Here is a description on "How To Explain The Diagnosis". It is taken from a book called Borderline Personality Disorder: A Clinical Guide. Written by John G. Gunderson, M.D..
"People with a borderline personality disorder have grown up feeling that they were unfairly treated, that they didn't get the attention or care they needed. They are angry about that, and as young adults, they set out in search of someone who can make up to them for what they feel is missing. When they think they've found such a person, they set in motion intense, exclusive relationships, which then fail because they place unrealistic expectations on the other person. Upon failing, they feel rejected or abandoned, and either their rage about being treated unfairly gets reawakened or they feel they've been bad and caused the rejection, in which case they become suicidal or self-destructive. Sometimes, their descriptions of having been mistreated cause others to feel guilty and try to make it up to them. Sometimes their self-destructiveness evokes protective feelings in others, who then try to be rescuers. Such guilty or rescuing responses from others validate the borderline person's unrealistically high expectations of having their needs met, and the cycle is apt to repeat itself."
I think in order to get a better overview of the disorder that one should look up the dsm-iv criteria for bpd. It includes criteria such as: unstable, intense relationships; impulsivity; affective instability; anger; suicidal or self-mutilating behaviors; identity disturbance; emptiness; abandonment fears and lapses in reality testing.
Yes, bipolar and bpd are similar.
This book says that the two overlap with regards to mood lability and impulsivity.
It says you can usually differentiate the two by the persons response to confrontation and interpretation. BPD patients react, bipolar patients are not fazed.
Both bipolar and bpd patients may respond to external controls by rage or flight, but bpd patients will typically be more emotional.
John Gunderson has a table here too.
Comparison of BPD and bipolar II disorder
Trait BPD Bipolar II
Mood lability/ Due to interpersonal sensitivity Autonomous and persistent
impulsivity (person acts out)
Affects Deep, intense; evoke strong Lack depth, pain; hard to
empathtic response empathize with
Prototypical Care seeking: seeks Begins energetic self-initiated
behavior exclusivity, is sensitive to activities that are left incomplete;
pattern rejection requiring others to clean up
Defense Splitting: polarizes realities Denial: ignores undesirable
and, if challenged, becomes realities and, if confronted with a
angry at challenge or changes reality, denies its emotional
to opposite view significance
Another diagram. This one is more basic.
sensitive to hostility and separations
Badness self image
bipolar II disorder/ cyclothymic
interpersonal in sensitivity
THANK YOU so much - that information was really helpful :-)
When someone asks me what Borderline Personality Disorder is or how I would describe it, this is what I tell them
Try to imagine the one thing in your life that gives you the most pleasure.
Picture it. Now try to imagine that one thing no longer mattering to you. No
matter how hard you try nothing gives you pleasure. That’s depression. Now
try to imagine what you need to do on a typical day. Do you go to work? Look
after your family? How about doing the dishes? Now imagine that you can’t do
any of those things and simply getting out of bed, not just in the morning, but
at all, seems impossible. That’s severe depression. Now imagine a self-hatred
or internal rage as intense or as deep and immobilizing as that sadness.
Imagine an emotional sensitivity and fear of loneliness so overwhelming, your
mind makes you feel numb as a form of protection. Think of all the people you
love and have loved and, no matter how hard you try, you end up hurting them
over and over again. Imagine needing help from others but the very things you
need help with pushes people away. Now imagine the pain of having all these
feelings mixed together, like a tornado of emotions, over and over again. A pain
so great it brings you to a point of having to escape. A pain so great you
consider hurting yourself. The unthinkable becomes thinkable. A pain caused
by symptoms of an illness you never asked for or deserve. Now try to imagine
living in the midst of all this emotional chaos and depression and trying to
maintain some level of “normal” existence. Still trying to succeed, to love and be
loved, trying to regroup and keep on trying after every relapse and starting over
again and again. Having the intelligence and ability to succeed but always being
interrupted by an unpredictable and ruthless illness. An illness people blame
you for. An illness people forget or don’t realize is exactly that, a physical
illness and not an individual’s shortcoming. Imagine all of this. That’s
Borderline Personality Disorder.
Infant abuse may be perpetuated between generations by changes in the brain induced by early experience, research at the University of Chicago shows.
A research team found that when baby rhesus monkeys endured high rates of maternal rejection and mild abuse in their first month of life, their brains often produced less serotonin, a chemical that transmits impulses in the brain. Low levels of serotonin are associated with anxiety and depression and impulsive aggression in both humans and monkeys.
Abused females who became abusive mothers in adulthood had lower serotonin in their brains than abused females who did not become abusive parents, the research showed.
That was a very graphic description. I could relate very strongly to that (although I think it's possible the pain and distress we do feel is well beyond any word/ s).
I read this article once about this person trying to describe lupus to her friend. She used spoons to demonstrate what her illness felt like.
She said you have a certain number of spoons for each day. These spoons are all you are allowed. These spoons represent things you wish to achieve in your day. Say, one spoon for getting out of bed, another for brushing your teeth, etc.
When her friend tried, she very quickly ran out of spoons. How do you manage she asked?
This could equally be applied to having bpd.
I loved your answer but wish the reality for us were very different.
