BPD and those pesky emotions.

bfmh14-copy2Hey guys,

I know it’s been a long time between posts but to be honest I’ve been working on much more important things like getting my shit together. Now I find myself in a familiar situation and I’m compelled to write about it. But first I’d llike to educate some of you as to what BPD actually is. Buckle up folks, this one is a long one.Now before I go into my personal experiences and so on here’s what Wikipedia says about BPD.

Borderline personality disorder (BPD) (called emotionally unstable personality disorder, emotional intensity disorder, or borderline type in the ICD-10) is a cluster-B personality disorder, the essential feature of which is a pattern of marked impulsivity and instability of affects, interpersonal relationships and self image. The pattern is present by early adulthood and occurs across a variety of situations and contexts.

Other symptoms usually include intense fears of abandonment and intense anger and irritability, the reason for which others have difficulty understanding. People with BPD often engage in idealization and devaluationof others, alternating between high positive regard and great disappointment. Self-harm and suicidal behavior are common.

The disorder is recognized in the Diagnostic and Statistical Manual of Mental Disorders. Because a personality disorder is a pervasive, enduring, and inflexible pattern of maladaptive inner experiences and pathological behavior, there is a general reluctance to diagnose personality disorders before adolescence or early adulthood. However, some emphasize that without early treatment symptoms may worsen.

Signs and symptoms

The most distinguishing symptoms of BPD are marked sensitivity to rejection, and thoughts and fears of possible abandonment. Overall, the features of BPD include unusually intense sensitivity in relationships with others, difficulty regulating emotions and impulsivity. Other symptoms may include feeling unsure of one’s personal identity and values, having paranoid thoughts when feeling stressed and severe dissociation.

Emotions

People with BPD feel emotions more easily, more deeply and for longer than others do. Emotions may repeatedly resurge and persist a long time. Consequently it may take longer than normal for people with BPD to return to a stable emotional baseline following an intense emotional experience.

In Marsha Linehan‘s view the sensitivity, intensity and duration with which people with BPD feel emotions have both positive and negative effects. People with BPD are often exceptionally idealistic, joyful and loving. However they may feel overwhelmed by negative emotions, experiencing intense grief instead of sadness, shame and humiliation instead of mild embarrassment, rage instead of annoyance and panic instead of nervousness. People with BPD are especially sensitive to feelings of rejection, isolation and perceived failure. Before learning other coping mechanisms, their efforts to manage or escape from their intense negative emotions may lead to self-injury or suicidal behavior. They are often aware of the intensity of their negative emotional reactions and, since they cannot regulate them, they shut them down entirely. This can be harmful to people with BPD, since negative emotions alert people to the presence of a problematic situation and move them to address it.

Whilst people with BPD feel joy intensely, they are especially prone to dysphoria, or feelings of mental and emotional distress. Zanarini et al. recognize four categories of dysphoria that are typical of this condition: extreme emotions; destructiveness or self-destructiveness; feeling fragmented or lacking identity; and feelings of victimization. Within these categories, a BPD diagnosis is strongly associated with a combination of three specific states: 1) feeling betrayed, 2) “feeling like hurting myself” and 3) feeling out of control. Since there is great variety in the types of dysphoria experienced by people with BPD, the amplitude of the distress is a helpful indicator of borderline personality disorder.

In addition to intense emotions, people with BPD experience emotional liability, or changeability. Although the term suggests rapid changes between depression and elation, the mood swings in people with this condition actually occur more frequently between anger and anxiety and between depression and anxiety.

Behaviour

Impulsive behaviour is common, including: substance or alcohol abuse, eating disorders, unprotected sex or indiscriminate sex with multiple partners, reckless spending and reckless driving. Impulsive behaviour may also include leaving jobs or relationships, running away and self-injury.

People with BPD act impulsively because it gives them immediate relief from their emotional pain. However in the long-term people with BPD suffer increased pain from the shame and guilt that follow such actions. A cycle often begins in which people with BPD feel emotional pain, engage in impulsive behavior to relieve that pain, feel shame and guilt over their actions, feel emotional pain from the shame and guilt and then experience stronger urges to engage in impulsive behavior to relieve the new pain. As time goes on, impulsive behavior may become an automatic response to emotional pain.

Self-harm and suicide

Self-harming or suicidal behaviour is one of the core diagnostic criteria in the DSM IV-TR. Management of and recovery from this behavior can be complex and challenging. The lifetime risk of suicide among people with BPD is between 3% and 10%. There is evidence that men diagnosed with BPD are approximately twice as likely to commit suicide as women diagnosed with BPD. There is also evidence that a considerable percentage of men who commit suicide may have undiagnosed BPD.

Self-injury is common and may take place with or without suicidal intent. The reported reasons for non-suicidal self-injury (NSSI) differ from the reasons for suicide attempts. Reasons for NSSI include expressing anger, self-punishment, generating normal feelings (often in response to dissociation), and distracting oneself from emotional pain or difficult circumstances. In contrast, suicide attempts typically reflect a belief that others will be better off following the suicide. Both suicidal and non-suicidal self-injury are a response to feeling negative emotions.

