them exactly what happened, but the general impression I got from his end of the conversation was that there would have to be several police reports to warrant an investigation and physical evidence to justify actually removing me from the home.

*I may not have understood what was going on. I thought he was filing a report but he claims he was trying to find out if he could get legal custody of me even though, at the time, he was not my legal guardian (later he adopted me.) He told me, I shudder to remember, that if I lived with him I would have to be more like a wife than a daughter. At the time and for years afterward I thought of him as my hero, my rescuer. Looking back older and wiser, it’s pretty obvious exactly what his motivations were.

What I am trying to say is, emotional abuse is indeed horrible, but it’s incredibly hard to prove and doesn’t exactly take priority in the eyes of child protective services. I guess if Stepdad had been willing to file reports and others in my family had been willing to come forward and acknowledge how bad it was, maybe, just maybe I would have been taken out of that situation. But the unfortunate thing is it is incredibly likely I would have ended up with Stepdad in some kind of alternate hell. He was already doing shit to me but he probably would have done a lot worse.

A lot of it, for me, was all psychology. For every real thing that happened I had a thousand horrible scenarios about what might happen. And I really felt that I had to hold it all together. It never ceases to amaze me how much shit there is. Every time I think I’ve scraped the bottom of the barrel, there’s something new. Thank God for the Dope helping me process this. I didn’t even realize until this moment how young I was when the shotgun/social services thing happened. I always thought I was older; I keep telling myself I was some kind of mature, reasonably objective observer doing what I had to do to hold my family together. I can’t even pretend that’s true. I was 13 years old at the most.