Aren’t DSM symptoms listed in order of prominence? I.e., someone with borderline personality would be more likely to display the first three or four symptoms, with the last 5-9 symptoms being ancillary.
Perhaps it will help if I describe my experiences with my last girlfriend, who suffered severe BPD on top of Bipolar Disorder. She certainly exhibited a number of the listed symptoms.
1) Frantic efforts to avoid real or imagined abandonment.
2) A pattern of unstable and intense personal relationships characterized by by alternating extremes of idealization and devaluation.
These two symptoms are closely related, in that the first symptom exacerbates the second. A BPD sufferer, like my ex-girlfriend, is so afraid of being abandoned that she will actively try to drive away the person she fears will abandon her. In other words, she will attempt to be the “dumper” rather than face the possibility of being the “dumpee”. I dated this girl for a little more than six months, and in that time we probably “broke up” and “reconciled” at least twenty times. She would become angry for one reason or another and inform me that she never wanted to talk to me again; the next day she was sorry and begging me to come back. I would always accept her apology and take her back. Yeah, my mistake, I know. I did it in a misguided attempt to be consistent with how I related to her. It took me far too long to realize the futility of that.
This behavior applies not just to romantic relationships - family members are targets as well. I had the “benefit” of getting to listen to her end of phone conversations with her father. She would go from talking to him as if her was the most wonderful father any girl could ever have, to screaming accusations of molestation. Sometimes she didn’t accuse him directly of molestation, but rather that somebody else had molested her and he didn’t do anything about it.
3) Identity disturbance; unstable self-image/sense of self
She had the uncanny ability to instantly come up with the worst possible interpretation of anything I said. Perfectly innocent, innocuous comments became scathing insults in her mind. I think this was related to her own conflicted self-image. Publicly, she was friendly and outgoing, chatting cheerfully with anybody and behaving as if she was the prettiest girl in the room. In reality, she was overweight and somewhat unkempt, and not especially pretty. But she was one of those women who somehow overcomes far-less-than-ideal physical appearance and manages to be sexy. Her public personality and the sexiness she managed to exude are what attracted me in the first place. But privately I guess she knew her flaws and must have spent a lot of time thinking about them, because I could make a comment about something (usually something that had nothing at all to do with her) and suddenly I was “being mean” to her. For example, let’s say I was with her, and I needed to leave to attend some pre-planned activity with male friends:
Me: Well, I’d better get going - I’m supposed to meet the guys…
She: Oh, so you don’t want to be seen with me, huh?
Me: … ?
4) Impulsivity in at least 2 areas that are self damaging.
While displaying none of the common signs of addiction, she would drink any alcohol or take any drug somebody put in front of her.
Promiscuity. She would have sex with just about anybody, male or female, who asked her. And then confess to me afterward (and on one occasion via telephone during.) And then get angry with me for not getting visibly angry myself.
One time, after telling me to “leave, go away, I don’t want to talk to you anymore” she apparently had a change of heart and came running after me topless. In broad daylight. In an apartment parking lot where several young children were playing.
5) Recurrent suicidal or self mutilating behavior.
She attempted suicide a couple years before I met her. According to her, she enjoyed her stay in the mental hospital so much that, shortly after she was released she chased somebody with a knife in an attempt to get sent back in.
8) Inappropriate, intense anger or difficulty controlling anger.
All I will say about this is that I hope to never again have to deal with a woman who can go from being the Sweetest Thing I’ve Ever Met to Raging Spawn of Satan in less than three seconds. For no reason. Every day. And, of course, I never knew where one of these blowups was going to take place.
Early in the relationship, before I understood the nature of BPD, I made the mistake of telling her about some of my somewhat kinky sexual fantasies. She started inserting subtle hints about the things I had told her into her angry tirades, in front of other people. Without coming right out and saying it, she managed to make it clear that she would be more than happy to show up at my church in the middle of the sermon, to announce my private business to the congregation. Or to my neighbors. Or my mom. That’s one big reason why it took me so long to extricate myself from the relationship. I had to be very, very careful with her. Fear sucks 
Since fleeing the state wasn’t an option, I adopted a policy of non-reaction. I just let everything she said roll off my back, and kept my behavior toward her the same no matter what. That seemed to do the trick. Eventually she gave up trying to get a reaction from me. She finally “dumped” me for real, and I let her have that satisfaction.
There was one very weird last phone call, though, about a month later.
She: If I get pregnant with some guy, will you be the father figure?
Me: Um, no…
She: Oh. Well, thanks. Bye!
Well, I have most* of those symptoms, but I don’t act anything like Phase42 describes. I’m not crazy after all! Phew.
[sub]*Not #5, thank goodness.[/sub]
That’s the thing. It is pathological.