I do believe that what we feel as Borderlines is for sure way beyond what words could ever even come close to describing. My description is the closest I have ever come, yet to me it seems not even close to the pain, frustration and loneliness that Borderlines deal with on a daily basis. I too wish the reality for us were different, or that atleast other people would understand that this was an actual illness instead of us just trying to be difficult or trying to get attention. But I am not sure that will ever change.
I think it has the potential to change. I have noted the difference within my own mhs.
(Before I was blamed, described as difficult, different, etc. One of my earlier T's even asked if out-patient treatment was appropriate -meaning perhaps I should be locked up permanently in some prison/ psych facility. My last T was brilliant. She accepted me for who I was and consequently I did make positive changes).
There is definitely a lack of understanding about the illness though. And perhaps, more importantly, a lack of willingness to know.
I need to go. But I am very passionate about this area. bpd, diagnosis, treatment, etc
I know that there is a possibility to change but I am just not sure it will happen until people are willing to believe that this is an actual illness. i know there are some good doctors out there like the psychiatrist that I have been seeing for the last 10 years, but he is one of the few. I also have been dealing with bad therapists lately. The ones who do not understand BPD and dont want to understand it. They tell me it is okay to cut as long as I dont do it more than once a week, and to them if I show up to my next appointment and I am at least alive then their job is accomplished. They look at BPD as a lifelong illness with no way out. Luckily I do have this one good doctor to help see me through it, but often you need more than just one person to help you through things like these. I am just hoping that there is some change in the way people look at and treat people with BPD before my daughter gets much older. She is four and already as signs of BPD, but of course is too young to actually get diagnosed with it. But every female in my biological family has it. But they are scared to diagnose her or help her because of what it might be. They would rather just find another person to blame for the problems. And with that lack of understanding us with BPD will not go far.
I am passionate about this area too, especially now that I am dealing with the bad therapist and see how most people get treated that have BPD and how lucky I was that as a teenager I wasnt treated that way.
No T should ever say it is OK to cut or hurt yourself. This kind of sounds like dbt rubbish where they say that you are acceptable. (My T wouldn't intervene to help me because that would be communicating a lack of trust in me and my ability). I found this approach very unhelpful as it triggered underlying issues and placed me at greater risk of harming myself. It definitely increased the crisis as I felt I wasn't being heard or understood.
To be fair, perhaps it not so much a dbt thing but how some T's choose to apply the skills, etc.
That's poor! My understanding of therapy is that it is suppose to enhance your quality of life. Existing, is not living -there is a difference!
BPD has an OK prognosis. I would say good, but I am the one living it, and currently it only feels like a possibility. Hope is everything.
These people shouldn't be projecting their feelings of hopelessness, etc onto you. I had people do this to me and it is crippling. We already carry a huge burden.
If you are able to manage your own symptoms -then there is a possibility your daughter would be OK. I expect that can both motivate you and overwhelm you.
I'm the opposite. I've consistently had bad (unskilled, inexperienced) T's and this past year I've had a really good one. She left in the middle of September though.
I hope you're working towards finding a good T.
I need to get off-line as we are expecting a phone call. I asked to make an emergency doctors appointment for my mother as her head injury is deteriorating.
They should be calling soon. Sorry to do this to you.
Thats what I thought about my therapist, too. I really was so used to people telling me it was not okay to cut but lately it seems like every one is telling me that its not so bad if you dont do it often. My therapist says she looks at it like it is a coping mechanism just like using drugs and alcohol and she would not put her patients in a hospital for using drugs or alcohol so why would she do that with cutting? Sounded pretty stupid to me. But at the same time, since I am a cutter, in a way I want them to say I can do it, but I also know that my psychiatrist and old high school psychologist are the ones who really care about me because they tell me not to cut and give me strict rules and guidelines to follow. The only rule I have to follow with my T is to not contact her between sessions and if I absolutely have to it must be during work hours on her office phone. And she tells me that my psychiatrist and I have an unethical and unhealthy relationship because I am allowed to call him, text him or e-mail him in an emergency.
I am trying to learn how to manage my symptoms so that if my daughter doesnt get the right help then i will be able to teach her what I have learned. I have heard that some therapists think the prognosis for BPD is good and some think its bad. But most people I run into think that we do what we do on purpose just because we like being difficult. I have heard about this DBT and even started some with my old therapist but didnt get far enough into it to know if it will help. My T that I have now keeps talking about it but she doesnt try it with me. She basically calls our appointments checkin sessions just to make sure I am okay. But I guess when you cant afford a therapist that you pay your own money too then that is how you get treated.
I think the most frustrating part about the BPD is not knowing who I am or even really what I like. I was thinking about this earlier and if someone asked me what I liked to do I couldnt even tell them. I would be willing to do anything whether its safe or not if it meant I didnt have to be alone but at the same time that I didnt have to be in a big crowd. But I dont think I ever feel pleasure or happiness in anything. And it seems like I am a different person depending on who I am around. It is like my personality reflects off who ever I am hanging out with. Which means when I am in a big group and am not there with anyone specific person then its almost like I have no personality at all. I dont know if I have split personalities or DID or what, but dealing with this aspect of it is most frustrating to me. I wish I knew how to just be one person all the time.