Sexual abuse can be a particular trigger for suicidal behavior in adolescents with BPD tendencies.

Interpersonal relationships

People with BPD can be very sensitive to the way others treat them, feeling intense joy and gratitude at perceived expressions of kindness, and intense sadness or anger at perceived criticism or hurtfulness. Their feelings about others often shift from positive to negative after a disappointment, a perceived threat of losing someone, or a perceived loss of esteem in the eyes of someone they value. This phenomenon, sometimes called splitting or black-and-white thinking, includes a shift from idealizing others (feeling admiration and love) to devaluing them (feeling anger or dislike). Combined with mood disturbances, idealization and devaluation can undermine relationships with family, friends, and co-workers. Self-image can also change rapidly from positive to negative.

While strongly desiring intimacy, people with BPD tend toward insecure, avoidant or ambivalent, or fearfully preoccupied attachment patterns in relationships, and they often view the world as dangerous and malevolent. BPD is linked to increased levels of chronic stress and conflict in romantic relationships, decreased satisfaction of romantic partners, abuse and unwanted pregnancy. However, these factors appear to be linked to personality disorders in general.

Manipulation to obtain nurturance is considered to be a common feature of BPD by many who treat the disorder, as well as by the DSM-IV. However, some mental health professionals caution that an overemphasis on, and an overly broad definition of, manipulation can lead to misunderstanding and prejudicial treatment of people with BPD within the health care system. (See Manipulative behavior and Stigma under Controversies.)

Sense of self

People with BPD tend to have trouble seeing a clear picture of their identity. In particular, they tend to have difficulty knowing what they value and enjoy. They are often unsure about their long-term goals for relationships and jobs. This difficulty with knowing who they are and what they value can cause people with BPD to experience feeling “empty” and “lost”.

Cognitions

The often intense emotions experienced by people with BPD can make it difficult for them to control the focus of their attention—to concentrate. In addition, people with BPD may tend to dissociate, which can be thought of as an intense form of “zoning out”. Dissociation often occurs in response to experiencing a painful event (or experiencing something that triggers the memory of a painful event). It involves the mind automatically redirecting attention away from that event, presumably to protect against experiencing intense emotion and unwanted behavioural impulses that such emotion might otherwise trigger. Although the mind’s habit of blocking out intense painful emotions may provide temporary relief, it can also have the unwanted side effect of blocking or blunting the experience of ordinary emotions, reducing the access of people with BPD to the information contained in those emotions which helps guide effective decision-making in daily life. Sometimes it is possible for another person to tell when someone with BPD is dissociating, because their facial or vocal expressions may become flat or expressionless, or they may appear to be distracted; at other times, dissociation may be barely noticeable.

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Now don’t get me wrong I’ve always struggled with BPD but way more-so as of late. I’ve learned through experience how to manage some of the symptoms but some of them I couldn’t control if I tried. Sometimes I dive in head first and just experience it in the most positive and exciting ways possible. But sometimes the negative emotions like rejection and shame are overwhelming. I’ve struggled and overcome for the most part the self harming. I’m not suicidal anymore.. in fact I haven’t been that way for a couple of years. I’ve stopped the drinking and the drugs. I’ve stopped the lies and manipulation that I used to do so much just to make people care about me.

I’ve discovered my self esteem. I know I am a good person and having to remind myself of that doesn’t mean I’m not making progress and how far along I have come instead of doing what comes natural, which is fixating on the negatives of my situation.

I just wish sometimes the intense emotions would cool down. I can’t focus. I try really hard not to obsess about things. It’s hard to look at anything objectively when you’re feeling emotions that roar inside my chest like the heart of a volcano. It’s funny, it makes me feel more alive than anything else. It really does. But it hurts to feel things like I do. I have to force myself to step back, to maintain some emotional distance. It’s a defence mechanism because the feeling of rejection and heartbreak are all too familiar I suppose. But at the same time, I also feel like I have nothing to lose. It’s not like it’s a secret how I feel (I’m about as subtle as a sledgehammer)

Yet the depths of these feelings are unknown to everyone except me. I’m afraid. But at the same time, I’m not. I love contradicting myself lol. But I’m more self aware than a lot of other people. I’m not full of myself when I say this. I know what I want, and my ambitions are quite simple. I just want to be happy. I want to love and be loved. I want to share all of me. I want a family of my own.

I have a completely different relationship with myself. How I felt emotions, how I coped with my darker impulses, and how hard it is to focus was once considered a curse. Now I choose to look at the positives and embrace those pesky emotions, even the ones that hurt. It’s a blessing that I feel so strongly. How many people in life have shut themselves off from how they really feel and how many can say they are truely in touch with themselves (giggity) and have a level of empathy like this?

BPD isn’t a curse. It’s just a part of my life.

 

Until next time,

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