Maybe you don’t understand because you haven’t lived with someone who has 3 inch scars every 1/4 of an inch up her arms to her biceps. Who drinks to oblivion every night. Who had 5 children because it brought her attention for just a little while, then neglected them for the rest of their life.
My mother tried to kill me. Or does everyone’s mother do that?
If you take an Abnormal Psych class in college, the professor will usually warn the class it will seem like you have half the disorders covered just from reading the symptoms. Real psych cases are a lot different from what most people imagine. I am bipolar and could write a book about the stuff that I did during manic episodes. It was really extreme and scary to a whole lot of people including myself. Sleeping 18 hours a day during depressive episodes didn’t do me any good either. That is not nearly the same as the normal mood swings that everyone has. Luckily, Bipolar disorder is easily treated and things are fine now.
I was committed to a psych ward about 10 times before I was effectively treated. It is interesting because you can see people with all kinds of disorders and it looks like a movie except no one is acting. I could usually tell someone’s diagnosis just by talking with them for a few minutes. When you get to see these disorders first hand, it becomes obvious how real they are and how pronounced the symptoms are. Most people don’t get to see that so they read the symptoms of these disorders according to their own frame of reference which is much different,
Cite?
Women and Borderline Personality Disorder is a book written by a feminist psychologist who says that many cases of BPD are the result of women trying to come to terms with “conflicting social expectations.” Here is a review of the book that delineates the author’s points. I’ve not read it, but it doesn’t sound like some kind of anti-psychiatry hack job.
Just because a diagnosis is right in one case, doesn’t mean it’s right in other cases. And when you’re dealing with a personality disorder which has symptoms that could apply to a broader base of people, there are going to be a lot more “false positives” than there would be in, say, a disease like schizophrenia.
:rolleyes:
If you can’t see the difference between “I feel sad/empty/angry sometimes” and a mental disorder from what others have said in this thread, then you never will.
Do you not believe people have been diagnosed in the past for non-pathological behavior that bears only a passing resemblance to true BPD? I’m not saying these symptoms can’t reach pathological levels; I’m just saying that it’s easy to misdiagnose mental disorders and that’s especially true when it comes to personality disorders, whose criteria for diagnosis are often fuzzy.
Of course there have been misdiagnoses. But that’s not what you’re saying.
“Personally, it sounds like a made-up diagnosis to me. I think I’d have a really hard time finding people who didn’t manifest two or three of those symptoms.”
That doesn’t mean they have BPD at all.
QtM:
“But we are talking precisely that, a pathological degree. Which means the person must have at least 5 of those traits to the extent that the behaviors persist despite significant recurrent negative consequences from said behaviors.”
Which is the significant point you seem to be missing. It’s not easy to misdiagnose if you’re a trained professional.
My apologies for mixing up borderline with bipolar. Must’ve been that B at the beginning.
Then again, you might have replied along the lines of, “I think you have borderline confused with bipolar,” instead of going all :rolleyes: as you did.
For those familiar with Lois McMaster Bujold’s works, Tien Vorsoisson in Komarr had BPD, although it was never mentioned in the book.
I’m sorry if I seemed rude. For what it’s worth, it seemed rude of you to try to correct me on something you didn’t know anything about.
I’d throw in 7, based on the scene where Close sits in her apartment in a seemingly catatonic state flicking a lamp on and off, apparantly for hours.
I have been diagnosed with BPD. It’s rarely an exclusive diagnosis, there are normally other mental problems present. In my case “Pure O” OCD and Dysthymia.
(All diagnosed by professionals, no self-diagnosis)
This site offers a good break down on the DSM criteria. (not the best site in the world to navigate, but scroll down a bit)
BPD is difficult to treat, but not untreatable, the main problem is that due to the nature of BPD it requires a lot of intensive therapy from someone who fully understands the disease, and there just arent enough resourses available. It can take years of regualr sessions to get anywhere, and although the sufferer may never be completely “cured” they learn better ways of coping, and people around them can learn better ways of coping with them. So, yes, the recovery rate is low but it’s not non-existant.
A very positive, if a little grueling book is “Get Me Out of Here” by Rachael Reiland.
Obviously I can’t speak for other BPs, but I frequently have delusional episodes where I am unable to connect to reality.
For example, a common one is, say typing on a message board, I am unable to reassure myself that I’m not actually typing strings of random characters. Most of the time it’s just a fleeting thought and I’m able to keep my hold on reality, but occasionally it’ll escalate beyond all proportions and I start getting very frightened and paranoid and it can be difficult to ground myself again.
Of course, everyone has moments of feeling that. The difference is (generalisation warning) most people have reasons for feeling like that, and they follow the normal patterns of those feelings.
In my case, I can go from being irrationally angry at literally nothing to within a matter of seconds hyperactive to suddenly in the depths of depression. All apparently caused by nothing, all extremes, and all within the space of 10 minutes.
