Wednesday, June 18, 2008

Can it be Borderline Personality if There is No Cutting or Substance Abuse?

Borderline Personality Disorder (BPD) is widely associated with self harming, suicidal ideation, substance abuse, and difficulty holding employment or staying in school. However there are many people with clinical BPD or BPD traits that are not self destructive and are very productive in school and the workplace. The later are often missed by family or physicians as having BPD traits - but are seen as difficult or "characterless" people. When this happens, the family and clinical responses can exacerbate the problems rather than help.

To support a difficult loved one and to make appropriate family decisions it is important to understand what is affecting your family member - are they mentally ill or are they just troubled? BPDFamily.com is a support group for family and friends to explore issues like this.

20 percent of all psychiatric inpatients have BPD, as do 10 percent of all mental health outpatients according to the American Psychiatric Association.  Their characteristics of low functioning borderlines include:

1. They acknowledge they have some behavior problems (not necessarily BPD, however)

2. They cope with pain through self-destructive behavior, such as self-injury and actions that put them in harm’s way. The term for this is “acting in”

3. They (often desperately) seek help from the mental health system. Some are hospitalized for their own safety. They may often become very attached to their professional caregivers

4. They have a difficult time with daily functioning and may even be disabled. This is called “low functioning”

5. If they have overlapping (“comorbid) other disorders, they tend to be the kind that require intensive professional treatment, such as Bipolar, Clinical Depression, or an Eating Disorder

6. Family members’ greatest challenges are keeping their loved one alive and functioning. Other concerns might be their inability to, earn their own living and adequately parent their child.

In a discussion on BPDFamily.com, Randi Kreger, co-author of Stop Walking on Eggshells, says the situation with high functioning borderlines will look more like this:

"1. Denial is their primary characteristic. They disavow having any problems and see no need to change. Relationship difficulties, they say, are everyone else’s fault. If family members suggests they may have BPD, they almost always accuse the other person of having it instead. (This is why I strongly advise non-BPs to leave this disclosure to a trained professional)

2. They cope with their pain by raging outward, blaming and accusing family members for real or imagined problems (“acting out”)

3. They refuse to seek help from the mental health system unless someone threatens to end the relationship. If they do go, they usually don’t intend to work on their own issues. In couples therapy, their goal is often to convince the therapist that they are being victimized

4. They may hide their low self-esteem behind a brash, confident pose that hides their inner turmoil. They usually function quite well at work and only display aggressive behavior toward those close to them (high functioning). But the black hole in the gut and their intense self-loathing are still there. It’s just buried deeper

5. If they also have other mental disorders, they’re ones that also allow for high functioning such as Narcissistic Personality Disorder (NPD) or Antisocial Personality Disorder (APD). (These mostly appear concurrently in men—especially APD)

6. Family members’ greatest challenges include coping with verbal abuse, protecting children, trying to get their family member to seel treatment, and maintaining their self-esteem and sense of reality. Partners, especially, are in relationships with Cluster Two BPs. "




xxxx#.com BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of nearly 75,000 volunteer members and alumni formed in 1998. We welcome you to join our free 24 hour on-line support community with its nearly 3 million postings and grow with us as we learn to live better lives in the shadow of this disorder. For more information or to register, please click here. www.bpdfamily.com

9 comments:

  1. i love the easy access to this info is this new or i just never seen it before

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  2. Hi anonymous.. Thanks for noticing us! We just started this blog in June to bring the highlights of bpdfamily.com to more people.

    I'm glad you like it.

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  3. BPD, BPI, post-traumatic stress disorder, psychotic, autoimmune diseases (ETC.) Hard to deal with it all. Suppposedly, I am high-functioning BPD. I just want to run away and hide and never come out.

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  4. I have a business partner who almost certainly is a High Functioning BP. All the symptoms precursors, indicate this, and having visited a psychologist as a result of the suggestion that i have problems, the psychologist explained that this persons traits were probably High Funct. BPD.
    Given that this is the case, what strategies should I be aplying to handle his frequent outbursts - his anger seems to boil to the surface whenever he starts to feel as though he is not "respected" (his words), not listened to or perhaps when he feels he is not contributing (not sure about this - may be badly described).
    Anyway, any advice on how to control his outbursts, or better, how to respond to his aggressive "discussions" would be greatly appreciated.

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  5. I am a new one, here. after a bad conflict where I engaged in a verbal abuse exchanges, I was addressed as having BPD by a co-workers, for misunderstanding him, considering him as a friend of mine while he was not. He also said I thought differently, was manipulative and other bad things. That I tried to depend on him ( Yes, admit I often asked him to pick me up from work).
    I admit myself of doing things wrongly and took part in rude verbal exchanges(called him stupid and has too far premonition). But I want to know, if you are getting mad and call people stupid(not every week, or every month or even every six months) if you feel someone is getting away from you, is it a sin to ask? is it really "crossing" the boundary to ask?

    To my mind it is better to ask than leaving thing without explanation. Perhaps it is also wrong. If it is, I do not mind to seek help. However when I read about borderline, it is so bad, the articles feature these people with BPD as completely evil, stupid criminals that do not deserve any relationship. I admit I had two fail relationship, not from the outrage or the sensitiveness of being abandoned, but because were were truly different persons with different habits, dreams and even belief systems.

    Is it possible that a BPD symptom occur like 4, 4, 0r even more years? I really need to know.
    And for those out there who feel as normal people without shortcomings, please, please be careful in addressing other with psychological labels. you make things worse. Unless you a psychologist yourself, please don't play psycho-analysis.
    thank you for this wonderful site.

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  6. I'm just praying that all this information keeps getting into the media....like the widely spread newspapers, and magazines. Too many people who are suffering from this and they have no clue they are being victims. Please, everyone, try to get the media to cover this as much as possible. It is not well enough known and it is important. G-d forbid that someone should suffer a lifetime because they didn't find out why and what BPD is.

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  7. As a high functioning BPD (Phd, MA, BA et al) I am dismayed, but not surprised, by the comments.

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  8. Achilles,
    I don 't wish to stigmatize anyone, but how do I express the reality of my experience without doing so? So much of what I experienced is consistent with what is on this site.

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  9. Achilles Peleus,
    So much of what is on this post is consistent with my former fiancée. Very high functioning, but exhibited 8 of the 9 traits in the DSM after we became engaged. Some of her contacts came forward after the fact and eventually I learned of the dishonesty, lack of accountability, promiscuity, projection, devaluation, etc.
    How does one communicate their experience without stigmatizing those who are afflicted with this devastating illness? I understand the disorder can manifest in more than 250 ways, so not every BPD is the same. So much of what I have learned however, does seem to hold some common traits for the BPD, and negative relationship experiences for the non.

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