It confuses the crap out of me.
heh, but if you’re lucky enough to catch the swing when you’re on my “pedestal” you wont find anyone in the world that could be nicer or do more things for you. 
Phase42 a lot of what you’ve describes about your ex, I can relate to in myself, to greater or lesser degrees, but if I can just take this one as an example:
I find it very difficult to actually know who or what I am, or what my self image should be. See the point above about switching between different mood states. When you cycle through feelings, desires and opinions that quickly it’s very hard to try and work out which bits are you and which bits are the disease (well, it’s all me, I just can’t mesh it all in my mind, “splitting”).
For example, I don’t know whether I consider myself ugly or attractive (there is no inbetween), so how am I supposed to work out what other people think of me, or if the comment they made is a compliment or sarcasm?
I’ll have a look at that, sounds interesting, cheers.
If people are interested I can try to give some examples about how the DSM criteria manifests in myself (I’ve given a couple of bits already I know), but obviously my responses will be different to any other BP. I’m sure there’s a few of us here.
My oldest daughter, now 18, is diagnosed BPD. We finally had to kick her out of the house, because she was bent on destroying not only herself, but the rest of the family, too. She manifested at least seven of the nine symptoms, regularly, pathologically, and frequently. She’s an alcoholic and drug addict; she’s been hospitalized three times for suicide attempts, and at least three more times for suicidal ideations. She cuts herself regularly, and if you take away all her sharp stuff, she’ll cut herself with her thumbnail. She’s bipolar, too. All available help has been offered to her, but she rejects it all. The professionals, in any capacity, are apparently only out to “attack her”. She has been on effective medications, but won’t take them consistently.
The thing is, the attitude that’s shown in this thread (“yeah, but everybody’s like that sometimes”) was really hard on me before she was diagnosed. I would try to tell people how it was to live with her, and they’d all say “Well, you know teenagers; they’re all like that” and I’d try to explain how extreme it all was with her, and they’d pat me condescendingly on the head and their eyes would glaze over. . .
It was scary when she was diagnosed (finally), but a little bit comforting, too, because it carried with it the message that, no, all teenagers are not like that. For the naysayers, I guess it’s one of those things you have to experience to believe, but I hope you never have to experience it. I’d just as soon you went on being naive.
Thanks for sharing that, Tinuviel! It sounds like you have some insight into your situation, and that’s a real plus. Best of luck, Nightingale.
Luhtiénëo I Melda!
For about the first sixteen years of my life I just assumed that this was standard maternal behavior. :eek:
The problem with “personality disorders” and in large measure, mental health diagnoses, is that they are based upon a medical-type diagnosic criteria, which contains the underlying assumption of a disease pathology and subsequent standard program of treatment or cure. This would be fine if all “mental illnesses” had identical root causes and effects, but baring those which have a specific neurophysical origin (like some forms of bipolar, autism, OCD, et cetera), most neuroses and psychoses have developmental progression that is unique to each person. The result is that in order to fit them into some kind of system for insurance and treatment purposes a set of standard, if rather vague and highly subjective, Chinese restaurant menu of critiera are laid out with some basic guidelines as to how many and to what extent of pervasion establishes a genuine pathology. This is why self-diagnosis is strongly discouraged, and any therapist who is too fixated on pathology rather than actual treatment is to be avoided. The established pathologies in, say, the DSM, are better used as a way of initially focusing in on the behaviors that are most troubling and then trying to establish root historical causes, than as symptoms to be “cured” or suppressed.
It’s a crappy system, but it’s the best we have. Until someone figures out a way to diagnosis and treat neurosis and psychosis by direct neurological manipulation (say, replacing the memories of abuse with false memories of a good childhood, or instilling a permanent positive attitude in the client) we’ll continue to stumble about with the crude, pseudoscientific approaches to “mental health”.
Someone with Borderline Personality Disorder is “batshit crazy” in the way that someone with Tourette’s Syndrome is “fucking annoying” or someone with ADD is “a lazy son of a bitch”. Yeah, the behavior is malefactious, but the motive behind it is compulsive, not calculated. That doesn’t make it any easier to cope with (or indeed, much easier to treat), but equating the behavior with a lack of moral fortitude or an embedded sense of depravity doesn’t help, either. You can reserve those armchair diagnoses for the Jeffrey Dahmers and Dennis Raders of the world.
Stranger
norinew, your daughter sounds a lot like my ex, who was also bipolar on top of BPD.
I forgot to mention in my previous post this interesting bit: Her father and I have the same first name, and my profession is the same as her father’s was when she was growing up. When I finally got to meet her dad, I discovered that we were almost identical in personality, too. Hmmmm…
Aye, luckily, it’s taken a long time and a lot of help from professionals, but mostly from friends. Although that probably means I’m not your average BP (thankfully!)
Hantale 